Journal of Ideas in Health
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Prevalence and detection of SARS-CoV-2 by RT-PCR: an analytical study
Get PDFBackground: The COVID-19 pandemic has significantly affected the healthcare system. RT-PCR has played a major role in the confirmation of SARS-CoV-2 thus helping in an early diagnosis, clinical interventions and patient isolation. This study was conducted to ascertain the importance of RT-PCR testing among symptomatic and asymptomatic cases in different age groups with association to infection.
Methods: This retrospective cohort study was conducted from August 2020 to August 2021, in the Department of Microbiology, Autonomous State Medical College and Sarojini Naidu Memorial Hospital, Firozabad, Uttar Pradesh, India. Samples were collected from a total of 342, 281 cases which comprised of symptomatic patients (ILI, SARI), asymptomatic contacts, those seeking hospitalization, travelers and were subjected to testing by RT-PCR. The cases were divided into group A of patients presenting with symptoms ≤7 days, group B of patients with signs and symptoms >7 days and group C comprised of asymptomatic cases. The symptoms of patients were associated with the Ct values of the E/N screening gene and the RdRp/ORF1ab confirmatory genes. The Chi-square test was done to test the statistical significance of association of symptomatic patients with the outcome of the test.
Results: The number of positive samples were 4,342 showing a prevalence of 1.3%. The maximum prevalence of infection was found in the age group of 20-29 years followed by the age group 30-39 years (p-value <0.05). The maximum positivity and high viral load were seen in the patients who presented with symptoms ≤7 days with Ct values ≤25.
Conclusion: The maximum infection was found in the young age group. The screening and confirmatory genes could be detected in the samples of asymptomatic cases also which was helpful in isolating them and breaking the chain of further spread of the virus
Evaluation of first hospital entry and hospitalization related prescription polypharmacy targeting patients of fifty years old and more at a general hospital, Duhok, Iraq: Polypharmacy in elderly patients
Get PDFBackground: Polypharmacy is the intake of ≥ 5 medications. This study evaluates the prevalence of polypharmacy among elderly patients hospitalized during October 2023 at Azadi Hospital in Duhok, Iraq.
Methods: This was a retrospective cross-sectional study. The files of 373 patients aged ≥ 50 years were reviewed for the occurrence of polypharmacy (5 medications), major polypharmacy (6-9 medications) and excessive polypharmacy (≥ 10 medications) as well as their disease conditions.
Results: The 373 patients received 5 to 10 medications at first hospital entry, and during hospitalization (1-29 days), 220 (58.98%) of them received 5 to 12 medications. Cardiovascular disorders (44.04%) were the most encountered conditions in the hospitalized patients, followed by endocrine disorders (26.4%) and gastrointestinal disorders (8.14%). Polypharmacy occurred in 63 (16.89%) patients on the first day of hospital entry and in 73 (19.57%) during the hospitalization period. Major and excessive polypharmacy occurred among 90 (24.13%) and 2 (0.54%) of patients at the first entry and among 129 (34.58%) and 18 (4.83%) patients during the hospitalization, respectively. During hospitalization, polypharmacy significantly (Chi squared=22.655; df=1; p=1.9387˟10-6) increased by 17.43% when compared to that of the first hospital entry. The most commonly used medications at the first hospital entry were paracetamol (17.18%) followed by antibiotics (11.8%). During hospitalization the most commonly used medications were antibiotics (13.52%) followed by proton pump inhibitors (11.43%).
Conclusion: The prevalence of polypharmacy was high among elderly hospitalized patients. This condition might increase the risk of potential drug-drug interaction and the intake of inappropriate medications. Alerting clinicians about the significance of polypharmacy is necessary in prescribing and deprescribing medications to hospitalized elderly patients
The experiences of adult children caring for a parent with Korsakoff’s syndrome
Get PDFBackground: Korsakoff’s syndrome (KS) is a debilitating psychoneurological disorder that can occur in adults with alcohol use disorder (AUD). People with KS experience a sudden onset of symptoms including confabulation, anterograde and retrograde amnesias, apathy, issues with vision and gait, and lack of insight. Frequently an adult child of the parent with alcohol-induced KS becomes the caregiver, regardless of the status or quality of the relationship with their parent. While there is a rich literature base in the areas of adult children of parents with AUD and caregiving, there are no studies that have explored the experiences of adult children caring for a parent with alcohol-induced KS. This study aimed to explore the experiences of adult children who provide care for a parent or parental figure suffering from alcohol-induced Korsakoff syndrome (KS).
Method: This study used a generic qualitative approach with thematic analysis using both in person and web-based video interview methods and field notes to address this gap in the literature. Eight individuals participated in the study, men (n=2) and women (n=6), with participants ranging in age from 31 to 43 years (average age 37 years).
Results: Five themes emerged: addiction and the adult child, experiencing caregiver burden, experiencing a variety of emotions, professional healthcare experiences, and observations of symptoms. These themes emerged over seven anchor events in their caregiving experiences: interactions with their parent pre-diagnosis, parent’s medical emergency, hospitalization, diagnosis, housing, legal, and financial.
Conclusion: The results provide a foundation for future research in the areas of KS, caregiving, and adult children of parents with AUD. They also provide a basis to inform the development of interventions with this population and demonstrate a need for more awareness of KS among healthcare professionals.
Breaking the silence: navigating adolescent knowledge, attitude, and perception on substance abuse in Diyala Province, Iraq
Get PDFBackground: Drug use often leads to a range of health risks, social complications, and involvement in criminal behavior. This study aims to investigate adolescents\u27 understanding, opinions, and perspectives on substance abuse.
Methods: Between October and December 2023, a cross-sectional study was undertaken in Diyala Province, Iraq. High school students were sampled using a multistage sampling technique. Bivariate analysis utilized independent sample t-tests and one-way analysis of variance (ANOVA). Additionally, a multivariable linear regression analysis was performed to predict factors associated with knowledge, attitudes, and perceptions. All statistical analyses were carried out using SPSS version 16.
Results: The study encompassed 365 students, with a mean age (SD) of 17.5 (+ 8.2), predominantly male (57.3%). Overall accuracy rates for knowledge, attitude, and perception stood at 87.1%, 86.7%, and 88.7%, respectively. Approximately 5.2% of the sample reported cannabis (hashish) use. Regression analysis revealed significant associations between higher knowledge scores and male gender (p=0.002, 95% CI:0.341, 0.729), urban residency (p<0.0001, 95% CI:1.165, 4.524), and monthly income > US$400 (p >0.0001, 95% CI:0.907, 1573). Attitudes toward drug abuse prevention were influenced by male gender and highly educated parental backgrounds (p<0.001, 95% CI:1.412, 5.223; p=0.002, 95% CI: 2.160, 4.881; p=0.007, 95% CI:1.810, 5.690). Perception scores were significantly associated with male gender (p=0.001, 95% CI: 0.430, 0.691), students from smaller families (p=0.013, 95% CI:2.201, 5.003), and those in the sixth class (p=0.021, 95% CI:1.423, 4.202).
Conclusion: While adolescents demonstrate a solid understanding of societal norms and consequences associated with substance abuse, there may still be areas where perceptions can be refined and aligned more closely with the realities of drug abuse
Rodent reservoirs: unraveling spectrum of zoonotic and pathogenic bacteria
Get PDFBackground: Zoonotic diseases are the major public health threat, with over 70% originating from wildlife. Rodents, while beneficial to the environment, transmit many zoonotic diseases such as hemorrhagic fevers, plague, tularemia, and leptospirosis, mainly due to increased agriculture and land use changes. Understanding rodent-borne pathogens is essential for effective intervention. Therefore, this study aimed to identify pathogenic and zoonotic bacteria in rodents and identify rodent species in the study area.
Methods: A total of 116 rodents achieved samples (101 oral-pharyngeal and 15 rectal swabs) collected from Kibondo, Uvinza and Kyerwa were used in this study. Total RNA (Ribonucleic Acid) was extracted from each swab sample and then pooled based on rodent species, location and swab types to make twelve pools. A portion of pooled swabs were polyadenylated and used for metagenomics sequence libraries preparation. A 16S rRNA (ribosomal Ribonucleic Acid) metagenomics sequencing was performed on 12 pools by using MinIon platform in order to identify microbial diversity.
Results: A total of 13 different microbial communities includinng bacteria were identified; where, 15 families of potentially pathogenic, zoonotic and bacteria of unknown zoonotic potential were also identified. These families included Mycobacteriacea, Helicobacteriacea, Enterobacteriacea, Vibrionacea, Staphylococcaceae, Nocardiaceae, Bacillaceae, Pasteurellaceae, Streptococcaceae, Campylobacteraceae, Leptospiraceae, Brachyspiraceae, Moraxellaceae, Enterococcaea, Flavobacteriacea. Potentially zoonotic pathogenic bacteria including Mycobacterium tuberculosis, Vibrio cholerae, Helicobacter pylori and Vibrio parahaemolyticus are reported in this study.
Conclusion: This study identifies several bacteria of public and veterinary importance, highlighting the possibility of increased risk of human infection and risk of cross-transmission between rodents, humans, and animals given the proximity between rodents, humans and animals. While no concrete evidence of rodent-to-human transmission was found, we hypothesize that rodents are a potential infection source, especially in resource-poor areas with close rodent-human contact
Postoperative satisfaction and perception among laparoscopic cholecystectomy patients in Diyala Province, Iraq
Get PDFBackground: Over the past two decades, laparoscopic surgeries have significantly progressed, and surpassing traditional surgical methods across multiple medical fields. This study aims to assess the patients’ satisfaction and the related factors toward the laparoscopic cholecystectomy in Iraq.
Methods: A cross-sectional study was conducted from April 2023 to 30th March 2024 at the Alkalis General Hospital and Al Hayat Private Hospital, Diyala province, Iraq. Semi-structured questionnaire was recruited to collect the pre and post operative data from patients. Statistical analysis was carried out using SPSS-21, with significance set at p < 0.05.
Results: Data of 157 patients with mean age (+ Standard Deviation) of 47.57 (SD +12.80) were analyzed. Most of them (53.5%) were females, operated in public hospitals (52.2%), unemployed (51.6%), and earned less than USD 400 (60.5%). The majority of patients expressed high overall satisfaction with the laparoscopic cholecystectomy procedure (42.7% being strongly satisfied and 38.9% satisfied). In the multiple logistic regression, the patients who were operated in private hospital (OR = 4.506, 95% CI: 1.394 to 14-577; P-value= 0.012), with monthly income exceeds USD 400 (OR = 4.887, 95% CI: 1.531 to 15.601; P-value=0.007), involved in the choosing of surgery technique (OR = 5.596, 95% CI: 1.425 to 21.982; P-value=0.014), and those recommend laparoscopic cholecystectomy for others (OR = 9.100, 95% CI: 1.425 to 21.982; P-value=0.001), had the highest odds ratios. The Hosmer and Lemeshow test indicated a good fit (p = 0.552).
Conclusion: Patient satisfaction is high especially among high income patients operated in private hospital however, the perception of postoperative outcomes remains important areas of focus, particularly in regions with unique healthcare challenges like Iraq
Clinical spectrum of demyelinating disease of central nervous system and frequency of anti AQP4 and anti MOG among them: one-year single-center retrospective study
Get PDFBackground: Inflammatory demyelinating diseases of the central nervous system (CNS) are autoimmune conditions leading to significant neurological disability in adults. Recent classifications include myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD) and neuromyelitis optica spectrum disorder (NMOSD) which pose diagnostic challenges due to overlapping clinical and radiological features. This study aimed to assess the clinical spectrum among adults and children diagnosed with CNS demyelinating diseases and to find the proportion of MOG and/or aquaporin-4 (AQP4) autoantibodies amongst them.
Methods: This single-center, retrospective study examined 20 patients diagnosed with CNS demyelinating disorders between March, 2023 and February, 2024. Data pertaining to demographics, disease types, CSF analysis, MRI findings, treatment modalities, and serological profiles for anti-AQP4 and anti-MOG antibodies were collected from hospital records and evaluated.
Results: Among 20 patients [median age, 34 years (IQR, 18.75); males (n=10) and females (n=10)], acute transverse myelitis (TM) was the most common demyelinating disorder at onset (60%) followed by optic neuritis (ON) (20%). CSF analysis found elevated protein levels in 53% and pleocytosis in 33% of patients. MRI findings revealed longitudinal extensive involvement in 52% of patients, predominantly affecting the cervical and dorsal spine. Serological testing identified 15% positive for anti-AQP4 and 10% for anti-MOG antibodies. MOG+ patients were significantly younger than AQP4+ patients (mean age 16.5 vs. 36.66 years, p=0.016). Both MOG+ patients were male, with 50% presenting with acute TM and 50% with acute disseminated encephalomyelitis. Among AQP4+ patients, the male-to-female ratio was 1:2, with 66.66% presenting with acute TM and 33.33% with ON.
Conclusion: CNS demyelinating disorders primarily affect younger individuals, with TM as the most common initial disorder and extensive spinal involvement in cervical and dorsal regions. Serological testing identified three patients with anti-AQP4 and two with anti-MOG antibodies, providing valuable insights into the clinical spectrum of these disorders through cell-based assays
Assessing knowledge and readiness of senior medical students in diagnosing appendicitis
Get PDFBackground: Acute appendicitis, a common atraumatic surgical emergency, peaks in the second and third decades but can affect individuals of all ages. This study aims to evaluate the knowledge and preparedness of senior medical students in accurately diagnosing appendicitis.
Methods: A cross-sectional study was conducted from February to May 2024, targeting final-year medical students at the Faculty of Medicine, University of Diyala, Iraq. Using a universal sampling approach, a semi-structured questionnaire was employed, covering socio-demographic data and 30 questions assessing appendicitis knowledge and preparedness. Data were analyzed with SPSS version 21.0, applying descriptive statistics, with statistical significance set at P < 0.05.
Results: The study surveyed 119 senior medical students on demographics, appendicitis knowledge, risk factors, and diagnostic methods. Most participants were female (73.9%), single (83.2%), and had completed a General Surgery course (75.6%). Knowledge of appendicitis was high, with 86.6% recognizing it as appendix inflammation and 78.2% understanding perforated appendicitis. Clinical exposure was limited, with only 41.2% encountering appendicitis cases. Surgical treatment was preferred (94.9%), with laparoscopic appendectomy slightly favored (54.6%). Common symptoms like pain localization and digestive issues were well-recognized, but awareness of risk factors like diabetes (42.8%) and obesity (59.7%) varied. CT scans (74%) and ultrasound (63.1%) were considered the most effective diagnostic methods, while MRI received mixed responses (27.7% agreement).
Conclusion: This study emphasizes the need for enhanced clinical exposure, focused training on atypical presentations, education on risk factors and less common complications, and improved understanding of supportive diagnostic tests to strengthen medical students\u27 diagnostic and procedural readiness for appendicitis
A paradox of the ovulatory patterns in the living laboratory, African giant pouched rat (Cricetomys gambianus) from Tanzania
Get PDFThe African giant pouched rat (Cricetomys gambianus) has emerged as a valuable model animal deployed in biomedical and other researches with humanitarian application due to its intelligence, socio-behavior, and adaptability to captivity. This rodent lives in solitary and belongs to the family Cricetidae that synchronises sexual behavioral onset with subsequent maturation of their gonads and gametes just prior to the beginning of the short rains of Tanzania. The current study set out to investigate whether ovulation in this species is induced or spontaneous. The study involved five sexually mature intact tame females and five sexually matured vasectomized wild males. Females were monitored non-invasively for ovarian cyclicity by measuring urinary progesterone every 2 days over 84days. Females were subjected to three separate step-wise experiments with different treatments as follows: step one was singly housed, which served as the control (C), followed by Non-Physical Contact with a vasectomized male (NPC) and Physical Contact with the same vasectomized male (PC), respectively. The average urinary progesterone concentration was similar in all three treatments, with a urinary progesterone spike indicating ovulation occurring in all treatments, suggesting a spontaneous ovulating strategy. However, upon assessment of the male penis, it was revealed that part of the glans penis had small epidermal spines which somehow resembles to those reported in induced ovulators. The findings from this study on the African giant pouched rat leaves a paradox as profiles of progesterone from females strongly suggest a spontaneous pattern of ovulation although the penile morphology of males have features suggesting induced pattern of ovulation.
The role of effective patient-doctor communication in improving healthcare in Nigeria: a case study of the university of Abuja teaching hospital, Gwagwalada
Get PDFBackground: Patient-doctor communication is an important aspect of healthcare delivery. It impacts health outcomes and clinical success. This study explored the role of effective patient-doctor communication in improving healthcare in Nigeria.
Methods: This study used a mixed-methods design, integrating both qualitative and quantitative approaches. The qualitative method involved in-depth interviews with 15 doctors. The quantitative method followed a cross-sectional design, using questionnaires to collect data from 222 patients at the University of Abuja Teaching Hospital, Gwagwalada. The quantitative data from the questionnaires were analyzed using descriptive statistics, in contrast, the qualitative data from the interviews were analyzed using thematic analysis.
Results: Findings revealed that accurate diagnosis, better treatment outcomes, patient satisfaction, and early detection of potential health issues are the outcomes of effective patient-doctor communication at the University of Abuja Teaching Hospital, Gwagwalada. It was also found that doctors employ patient-centered communication, active listening, and collaborative care to effectively communicate with patients. However, language barriers and cultural differences result in dissatisfaction among doctors and patients. Additionally, an overwhelming number of patients waiting to be seen, delayed appointments, inadequate file records, disorganized workloads, and system failures are setbacks that hinder effective patient-doctor communication at the University of Abuja Teaching Hospital, Gwagwalada.
Conclusion: Effective patient-doctor communication offers great potential for improving healthcare delivery. Therefore, hiring sufficient employees will effectively aid in managing the high volume of patients. Furthermore, hospitals should employ professional interpreters proficient in local languages to facilitate effective communication. Also, when patients share their cultural beliefs, healthcare providers should educate them on how these beliefs can influence their treatment