Medicine and Health Sciences - Publication
163 Publications foundPatterns of Abdominal Surgical Emergencies of Patients Treated at Ambo Referral Hospital from January 1, 2018 to December 30, 2019, Oromia Regional State, Ambo, Ethiopia
Authors: Leta Alemu Diba , Abel Ambaye Anfucho
In Medicine and Health Sciences
Acute abdomen is an acute onset of abdominal disease entities that require immediate surgical intervention in most of the cases. It is the commonly encountered emergency in the practice of general surgery but there was no much information regarding its magnitude in our country. Objective: This study had assessed the pattern of acute abdomen of patients surgically treated at Ambo referral hospital from January 2018-Dec. 2019 Methodology: This study was conducted at Ambo referral hospital and retrospective analysis of surgically treated acute abdomen patients from January 2018-Dec. 2019G. C. Enrolled patients medical record number was collected from surgical operation registration book and the charts were collected from chart collection room. Results: During this study period there were total of one hundred and eleven (111) patients admitted with diagnoses of acute abdomen and surgically treated on emergency basis. Males were more affected than females and most affected group were young age falls in 2nd and 3rd decades. The most common presenting symptoms were abdominal pain and vomiting whereas abdominal tenderness and distension were the leading signs. The leading causes of acute abdomen were acute appendicitis followed by intestinal obstruction and abdominal trauma. The investigation was ordered according to clinical diagnoses to aid/ confirm diagnoses. Post-operative stay was relatively similar with studies conducted in some part of the country and all over the world. In the study period above 90% were discharged with improvement where as 9% were died. Conclusion: This study depicted the commonest presenting symptoms and signs, most common etiology of acute abdomen and pre and post op stay which affected the outcome. Still some variables need deep study like why trauma becomes a 3rd leading cause and less affected females.
A Qualitative Analysis of the Impact of Political Trust in the Uptake of COVID-19 Vaccine in Three Nigerian Geopolitical Zones
Authors: Nwoke Emmanuel Chukwuebuka , Ebenezer Obi Daniel , Oladapo Michael Olagbegi , Paul Olaiya Abiodun , Ahmed Mamuda Bello , Michael Avwerhota , Michael Olabode Tomori , Friday Iyobosa Igbinovia , Adebanke Adetutu Ogun , Folake Abiola Abiodun , Stellamaris Moronkeji , Esther Brodrick-Shehu
In Medicine and Health Sciences, Medicine, Public Health
The issue of COVID-19 vaccination is an important step in the control of the COVID-19 infection in the community. There have been different adopted strategies in the control of the infection and the best public intervention has been getting vaccinated for now. The most likely solution to ending the current pandemic remains through achieving a better community reach, and the frank acceptance of the availed WHO-approved COVID-19 vaccine in communities. In this study, the reason for the COVID-19 vaccine uptake was evaluated across 3 geopolitical zones in Nigeria with differential political affiliation. This study utilized a qualitative sample collection methodology to qualify the prevalence of different views on COVID-19 vaccine acceptability, access, and political trust. The data was gathered utilizing pre-tested in-depth interviews, which were transcribed and analyzed thematically through the transcripts obtained from the open-ended key informant interviews. The findings from the qualitative studies indicated that the fear of the side effects, apathy/lack of interest, scarce logistics, people’s opinion, and self-denial were more of the pertinent issue around the poor COVID-19 vaccine uptake among the respondents. Government needs to ensure that health interventions rolled are adequately accessible to the targeted people and should consider the community culture while rolling out health interventions.
Inferior Epigastric Artery a Boon in Accessory Lower Polar Artery Revascularization in Renal Transplantation
Authors: Kabilan Saminathan , Balaraman Velayutham , Muthu Veeramani
In Medicine and Health Sciences, Public Health
Multiple renal arteries occur unilaterally and bilaterally in 23% and 10% of the population, respectively. During renal transplantation failure to recognize and preserve an accessory renal artery may lead to ureteral necrosis, segmental renal infarction, postoperative hypertension, or calyceal fistula formation. The problem with accessory renal artery is prolonged ischemia and delayed graft function. Long ischemia can be avoided if lower polar accessory renal artery is anastomosed to inferior epigastric artery after de-clamping as soon as the main renal artery and venous anastomosis is done. Aim: In this study we report our experience with live donor renal transplantation with multiple arteries in which the lower polar artery was anastomosed to the inferior epigastric artery. This study describes the surgical technique and outcomes of live donor renal allografts with multiple arteries in which the lower polar artery was anastomosed to the inferior epigastric artery after de-clamping. Material & Methods: Between 2012 and 2020, 68 consecutive live donor renal transplants were performed involving single Urology-Nephrology team. This included 48 with single and 20 with multiple arteries. Anastomosis of the lower polar artery to the inferior epigastric artery was used for 8 grafts with multiple arteries. Results: Successful revascularization of all areas of the transplanted graft was confirmed by Doppler ultrasonography in most patients and radionuclide renal scanning + MRA in some patients. Conclusions: In live donor renal transplantation with multiple arteries; the anastomosis of the lower polar artery to the inferior epigastric artery after de-clamping, avoids prolongation of the ischemia time that occur with other surgical techniques.
A Cross-Sectional Assessment of Self-Medication Among University Students of Lahore, Pakistan
Authors: Muhammad Ans , Sameen Abbas , Anosh Sana , Mishal Bajwa , Kalsoom Jehan Khan , Waqas Abdul Aziz , Asima Bibi , Mujahid Hussain
In Medicine and Health Sciences
Background: Symptoms or ailments that a person is aware of and chooses to treat on their own are referred to as self-medication. The idea of self-medication has been influenced by awareness of individual responsibility for own health and unnecessary professional care for mild illnesses. Self-medication is common practice around the globe. Gradually, it is becoming a form of self-care. Lot of research has been done in the area and the result revealed that the self-medication is more common among the literate people as compared to the illiterate. Trend is rather prominent among the young population who tend to have more knowledge of drugs and their use, have lower risk perception, therefore are more influenced by self-medication. Objective: A cross-sectional study was conducted to assess the knowledge about self-medication among engineering, arts & humanities students in Lahore during a period of 7 months (December 2018-June 2019). Methodology: A self-administered questionnaire was designed after the extensive review of previous research and was reviewed by an expert panel of professors & lecturers of clinical pharmacy of Punjab University College of pharmacy. Human ethics committee of Punjab University College of Pharmacy, University of the Punjab approved the study protocol. A total sample of 1000 students were calculated by sample size calculator. All statistical analysis was done by SPSS version 23. Results: A total of 1000 questionnaire were received with overall response rate of 63%. In this study, younger age, male, and unmarried students residing in hostels and those who have access to nearby pharmacy tended to self-medicate more than their peers with significant difference. About 43.4% of respondents followed their doctor's advice, while about 37.2% took their own advice or that of friends, family members, or the media. Conclusion: Self-medication misuse or abuse can be dangerous and endanger lives; if practiced impulsively, it may also be a health issue that requires education and attention from Pakistan's health care authorities. Future research is also required to determine how self-medication affects Lahore and Pakistan's non-medical students' health.
The Evaluation of Oral Health in Patients with Chronic Kidney Disease – A Longitudinal Study
Authors: Mimoza Canga , Irene Malagnino , Edit Xhajanka , Rozela Xhemnica , Vergjini Mulo , Vito Antonio Malagnino
In Life Sciences, Medicine and Health Sciences
Background: Chronic kidney disease affects more than 10% of people globally. The aim of the study was to assess oral health in patients with chronic kidney disease. The sample was composed of 233 patients, of which 147 (63%) were males and 86 (37%) were females. Participants' age varied from 31 to 70 years old. We divided the participants into four age groups: 31-40, 41-50, 51-60, and 61-70 years old. Data were analyzed by using (IBM, New York, USA, SPSS Statistics for Windows), Version 23.0. The significance level (α) was set at 0.05, with a confidence interval (CI) of 95%. The prevailing age range was from 51 to 60 years old, with 31.8% of the participants. A considerable number of patients with chronic kidney disease had low incomes, respectively 42.4% of them. 80.7% of the patients were current smokers and 73.4% of them consumed alcohol. A large proportion of respondents 83.7% of them were diabetic patients. 63.1% of the participants reported that they had hypertension. According to our findings, 55.8% of the participants brush their teeth only once a day. The study found a strong correlation between chronic kidney disease and diabetes mellitus (CI 95; 1.17-1.33, P-value ˂.0001), hypertension (P ˂.0001), alcohol consumption (P=.001), and smoking (P =.000). Gingivitis was the most common oral disease which affected 73.4% of the participants, followed by 56.7% of them who had dental caries.
Prevalence and Mortality Associated with Tuberculosis Among HIV-Infected Patients in High-Volume HIV Care Sites in Conakry
Authors: Niouma Nestor Leno , Foromo Guilavogui , Mohamed Diallo , Aboubacar Sidiki Magassouba , Youssouf Koita , Laye Kaba , Souleymane Chaloub , Andre Kamano , Alexandre Delamou , Alioune Camara
In Life Sciences, Medicine and Health Sciences
Introduction: The objective of this study was to estimate the prevalence of tuberculosis and to identify factors associated with its occurrence among HIV-infected patients on antiretroviral therapy. It also estimated the survival rate among HIV patients co-infected with TB and among HIV patients not co-infected with TB. Methods: In this study, two types of studies were used. An analytical cross-sectional study was used to estimate the prevalence of TB at the time of data collection or extraction among HIV-infected patients. A historical cohort study was used to analyze the survival of HIV patients on ART at different time points during their follow-up. We used Kaplan Meir survival analysis techniques to estimate the cumulative incidence of death among patients on antiretroviral therapy at different follow-up periods. We used multivariate logistic regression to identify associations significantly associated with the occurrence of TB in patients living with HIV. Results: The prevalence of tuberculosis among HIV-infected patients was 21.19%. The cumulative probability of death for patients on ART was 6.80%, or an incidence rate of 3.27 per 100 person-years. The advanced clinical stage of HIV infection at ART initiation, the low CD4 count at ART initiation, and the high viral load at ART initiation were statistically associated with the occurrence of TB in HIV-infected patients (all AOR > 1, p-value < 0.05). Conclusion: This study showed that the cumulative probability of death was higher in patients co-infected with HIV and TB than in those who were not. A mixed study (a prospective quantitative component and a qualitative component) could allow a better understanding of this phenomenon of tuberculosis occurrence among HIV-infected patients in Guinea.
Immunotherapy and General Medical Aid in Metastatic/Recurrent Mucous Membrane and Cervical Cancers
Authors: Igor Tsaur
In Medicine and Health Sciences
Despite advances within the treatment of medical specialty malignancies, each repeated mucosa and cervical cancers once not amenable to localised medical care (surgery or radiotherapy), stay incurable with restricted prognosis and effective treatment choices. Therapy remains the quality of take care of girls with pathological process mucosa or cervical cancers. The addition of bevacizumab to first-line therapy for pathological process cervical cancer patients represents a major breakthrough in up survival. Additional recently, therapy methods targeting the PD-1/-L1 pathway have shown clinical activity in each mucosa and cervical cancers. The accrued understanding of the biology of those cancers is shaping target-specific treatments. Here we have a tendency to summarise current treatment choices and results from clinical trials of therapy and different targeted therapies that have already modified, or have the potential to vary, clinical observe in metastatic/recurrent mucosa and cervical cancer.
Coverage and Factors Associated with Cervical Cancer Screening: Results from a Population-Based WHO Steps Study in Ethiopia
Authors: Terefe Gelibo , Lizeth Roets , Theodros Getachew , Abebe Bekele
In Medicine and Health Sciences
Background: Cervix cancer is the most common cause of cancer deaths in Africa accounting for 10.4 deaths, which represents one in five of all cancer deaths in African women Munoz et al. Sub-Saharan Africa bears the highest global burden of this fatal yet entirely preventable disease. The problem is particularly severe in sub-Saharan Africa, where the age-adjusted incidence rate is 45 per 100,000 women with Ethiopia at 35.9 per 100,000 women. Data from the Addis Ababa population based cancer registry showed that breast and cervical cancers were the leading causes of cancer, comprising 22.6% and 10.8% respectively of all cases of cancers. Methods: Community-based Cross-sectional survey based on the World Health Organization (WHO) NCD Stepwise approach was done. The survey was conducted in the 9 regions and two city administrations (Addis Ababa and Dire Dawa) in Ethiopia. The target population for this survey included all men and 15-69 years old who consider Ethiopia to be their primary place of residence. A single population-proportion formula was used to determine the sample size design effect coefficient of 1.5, Z-score=1.96, proportion=35.2 and marginal error=0.04. A total of 513 EAs were covered nationwide. Thus, 5823 women were included in this study. A mix of sampling approach namely stratified, three-stage cluster sampling, simple random sampling and Kish method were employed to select the study settings and the study participants. Results: Cervical cancer screening rate in Ethiopia is extremely low (2.9%). When adjusted for demographic and residence confounders (age, location, income, education), cervical cancer screening is significantly associated with being at urban area (AOR=2.5, 95% CI: 1.1, 5.7), age 30-49 years (AOR=2.4, 95% CI: 1.2, 4.8), having annual household income of more than 30,000 ETB (AOR=7.1, 95% CI: 4.8, 10.4) and college and above level of education (OR=2.8, 95% CI: 1.1, 7.8). Conclusions: Cervical cancer screening rate in Ethiopia is extremely low as compared to the rates of other countries. This needs a mechanism to establish and strengthen the multi-sectoral response in general for the prevention and control of cervical cancer and increasing awareness of the community towards cervical cancer screening and strengthening the health system in particular.
Resting Heart Rate: Risk Indicator and Emerging Risk Factor in Cardiovascular Disease
Authors: Michael Böhm , Jan-Christian Reil , Prakash Deedwania , Jae B. Kim , Jeffrey S. Borer
In Medicine and Health Sciences, Medicine, Public Health
By NCBI Pubmed
Resting heart rate is central to cardiac output and is influenced by changes occurring in numerous diseases. It predicts longevity and cardiovascular diseases, and current evidence suggests that it is also an important marker of outcome in cardiovascular disease, including heart failure. Beta-blockers improve outcomes in heart failure; however, they have effects outside reducing heart rate. Ivabradine has demonstrated efficacy in reducing rehospitalizations and mortality in heart failure and in improving exercise tolerance and reducing angina attacks in patients with coronary artery disease, whereas selective heart rate reduction may also prove to be beneficial in therapeutic areas outside those in which ivabradine has already demonstrated clinical efficacy. This review provides an update on the associations between heart rate and cardiovascular outcomes in various conditions, the experimental effects of heart rate reduction with ivabradine, and the potential new indications in cardiovascular disease.