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Short report: knowledge and perceptions of health workers that strengthen adherence for paediatric and adolescent clients on the intensive adherence counselling program in Kampala, Uganda: a qualitative study
Get PDFBackground: Health care workers (HWs) support HIV positive children and
adolescents with detectable HIV viral loads on the intensive adherence
counselling (IAC) program to achieve viral suppression through
individual adherence counselling. Low re-suppression rates of 23%
showed low program effectiveness in fifteen public health facilities.
Objectives: We set out to determine the knowledge and perceptions of
HWs that support this program to improve its effectiveness. Methods: We
conducted a qualitative study where five HWs that oversee clinical care
for children on ART were interviewed about the program. Data on their
knowledge of the program, and perceptions on why it was not effective
was collected. Thematic analysis using the inductive approach was used.
Transcripts were read, coded and emergent themes determined. Results:
Five HWs participated and all were knowledgeable about the program. Two
themes emerged as barriers to IAC program effectiveness, patient
factors and health system factors. Patient factors were failure to
attend appointments, failure to change adherence practices, and lack of
consent. Health system factors were work overload, delay in getting
results and drug stock outs. Conclusions: HWs are knowledgeable about
the IAC program and client specific barriers should be addressed to
improve viral suppression for children
Atrial electromechanical delay and p wave dispersion associated with severity of chronic obstructive pulmonary disease
Get PDFBackground: The aim of this study was to evaluate atrial
electromechanical delay (AEMD) with both electrocardiography (ECG) and
echocardiography in patients with Chronic Obstructive Pulmonary Disease
(COPD). Methods: Total of 110 patients were included in this
cross-sectional case-control study. P-wave dispersion (PWD) was
measured on a 12-lead ECG. Atrial electromechanical intervals (PA) were
measured as the time interval between the onset of the P wave on the
ECG and the beginning of the late diastolic A wave. Results: PWD was
found to be 40.9\ub19.2 ms in the healthy control group,
45.6\ub18.2 ms in the mild COPD and 44.8\ub18.7 ms in the severe
COPD group (p<0.05). Intra-right atrial EMD was found to be
10.7\ub15.8 ms in mild COPD, 11.0\ub17 ms in severe COPD, and it
was 16.4\ub17.3 ms in healthy control group (p<0.001). Interatrial
EMD was detected to be 29.5\ub19.1 ms in the control group,
24.1\ub19 ms in mild COPD group, and 23.9\ub111.1 ms in the severe
COPD group (p<0.001). Conclusion: Both mild and severe COPD groups
decreased PWD, increased tricuspid PA and significantly decreased
interand right intra-AEMD times in comparison to the control group
Oral health related quality of life among HIV positive patients attending two HIV outpatient clinics in Nigeria - a cross sectional study
Get PDFBackground: The human immunodeficiency virus infection remains a
devastating disease of public health importance. Objectives: To assess
the association between oral health and quality of life and the factors
affecting the oral health related quality of life among HIV positive
patients in Nigeria. Methods: This was a cross sectional study of HIV
positive patients attending two HIV outpatient clinics in Nigeria.
Impact of oral health on quality of life was assessed using the
OHIP-14. Oral health status was assessed by the DMFT and Simplified OHI
indices. Level of significance was set at p< 0.05. Results: Three
hundred and fifty-two patients were seen, 64.2% being females.
Prevalence of impact was 8.5%; and the mean OHIP scores was
8.05\ub19.54. Highest impact was \u201cpainful aching\u201d
67(19.1%) with the domain of physical pain scoring the highest mean
impact of 2.32. Most patients (88.6%) were on HAART. Following logistic
regression, after controlling for potential confounders, independent
factors associated with poor OHRQoL were perceived need for dental
treatment, HAART use, and higher DMFT (p<0.05). Conclusion: The
domain of physical pain had the highest impact, while perceived need
for dental treatment, HAART use and higher caries index were
contributory to poor OHRQoL
A comparative study of serological diagnosis of Dengue outbreak 2019
Get PDFPurpose: The interpretation & correlation of the different
laboratory parameters in positive dengue cases in order to evaluate
that which laboratory test is more significant for diagnosis of Dengue.
Methods: Prospective examination of samples (patients\u2019 serum) for
dengue virus of different genotype by using multiplex anti-dengue IgM,
IgG. We have done NS-1 test by (ICT) immunochromatographic devices, and
complete blood picture (CBC) by Sysmex XP-100. Result: Detection of
Viral RNA in 100 patients showed effects in the total of 73 (73.0%)
samples. This graphical comparison shows the whole positive cases
including dengue NS-I antigen, dengue serology (IgM & IgG), total
62 positive cases of NS-I are detected, 10 positive cases of dengue IgM
and 9 positive cases of IgG detected, in which Complete Blood Test
(CBC) shows remarkable reduction in Platelets (32 cases) and Leucopenia
in (24 positive cases). Conclusion: In this research, it is concluded
that the diagnosis of dengue cases is preliminary limited to initial
stages i.e. CBC or sometimes dengue NS-I, as dengue IgM severity is
more effective than that of Dengue NS-I & IgG. Many patients who
had negative results in CBC and NS-1 testing, became positive when IgM
and IgG serology testing has been done
Diphtheria serology in adults in Central Java and East Java, Indonesia: the importance of continuous diphtheria vaccination
Get PDFBackground: Vaccination increase immunity against diphtheria, yet will
decrease by aging. Therefore, boosters are needed to be done regularly.
Objectives: This study aims to determine the immunity to diphtheria for
the population of 16 years old and above. Methods: The sample of study
were 295 collected blood serums by Riskesdas project in 2013, the
criteria was above 15 years of age and originating from the Provinces
of Central Java or East Java inclusively. Immunity assessment was based
on antibody titer (IgG) against diphtheria using Vero Cell cytotoxicity
test. Statistical analysis was performed using the X2 test. Results:
The full protective IgG titer (>0.1 IU/ml) at the age of 16-20 years
included 75% sample with a geometric mean titer (GMT) of 0.19 IU/ml.
Yet, at the age of 21-60 years and > 60 years, full protective IgG
titers only cover 45.5% and 33.3% sample with GMT respectively 0.06 IU
/ ml. Statistical analysis showed the relationship between age and
immune status with p-value 0.003. Otherwise, no relationship between
the status of immunity with sex and residency with p-values of 0.16 and
0.43. Conclusions: The immune status against diphtheria at the age of
above 15 years decreases with aging
Presentation, etiology and treatment outcome of neovascular glaucoma in Ekiti state, South Western Nigeria
No full textBackground: Neovascular glaucoma (NVG), a form of secondary glaucoma
has varying causes across geographical locations. Objective: The
objective of this study was to determine the presentation, aetiology,
and outcome of treatment of patients with NVG in a Nigerian tertiary
hospital. Method: A retrospective review of records of all cases of NVG
seen over a 5year period was carried out. Demographic characteristics,
presenting visual acuity and coexisting ocular and systemic conditions
were noted. Data were analysed with Statistical Package for Social
Sciences (SPSS) version 25. Results: 29 eyes of patients with NVG were
analysed. Most of the patients (89.70%) presented with visual acuity
less than 3/60 in the affected eye. All patients except one were
treated with anti-glaucoma medications while only 9(31%) consented to
and received anti-vascular endothelial growth factor. No patient had
improvement in visual acuity despite resolution of other symptoms at
12week follow up. Conclusion: NVG though not as common as other forms
of glaucoma accounted for a large proportion of monocular blindness in
the affected eyes at presentation. There is need for health promotion
and education among our people on the need for early preventive eye
check practices
Effect of different cold application materials on pain during chest tube removal: three-arm randomized controlled clinical trial
No full textBackground: Chest tube causes severe pain during removal because it
attaches to the endothelium in the chest cavity. Objectives: This study
aimed to determine the effectiveness of cold application with ice pack
and gel pad in the control of pain experienced during chest tube
removal. Methods: The sample of prospective, parallel three-arm
(1:1:1), randomized controlled clinical trial consisted of 180 patients
in two experimental groups (ice pack/gel pad) and one control group.
The primary outcome was effect of cold application materials on
severity of pain during chest removal. Secondary outcomes were duration
of cold application and analgesic requirements of the patients.
Results: The study found that the cold application using either of the
materials reduced the severity of pain and the need for analgesics
after the removal of chest tube compared to the control group
(p<0.05). But cold application with ice pack allowed the skin to
drop to the temperature effective in pain control in a shorter time
than gel pad application (p<0.05). Conclusions: Despite entirely
covering the area around the chest tube, the gel pad was more
disadvantageous than ice pack in pain control due to the longer
duration of cold application
Perspectives of skilled birth attendants and pregnant women regarding episiotomy: a quantitative approach
No full textBackground: The World Health Organization recommended less than 10%
episiotomy rate for Skilled Birth Attendants (SBAs) and hospitals in
1996. More than two decades afterwards, some health facilities are
still grappling with meeting the set target. Objectives: This study
assessed the perspectives of SBAs and pregnant women regarding
episiotomy in a Nigerian university teaching hospital. Methods: A
cross-sectional design was employed. Census sampling was used to select
19 SBAS and 973 vaginal birth records from 2019, while consecutive
sampling technique was used to enrol 134 consenting pregnant women
obtaining antenatal services in the facility. Data was collected using
a three part instrument involving a data extraction sheet, episiotomy
practice questionnaire for SBAs, and feelings about episiotomy
questionnaire for pregnant women. Assembled data were summarised with
descriptive statistics. Results: The episiotomy rate was 345(35.5%).
About 266 (77.1%) of first time mothers (primips) and 79(22.9%) of
nonfirst time mothers (multips) received episiotomy. Ten (52.6%) of the
SBAs were unsure of any evidence supporting routine episiotomy. All the
19(100%) SBAs reported that there was no existing facility-based policy
regarding routine episiotomy. Seventy five (56%) of the pregnant women
reported feeling generally bad about episiotomy. One hundred and one
(82.3%) of them hinted that they will not feel satisfied if they were
given episiotomy with the reason that it ensures quick vaginal birth.
Conclusion: The rate of episiotomy was higher than global recommended
standards and primips are disproportionately affected. If organised by
professional societies, more scientific conferences on limiting
episiotomy might remedy this situation
No full textBackground: Improving the reproductive health of young women in
developing countries requires access to safe and effective methods of
fertility control. Volta Region records one of the highest prevalence
of teenage pregnancy and adolescents aged 15-19 years are the least
acceptors of contraceptives in the Region. Guided by the Theory of
Planned Behaviour, this study determined predictors of intention to use
modern contraceptives among female Senior Secondary School students in
the Kpando Municipality, Ghana. Method: A cross-sectional design was
adopted, collecting data among a multistage sample of 270 participants,
using a pre-tested self-administered questionnaire and analysing them
using Stata software Version 16 at the 0.05 level of significance.
Results: The mean age of the respondents was 16.78 \ub1 1.31. About
40.2% of the sexually experienced participants used a modern
contraceptive during ther first sexual encounter. However, the majority
(69.3%) had the intention to use modern contraceptives. Regarding
subjective norms, the majority of the significant others (63.0%) were
not supportive of modern contraceptive use and more than half of the
respondents (59.3%) had a positive attitude towards modern
contraceptive use, while 54.1% perceived that they had control over
modern contraceptive use. The majority (69.3%) had the intention to use
modern contraceptives. Perceived behavioural control was the only
significant predictor of the intention to use modern contraceptives
[AOR= 9.80 (C.I: 5.11, 18.77); p< 0.001]. Conclusion: Interventions
to increase the perception of control over contraceptive use is of the
essence. This will help increase their intention to use modern
contraceptives
Seedling production of Ceiba speciosa in different volume of tubes using biosolids as substrate
No full textUm dos problemas encontrados na forma\u447\u443o de povoamentos
visando \u440 restaura\u447\u443o florestal \u449 a qualidade
das mudas. O objetivo deste trabalho foi avaliar diferentes volumes de
tubetes para a produ\u447\u443o de mudas de Ceiba speciosa,
utilizando o bioss\u453lido como substrato. O experimento constou da
fase de produ\u447\u443o das mudas e da avalia\u447\u443o do
desempenho dessas no campo. Os tratamentos utilizados foram os tubetes
de 55, 110, 180 e 280 cm\u413. Ambas as fases do experimento foram
instaladas em delineamento inteiramente casualizado, sendo a fase de
viveiro composta por quatro repeti\u447\u455es de 12 plantas, e a
fase de campo composta por 20 mudas de cada tratamento, com altura e
di\u442metro mais pr\u453ximos da m\u449dia da \u45altima
avalia\u447\u443o realizada no viveiro. Utilizando-se o
bioss\u453lido como principal componente do substrato para a
produ\u447\u443o das mudas de Ceiba speciosa, e para as
condi\u447\u455es de s\u44dtio em que foi implantado o povoamento
florestal, recomenda-se o uso do tubete de 110/cm3, pois neste ocorreu
crescimento similar ao das plantas nos tubetes de maior volume,
resultando em menor volume de substrato, menor \u441rea ocupada no
viveiro e maior facilidade de transporte e manejo.One of the problems encountered in the formation of stands aimed at
forest restoration is the quality of the seedlings. The objective of
this study was to evaluate the different volumes of tubes for the
seedling production of Ceiba speciosa, using biosolids as a substrate.
The experiment consisted of the seedlings production stage and
evaluation of the performance in the field. The treatments were the
tubes of 55, 110, 180 and 280 cm\u413. Both phases of this experiment
were installed in a completely randomized design, with the stage of
seedling production composed by four repetitions of 12 plants, and
field stage composed by 20 seedlings from each treatment, with height
and diameter closer to the average for the last assessment carried out
in the nursery. Using biosolids as the main component of the substrate
for the production of Ceiba speciosa seedlings, and for the site
conditions where the forest stand was implanted, it is recommended to
use the 110/cm3 tube, because in this tube occurred growth similar to
plants in the tubes of larger volumes, resulting in lower volume of
substrate, smaller area occupied in the seed-plot and greater ease of
transport and handling