Background Cervical cancer is the 4th most common cancer in women worldwide. as well as the 4th most common cause of cancer-related death. The main objective of this study was to identify factors that affect the survival time of outpatients with cervical cancer. Methods A retrolective study including outpatients with cervical cancer was carried out in a hospital. To achieve the aim, 322 outpatients with cervical cancer were included in the study based on the data taken from the medical records of patients enrolled from May 15, 2018, to May 15, 2022, at the University of Gondar referral hospital, Gondar, Ethiopia. The Kaplan–Meier plots and log-rank test were used for the comparison of survival functions; the Cox-PH model and Bayesian parametric survival models were used to analyze the survival times of outpatients with cervical cancer. Integrated nested Laplace approximation methods have been applied. Results Out of a total of 322 patients, 118 (36.6%) died as outpatients. The estimated median survival time for patients was 42 months. Using model selection criteria, the Bayesian log-normal accelerated failure time model was found to be appropriate. According to the results of this model, oral contraceptive use, HIV, stage, grade, co-morbid disease, history of abortion, weight, histology type, FIGO stage, radiation, chemotherapy, LVSI, metastatic number, regional nodes examined, and tumor size all have a significant impact on the survival time of outpatients with cervical cancer. The Bayesian log-normal accelerated failure time model accurately predicted the survival time of cervical cancer outpatients. Conclusions The findings of this study suggested that reductions in weight, treatment, the presence of comorbid disease, the presence of HIV, squamous cell histology type, having a history of abortion, oral contraceptive use, a large tumor size, an increase in the International Federation of Gynecologists and Obstetricians stage, an increase in metastasis number, an increase in grade, positive regional nodes, lymphatic vascular space invasion, and late stages of cancer all shortened the survival time of cervical cancer outpatients.
Background and Aims: Cervical cancer is the fourth most common cause of cancerrelated death in the world. The objective of this study was to determine factors that affect the longitudinal change of tumor size and the time to death of outpat Methods: A retrospective follow-up study was carried out among 322 randomly selected patients with cervical cancer at the University of Gondar Referral Hospital from May 15, 2018 to May 15, 2022. Data were extracted from the patient's chart from all patients' data records. Kaplan-Meier estimator, log-rank test, the Cox proportional-hazard model, and the joint model for the two response variables simultaneously were used.Results: Among 322 outpatients with cervical cancer, 148 (46%) of them were human immunodeficiency virus (HIV) positive and 107 (33.3%) of them died. The results of joint and separate models show that there is an association between survival and the longitudinal data in the analysis; it indicates that there is a dependency between longitudinal terms of cervical tumor size and time-to-death events. A unit centimeter square rise in tumor size, corresponding to an exp (0.8502) = 2.34 times, significantly raised the mortality risk. Conclusion:The study showed that HIV, stage of cancer, treatment, weight, history of abortion, oral contraceptive use, smoking status, and visit time were statistically significant factors for the two outcomes jointly.Implications: As a result, adequate health services and adequate resource allocations are critical for cervical cancer control and prevention programs. Therefore, the government should provide adequate funding and well-trained health professionals to hospitals to sustain screening programs with appropriate coverage of cervical cancer patient treatments.
Objective: The aim of this study was to evaluate the change in fasting blood sugar (FBS) over time and its determinants in diabetic patients.Methods: A longitudinal data analysis retrospective-based study was considered with a sample of 312 patients, and the linear mixed effect model was applied.Results: Based on the linear mixed model, the 3-month change in time decreases the average FBS level by 0.0111. An increase of one unit of body mass index (BMI) increases the FBS level by 0.0434. Similarly, an increase in blood pressure (DBP) per unit increased the average log FBS level by 0.0005. Secondary and higher education levels lower log FBS levels by 99.41% and 99.45%, respectively, compared with noneducated individuals. Conclusion:The study showed that hypertension history, type of diet, age, status of education, type of drug, body mass index, diastolic blood pressure, and time were statistically significant factors.Implications: According to the study, eating a healthy diet, maintaining a healthy body weight, and a low blood sugar level are essential to controlling blood sugar and preventing long-term complications. The government should build an educational institution proportional to the population and open programs to increase awareness about the prevention mechanism of diabetes in communities.diabetes mellitus, fasting blood sugar, linear mixed model, longitudinal data analysis | INTRODUCTIONDiabetes mellitus (DM) is a lifelong disease that affects human health whether the pancreas does not produce enough insulin (the hormone that controls blood sugar), or the body cannot use insulin effectively. 1 DM is a chronic and progressive disease with an increase in blood sugar levels. 2 Diabetes can affect many parts of the body, including blood vessels, eyes, the heart, kidneys, and nerves. This also increases the overall risk of dying. [1][2][3][4] The typical signs of diabetes disease include inflated urine, water thirst, persistent hunger, loss of weight, changes in vision, and fatigue. 5 Diabetic diseases are divided into three main categories according to their origin and cause: gestational diabetes, Type 2 diabetes, and Type 1 diabetes. 6 When the body does not produce the necessary insulin, Type 1 diabetes develops, on the other hand, Type 1 diabetes develops when the body produces an elevated level of blood sugar or sugar due to errors in insulin synthesis or inadequate insulin. 6 Unlike the above two, gestational diabetes is a disease of
BackgroundThe effect of human immunodeficiency virus (HIV) on precancerous cervical lesion is not consistent across studies. Besides to the variability in the presence of a significant association between HIV and precancerous cervical lesion, the reported strengths are inconsistent among studies that report a significant association. Therefore, we sought to determine the impact of HIV on women's risk of precancerous cervical lesion by conducting a systematic review and meta‐analysis of case–control studies in Ethiopia.MethodsRelevant articles were systematically searched on African Journals Online, Cochrane Library, Science Direct, Google Scholar, and PubMed from January 1, 2023, to February 20, 2023. After critical appraisal, pertinent data were extracted into an Excel spreadsheet and then exported to STATA 14 for further statistical analysis. The pooled effect size was estimated using the random‐effect model. The Egger's regression test and I2 statistics were employed to assess publication bias and heterogeneity among included studies, respectively.ResultsTen case–control studies with a total of 3035 participants (992 cases and 2043 controls) were involved in this meta‐analysis. According to our analysis, HIV‐infected women were 2.86 times more likely to develop precancerous cervical lesion as compared with their counterparts (odds ratio: 2.86, 95% confidence interval: 1.79, 4.58).ConclusionWe found that HIV‐infected women have a higher risk of precancerous cervical lesion. Thus, targeted screening programs should be considered to reduce the burden of cervical cancer among HIV‐infected women in Ethiopia.
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