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Effects of Age and Comorbidities on Prognosis and Mortality in Geriatric Patient Groups in İntensive Care
No full textBackround: Treatment of geriatric intensive care patients is tiring and difficult for intensive care physicians due to comorbidities, accompanying acute illnesses and vulnerabilities.
Aim: The aim of our study was to determine other factors affecting mortality and morbidity with age in geriatric intensive care patients.
Patients and Methods: A total of 937 geriatric intensive care patients were divided into three groups as young-old (65-74 years), middle- old (75-84 years), and oldest-old (85 years and more). Demographic characteristics such as age, gender, and comorbid diseases (oncological malignancy, chronic renal failure, sepsis, chronic anemia, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, pulmonary embolism) were recorded. The number of patients who needed a mechanical ventilator, developed decubit ulcers, underwent percutaneous tracheostomy, and renal replacement therapy were recorded. In addition, the number of central venous catheter insertions for patients, Acute Physiology and Chronic Health Evaluation II scores (APACHE II), hospitalization days, and mortality rates were recorded and compared.
Results: In the comparison between the groups in terms of gender, in the 65-74 years’ age group, male gender was higher, while in the age group of 85 years and more, the female gender was found to be statistically higher. Among comorbid diseases, the rate of oncological malignancy was found to be statistically significantly lower in patients aged 85 years and more. Comparing the APACHE II scores of the patients as per the groups, scores were found to be statistically significantly higher in the oldest- old group. APACHE II Score, central venous catheter application, chronic obstructive pulmonary disease, chronic renal failure, sepsis, oncological malignancy, and renal replacement therapy were shown to be statistically significant as factors affecting death. The factors affecting the survival or hospitalization time of the patients of decubit ulcer, mechanical ventilator, percutaneous tracheostomy, chronic obstructive pulmonary disease, Sepsis, APACHE II Score, and age were shown to be statistically significant.
Conclusion: Our study showed that not only age has an effect on mortality and morbidity in geriatric intensive care patients but also comorbidities and intensive care treatments of the patients are also effective in this process.  
Quantitative and Qualitative Assessment on Individual Perception and Self-Care Practice of Refractive Error in a Rural Community in Enugu, South East Nigeria
No full textBackground: Globally, uncorrected refractive errors have been identified as the most common cause of visual impairment and the second leading cause of treatable blindness.
Aim: This study quantitatively and qualitatively assessed individual perception and self-care practice of refractive error (RE) in a rural community in Enugu State.
Subjects and Methods: A descriptive, cross-sectional, population-based survey was done in Amorji community, Enugu State. A pretested, researcher-administered questionnaire was used to interview the respondents on knowledge of causes, features and treatment of RE, their self-care practices, and attitudes toward RE. Focus group discussions (FGDs) and in-depth interviews (IDIs) were also carried out to qualitatively assess these parameters. Data was analyzed using SPSS version 20.
Results: A total of 522 adults, 307 (58.8%) males, and 215 (41.2%) females aged 43 ± 31.6 (range 18–83) years participated in the study. Of the participants, 235 (45.0%) had good knowledge of RE; 272 (52.1%) had positive attitude toward RE, while only 51 (9.8%) had good self‑care practice. Educational status was significantly (p = 0.02) associated with participants’ knowledge, attitude, and self-care practices. Good knowledge significantly (p = 0.001) influenced attitude and self‑care practices among the participants. Results from FGDs and IDIs were in agreement with those obtained from the questionnaire-based part of the study.
Conclusion: The participants from Amorji community had good knowledge of the features of RE but poor knowledge of its causes and treatment. They also exhibited positive attitude, but poor self-care practices toward refractive errors. 
The Effect of Different Staining Solutions on the Color Stability of Temporary Crown Materials
No full textBackground: The esthetic expectations of patients are increasing by the day. That is why it is important to minimize the color changes in the oral cavity in both the temporary and permanent restorations.
Aim: This study was carried out to compare the time-dependent color changes of polished and unpolished temporary crown materials prepared by different methods in various solutions.
Materials and Methods: Half of the two different temporary restoration materials prepared with a diameter of 10 mm and a thickness of 2 mm were polished, and half were not polished. The ΔE* values of the samples kept in various solutions were recorded. Data were statistically evaluated by using variance analysis (ANOVA) and a Tukey HSD multiple comparison test.
Results: It was determined that the material type, the solution, the interaction between the material types and the surface treatment, and the interaction between the surface treatment and the solution were statistically significant for color change (p < 0.001).
Conclusion: The most significant color change in the inter‑material evaluation was observed in chemically polymerized polymethyl methacrylate. In the evaluation between beverages, the highest color change was found in sugared coffee, and the lesser color change was observed in polished samples 
Non-adherence to growth monitoring and promotion sessions amongst caregivers of children under 5 years in Polokwane Municipality, Limpopo province
No full textBackground: Child growth is crucial for nutritional and health status; poor growth may result in stunting. South Africa experiences a high prevalence of stunting, micronutrient deficiencies and late identification of growth faltering. Non-adherence to growth monitoring and promotion (GMP) sessions remains a challenge and caregivers contribute to non-adherence. Therefore, this study explores factors affecting the non-adherence of GMP services.Methods: Qualitative approach and phenomenological exploratory study design were used. One-on-one interviews were conducted with 23 participants conveniently sampled. Sampling size was dependent on data saturation. Voice recorders were used to capture data. Tesch’s eight steps, inductive, descriptive and open coding techniques were used to analyse data. Measures of trustworthiness were ensured through credibility, transferability, dependability and confirmability.Results: Participants indicated non-adherence to GMP sessions because of a lack of knowledge of the importance of adherence and poor service by healthcare workers, which includes long waiting hours. Inconsistent availability of GMP services at healthcare facilities and growth of the firstborn children with non-adherence to GMP sessions are factors influencing participants’ adherence. A lack of transportation and lunch money also contributed to non-adherence to sessions.Conclusion: A lack of knowledge of the importance of adherence to GMP sessions, long waiting hours and inconsistent availability of GMP services at facilities contributed enormously to nonadherence. Therefore, the Department of Health must ensure consistent availability of GMP services to demonstrate the importance and enable adherence. Healthcare facilities should reduce waiting hours to minimise the need for lunch money, and service delivery audits should be conducted to identify other factors contributing to non-adherence to address these.Contribution: Primary health care providers should conduct service delivery audits and internal surveys to identify factors that contribute to non-adherence in order to introduce measures to address them
Clinical review of stroke care at National District Hospital, Bloemfontein
No full textBackground: Stroke is a leading cause of morbidity and mortality affecting sub-Saharan Africa. Studies show that dedicated stroke units improve patient outcomes. National District Hospital (NDH) manages strokes, with the potential of becoming a dedicated stroke unit in Bloemfontein, South Africa. The study aimed to describe the clinical characteristics, management and outcomes of patients presenting with stroke at NDH.Methods: In this retrospective descriptive study, emergency department registers were used to identify patients presenting with symptoms of a stroke between 01 January 2019 and 31 March 2019. Relevant data were extracted from hospital files.Results: Of the 106 identified patients, 53 were included in the study. The median age was 61 years (range 28–89 years), with an almost equal split between genders. The most common risk factor was hypertension (81.3%). The median time from symptom onset to presentation at NDH was 9 h. No patient received thrombolysis. One patient received neurosurgical intervention. The most prescribed secondary preventative drugs were antihypertensivemedication, statins, anticoagulation and antiretroviral therapy. Half (52.8%) of the patients received rehabilitation as in-patients. Final diagnoses were ischaemic strokes (26/53, 49.0%), transient ischaemic attacks (10/56, 22.7%) and haemorrhagic strokes (6/56, 13.6%). The 6-month post-infarct mortality rate was 37.5%.Conclusion: Patient outcomes were comparable to similar South African studies. Time delays in stroke management remain a major obstacle. Identified action points include community education, improving emergency medical services and establishing a dedicated stroke unit.Contribution: This study underlines the importance of stroke and cardiovascular disease prevention and stresses the value of establishing dedicated stroke units
Alexis O-ring wound retractor versus traditional metal retractors for the prevention of postcaesarean surgical site infections
No full textBackground: Postcaesarean surgical site infections (SSI) remain a burden globally. The Alexis® O C-Section Retractor, a plastic sheath retractor known to have decreased incidence of SSIs in gastrointestinal surgery, is yet to have its efficacy established during caesarean section (CS). This study aimed to compare the differences in the rate of postcaesarean surgical wound site infections between the Alexis® retractor and traditional metal retractors during CS at a large tertiary hospital in Pretoria.Methods: Pregnant women scheduled for elective CS were prospectively randomised to either the Alexis® retractor group or the traditional metal retractor group at a tertiary hospital in Pretoria between August 2015 and July 2016. The defined primary outcome was development of SSI, and secondary outcomes comprised patients’ peri-operative parameters. All participants’ wound sites were observed in the hospital for 3 days before discharge and again at 30 days postpartum. Data were analysed using SPSS version 25 with p < 0.05 considered significant.Results: A total of 207 participants were involved, Alexis® (n = 102) and metal retractors (n = 105). None of the participants developed postsurgical site wound infection after 30 days, and there were no differences in time to delivery, total operative time, estimated blood loss or postoperative pain between the two arms of study.Conclusion: The study found no difference in participants’ outcomes using the Alexis® retractor in comparison with the traditional metal wound retractors. We suggest that the use of Alexis® retractor be at the surgeon’s discretion and its routine use not advised for now.Contribution: This research being the first of its kind in South Africa in which patients’ clinical outcomes were compared post caesarean section from Alexis’s plastic sheath group and metal retractors group in an attempt to proffer solution to the high burden of SSI. Although no difference was seen at this point, the research was pragmatic, as it was carried out in a setting with high burden of SSI. The study is going to serve as a baseline against which studies carried out in future can be compared
Suicide attempts among students of higher education, Nelson Mandela Bay Municipality, South Africa
No full textBackground: Worldwide, death by suicide is a leading cause of death among young people, and students of higher educational institutions constitute a vulnerable group. This study aimed to determine the lifetime prevalence and associated factors of suicide attempt among students of a higher education institution in Nelson Mandela Municipality.
Methods: A cross sectional study was conducted among students of East Cape Midland College in Nelson Mandela Municipality. The participants were selected by stratified random sampling and a standardised self-administered questionnaire was used to collect data.
Results: The prevalence of lifetime suicide attempts was 16.0% among the participants. Multivariate logistic regression analysis revealed higher odds of suicide attempts among participants who: experienced bullying (OR: 1.66, CI: 1.05–2.61; p < 0.001), had underlying medical conditions (OR: 3.27, CI: 2.08–5.14; p < 0.001 ), had abnormal body weight perceptions (OR: 1.64, CI: 1.03–2.62; p < 0.05), had experienced sexual abuse (OR: 5.72, CI: 2.86–11.45; p < 0.001), or had someone very close who had experienced sexual abuse (OR: 1.77, CI: 1.02–3.05; p < 0.05).
Conclusion: This study identified history of sexual abuse, bullying, perceptions of abnormal body weight and underlying medical conditions as associated risk factors of suicide attempts among the participants. The high prevalence of suicide attempts among the participants (16%) demonstrates the urgent need for campus-based interventions and prevention strategies aimed at addressing the identified associated factors
Knowledge of final year undergraduate nursing students about HIV and AIDS in Eswatini
No full textBackground: Human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) are overwhelming health issues globally. They have caused many devastating and draining health issues, which have escalated a critical need for a well-trained and sustainable healthcare workforce in order to meet the needs of people living with HIV and AIDS (PLWHA). Health science students are the future healthcare providers who will implement proper preventive measures, as well as health educational and promotional sessions to promote information and knowledge among the public regarding HIV and AIDS in Eswatini.
Methods: A quantitative cross-sectional study was conducted on 140 final-year undergraduate nursing students in three nursing universities in Eswatini. A questionnaire adapted from Othman and Ali in Malaysia with closed-ended questions was modified and used to collect data. The questionnaire consisted of questions on the virus structure, transmission, prevention and management of HIV and AIDS. Statistical Package for the Social Sciences (SPSS) version 20 was utilised to analyse the data.
Results: The level of knowledge about HIV and AIDS was high, as evidenced by a mean score and standard deviation of (91.02 ± 5.00). However, there were low scores on questions related to the transmission of the disease.
Conclusion: Across all three universities in Eswatini, there were good nursing education programmes on HIV and AIDS, evidenced by the high knowledge level about HIV and AIDS. However, there are still some knowledge gaps on HIV and AIDS transmission and management that need to be attended to.
Contribution: This study contributed by providing knowledge of undergraduate nursing students’ HIV and AIDS training and management of PLWHA
Failed tracheal intubation in primary health care
No full textTracheal intubation in primary health care is a necessary skill and usually one that is necessary for appropriate emergency management of unstable patients. Primary care practitioners may not have an anaesthetist or critical care doctor available to help them in these emergencies and must manage these patients themselves. Often tracheal intubation may fail because of multiple possible factors and a different course of action may be needed to minimise the potential for harm to the patient. The primary care professional or family physician will have to manage this failed intubation. Primary health care facilities providing obstetric services must have guidelines and appropriate equipment for management of airway problems. This article will explore reasons for the failure of tracheal intubation and how this can be managed
Eriocalyxin B mediates the migration and inflammation of TGF β2 induced human lens epithelial cells by inhibiting JAK/STAT3 pathway
No full textPurpose: To study the role of Eriocalyxin B (EriB) in the migration and inflammation of TGF-β2-induced human lens epithelial cells (hLECs), and to elucidate the molecular mechanisms involved. Methods: The hLECs cultured in vitro were divided into 5 groups, viz, control, TGFβ2, TGFβ2+2 μM EriB, TGFβ2+4 μM EriB, and TGFβ2+8 μM EriB groups. CCK-8, clone formation and Edu labeling assays were performed to assess the effect of EriB on the proliferation of hLECs cells. To determine the role of EriB in cell migration, Transwell and wound healing assays were used. The levels of vimentin, α-SMA, snail, TNF-α，IL-1β，IL-6, P65, p-P65, p-JAK2, JAK2, p-STAT3, STAT3, and β-catenin in hLECs cells were evaluated by enzyme-linked immunosorbent assay (ELISA) and western blot analysis in order ascertain the signaling pathways involved. Results: The rate of cell proliferation significantly decreased in TGFβ2+2μM EriB, TGFβ2+4μM and TGFβ2+8μM groups compared with TGFβ2 group (p < 0.001). In addition, the migration of hLECs cells and epithelial mesenchymal transition were inhibited by EriB in a dose-dependent way (p < 0.001). ELISA results showed that compared to TGFβ2 group, TNF-α, IL-1β and IL-6 levels in EriB group significantly decreased (p < 0.001). The levels of TNF-α, IL-1β, IL-6, p-P65/P65, p-JAK2/JAK2, p-STAT3/STAT3 and metastasis-associated proteins (α-SMA and snail) in hLECs cells were downregulated by EriB (p < 0.001). Furthermore, vimentin level was increased by EriB (p < 0.001). Conclusion: The results show that EriB inhibits the growth, metastasis and inflammation of hLECs cells by inhibiting JAK/STAT3 pathway, thus indicating that this pathway is a potential therapeutic target for treating catarac