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Prevalence and risk factors for acute stress disorder and posttraumatic stress disorder after burn injury.

Am J Surg 2021 Jul 26. Epub 2021 Jul 26.

Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA; The Burn Center, Department of Surgery, MedStar Washington Hospital Center, USA; Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA. Electronic address:

Background: Psychological consequences of burn injury can be profound. Acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) are known sequelae, but routine identification is challenging. This study aims to identify patient characteristics associated with outpatient positive screens. Read More

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Healthcare Utilization for Stroke Patients at the End of Life: Nationally Representative Data.

J Stroke Cerebrovasc Dis 2021 Jul 27;30(10):106008. Epub 2021 Jul 27.

Department of Neurology, Icahn School of Medicine at Mount Sinai, 1468 Madison Ave, Annenberg 301B, New York 10029, United States. Electronic address:

Objectives Stroke and post-stroke complications are associated with high morbidity, mortality, and cost. Our objective was to examine healthcare utilization and hospice enrollment for stroke patients at the end of life. Materials and methods The 2014 Nationwide Readmissions Database is a national database of > 14 million admissions. Read More

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Leveraging Health Information Technology to Collect Family Cancer History: A Systematic Review and Meta-Analysis.

JCO Clin Cancer Inform 2021 Jun;5:775-788

Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Weill Cornell Medicine, New York, NY.

Purpose: Collection of family cancer histories (FCHs) can identify individuals at risk for familial cancer syndromes. The aim of this study is to evaluate the literature on existing strategies whereby providers use information technology to assemble FCH.

Methods: A systematic search of online databases (Ovid MEDLINE, Cochrane, and Embase) between 1980 and 2020 was performed. Read More

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Association between public media and trends in new acute coronary syndrome presentations during the first COVID‑19 wave in the Netherlands.

Neth Heart J 2021 Jul 29. Epub 2021 Jul 29.

Netherlands Heart Registration, Utrecht, The Netherlands.

Background: We aimed to evaluate the association between public media and trends in new presentations of acute coronary syndrome (ACS) during the first wave of the coronavirus disease 2019 (COVID‑19) in the Netherlands.

Methods: New ACS presentations per week in 73 hospitals during the first half of 2019 and 2020 were retrieved from the national organisation Dutch Hospital Data and incidence rates were calculated. Stratified analyses were performed by region, type of ACS and patient characteristics. Read More

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National Prevalence of Influenza Diagnoses and Vaccination Rates Among Patients Presenting to United States Physician Offices and Hospital Outpatient Departments, 2009 to 2016.

Open Forum Infect Dis 2021 Jul 26;8(7):ofab148. Epub 2021 Mar 26.

College of Pharmacy, The University of Texas at Austin, Austin, Texas, USA.

Background: Influenza health resource utilization studies are important to inform future public health policies and prevent outbreaks. This study aimed to describe influenza prevalence, vaccination, and treatment among outpatients in the United States and to evaluate population-level characteristics associated with influenza health resource utilization.

Methods: Data were extracted from the National Ambulatory and National Hospital Ambulatory Medical Care Surveys (2009 to 2016). Read More

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Impact of Atrial Fibrillation Case Volume in the Emergency Department on Early and Late Outcomes of Patients With New Atrial Fibrillation.

Ann Emerg Med 2021 Aug;78(2):242-252

Alberta SPOR Support Unit Data Platform, University of Alberta, Edmonton, Canada; Division of General Internal Medicine, University of Alberta, Edmonton, Canada.

Study Objective: To define the association between atrial fibrillation case volume in the emergency department and death or all-cause hospitalization at 30 days and 1 year in patients with new atrial fibrillation. Secondary objectives examined repeat ED visits and the management of atrial fibrillation within 90 days.

Methods: We identified all adults presenting to an ED in Alberta, Canada, with a new primary diagnosis of atrial fibrillation/flutter between 2009 and 2015 using International Classification of Diseases, 10th Revision code I48. Read More

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Trends in national opioid prescribing for dental procedures among patients enrolled in Medicaid.

J Am Dent Assoc 2021 Aug;152(8):622-630.e3

Background: The authors examined trends in opioid prescriptions by dentists for children and nonsenior adults enrolled in Medicaid.

Methods: The authors used the IBM Watson Medicaid claims databases for 2012 through 2019 and the Centers for Disease Control and Prevention conversion data set. Opioid prescriptions were linked to a dental visit when prescribed within 3 days of the dental visit and if the patient had no medical visit reported during that period. Read More

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Factors That Drive Annual Variation in Pediatric Elbow Fracture Occurrence, Severity, and Resource Utilization.

J Pediatr Orthop 2021 Jul 29. Epub 2021 Jul 29.

Vanderbilt University School of Medicine Division of Pediatric Orthopaedics, Monroe Carell Jr. Children's Hospital at Vanderbilt Department of Orthopaedics, Vanderbilt University Medical Center Departments of Pharmacology Pediatrics Pathology, Microbiology, and Immunology Center for Bone Biology, Nashville, TN The Wharton School at the University of Pennsylvania, Philadelphia, PA.

Background: Elbow fractures are the most common pediatric fractures requiring operative treatment. To date, few studies have examined what annual factors drive pediatric elbow fracture incidence and no studies have examined which annual factors drive elbow fracture severity or resource utilization. The goal of this study was to not only document the annual patterns of pediatric elbow fracture incidence and severity but also the impact of these patterns on resource utilization in the emergency department, emergency medical service transportation, and the operating room (OR). Read More

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Socioeconomic inequalities in birth outcomes: An 11-year analysis in Colombia.

PLoS One 2021 29;16(7):e0255150. Epub 2021 Jul 29.

Instituto de Investigaciones Clínicas, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.

Objective: To examine socioeconomic inequalities in birth outcomes among infants born between 2008 and 2018 and assessed trends in inequalities during that period in Colombia, a middle-income country with high levels of inequality emerging from a long internal armed conflict.

Methods: Using birth certificate data in Colombia, we analysed the outcomes of low birth weight, an Apgar score <7 at 5 minutes after birth and the number of prenatal visits among full-term pregnancies. Maternal education and health insurance schemes were used as socioeconomic position (SEP) indicators. Read More

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Review of interruptions in a pediatric subspecialty outpatient clinic.

PLoS One 2021 29;16(7):e0254528. Epub 2021 Jul 29.

Division of Pediatric Gastroenterology, Doernbecher Children's Hospital, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, United States of America.

Introduction: The objective of this study was to describe interruptions in the pediatric ambulatory setting and to assess their impact on perceived physician communication, patient satisfaction and recall of provided physician instructions.

Methods: An observational study was performed at the Children's Hospital of Philadelphia, Pediatric Gastroenterology clinic. Participation consisted of video recording the clinic visit and the caregiver completed post-visit surveys on communication and satisfaction. Read More

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Transjugular intrahepatic portosystemic shunt (TIPS) placement at index portal hypertensive decompensation (anticipant TIPS) in cirrhosis and the role of early intervention in variceal bleeding and ascites.

Indian J Gastroenterol 2021 Jul 29. Epub 2021 Jul 29.

Gastroenterology and Advanced G.I. Endoscopy, Ernakulam Medical Center, Kochi 682 028, India.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) placement improves survival in patients with refractory/recurrent acute variceal bleeding (RAVB) and refractory ascites/hydrothorax. Recently, early TIPS was shown to reduce rebleeding and improve survival compared to the conventional TIPS. We aimed to study outcomes in patients with cirrhosis undergoing TIPS at first significant portal hypertensive (PHT) decompensation (termed anticipant TIPS) compared to those undergoing TIPS for recurrent or persistent PHT complications (conventional) and compared the former to matched controls on standard medical management (SMT). Read More

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High Concentrations of Triglycerides are Associated with Diabetic Kidney Disease in New-onset Type 2 Diabetes in China: Findings from the China Cardiometabolic Disease and Cancer Cohort (4C) Study.

Diabetes Obes Metab 2021 Jul 28. Epub 2021 Jul 28.

Karamay Municipal People's Hospital, Xinjiang, China.

Aims: The aims of this study were to evaluate the associations of metabolic abnormalities with incident DKD and to explore whether dyslipidemia, especially high fasting triglyceride (TG), was associated with the development of DKD.

Methods: A total of 11 142 new-onset type 2 diabetes patients with a baseline estimated glomerular filtration rates (eGFR) ≥60 mL/min/1.73 m were followed up during 2011-2016. Read More

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Loneliness in Primary Care Patients: Relationships With Body Mass Index and Health Care Utilization.

J Patient Cent Res Rev 2021 19;8(3):239-247. Epub 2021 Jul 19.

Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA.

Purpose: Rates of loneliness and obesity have increased in recent decades. Loneliness and obesity independently have been found to be risk factors for negative physical and mental health outcomes. This study examined the rates and interrelationships of loneliness, body mass index (BMI), and health care utilization in a primary care setting. Read More

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Association between secondhand marijuana smoke and respiratory infections in children.

Pediatr Res 2021 Jul 29. Epub 2021 Jul 29.

Children's Hospital Colorado, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA.

Background: Little is known about the effects of secondhand marijuana smoke on children. We aimed to determine caregiver marijuana use prevalence and evaluate any association between secondhand marijuana smoke, childhood emergency department (ED) or urgent care (UC) visitation, and several tobacco-related illnesses: otitis media, viral respiratory infections (VRIs), and asthma exacerbations.

Methods: This study was a cross-sectional, convenience sample survey of 1500 subjects presenting to a pediatric ED. Read More

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The impact of non-medical cannabis legalization and other exposures on retention in longitudinal cannabis research: a survival analysis of a prospective study of Canadian medical cannabis patients.

J Cannabis Res 2021 Jul 28;3(1):34. Epub 2021 Jul 28.

Department of Psychology, University of British Columbia, 3333 University Way, OkanaganKelowna, B.C, V1V 1V7, Canada.

Background: Despite repeated calls by medical associations to gather evidence on the harms and benefits of cannabis, there are ongoing methodological challenges to conducting observational and clinical studies on cannabis, including a high rate of patients that are lost to follow-up (LTFU). This study explores factors potentially associated with retention in a large prospective study of Canadian medical cannabis patients, with the goal of reducing the probability that patients will be lost to follow-up in future cannabis research.

Methods: The Tilray Observational Patient Study (TOPS) was a multi-site, prospective study assessing the impact of medical cannabis over 6 months in a broad population of authorized Canadian cannabis patients. Read More

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Health Disparities Between Older Lesbian, Gay, and Bisexual Adults and Heterosexual Adults in the Public Mental Health System.

Psychiatr Serv 2021 Jul 29:appips202000940. Epub 2021 Jul 29.

New York State Office of Mental Health, Albany.

Objective: In this study, the authors examined disparities in general health, substance use, mental health conditions, and acute service use between lesbian, gay, and bisexual (LGB) adults (ages ≥50 years) and a matched sample of heterosexual adults.

Methods: Individuals whose electronic health record indicated their sexual orientation as gay, lesbian, or bisexual from the 2015 New York State Office of Mental Health Patient Characteristics Survey were matched with heterosexual individuals, resulting in N=1,659 individuals in each of the two groups. Differences in health status indicators and acute service use were compared in generalized estimating equation models. Read More

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Gonioscopy-assisted transluminal trabeculotomy (GATT) outcomes in eyes with open-angle glaucoma resistant to maximum treatment.

Arq Bras Oftalmol 2021 Jul 14. Epub 2021 Jul 14.

Department of Ophthalmology, School of Medicine, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.

Purpose: To report the initial 2 years' learning curve on gonioscopy-assisted transluminal trabeculotomy performed using the thermally blunted suture technique and review the factors that could potentially affect the outcome.

Methods: This retrospective study evaluated 100 eyes from 89 participants with glaucoma resistant to maximum clinical treatment, which was defined as having an intraocular pressure >21 mmHg in addition to three or four different hypotensive drugs. Intraocular pressure values at baseline, 1 week, and at 1, 2, 3, 6, 12, and 24 months of follow-up and details regarding the need of antiglaucoma medication and further glaucoma surgery were recorded. Read More

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Impact of pneumococcal conjugate vaccines on healthcare utilization and direct costs for otitis media in children ≤2 years of age in two Swedish regions.

Hum Vaccin Immunother 2021 Jul 28:1-9. Epub 2021 Jul 28.

GSK, Rockville, MD, USA.

In Sweden, the 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in 2009 and replaced by the pneumococcal non-typeable protein D conjugate vaccine (PHiD-CV) or the 13-valent PCV (PCV13) from late 2009. We assessed the impact of PCVs on rates of antibiotic prescribing, tympanostomy tube placement (TTP), and healthcare resource utilization and direct costs of physician-diagnosed otitis media/acute otitis media (OM) in children ≤2 years of age living in Skåne (PCV7 then PHiD-CV) or Västra Götalandsregionen (VGR; PCV7 then PCV13). Retrospective cohort study using linked patient-level data from national and regional (Skåne and VGR) healthcare databases in Sweden from July 1, 2005, to December 31, 2013 (NCT02742753). Read More

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Trends and complications associated with acute new-onset heart failure: a National Readmissions Database-based cohort study.

Heart Fail Rev 2021 Jul 28. Epub 2021 Jul 28.

Division of Cardiology, Promedica Toledo, Toledo, OH, USA.

Literature regarding recent trends and outcomes of acute new-onset heart failure (AHF) with preserved ejection fraction (AHFpEF) and reduced ejection fraction (AHFrEF) is limited. The objective of this study is to study the outcomes of AHFpEF and AHFrEF in the USA. Data from the National Readmissions Database (NRD) sample that constitutes 49. Read More

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Development and pilot implementation of a remote monitoring system for acute toxicity using electronic patient-reported outcomes (ePROs) for patients undergoing radiation therapy for breast cancer.

Int J Radiat Oncol Biol Phys 2021 Jul 24. Epub 2021 Jul 24.

Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY; Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address:

Purpose/Objective(s): We aimed to develop and study the implementation of a remote system for toxicity assessment and management of acute breast radiation side effects using electronic patient-reported outcomes (ePROs).

Materials/methods: A response-adapted PRO-CTCAE-based assessment for breast radiation toxicity was administered weekly during and for 8 weeks after radiation from June 2019 to July 2020. The care team received alerts when "severe" symptoms were reported by patients who were then contacted. Read More

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Evaluation of Unscheduled Return Visits to the Pediatric Emergency Department and Risk Factors for Admission After Return Visit.

Pediatr Emerg Care 2021 Jul 27. Epub 2021 Jul 27.

From the Division of Pediatric Emergency Medicine, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, University of Health Sciences Division of Pediatric Emergency Medicine, Hacettepe University Faculty of Medicine Department of Pediatrics, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey.

Objective: Unscheduled return visits to the emergency department (unscheduled RTED) increase both the workload and overcrowding in the emergency department. The aim in the present study is to identify the patient groups that require more careful and closer follow-up to reduce the rates of unscheduled RTED and hospital admissions after a return visit.

Methods: Among the patients admitted to the emergency department of our hospital between 2016 and 2017, those who made an unscheduled RTED within 72 hours after their first visit to the emergency department were evaluated retrospectively. Read More

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An Analysis of Tracheostomy Complications in Pediatric Patients With Scoliosis.

Laryngoscope 2021 Jul 27. Epub 2021 Jul 27.

Pediatric Otolaryngology - Head and Neck Surgery, Texas Children's Hospital, Houston, Texas, U.S.A.

Objectives/hypothesisal: To analyze tracheostomy-related complications in pediatric patients with scoliosis.

Study Design: Retrospective chart review.

Methods: A retrospective chart review of all patients with tracheostomy and scoliosis was performed at a single institution. Read More

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The Role of Schedule Volatility in Home Health Nursing Turnover.

Med Care Res Rev 2021 Jul 26:10775587211034310. Epub 2021 Jul 26.

University of Pennsylvania, Philadelphia, PA, USA.

Despite considerable research on nursing turnover, few studies have considered turnover among nurses working in home health care. Using novel administrative data from one of the largest home health care organizations in the United States, this study examined turnover among home health nurses, focusing on the role of schedule volatility. We estimated separation rates among full-time and part-time registered nurses and licensed practical nurses and used daily visit logs to estimate schedule volatility, which was defined as the coefficient of variation of the number of daily visits in the prior four weeks. Read More

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Nursing students' attitudes, knowledge and willingness of to receive the coronavirus disease vaccine: A cross-sectional study.

Nurse Educ Pract 2021 Jul 13;55:103148. Epub 2021 Jul 13.

School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian 271000, Shandong, China. Electronic address:

Aim: This study aimed to investigate the knowledge, attitudes and willingness of nursing students to receive the coronavirus disease (COVID-19) vaccine and the influencing factors.

Background: Vaccination is one of the most effective measures to prevent COVID-19, but the vaccination acceptance rate varies across countries and populations. As trustworthy healthcare providers, nursing students' attitudes, knowledge and willingness to receive the COVID-19 vaccine may greatly affect the present and future vaccine acceptance rates of the population; however, studies related to the vaccine acceptance rates among nursing students are limited. Read More

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Potential public health impact of the adjuvanted recombinant zoster vaccine among people aged 50 years and older in Beijing.

Hum Vaccin Immunother 2021 Jul 26:1-12. Epub 2021 Jul 26.

GSK, Wavre, Belgium.

Herpes zoster (HZ) is a painful, unilateral rash which occurs upon reactivation of latent varicella zoster virus due to age-related immunity decline or immuno-suppression. In 2019, the recombinant zoster vaccine (RZV) was the first vaccine to be approved in China for HZ prevention. This study aimed to estimate the potential public health impact of RZV vaccination, compared with the status quo of no vaccination, in individuals ≥50 years of age (YOA) in Beijing, by adapting the published ZOster ecoNomic Analysis (ZONA) model. Read More

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Systematic review and Meta-analysis: Clinical, Endoscopic, Histologic and Safety Placebo Rates in Induction and Maintenance trials of Ulcerative Colitis.

J Crohns Colitis 2021 Jul 26. Epub 2021 Jul 26.

Division of Gastroenterology, Department of Medicine, Western University, London, Ontario, Canada.

Background And Aims: Quantifying placebo rates and the factors influencing them are essential to inform trial design. We provided a contemporary summary of clinical, endoscopic, histologic and safety placebo rates in induction and maintenance clinical trials of ulcerative colitis, and identify factors influencing them.

Methods: MEDLINE, EMBASE, and the Cochrane library were searched from April-2014 to April-2020, updating a prior meta-analysis that searched from inception to April-2014. Read More

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Community-Level Characteristics of Timely PCP Follow-Up Care and Post-Discharge ER Usage.

Hosp Top 2021 Jul 25:1-8. Epub 2021 Jul 25.

Healthcare Administration Program, University of Houston-Clear Lake, Houston, TX, USA.

Achieving equitable access has been a central goal in healthcare for years; access by low-income Americans is a major concern for policymakers. We examined the differences in post-discharge primary care follow-up visits and 30-day post discharge ER visits across several characteristics. The results suggest that higher housing density, percent minority population, percent unemployed, and percent uninsured point to lower rates of PCP follow-up care and higher rates of post-discharge ER visits. Read More

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Enduring problems in the offspring of depressed parents followed up to 38 years.

EClinicalMedicine 2021 Aug 13;38:101000. Epub 2021 Jul 13.

Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA.

Background: while the increased risk of major depressive disorder (MDD) in offspring of depressed parents is one of the best-replicated findings in psychiatry, their long-term outcomes are less well known. The clinical outcomes of biological offspring of depressed (high-risk) and not depressed (low-risk) parents who have been directly interviewed over the years are presented.

Methods: longitudinal retrospective cohort study began in 1982, and 276 biological offspring of moderately-to-severely depressed or non-depressed parents from the same community were followed up to 38 years. Read More

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Violence Against Women in Tanzania and its Association With Health-Care Utilisation and Out-of-Pocket Payments: An Analysis of the 2015 Tanzania Demographic and Health Survey.

Seema Vyas

East Afr Health Res J 2019 29;3(2):125-133. Epub 2019 Nov 29.

Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.

Background: Violence against women is a major public health concern. In addition to adverse physical, mental, and sexual and reproductive health consequences, violence against women confers a considerable cost to health services and the health sector as well as to individuals and households in the form of out-of-pocket expenditures. This study aimed to assess whether physical or sexual violence against women is associated with higher health-care utilisation rates and out-of-pocket expenditures in Tanzania. Read More

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November 2019

Magnitude and Determinants of Antenatal Care Utilization in Kandahar City, Afghanistan.

Obstet Gynecol Int 2021 2;2021:5201682. Epub 2021 Jul 2.

Para-Clinic Department, Faculty of Medicine, Malalay Institute of Higher Education, Kandahar, Afghanistan.

Background: Women's and children's health is a crucial public health concern that epitomizes the universal platform for Sustainable Development Goals (SDGs). Appropriate and timely care during pregnancy can improve maternal and child health.

Objectives: The present study aimed at determining the magnitude and determinants of antenatal care services' utilization in Kandahar city. Read More

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