49 research outputs found
Treatment outcome and survival status among adult patients treated for lupus nephritis in selected tertiary hospitals of Ethiopia
No full textAbstract Lupus nephritis (LN) is kidney involvement of systematic lupus erythematous that ranges from mild to severe and occurs in 60% of adult patients. Despite advances in therapy, LN morbidity and mortality remains high. There is a paucity of data regarding adult LN patient's treatment outcome, survival status, and associated factors in developing countries, particularly in Ethiopia. This study aimed to assess the treatment outcome, survival status, and associated factors of adult patients treated for LN in two selected tertiary hospitals [Tikur Anbessa Specialized Hospital (TASH) and St. Paul’s Hospital Millennium Medical College (SPHMMC)] of Addis Ababa, Ethiopia. A hospital-based retrospective cross-sectional multicenter study was conducted from January 1, 2016 to January 1, 2021. Socio-demographic, clinical, and treatment-related data were collected from patient’s medical records by using a structured abstraction checklist. Descriptive statistics were used to summarize the quantitative data as appropriate. The modified Aspreva Lupus Management Study (mALMS) criteria was applied to categorize LN treatment outcomes into complete, partial, and non-response. Multinomial logistic regression analysis was performed to identify predictors of LN treatment outcome. Patients’ survival was estimated by using Kaplan–Meier and Cox proportion regression analysis. P value < 0.05 was considered to declare statistical significance. A total of 200 LN patients were included in the final analysis. Amongst these, the majority of them (91.5%) were females. The median age of the patients was 28 (15–60) years. The mean duration of treatment follow-up was 28 months. The commonly prescribed immunosuppressive drugs during both the induction (49.5%) and maintenance (60%) phases were a combination of mycophenolate mofetil with prednisolone. Complete, partial, and non-responses at the last follow-up visit accounted for 66.5%, 18.0%, and 15.5%, respectively. Patient survival at the last follow-up visit was more than 90% for patients with complete response to the induction therapy. Non-response at the last follow-up visit was significantly associated with severe disease activity index (adjusted odds ratio [AOR] = 6.25, 95% confidence interval [CI] 1.49–26.10), presence of comorbidity (AOR = 0.21, 95% CI 0.05–0.92), baseline leucopenia (AOR = 14.2, 95% CI 1.04–201.3), partial response at the end of induction therapy (AOR = 32.63, 95% CI 1.4–736.0), and duration of induction therapy of greater than 6 months (AOR = 19.47, 95% CI 1.5–258.8). This study unveiled that lower numbers of LN patients were presented with non-response at the last follow-up visit and non-response to induction therapy was associated with lower patients’ survival rates compared with complete or partial response
Medication adherence and its associated factors among diabetic patients at Zewditu Memorial Hospital, Addis Ababa, Ethiopia
No full textAbstract Objective Diabetes is a global problem with devastating human, social and economic impact. Anti-diabetic medications play a major role in the glycemic control of patients with diabetes. However, inadequate adherence compromises safety and treatment effectiveness, leading to increased mortality and morbidity. The aim of this study was to assess adherence to anti-diabetic medications and associated factors among patient with diabetes mellitus receiving care at Zewditu Memorial Hospital. Results Among the total of 146 diabetic patients (mean age 46.5 ± 14.7), the level of adherence to anti diabetic medication was 54.8% (80) whilst 45.2% (66) of the participants were non adherent. Multiple logistic regression showed that knowledge of medication (AOR = 4.905, 95% CI 1.64–14.62, medication availability (AOR = 0.175, 95% CI 0.031–0.987) and education level (AOR = 13.65, 95% CI 1.45–128.456) were reasons for non-adherence
Medication prescribing errors in the medical intensive care unit of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
No full textHousehold food insecurity access scale and dietary diversity score as a proxy indicator of nutritional status among people living with HIV/AIDS, Bahir Dar, Ethiopia, 2017.
No full textBACKGROUND:Both household food insecurity and household dietary diversity have been found reliable in describing the dietary intake of a population. However, it had not been proven as reliable instrument for assessing nutritional status of individuals in a clinical context. There has been a need for evidence on the validity of using proxy and easy dietary indicators for nutritional status. METHOD:A facility based cross sectional study design was employed on 423 people with HIV infection visiting all ART clinics in Bahir Dar, North Ethiopia. Nutritional status was determined by computing BMI. Food insecurity was assessed using household food insecurity access scale. Dietary diversity was measured using a tool adopted from Food and Nutrition Technical Assistance Project. Data were entered to Epidata version 3.1and analyzed by SPSS version 20. Reliability analysis, sensitivity and specificity analysis were determined. RESULT:The sensitivity of the household food insecurity access scale and dietary diversity score was 87.9% and 79.8%, respectively, while their specificity was 56.2% and 70.2%. The AUC at 95% CI for the household food insecurity access scale and household dietary diversity score were 73.4 (68.4-78.4) and 73.1 (68.1-78.2) while their cut of point that maximized their sensitivity and specificity was 1 and 6 respectively. Household food insecurity access scale and household dietary diversity score were found to be reliable tools with a Cronbach's Alpha of 0.926 and 0.799, respectively. CONCLUSION:In assessing under nutrition among PLHIV especially in limited resource settings, both the household food insecurity access scale and household dietary diversity score were found valid and reliable proxy indicators for measuring nutritional status
Medication adherence and its associated factors among diabetic patients at Zewditu Memorial Hospital, Addis Ababa, Ethiopia
No full textObjective:
Diabetes is a global problem with devastating human, social and economic impact. Anti-diabetic medications play a major role in the glycemic control of patients with diabetes. However, inadequate adherence compromises safety and treatment effectiveness, leading to increased mortality and morbidity. The aim of this study was to assess adherence to anti-diabetic medications and associated factors among patient with diabetes mellitus receiving care at Zewditu Memorial Hospital.
Results:
Among the total of 146 diabetic patients (mean age 46.5 ± 14.7), the level of adherence to anti diabetic medication was 54.8% (80) whilst 45.2% (66) of the participants were non adherent. Multiple logistic regression showed that knowledge of medication (AOR = 4.905, 95% CI 1.64–14.62, medication availability (AOR = 0.175, 95% CI 0.031–0.987) and education level (AOR = 13.65, 95% CI 1.45–128.456) were reasons for non-adherence
Knowledge, attitude and practice towards insulin self-administration and associated factors among diabetic patients at Zewditu Memorial Hospital, Ethiopia.
No full textBackgroundDiabetes mellitus is a common health problem worldwide. Proper insulin administration plays an important role in long term optimal blood sugar control. Adequate knowledge and attitude about insulin self-administration could also improve the management of diabetes and eventually improve the quality of life. This study aimed to assess knowledge, attitude and practice towards insulin self-administration and associated factors among diabetic patients at Zewditu Memorial Hospital (ZMH), Ethiopia.MethodsAn institution-based cross-sectional study was conducted among 245 diabetic patients who were selected by systematic random sampling during follow-up at ZMH. The data was collected using an interviewer-administered structured questionnaire and analyzed by SPSS v.20. Binary logistic regression was used to identify associated factors of patients' knowledge and P ResultsAmong 245 patients enrolled, 53.9% were male with a mean age of 53.26 ±13.43 years and more than 84% of the patients can read and write. The overall patients' knowledge was 63.4%. Better knowledge was observed concerning timing (78.4%) and site of insulin injection (89.4%), while knowledge on the angle of inclination during insulin administration (43.3%) and complications of insulin therapy (49%) were low. Patients who were male gender, never married, government or NGO employees, urban residents, who completed elementary and higher education had a higher knowledge than their comparators. The majority (62%) of the study patients had a favorable attitude on insulin self-administration. Although the majority 177(72.2%) of the study patients have administered insulin themselves, only 120(49.0%) of the patients injected insulin appropriately at 450. Frequent repetition of the injection site was practiced among 176(71.8%) patients and 139(56.7%) injected insulin before or immediately after food intake.ConclusionPatients' knowledge and attitude seem suboptimal and malpractice of insulin self-administration was reported. Therefore, the gaps should be addressed through patient education and demonstration of insulin injection during each hospital visit
Prevalence and management practice of first generation antipsychotics induced side effects among schizophrenic patients at Amanuel Mental Specialized Hospital, central Ethiopia: cross-sectional study
No full textAbstract Background First-generation antipsychotics (FGAs) are associated with a range of adverse events which can significantly reduce patients’ quality of life and contribute to non-adherence. The aim of this study was to assess the prevalence and management practice of first generation antipsychotics induced side effects among schizophrenic patients. Methods The study was conducted at Amanuel Mental Specialized Hospital from March to June, 2017. Data from patients were collected using a pretested structured questionnaire. Demographics and side effects of antipsychotics were collected by face to face interview. Clinical characteristics, medications and previous history of adverse drug events were extracted from medical records using data abstraction format. The data were analyzed using statistical software for social sciences (SPSS) version 20. Descriptive statistics and chi-square tests were done. Statistical significance was considered at p < 0.05. Results Out of 356 participants, 300 of them had complete data and were included in the study. The mean age of participants was 33.71 ± 10.2 years. The majority, 195(65.0%), of participants were males. Most of the participants, 293(97.7%), developed FGA medication induced side effects. One hundred sixty three (54.3%) participants were treated with Trihexyphenidyl for FGAs induced side effects. Dose reduction of antipsychotics was done for 51(17.0%) participants. Most of the participants’ side effects were not managed according to American Psychiatric Association guideline; 178 (82.4%). The most common types of FGAs induced side effects were cardiovascular side effects 169(56.3%); sedation and CNS side effects 149(49.6%); and extrapyramidal side effects 114(38.0%). There is a significant association between occurrence of side effects of FGAs and duration of illness (P = 0.04). Conclusions The prevalence of first generation antipsychotics induced side effects was high. However, management practice of the side effects was minimal
The role of Transformational Leadership style on Organizational Commitment in Bahrdar city Administration Revenue office
No full textAbstract: It has become clear that organizational commitment (OC) has important implications for employees and organizations as confirmed by past researchers. This study examines the impact of transformational leadership styles on employees" organizational commitment in the Bahrdar city revenue office. The transformational leadership styles have been chosen as focus of research to investigate the impact on organizational commitment. This is imperative in order to ensure the successful management of employees and also to improve performance and achievements of organizations. The study sample size was 120employees.Two separate instruments, namely multifactor leadership questionnaire (MLQ) and organizational commitment questionnaire (OCQ), were used to measure transformational leadership styles and employees" organizational commitment respectively. The results have indicated that four dimensions of transformational leadership styles have positive and significant relationship with organizational commitment
Türk ticaret kanunu bakımından anonim şirketin yönetiminde özen ve bağlılık yükümlülüğü
No full textDuty of care and loyalty are among the general principles regulatedunder the provisions of the Turkish Commercial Code in relation to jointstock companies. But, who owes these duties and for whom they are owed isargumentative. The standard of care prescribed in the Turkish CommercialCode is also open for arguments. In addition, their application in the case ofcontrolled and controlling companies which is taken as an exception to thegeneral rule is exposed to divergent views. In this article, the author arguesthat members of the board of director, managers and any person who has orexercises managerial power owe duty of care and loyalty for the company,shareholders and third party creditors. The standard of care prescribed in theCode is also a slightly different version of the American Business JudgmentRule. And finally, there is a room for the application of the principles in thecontext of a fully controlled company. To reach these conclusions, the authoranalyzed Turkish laws and different secondary sources.Özen ve bağlılık yükümlülükleri, anonim şirketlerle ilgili olarak, TürkTicaret Kanununda düzenlenen genel ilkeler arasındadır. Ancak, yükümlülüklerinkime karşı ve kimin lehine olduğu tartışmalıdır. TTK'da öngörülen özenderecesi de tartışmalara açıktır. Buna ek olarak, genel kuralın istisnası olarakkabul edilen tam hakimiyet halinde bulunan bir şirkette durumunda bunlarınuygulaması farklı görüşlere maruz kaldıkları görülmektedir. Bu yazıda, yazar,yönetim kurulu üyelerinin, yöneticilerin ve yönetim yetkisine sahip olan ya dayetkisini kullanan kişinin şirkete, ortaklara ve üçüncü kişi alacaklılara özen vebağlılık yükümlülüğü altında olduğunu ileri sürmektedir. Kanunda öngörülenözen derecesi de Amerikan Business Judgment Rule’unden biraz farklı olaraköngörülmüştür. Ve, son olarak, tam hakimiyet halinde bulunan bir şirketteprensiplerin uygulanması için alan bulunmaktadır. Bu sonuçlara varmak için,yazar kanunlardan ve farklı ikincil kaynaklardan yararlanmıştır
