SAGE Open Medicine最新文献

{"title":"Determinants of pneumonia among adult asthmatic patients attending public hospitals in Awi Zone, Northwest Ethiopia: A case control study.","authors":"Abiyie Bitew Godie, Daniel Mulat Eshetu, Wolde Melese Ayele, Sileshi Berihun, Mikias Getahun Molla","doi":"10.1177/20503121261460305","DOIUrl":"10.1177/20503121261460305","url":null,"abstract":"<p><strong>Background: </strong>Asthma and pneumonia are common respiratory conditions worldwide. Pneumonia is a life-threatening lung infection and a frequent comorbidity among adult asthmatic patients, often causing hospital admission. Despite the global burden, evidence on determinants of pneumonia among adult asthmatic patients in Ethiopia is limited.</p><p><strong>Objective: </strong>This study aimes to identify determinants of pneumonia among adult asthmatic patients attending public hospitals in Awi Zone, Northwest Ethiopia.</p><p><strong>Methods: </strong>A multicenter unmatched case-control study was conducted from August 20 to October 25, 2025 among 359 adult asthmatic patients (120 cases and 239 controls) in public hospitals of Awi Zone, Northwest Ethiopia. Eligible participants were adults aged ≥18 years with ≥6 months asthma diagnosis and ≥3 months follow-up. Cases were asthmatic patients with pneumonia, and controls were those without pneumonia. Patients with COPD and newly diagnosed asthma were excluded. Participants were selected consecutively. Data were collected using interviewer-administered questionnaires and medical records. Determinants were identified using bivariable and multivariable logistic regression, with statistical significance set at p<0.05.</p><p><strong>Results: </strong>Cases were older than controls, with mean ages of 60.25 ± 15.36 and 44.85 ± 11.04 years, respectively. In multivariable analysis, demographic, behavioral, and clinical factors were associated with pneumonia. Increasing age (AOR = 1.06, 95% CI: 1.01-1.10) and current alcohol use (AOR = 2.93, 95% CI: 1.03-4.38) increased the odds. Prior hospital admission for acute asthma exacerbation showed the strongest association (AOR = 13.22, 95% CI: 9.55-19.51). Inhaled corticosteroid use (AOR = 4.06, 95% CI: 3.16-7.23) and loss of follow-up (AOR = 4.48, 95% CI: 3.42-7.16) were also associated with higher odds, while controlled asthma was protective (AOR = 0.06, 95% CI: 0.02-0.16).</p><p><strong>Conclusion: </strong>Age, alcohol use, prior hospitalization, inhaled corticosteroid use, and irregular follow-up increased pneumonia risk, while controlled asthma was protective. Strengthening follow-up and interventions may reduce pneumonia among asthmatic patients.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261460305"},"PeriodicalIF":2.2,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13261009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etiologic spectrum and predictors of visual acuity in non-glaucomatous optic atrophy.","authors":"Meraj Sharifi, Amin Zand, Mohammad Sharifi, Ali Sharifi","doi":"10.1177/20503121261461345","DOIUrl":"10.1177/20503121261461345","url":null,"abstract":"<p><strong>Aim: </strong>To determine the prevalence and underlying causes of nonglaucomatous optic atrophy (NGOA) in a tertiary referral center in southeastern Iran and to identify predictors of current visual acuity in this population.</p><p><strong>Methods: </strong>In this descriptive cross-sectional study, patients with a confirmed diagnosis of NGOA were included. All cases had a definitive etiologic diagnosis based on clinical evaluation, paraclinical investigations, and thorough review of medical records. Patients were classified into etiologic categories including hereditary or developmental disorders; secondary or consecutive optic atrophy; traumatic optic neuropathy (TON); compressive lesions; raised intracranial pressure-related involvement; inflammatory or demyelinating disease; infiltrative processes; toxic exposure; and ischemic causes.</p><p><strong>Results: </strong>A total of 155 eyes from 155 patients with NGOA were analyzed, of whom 86 (55.5%) were male. Overall, 75 patients (48.4%) had a best-corrected visual acuity (BCVA) of ≥ 1.90 logMAR (logarithm of the minimum angle of resolution), corresponding to counting fingers vision or worse. Patients with toxic optic neuropathy demonstrated the poorest visual outcomes, with 5 of 6 cases (83.3%) having a BCVA of ≥ 1.90 logMAR. Ischemic causes were the most prevalent etiology, identified in 46 patients (29.7%), including 45 cases of non-arteritic anterior ischemic optic neuropathy (AION). TON was the second most common cause, observed in 37 patients (23.9%). In multivariate analysis, a longer duration from symptom onset was the sole independent predictor of poorer current visual acuity (β = 0.253, <i>P</i> = 0.010).</p><p><strong>Conclusion: </strong>Previous non-arteritic AION was the most common cause of NGOA in this cohort, followed by TON. Toxic exposure was associated with the poorest visual acuities. Among all evaluated variables, the duration from symptom onset was the only independent predictor of current visual acuity.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261461345"},"PeriodicalIF":2.2,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of asthma and the premature mortality in Eastern sub-Saharan Africa, from 1990 to 2023.","authors":"Sebsibe Tadesse, Dereje Chala Diriba, Anteneh Berhane, Hailu Lemma, Geleta Nenko Dube, Degefa Dhengesu Hero, Mihretu Tagesse Sergindo","doi":"10.1177/20503121261460575","DOIUrl":"10.1177/20503121261460575","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of information that characterized the burden of asthma in the Eastern Sub-Saharan African (ESSA) region. Therefore, this study estimated the prevalence of asthma and its premature mortality in the region from 1990 to 2023.</p><p><strong>Methods: </strong>Data on the prevalence of asthma and the years of life lost (YLL) were extracted from the Global Burden of Diseases 2023 database for the ESSA region. Asthma prevalence was estimated using disease modelling with a Bayesian meta-regression tool (DisMod-MR 2.1), whereas YLLs were derived using the Cause of Death Ensemble model (CODEm). The Comparative Risk Assessment Framework was applied to identify the risk factors for years of life lost. The spatiotemporal Gaussian process regression technique (ST-GPR) was used to smooth the trend. Age-standardized rates as well as the percentage change between 1990 and 2023 were estimated.</p><p><strong>Results: </strong>There were an estimated 20,716,738 prevalent cases (95% UI: 16,523,031-26,057,565) of asthma in the ESSA region in 2023, with an age-standardized rate of 4,324 cases per 100,000 population (95% UI: 3,555-5,261). There were an estimated 918,517 years of life lost (95% UI: 582,476-1,379,986) in the region and 297 age-standardized years of life lost per 100,000 population (95% UI: 221-487). No inter-country variations were estimated throughout the region. However, the YLLs rate increased with age. Occupational asthmagens, high body-mass index, sexual violence against children, and tobacco use were the leading risk factors for asthma-related premature mortalities in the region, with variable impacts by countries.</p><p><strong>Conclusion: </strong>There were high and persistent rates of morbidity and premature mortality from asthma in the ESSA region from 1990 and 2023. Targeted strategies are urgently needed to mitigate asthma risk factors and improve disease management.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261460575"},"PeriodicalIF":2.2,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13261008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, awareness, attitudes and perceptions on gestational diabetes among females: A systematic review.","authors":"Christiana Asiedu, Daniel Kwabla Ahiagbede, Eunice Johnson, Sarah Esi Bilson, Grace Atitsogbey, Emmanuella Florence Odi Asiedu","doi":"10.1177/20503121261459803","DOIUrl":"10.1177/20503121261459803","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is a common pregnancy complication with significant maternal and neonatal consequences.</p><p><strong>Aim: </strong>To synthesise evidence on knowledge, awareness, and perception of men and women of reproductive age on GDM to enhance effective prevention and management of GDM.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines across PubMed, CINAHL, Embase, Scopus, Web of Science, PsycINFO, JSTOR, Dimensions AI, and HINARI for studies published between 2000 and 2025. 50 studies, with a total sample size of 29,590 participants, assessing knowledge, awareness, attitudes, or perceptions of GDM among pregnant, postpartum, or reproductive-age women were included. Data were extracted, quality-appraised using JBI and MMAT tools, and synthesised thematically.</p><p><strong>Results: </strong>Fifty studies were included, primarily cross-sectional (88%), with qualitative (8%) and mixed-methods (4%) designs. Women generally demonstrated limited understanding of GDM risk factors, screening procedures, and long-term implications. Cultural norms, emotional responses, and healthcare experiences shaped perceptions and attitudes, sometimes reducing engagement with preventive behaviours. Factors improving knowledge and adherence included structured education, prior exposure to diabetes, supportive healthcare interactions, and family involvement.</p><p><strong>Conclusion: </strong>Awareness and understanding of GDM remain inadequate globally emphasizing major public health concern. Targeted educational interventions, culturally sensitive resources, and enhanced provider-patient engagement are essential to improve knowledge, attitudes, and health outcomes. Future research should prioritise interventional and longitudinal studies using standardised measures across diverse populations.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261459803"},"PeriodicalIF":2.2,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148227029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Children with speech and language delay aged 2-10 Years in Palestine: A case-control study of socio-demographic, biological, familial, and environmental factors.","authors":"Saad Al-Lahham, Raghad Dweikat, Tala Nazzal, Nada Abo Shama, Aya Bishara, Nabaa Khaskia, Maimana Jbara, Adan Haj Yahia, Mustafa Ghanim, Majdi Dwikat, Mohammad Abuawad, Samar Alkhaldi, Anas Hamdan, Wafa Abdel Jalil, Laith El-Lahham, Maha Rabayaa, Malik Alqub","doi":"10.1177/20503121261459505","DOIUrl":"10.1177/20503121261459505","url":null,"abstract":"<p><strong>Introduction: </strong>Speech and language delay (SLD) is a common developmental problem that affects 3-20% of children globally, with significant long-term consequences if left untreated. Despite extensive research on SLD risk factors, regional studies in Palestine remain limited. This study sought to identify key characteristics impacting SLD in Palestinian children aged 2 to 10 years.</p><p><strong>Methods: </strong>Between January and March 2025, a case-control study was conducted at ten specialized institutes in Palestine. The study included 184 children with SLD and 136 controls who were matched for age and gender. Data were collected using standardized questionnaires that assessed socio-demographic, biological, familial, and environmental factors. SPSS v26 was used for statistical analysis, which included chi-square tests and logistic regression (p-value < 0.05 indicated significance).</p><p><strong>Results: </strong>Significant risk variables for SLD were rural residency (OR = 4.4, p = 0.008), lower parental education (paternal p = 0.003; maternal p < 0.001), and low family income (OR = 2.5, p = 0.030). Maternal employment showed a protective effect (OR = 0.273, p < 0.001). Biological characteristics such as ENT issues (OR = 3.9, p = 0.012) and a family history of SLD (OR = 8.6, p = 0.001) were significantly linked with SLD. There was no substantial correlation between the multilingual surrounding environment and family size.</p><p><strong>Conclusion: </strong>The study emphasizes the diverse characteristics of SLD in Palestinian children, with a focus on socioeconomic disparities, biological factors, and familial history. These findings emphasize the necessity of targeted early therapies, particularly in rural and low-income populations, to mitigate the long-term impact of SLD.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261459505"},"PeriodicalIF":2.2,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13247289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physicochemical and bacteriological quality of drinking water in Debre Markos town, Northwest, Ethiopia.","authors":"Biachew Asmare, Amare Bekalu, Abaynesh Alamneh","doi":"10.1177/20503121261456516","DOIUrl":"10.1177/20503121261456516","url":null,"abstract":"<p><strong>Background: </strong>Access to safe drinking water is essential for human health; however, water contamination remains a major concern in developing countries such as Ethiopia. Rapid urbanization and inadequate sanitation threaten water quality. This study evaluated the physicochemical and bacteriological quality of drinking water.</p><p><strong>Objective: </strong>This study aimed to assess the physicochemical and bacteriological quality of drinking water in Debre Markos Town in 2024.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using 66 water samples collected from boreholes, disinfection points, water taps, and household storage containers through stratified simple random sampling. Sample collection and laboratory analysis were performed according to ES ISO 5667-1 (2001) guidelines.</p><p><strong>Results: </strong>Among the physicochemical parameters assessed, temperature, pH, electrical conductivity, turbidity, nitrate, and fluoride levels generally met WHO standards, except for elevated temperatures (>15°C) at the source level. Free residual chlorine levels in source water, tap water, and household storage containers were below the recommended limits, whereas satisfactory levels were observed at the disinfection points. Bacteriological analysis revealed no detectable total or fecal coliforms at the disinfection points. However, total coliforms were detected in 22 (81.5%) tap water samples, 24 (88.9%) household water samples, and three borehole samples. In addition, fecal coliforms were detected in 3 (37.5%) borehole samples, 17 (63%) tap water samples, and 21 (77.8%) household water samples.</p><p><strong>Conclusion and recommendation: </strong>Although most physicochemical parameters met acceptable standards, water temperature, free residual chlorine, total coliforms, and fecal coliforms exceeded recommended limits in several samples. Strengthening source protection, ensuring effective disinfection, and maintaining regular water treatment are essential to improve drinking water quality in Debre Markos Town.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261456516"},"PeriodicalIF":2.2,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13230664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral health after stroke: A mixed-methods study involving healthcare professionals, stroke survivors and primary caregivers.","authors":"Nalia Gurgel-Juarez, Hillel Finestone, Katrine Sauvé-Schenk, Michael Wiseman, Dylan Blacquiere, Ramin Banimahdi, Anne Carey, Heather L Flowers","doi":"10.1177/20503121261456557","DOIUrl":"10.1177/20503121261456557","url":null,"abstract":"<p><strong>Objectives: </strong>Maintaining good oral health after stroke is challenging due to physical and cognitive impairments and hospital-related factors. This study aimed to understand the oral and/or denture care (ODC) practices of healthcare professionals (HCPs) and explore the oral health and ODC experiences of stroke survivors (StS).</p><p><strong>Methods: </strong>We used a mixed-methods approach. Quantitative data were derived from a survey of HCPs in acute stroke care and rehabilitation and from a retrospective chart review of admissions over one year. An embedded qualitative multiple case study with StS admitted to rehabilitation gathered information from care observations, oral examinations, semi-structured interviews, and charts.</p><p><strong>Results: </strong>The survey involved 32 HCPs. All believed that ODC was part of self-care and over 90% believed that toothbrushing helps patients feel better and provides comfort while eating. However, 59% indicated insufficient training to perform oral health assessments and provide ODC. The chart review included 168 charts: 103 from acute care and 65 from rehabilitation. Notations about patient oral health status were written by nurses or speech-language pathologists in 46% and 65% of acute care and rehabilitation charts, respectively. ODC occurred less than once/day in acute care. In rehabilitation, occupational therapists assessed ODC functions in 55% of patients, but documentation of ODC provision was lacking. Qualitative themes from the case study included i) Valued oral health and ODC, ii) Independent ODC before stroke, iii) inconsistent support for ODC in acute care, iv) increased self-efficacy despite irregular ODC during rehabilitation, and v) ongoing reliance on caregivers or staff for ODC.</p><p><strong>Conclusions: </strong>This study identified significant gaps in oral health and ODC practices during post-stroke hospitalization despite attention to oral health from HCPs. Both settings lacked evidence-based ODC approaches tailored to patient needs. We advocate for protocols that include oral screening tools, promote twice-daily toothbrushing, and incorporate ODC education for HCPs, StS, and caregivers.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261456557"},"PeriodicalIF":2.2,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13226986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148157909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgeons' pursuit of professional achievement and work-life balance in a demanding working environment: An exploratory qualitative study in Japan.","authors":"Kenji Fujiwara","doi":"10.1177/20503121261456901","DOIUrl":"10.1177/20503121261456901","url":null,"abstract":"<p><strong>Background: </strong>A challenging working environment discourages younger generations from pursuing a surgical career, contributing to the decline in the number of surgeons in Japan. However, current surgeons' perceptions of their work environment remain poorly understood. To address this gap, an exploratory qualitative study was conducted.</p><p><strong>Methods: </strong>Two semi-structured interviews were conducted in person or via email: (i) focusing on surgeons' primary interests, career goals, and perceptions of daily workloads, and (ii) focusing on issues affecting work-family balance. A total of 24 interview transcripts were collected across two interviews (12 participants in Interview 1 and 12 in Interview 2, with partial overlap between them). Participants were recruited through purposive and snowball sampling. Data were analyzed using reflexive thematic analysis to identify patterns across datasets.</p><p><strong>Results: </strong>In the first interview, participants showed diverse priorities: approximately one-quarter prioritized pursuing professional mastery, one-quarter prioritized family life, and a similar proportion reported aiming to balance both domains. Half of the participants accepted multitasking as part of their daily role, although many preferred to limit it to tasks directly related to surgery. More than half expressed frustration with workload disparities and indicated that salaries did not always correspond to actual duties. In the second interview, two-thirds of participants reported strong concern about night and weekend calls while raising children, and several described feelings of guilt regarding limited family time.</p><p><strong>Conclusions: </strong>Many participants described efforts to balance professional achievement with work-family considerations, while highlighting multitasking, workload disparities, and unpredictable after-hours calls as challenges. These findings provide insight into factors affecting surgeons' work experiences in Japan and may inform strategies to support work-life balance and surgical workforce sustainability in similar contexts.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261456901"},"PeriodicalIF":2.2,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 pandemic on surgical volume, clinical presentations, and management of rhegmatogenous retinal detachment: A systematic review and meta-analysis.","authors":"Hassan Asadigandomani, Ali Tahmasebi, Mahan Jalilzadeh, Melika Arab Bafrani, Fatemeh Mahmoudi, Kimia Daneshvar, Sara Kamali Zonouzi, Hamid Riazi-Esfahani, Elias Khalili Pour","doi":"10.1177/20503121261456478","DOIUrl":"10.1177/20503121261456478","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically evaluate the impact of the COVID-19 pandemic, particularly lockdown (LD) periods, on the incidence, clinical presentations, surgical management, and outcomes of rhegmatogenous retinal detachment (RRD).</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Embase, and Web of Science up to June 2025. Observational studies comparing RRD patients during COVID-19 LDs or pandemic periods with pre-pandemic controls were included. Outcomes assessed included RRD incidence, baseline clinical characteristics, intervals from symptom onset to first visit and surgery, surgical interventions, and anatomical and visual outcomes. Meta-analyses were performed for comparable outcomes using random- or fixed-effects models based on heterogeneity.</p><p><strong>Results: </strong>Twenty-nine observational studies involving more than 116,000 eyes were included. COVID-19-related restrictions were associated with a significant reduction in RRD surgical volume (rate ratio 0.71; 95% CI: 0.60-0.84), although marked regional heterogeneity was observed. Marked heterogeneity across studies appeared to be partly related to differences in LD severity, duration, and regional healthcare system burden. Patients presenting during LD periods were significantly less likely to have macula-on RRD (OR = 0.61; 95% CI: 0.46-0.83) and more likely to exhibit moderate-to-severe proliferative vitreoretinopathy (PVR) (OR = 2.58; 95% CI: 1.37-4.87) compared with pre-LD periods. Time from symptom onset to surgery increased during LD periods, while presentation-to-surgery intervals decreased. Surgical practice shifted toward greater use of pars plana vitrectomy (PPV), often combined with longer-acting gas tamponades or silicone oil. Despite increased disease severity, single-surgery retinal attachment rates and postoperative visual outcomes remained largely unchanged across periods.</p><p><strong>Conclusions: </strong>The COVID-19 pandemic had substantial and region-specific effects on RRD management, influencing patient presentation patterns, disease severity, and surgical strategies. Nevertheless, adaptive healthcare responses helped preserve overall anatomical and visual outcomes.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261456478"},"PeriodicalIF":2.2,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Household disposal of unused and expired medications in Bahir Dar City, Northwest Ethiopia: Knowledge, attitudes, practices, and factors associated with good disposal practices.","authors":"Biset Asrade Mekonnen, Tefera Minwagaw Biadigilign, Gizachew Motbaynor Alene, Dagninet Derebe Abie","doi":"10.1177/20503121261456532","DOIUrl":"10.1177/20503121261456532","url":null,"abstract":"<p><strong>Introduction: </strong>Proper household management of unused and expired medications reduces environmental and public health risks. The aim of this study was to assess household knowledge, attitudes, and disposal practices of unused and expired medications, and identifies factors associated with good disposal practices among households in Bahir Dar City, Northwest Ethiopia.</p><p><strong>Methods: </strong>A community-based cross-sectional study was conducted from October 1, 2025, to October 30, 2025. A total of 417 participants were selected using simple random sampling. Data were collected through face-to-face interviews using a pretested, structured questionnaire. Data were entered into Microsoft Excel and analyzed using SPSS version 26. Variables with p-values <0.05 in multivariable logistic regression analysis were considered statistically significant.</p><p><strong>Results: </strong>Among 415 participants, 32.2% had good knowledge, 56.4% had a positive attitude, and 43.4% demonstrated good storage and disposal practices. The majority (89.4%) stored unused and expired medications at home, mainly due to improvement in medical condition (53.4%), intolerable side effects (17.5%), and medication change (14.3%). Analgesics (55.0%) and antibiotics (32.1%) were the most commonly stored medications. Although 75.7% reported disposing of unused and expired medications, poor practices were common. Unused medications were often kept until expiry (53.3%), discarded in household garbage (23.3%), or flushed into toilet or sink (15.4%). Expired medications were mainly discarded in household garbage (70.4%), whereas only 9.2% were returned to pharmacies or health facilities. Good disposal practices were significantly associated with age >35 years (AOR=7.14, 95% CI: 1.29-39.67), health insurance (AOR= 2.97, 95% CI: 1.03-8.55), college or higher education (AOR=2.14, 95% Cl: 1.02- 9.20), good knowledge (AOR = 3.41, 95% CI: 1.44-21.49), and positive attitude (AOR = 4.65, 95% CI: 1.29-16.76).</p><p><strong>Conclusion: </strong>Households in Bahir Dar City had a positive attitude; however, their knowledge and disposal practices were poor. Strengthening public awareness and implementing medication take-back systems are recommended to promote good disposal practices and reduce public health and environmental risks.</p>","PeriodicalId":21398,"journal":{"name":"SAGE Open Medicine","volume":"14 ","pages":"20503121261456532"},"PeriodicalIF":2.2,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}