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Breastfeeding practices in the neonatal period at Naivasha District Hospital-Kenya
No full textBackground: Exclusive breastfeeding is among the low-cost, high-impact interventions with proven effectiveness in reducing neonatal mortality.
Objectives: The primary objective of this study was to determine the breastfeeding practices during the neonatal period (use of pre-lacteal feeds, adherence to initiation of breastfeeding within an hour of delivery, exclusive breastfeeding in the neonatal period), and the secondary objective was to assess the knowledge of mothers of exclusive breastfeeding.
Design: A longitudinal descriptive study was conducted to follow-up mothers who delivered at the Naivasha district hospital during a period of 28 days during the period August 2012 to October 2012.
Setting: The Recruitment of subjects was done in the post-natal ward at the Naivasha District hospital and then the mothers were followed up by phone call interviews at home.
Subjects: The study population was mother/newborn pairs who were stable after 24 hours of delivery. The mothers had delivered normally at term and had signed informed consent.
Results: Two hundred and seven mother-neonate pairs completed the study. Timely initiation of breastfeeding was practiced by 147 (71%) participants, while pre-lacteal feeds were given to 63(30.4%) babies. The rate of exclusive breastfeeding was 89.9% (186/207) at 2 weeks, declining by 4.4 % to 85.5% (177/207) at week 4. One hundred and forty-five (70%) mothers had adequate knowledge on exclusive breastfeeding.
Conclusion: Timely initiation of breastfeeding, maternal knowledge of EBF, and exclusive breastfeeding rates during the neonatal period were above average. However, the use of prelacteal feeds was common
Electronic Medical Record Utilization, Determinant Factors and Barriers Among healthcare Providers at Selected Health Facilities in Addis Ababa, Ethiopia
No full textBackground: Electronic medical record (EMR) is a longitudinal collection of patient information that can be created and managed by authorized clinicians. In developing nations, the adoption of EMR is extremely slow, and the fundamental barriers are not addressed. Despite the effort to digitize the health system in Ethiopia, evidence shows that the progress of utilizing EMR is very slow, with only limited individuals utilizing the system over ten years since its inception. Therefore, this study aims to assess the utilization of EMR and its determinants among healthcare providers in Addis Ababa.Method: A mixed study design was conducted, enrolling 367 healthcare providers and 12 key informants at selected health facilities in Addis Ababa from May to August 2020. A multi-stage sampling technique was used to identify participants. STATA version 15 was used to analyze quantitative data, while Atlas.ti was used to manage qualitative data. Descriptive statistical summary measures were used to describe variables. Stepwise logistic regression was used to select variables. Variables with a p-value of less than 0.05 in the multivariable logistic regression model were considered statistically significant.Result: A total of 353 respondents, mainly nurses (48.2%) and physicians (11.6%), were enrolled, yielding a response rate of 96.2%. The overall rate of EMR utilization was 68.5% (95% CI = 63.7, 73.4). EMR utilization was significantly associated with access to EMR training (AOR, 5.8; 95% CI = 1.6, 20.7), age (AOR, 0.37; 95% CI = 0.1, 0.9), type of health institution (AOR, 7.17, 95 % CI=3.2, 16.2), being pharmacists (AOR=9.61, 95% CI=1.97, 46.8) and having a favorable attitude (AOR, 2.3; 95% CI = 1.2, 4.5). On the other hand, qualitative exploration revealed that power fluctuation, shortage of EMR administrators, absences of guidelines, and vendor phase-out were hindering the utilization of EMR.Conclusion: The utilization of EMR was found to be relatively low, owing to lack of EMR training, age, being a pharmacist, the attitude of healthcare professionals and type of health institution. The absence of clear EMR guidelines, phase-out of vendors, and power fluctuation hinders EMR utilization and needs intervention. We recommend periodic training, deploying EMR admins and making the EMR interface friendly. Furthermore, a strict binding agreement and clear phase-out strategy with EMR vendors are recommended
The development trajectory of overweight and obesity in American children and adolescents (interaction with social development)
No full textBackground: The high prevalence rate of childhood and adolescence obesity has thrown a global threat over the past few decades. This situation has propelled the scientists towards searching for the definite biological and social factors resulting in obesity so that a stable and appropriate preventive strategies can be established in early life.
Objective: The objective of this study was to detect subgroups showing segmental developing phases in the course of life with distinctive weight gain trajectories and identifying the probable reasons behind this onset of obesity in childhood & early adulthood.
Methods: The child survey was mediated by a group of trained interviewers to assess &evaluate each child with their mothers and their family’s environment. Mothers were thoroughly informed and the consent papers were signed by them moreover willingness from children were also recorded. For statistical analysis, the Hierarchical Generalized Linear Modeling (HGLM) method (developed using HLM software) was applied to study longitudinal effect on developmental obesity trajectory.
Results: Results clearly indicate that maternal obesity, smoking and alcohol consumption in pregnancy directly exert effect on growing trajectory of BMI. These responses are the important proof of the perinatal environment influencing the onset of obesity. The findings say, characteristics of environment, genetic factors may contribute, but excessive maternal weight and smoking in pregnancy are important predictor of childhood and adolescent obesity. Smoking of mother is suspected to limit the growth of the foetus which leads to low birth weight, which causes uncontrolled and fast development and thus obesity occurs, known as compensatory rapid postnatal growth.
Discussion: High maternal weight, maternal smoking am alcohol consumption in pregnancy, low educational qualification of the mother and lack of breastfeeding in infant were factors contributing in elevating the onset of childhood and adolescent obesity.
Conclusion: The outcomes of this study clearly allude that these advance risk factors must be controlled and thus these must be taken in account while designing preventive interventions
Trends of radiology caseload and report turnaround time before and after COVID-19 pandemic at the tertiary teaching hospital, Addis Ababa, Ethiopia
No full textBackground: Coronavirus pandemic has drastically change health institutions due to modifications to the health service delivery system. In line with this, patients visiting health institutions have markedly reduced numbers resulting in a reduced caseload of practicing physicians.Objective: This paper assessed the caseload in the radiology department of Tikur Anbessa Specialized Hospital and reported turnaround times before and after the COVID-19 pandemic in a tertiary teaching hospital.Methods: Institution-based Cross-sectional study design was employed for the radiology caseload. All patients’ groups seen in radiology department in all the modalities 6 months before and after the announcement of the COVID-19 in Ethiopia. For the evaluation of radiology report turnaround time, simple random sampling was employed using the source population as those 6 months before in 6 months after the declaration of Covid in Ethiopia. Data entry and analysis were done using SPSS version 16 statistical software. Time series analysis with 95% CI was used to determine the association between different variables for radiology caseloads.Result: The trend of patient load showed a marked decrease after the COVID-19 pandemic in the radiology department. The turnaround time from study time to residents’ report time (ST-RT) - after COVID-19 for MRI was increased by 17 hours. But resident report time to consultant verification time (RRT-CVT) was decreased by 1 day after the COVID-19 pandemic. For computed tomography [CT], ST-RT has decreased by 1 day and 4 hours but RRT-CVT time showed a slight increment by 1 hour and 30 min as compared to before COVID-19. This resulted in reduced exposure of residents and delays of verified patient reports.Conclusion: there is a decrease in patient load and an increase in turnaround time of radiology case reports after the COVID-19 pandemic compared with the trend before the pandemic. This will affect patient care and resident teaching. The department should look for ways of improving patient care and resident teaching through different innovative methods like the introduction of virtual education and teleradiology
Factors in bread preference: A cross-sectional study of the comparison of anthropometric measurements and macronutrient differences according to bread type preferences
No full textBackground: Bread is one of the most consumed foods by humankind throughout history. It is important to evaluate the factors affecting the food preferences of individuals and to examine the effect of frequently consumed food on anthropometric measurements and daily energy and macronutrient intake in order to improve public health and develop nutrition policies of society.Objective: The aim of the current study was two-fold: (1) to determine the factors affecting the bread type preferences of individuals (2) to compare anthropometric measurements and macronutrient differences according to bread type preferences.Methods: The study was conducted cross-sectional from January to October 2018 with randomly selected 1554 volunteer individuals aged between 18-65 years in Istanbul Province of Turkey. The data of the study were collected through a questionnaire form applied by the face-to-face interview method. Demographic information, anthropometric measurements, the most consumed bread types, and dietary records were examined in the questionnaire form.Results: It was determined that the preference for white bread was high (%66.3). White bread and whole-grain bread were consumed 159.4±94 g/day and 131.2±89.2 g/day, respectively. BMI and waist circumference were lower, while the difference was not significant. It was determined that the group who preferred whole-grain bread had fewer carbohydrates, higher fiber, higher protein, higher fat, higher saturated fat, and higher cholesterol intakes in their daily diets. Women, having high education status and old-age popularity increased the preference of whole-grain bread 1.73, 3.39, and 1.03 times compared to the preference of white bread (p<0.001).Conclusion: It has been determined that white bread is preferred more in society. Bread type preference was not associated with anthropometric measurements. It has been determined that the distribution of daily macronutrients of individuals who prefer whole-grain bread is more unbalanced. It was found that gender, educational status, and age were the factors affecting the preference of bread type
Two pathological fractures due to mandibular metastasis, rare in colon cancer; a case report presentation
No full textWe reported on 65 years old patient who has colon cancer and referred to our palliative care center with pain due to enlarging metastatic mass on the dorsal of the right hand. She had swelling and numbness on her jaw. Computed tomography (CT) scan was performed for mandible imaging and two pathologic fractures were detected on the right corpus and right condyle of the mandible. Clinicians should consider possible metastases for terminal stage cancer patients
Utilization of Eye Care Services in an Underserved Community in Enugu State, Nigeria
No full textBackground and Aim: To determine the utilization of eye care services in an underserved community in Enugu State, Nigeria.
Materials and Methods: A community-based cross-sectional study was conducted among adults aged 18 years and older. A structured questionnaire was used to collect information on the utilization of eye care services within the last two years.
Result: A total of 500 adults with a mean age of 48 ± 10 years participated in the study, the majority (65.6%) of whom were females. The utilization rate within the last two years was 18% (40/500). Utilization of eye care services was associated with age, religion, occupation, marital status, monthly income, education, family history, and history of ocular disease (all P < 0.05). The major barrier to the utilization of eye care services was cost (30%), distance (22.6%), and bad road infrastructure (15.2%).
Conclusion: There is a low rate of eye care service utilization in the Ugbawka community of Enugu State, Nigeria. The cost of eye care services, distance, and bad road infrastructure were the major barriers to the use of eye care services. These suggest the need for the provision of affordable and accessible eye care services in this community to reduce the burden of visual impairment and blindness. 
A Rare Case of Abdominal Cocoon Associated with Internal Hernia in an Adult
No full textA transmesenteric internal hernia (TIH) is a protrusion of a viscus through the mesenteric defect. It is secondary to previous gastrointestinal surgery in an adult. Early diagnosis and management are warranted to prevent the strangulation of the bowel in a TIH. Here, we are reporting a case of a 24-year- old gentleman with COVID-positive status who has presented with cough, abdominal cocoon, and features of subacute intestinal obstruction (SAIO) without any previous history of abdominal surgery. A nonoperative trial is given in the management of abdominal cocoon with SAIO. In contrast, delay in surgical intervention in TIH leads to bowel gangrene. Surprisingly even on contrast-enhanced computed tomography of the abdomen, TIH was not picked up. We have diagnosed this case intraoperatively with gangrene of the bowel. In an abdominal cocoon without any history suggestive of tuberculosis or previous surgery, or any other condition that leads to an intra-abdominal reaction, an internal hernia should be kept as a differential diagnosis. The delay in diagnosis and surgical intervention is associated with potentially disastrous complications
Determinants of Blood Pressure Control among Hypertensive Patients Attending a Rural Teaching Hospital in Southern Nigeria
No full textBackground: Hypertension (HTN) is the commonest cardiovascular risk factor in sub-Saharan Africa. It is a global public health threat, often associated with significant morbidities and mortality with rising prevalence both in rural and semi-urban areas of economically disadvantaged countries.
Aim: This study aimed to assess the determinants of blood pressure control among patients with hypertension receiving care at the Irrua Specialist Teaching Hospital in Southern Nigeria. Patients and Methods: A cross-sectional study of 502 consenting hypertensive adults receiving care at the Irrua Specialist Teaching Hospital, Irrua in Edo State, South-south Nigeria. A pre-tested semi-structured interviewer-administered questionnaire was used to collect data which was analyzed using SPSS version 21 and the level of significance was set at P < 0.05.
Results: Five hundred and two participants (226 males, 276 females) completed the study with a mean age of 52.98 ± 12.82 years. Optimal blood pressure control was found in 15.5% of the study participants. Blood pressure control was significantly associated with being married (OR 1.549, CI: 1.040‑2.309), having a monthly household income of over N50,000 (OR 1.691, CI: 0.999-2.863), engaging in physical activity (OR = 1.537, CI: 0.989-2.388), and not being obese evidenced by a normal Waist Hip Ratio (OR = 2.276, CI: 1.555-3.332).
Conclusion: Blood pressure control to target goal was low in the study population and achieved only in less than one‑fifth of respondents on antihypertensive therapy. Numerous socio-demographic and lifestyle variables were shown to be associated with blood pressure control. Physicians should emphasize medication adherence and lifestyle modification approaches in hypertensive adults.  
Allergic Rhinitis in Covid‑19 Patients
No full textBackground: Coronavirus disease-2019 (Covid-19) is transmitted by respiratory droplets and causes upper respiratory tract symptoms. These features of Covid-19 are essential regarding its potential association with allergic rhinitis (AR).
Aim: This study aimed to investigate the relationship between Covid-19 and AR and the effects of Covid‑19 in patients with AR.
Patients and Methods: Between April 2020 and June 2020, in Sanliurfa Mehmet Akif Inan Training and Research Hospital, 322 patients who were diagnosed with Covid-19 with polymerase chain reaction (PCR) positive oropharyngeal and nasopharyngeal swab samples and with AR in their medical history were detected using the hospital’s automation system. Demographic data including age, gender, and additional data such as main complaints, physical examination findings, duration of inpatient floor, and intensive care unit (ICU) stay were recorded. The medical history of the patients was reviewed and patients with previously diagnosed AR were identified. These patients were called by phone and their AR diagnoses were confirmed by performing the Score for Allergic Rhinitis (SFAR) questionnaire.
Results: The study population consisted of 322 patients aged between 18 and 85. Among these patients, 186 (57.8%) were male and 136 (42.2%) were female. Nineteen (5.9%) of these patients had a history of AR. There was no difference between the patients with and without a history of AR concerning age, gender distribution, type of presentation, ICU referral rate, duration of inpatient floor, and ICU stay (P > 0.05).
Conclusion: We conclude that the prognosis of Covid-19 was similar between patients with and without AR. The incidence of AR was relatively lower among patients with Covid-19.