bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Competitiveness of Ceylon Tea in the World Market
Authors: Kithsiri K.H.S. Kumara , Jayamanna V.S. , Abewickrama L.M.
Published: October 2020

Competitiveness and being competitive is vitally needed to enhance the performance and to tackle challenges in the highly competitive world tea market. The prestige brand Ceylon Tea established in the past has been enjoyed by Sri Lanka having no analysis done to determine the competitiveness of Ceylon Tea in its major destinations. This study was carried out by using the CMS model to determine the competitiveness and to test the possibility of using the model for such purposes. The total change of exported quantity to a particular country could be differentiated into three corporates such as market growth effect, composition effect and the residual effect or competitive effect by using the Constant Market Share (CMS) model. Fifteen destinations of Ceylon Tea markets were selected for the study based on the total quantity of Ceylon Tea exported and the potential of the country to import Ceylon Tea. Tea import data of last fifteen years from 2003 to 2015 were used for the study. The results revealed that Ceylon Tea is found to be competitive in Russia, Kuwait, Japan, Turkey, Germany, Australia, USA, and India, and Azerbaijan, Iran, UK and Libya are found to be having potential for being competitive for Ceylon Tea. However, Sri Lanka could have maintained its share of export and increased the market share in many of these destinations by enhancing the market growth as well as composition effect. Therefore, this model could be used to determine the competitiveness of Ceylon Tea in its destination. Further, tea promotion policy decisions including brand promotion through effective marketing communication could be achieved.
Quantitative and Qualitative Losses in Paddy, Maize and Greengram Stored under Household Conditions in Anuradhapura District of Sri Lanka
Authors: Kumari J.W.P. , Wijayaratne L.K.W. , Jayawardena N.W.I.A. , Egodawatta W.C.P.
Published: October 2020

Substantial losses are common due to various reasons of durable crops during storage, which threatens economy, health and food security. Despite the frequent reports on post-harvest losses of paddy and other cereals throughout Sri Lanka, a comprehensive study has not been conducted in Anuradhapura district in recent past to assess storage losses of aforesaid commodities. Objectives of this study were to find out main types of durable crops stored following harvest, and their quantitative and qualitative losses incurred during storage period at the household level in Anuradhapura district of Sri Lanka. Data were collected throughout Anuradhapura district representing all 22 divisional secretariats. The main stored commodities were paddy, maize and greengram. The storage period varied from 4 to 12 months. The storage losses of Nadu and Samba rice varietal types respectively were highest in Palagala and Kekirawa, whereas losses were minimum in Rambewa and Galenbindunuwewa. The main qualitative losses were the presence of damaged seeds, grain flour/dust, grains without kernel and faecal matter. The study highlights that severe quantitative and qualitative losses occur during storage of rice, maize and greengram, and appropriate remedial measures are needed to be developed to minimize the said losses ensuring food security.
A Rapid Shift from Chronic Hyperoxia to Normoxia Induces Systemic Anaphylaxis via Transient Receptor Potential Ankyrin 1 Channels on Mast Cells
Authors: Matsuda Kenshiro , Arkwright Peter D. , Mori Yasuo , Oikawa Masa-aki , Muko Ryo , Tanaka Akane , Matsuda Hiroshi
Published: October 2020

Extensive activation of mast cells is the major switch that triggers systemic anaphylaxis, resulting in the subsequent release of anaphylactic mediators into circulation. We previously demonstrated that rapid changes in oxygen tension lead to mast cell degranulation, and the released tryptase triggers retinal angiogenesis in a murine oxygen-induced retinopathy model. However, whether a rapid shift from hyperoxia to normoxia (relative hypoxic stress) is a risk factor for systemic anaphylaxis remains unknown. In this study, we demonstrated that the relative hypoxia stress induces systemic mast cell activation via transient receptor potential ankyrin 1 (TRPA1) channels, which immediately leads to hypothermia and increased vascular permeability in adult mice. Although mast cell–deficient or TRPA1-deficient mice did not exhibit anaphylactic symptoms following a rapid sift to normoxia, preinjection with bone marrow–derived cultured mast cells (BMCMCs) derived from wild-type TRPA1-expressing mice restored anaphylactic responses. In addition, we found that the rapid reductions in oxygen tension in a culture atmosphere triggered the degranulation of BMCMCs derived from wild-type TRPA1-expressing mice but not that of BMCMCs derived from TRPA1-deficient mice. In human LAD2 mast cells, the relative hypoxic stress led to the degranulation, which was suppressed by the addition of a TRPA1 inhibitor. Gradual reductions from hyperoxia to normoxia led to no anaphylactic symptoms. Our results demonstrated that TRPA1-triggered mast cell degranulation is a novel pathway that induces anaphylactic shock without Ag–Ab reactions. These findings introduce a potential role for oxygen in inducing mast cell–dependent anaphylaxis and highlight the need to reconsider chronic pure oxygen therapy for anoxic diseases.
A case of post-inflammatory warty dyskeratoma of the chest: Other dermoscopic features
Authors: Ingordo Vito , Ferrara Gerardo , Ingordo Irene , Argenziano Giuseppe
Published: October 2020

Warty Dyskeratoma (WD) is a rare condition consisting in single or multiple papular or nodular lesions of the skin or of the oral mucosamucosa. Histologically, a cupshaped epidermal invagination centred by a plug of epidermal hyperparakeratosis with suprabasal acantholysis and dyskeratosis is typically observed. A case of post-inflammatory WD, which was also observed by dermoscopy, is described. Dermoscopy showed an eight-shape whitish collarette surrounded by light brown pigmentation. A central white structureless area with an adjacent rosette were observed. Some small rust-coloured blood crusts were also observed in the centre of the lesion; no prominent vascular pattern was detected. The etiopathogenesis of this benign neoplasm could be multifactorial. Dermoscopy of WD is not specific but may help to ruling out other skin tumors.
Evaluation of spinopelvic parameters in lumbar prolapsed intervertebral disc
Authors: Poonia Apoorva , Lodha Sambhav , Sharma N C
Published: October 2020

Background: Sacro-pelvic morphology and orientation are usually described in terms of pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). Orientation and morphology of pelvis can affect degenerative changes in the lumbar spine. Thus, here we investigated the relationships between various sagittal spinopelvic parameters and the degree of disc degeneration in young adults. Material and Methods: A hospital-based cross-sectional study with a total of 60 cases was done. Patients presenting with back or leg pain having prolapsed disc on magnetic resonance imaging (MRI) were included in the study. A standing X-ray of LS spine from dorso-lumbar junction to mid-thigh was taken. Various spinopelvic parameters were assessed from the scannogram using the software. Results: The mean age was 39.27 years. L5S1 was the most common level. Mean SS, PT, PI, and LL were 37.78°, 13.52°, 51.33°, and 41.01°. Disc pathologies at L1L2, L2L3, and L4L5 level showed a positive correlation with PT, PI, and LL. Disc pathology at the L5S1 level shows a positive correlation with PT and LL. A statistically significant correlation between SS and degenerative spondylolisthesis at L4L5 was found from data with P = 0.023. Discussion: An increase in SS statistically significantly increases the chance of development of degenerative spondylolisthesis at L4L5. An increase in PT, PI, and LL will cause an increase in disc pathology at L1L2. An increase in SS, PT, PI, and LL will cause an increase in disc pathology at L2L3. An increase in SS, PT, PI, and LL will cause an increase in disc pathology at L4L5. An increase in PT and LL will cause an increase in disc pathology at L5S1. Conclusion: Standing lateral view radiograph from dorso-lumbar junction to the mid-thigh is as good as standing whole spine radiograph for measurement of spinopelvic parameters. Degenerative spondylolisthesis at L4L5 has a statistically significant correlation with an increase in SS.
PET-CT upstaging of unilateral operable breast cancer and its correlation with molecular subtypes
Authors: Singh Srishti , Raghavan Bagyam , Geethapriya Sivaramalingam , Sathyasree V V , Govindaraj Jayaraj , Padmanabhan G , Krishna Murali , Arafath Rasheed
Published: October 2020

Context: Prognosis and survival rates for breast cancer vary greatly depending on the cancer stage of the patient. Instead of a step-by-step approach using multiple investigations, we can get all the information about the metastatic load of the disease in PET-CT imaging by one single investigation. There is also a correlation between prognosis, FDG uptake, and molecular subtype of breast cancer (Luminal A, Luminal B, Human epidermal growth factor receptor 2 (HER2) positive and Triple-negative). Pre-treatment baseline PET-CT scan was done in 156 unilateral early and operable breast cancer patients from November 2017 to April 2019 in our prospective observational study.

Aims:

Results:

Conclusions:
Malignant perivascular epithelioid cell tumor of the ileum on 18F-fluorodeoxyglucose positron emission tomography/computed tomography with pathological correlation
Authors: Das Jeeban , Bou-Ayache Jad , Gollub Marc , Riedl Christopher , Ulaner Gary
Published: October 2020

A 75-year-old woman presented with a 1-month history of abdominal pain. Contrast-enhanced computed tomography (CT) demonstrated a large solid mass in the left lower abdominal quadrant, suspicious for malignancy. Staging with 18F-fluorodeoxyglucose (FDG) positron emission tomography/CT imaging demonstrated intense FDG uptake in the mass with no evidence of metastatic disease. Complete surgical resection was performed, and histopathological analysis confirmed a malignant perivascular epithelioid cell tumor of the ileum.
Diffuse bone marrow uptake related to granulocyte colony-stimulating factor-producing maxillary sinus carcinoma on 4-borono-2-18F-fluoro-L-phenylalanine positron emission tomography/computed tomography
Authors: Kusumahstuti Kharisma , Watabe Tadashi , Kitamura Naoya , Yamamoto Tetsuya
Published: October 2020

Granulocyte colony-stimulating factor (G-CSF) can be produced by tumor cells and is known to promote tumor growth, thereby potentially accelerating disease progression. Squamous cell carcinoma (SCC) at maxillary sinus is aggressive growth with poor prognosis. Maxillary sinus carcinomas are rare and can be clinically silent in the early stages or manifest with the same signs and symptoms of more common illnesses, leading to their delayed diagnosis of disease. Hypermetabolic uptake of 18F-fluorodeoxyglucose (18F-FDG) but not of 4-borono-2-18F-fluoro-L-phenylalanine (18F-FBPA), in the bone marrow of patients with G-CSF-producing tumors without bone marrow involvement during positron emission tomography (PET), has been reported. The present case report describes our first experience of bone marrow uptake in PET/computed tomography examination using 18F-FBPA, high uptake seen in the bone marrow of a patient with a G-CSF-secreting SCC of the maxillary sinus that it relapsed following chemoradiation therapy and surgical resection of the tumor.
The Unexamined Diversity: Disability Policies and Practices in US Graduate Medical Education Programs
Authors: Meeks Lisa M. , Taylor Nichole , Case Ben , Stergiopoulos Erene , Zazove Philip , Graves Lisa , McKee Michael , Swenor Bonnielin K. , Salgat Anah , Cerilli Caroline , Joshi Heidi , Moreland Christopher J.
Published: October 2020

Background

Graduate medical education (GME) institutions must ensure equal access for trainees with disabilities through appropriate and reasonable accommodations and policies. To date, no comprehensive review of the availability and inclusiveness of GME policies for residents with disabilities exists.

Objective

We examined institutions' compliance with Accreditation Council for Graduate Medical Education (ACGME) requirements and alignment with Association of American Medical Colleges (AAMC) policy considerations.

Methods

Between June and August 2019, we conducted a directed content analysis of GME institutional policies using the AAMC report on disability considerations and the ACGME institutional requirements as a framework.

Results

Of the 47 GME handbooks available for review, 32 (68%) included a disability policy. Forty-one of the 47 (87%) handbooks maintained a nondiscrimination statement that included disability. Twelve of the 32 (38%) handbooks included a specific disability policy and language that encouraged disclosure, and 17 (53%) included a statement about the confidential documentation used to determine reasonable accommodations. Nineteen of the 32 (59%) maintained a clear procedure for disclosing disabilities and requesting accommodations.

Conclusions

While disability policies are present in many of the largest GME institutions, it is not yet a standardized practice. For institutions maintaining a disability policy, many lack key elements identified as best practices in the AAMC considerations.
Editorial message
Authors: Haileamlak Abraham
Published: October 2020

Message from editor in chief.
Quality of Life People Living with HIV/AIDS and Its Characteristic from a VCT Centre in Indonesia
Authors: Handayani Sri , Ratnasari Nita Yunianti , Husna Putri Halimu , . Marni , Susanto Tantut
Published: October 2020

BACKGROUND: The quality of life (QoL) construct has also contributed to understanding the comprehension of factors involved in the existence of people infected by the HIV/AIDS. The objective of this study is to assess the quality of life (QoL) of people with HIV/AIDS (PLWHA) in Wonogiri District, Indonesia.METHODS: A cross-sectional study was conducted from September to November 2017. Convenience sampling method was employed to recruit 39 people living with HIV/AIDS (PLWHA) at Voluntary Counselling and Testing (VCT) of Wonogiri, Indonesia. Research data were collected using a self-administered questionnaire of WHOQOL-HIV BREF. The data were further analysed using a ttest and a Chi-square test, while linear regression was used to evaluate factors that correlate with the PLWHAs’ quality of life.RESULTS: The results showed that the gross mean score of social relationships domain is 13.59; psychological domain is 13.31;environment domain is 13.28; spiritual/personal beliefs domainis 13.15; physical domain is 13.10; and level of independence domain is 13.77. The symptom of HIV is associated with quality of life (B =7.611, β = 0.362, t = 2,046, p value = 0.049).CONCLUSION: Healthcare provider should increase providerinitiated testing and counselling (PITC) to contracting group, high risk group, susceptible group, and the community. The PLWHA are recommended to actively participate in peer support groups (PSGs) so that they can improve their quality of life.
Helping Babies Survive Training Programs: Evaluating a Teaching Cascade in Ethiopia
Authors: Steven Weinberg , Denise Jones , Bogale Worku , Megerssa Kumera , Carl Bose , Jacquelyn Patterson
Published: October 2020

Background: 2.6 million neonates die annually; the vast majority of deaths occur in low- and middle-income countries (LMICs). The Helping Babies Survive (HBS) programs are commonly used in LMICs to reduce neonatal mortality through education. They are typically disseminated using a train-the-trainer cascade. However, there is little published literature on the extent and cost of dissemination. In 2015, the Ethiopian Ministry of Health and partner organizations implemented a countrywide HBS training cascade for midwives in 169 hospitals.Methods: We quantified the extent of HBS dissemination, and characterized barriers that impeded successful hospital-based training by surveying a representative from each of the 169 participant hospitals. This occurred from September 2017 to April 2018. We also assessed the cost of the training cascade. To assess acquisition of knowledge and skill in the training cascade, multiple-choice question examinations (MCQE) and objective structured clinical evaluations (OSCE) were conducted.Results: Hospital-based training occurred in 132 participant hospitals (78%). 1,146 midwives, 69% of those employed by participant hospitals, received hospital-based training. Barriers included lack of preparation of hospital-based educators and limited logistical support. The cascade cost an average of 2,105 USD per facility or 197 USD per trainee. Knowledge improved and skills were adequate for regional workshop attendees based on MCQE and OSCE performance.Conclusion: The train-the-trainer strategy is an effective and affordable strategy for widespread dissemination of the HBS programs in LMICs. Future studies should assess knowledge and skill acquisition following the variety of pragmatic training approaches that may be employed at the facility-level.
Prevalence of Low Birth Weight and Prematurity and Associated Factors in Neonates in Ethiopia: Results from a Hospital-based Observational Study
Authors: Berhane Melkamu , Workineh Netsanet , Girma Tsinuel , Lim Ruth , J Lee Katherine , D Nguyen Cattram , Neal Eleanor , M Russell Fiona
Published: October 2020

BACKGROUND: Low birth weight and prematurity are associatedwith increased morbidity, mortality and multiple short and longtermcomplications, exerting impacts on the individual, thefamilies, the community and the health care system. Fetal,maternal and environmental factors have been associated with lowbirth weight and prematurity, based primarily on researches fromhigh-income countries. It is unknown whether these risk factorsare the same in low and middle income countries. The aims of thisstudy are to determine the prevalence of low birth weight andprematurity and associated factors in Jimma University SpecializedHospital, Ethiopia.METHODS: This observational study was conducted at JimmaUniversity Specialized Hospital, Ethiopia, from December 2014 toSeptember 2016. Multivariable logistic regression was used todetermine the associated factors, with results reported as oddsratios (OR) and 95% confidence intervals (CI).RESULTS: The prevalence of low birth weight and prematuritywere 14.6% and 10.2%, respectively. The mean birth weight was2,975g (standard deviation 494). Prematurity (OR 23.54, 95%CI15.35-36.08, p<0.001) and unmarried marital status (OR 5.73,95%CI 1.61-20.40, p=0.007) were positively associated with lowbirth weight. Female sex (OR 1.69, 95%CI 1.18-2.42, p=0.004) andunmarried marital status (OR 4.07, 95%CI 1.17-14.14, p=0.027)were positively associated with prematurity.CONCLUSION: The prevalence of lower birth weight andprematurity in this study is lower than other studies reported fromsimilar facilities. Prematurity and unmarried marital status areassociated with LBW whereas female sex and unmarried maritalstatus are associated with prematurity in this population.
Histogenesis and Histomorphometric study of Human Fetal Small Intestine
Authors: MN Salva , Gupta Chandni , Kumar Pandey Arvind , Kumar Nitesh , R Kotian Sushma , G Kalthur Sneha
Published: October 2020

Background: Intestine plays a major role for the normal growth of the fetus during the prenatal period. The process of the embryonic development is not quantified histologically. Therefore the main aim of the study was to measure the thickness of all part of the wall of the small intestine that are mucosa, submucosa and muscularis externa and to look for the appearance of the Brunner’s glands and Peyer’s patches in the submucosa of duodenum and ileum.Methods: The present study was carried out on 30 fetuses of gestational ages ranging from 11-36 weeks. Ten fetuses from each trimester were used in the study. Fetal small intestine were dissected carefully, and were separated as duodenum, jejunum & ileum and fixed in formalin solution. The tissue was processed for histology and then slides were stained with Haematoxylin and Eosin. The microscopic features were noted using light microscope.Results: The thickness of the mucosa, submucosa and the muscularis externa was observed to be increased in first trimester, decreased in the second trimester and again increased in the third trimester, which could be because of the increase cell turnover and the arrangement of the collagen fibers as to support the mucosa and the muscularis externa.Conclusion: Thus, the knowledge of the histogenesis and histomorphometry of the human fetal small intestine is crucial for the adult gastroenterologist to appreciate, because of the potential for these early life events to affect the responsiveness of the intestine to physiological or pathological challenges in later life.
Depression and Associated Factors Among the Patients with Type 2 Diabetes in Rwanda
Authors: MUKESHIMANA Madeleine , CHIRONDA And Geldine
Published: October 2020

Background: Various studies have found a greater prevalence of depression among patients having one or more chronic non communicable disease like diabetes mellitus than in the general population. This co-morbidity is linked with serious health consequences such as high mortality and morbidity, debility, low quality of life and increased health costs. The aim was to determine the prevalence of depression among patients with diabetes attending three selected district hospitals in Rwanda. Sociodemographic factors associated with depression were also explored.Methods: It was a descriptive cross sectional study. A sample of 385 was selected randomly to participate in the study and 339 complete the questionnaires making a response rate of 88%. The Patient Health Questionnaire-9 (PHQ-9) was used to screen depression. Descriptive and inferential analysis were done.Results: The majority of respondents 83.8% (n=284) had depression. Among them 17.9% (n=61) had moderately severe to severe depression while 81.9% (n=223) had minimal to moderate depression. A statistically significant association was found between age and depression (p=0.01) also between gender and depression (p=0.02). Significance was determined at P<0.05.Conclusion: we found a high prevalence of depression among patients with diabetes. The regular screening of depression among these patients is recommended.
Evaluation of Dental Anxiety and Fear in Patients who Admitted to the Faculty of Dentistry: Which Patients are More Risky in terms of Dental Anxiety.
Authors: YAKAR Burkay , KAYGUSUZ Türkkan Öztürk , PİRİNÇCİ Edibe
Published: October 2020

Background: Dental anxiety and fear make the dental operation and the treatment difficult. Beside that it causes the delays or absence in the dental appointments so it leads to problems for oral and dental health. The aim of this study was to investigate the frequency of dental anxiety, the factors affecting dental anxiety and the effects of dental anxiety on oral dental health of the participants.Methodology: We conducted a hospital-based, cross-sectional study among 342 patients attending the outpatient clinic of a tertiary dentistry hospital. Dental anxiety and trait anxiety levels of the participants measured using MDAS and STAI scales. Weconducted the student t-test, One-way Anova and Tukey’s post hoc for the analysis of our data. The Pearson’s correlation analysis has been used for the analysis of two different quantitative data obtain from MDAS and STAI scales.Results: The age average of 342 participant of our research was 34,41±11,78. 59,1% of our participants was women. (n=202) Dental anxiety was existing in the 42,1% of the participants (n=144). 56,4% of the participants have had a hard and painful dental treatment experiences. 15,2% of our participants (n=52) had MDAS 19 point or more.Conclusions: High and statistically significant dental anxiety scores have been detected for the patients who are women, housewives, who had uneasy and painful dental treatment stories who have personel inclinations to the anxiety. Examinations directed to the factors which would increase the dental anxiety, may prevent possible complications and also the risk carried by the patients related to the dental health may be estimated with the help of this kind of examinations.
Increased Uric Acid and Life Style Factors Associated with Metabolic Syndrome in Thais
Authors: Suwit Klongthalay  , Kanjana Suriyaprom
Published: October 2020

BACKGROUND: The prevalence of metabolic syndrome (MS) has been continually increasing in developing countries especially in Thailand. Although insulin resistance and central obesity are initially considered as significant risk factors, the other causal factors leading to the development of MS continue to challenge the investigators. The aims of this study were to evaluate the prevalence of MS in Pathum Thani province, Thailand and to investigate the relationship between MS and risk factors.METHODS: This cross-sectional study was performed with 202 Thai volunteers. Anthropometric-biochemical variables and blood pressures in each subject were measured.RESULTS: Almost one-third (32.7%) of the participants were diagnosed with MS based on the harmonized criteria, and one of the most significant risk factors is the elevated blood pressure. Weight, BMI, waist and hip circumferences, waist-hip ratio, blood pressure, glucose, triglycerides and uric acid were significantly higher in subjects with MS subjects. However, HDL-C levels were significantly lower in subjects with MS, compared to subjects without MS (p<0.001). The results of regression model after adjustment for age and gender showed that the increased serum uric acid level (OR=1.31, 95%CI: =1.04-1.66), cigarette smoking (OR=3.72, 95%CI: =1.51-9.15) and physical activity (OR=0.36, 95%CI: =0.19-0.67) were significantly related to MS.CONCLUSIONS: These findings suggest that the decrease of uric acid level, the promotion of physical activity and smoking cessation may decrease the risk of developing MS among Thais.
Experience and Challenges of Objective Structured Clinical Examination (OSCE): Perspective of Students and Examiners in a Clinical Department of Ethiopian University
Authors: Getu Ataro  , Solomon Worku  , Tsedeke Asaminew
Published: October 2020

BACKGROUND: Invented nearly half a century ago, Objective Structured Clinical Examination (OSCE) is overwhelmingly accepted clinical skills assessment tool and has been used worldwide for evaluating and teaching learners’ competences in health care disciplines. Regardless of factors affecting the attributes, OSCE is considered as reliable and powerful tool with certain validity evidences. In spite of its advantages and various promotion efforts, the progress of OSCE implementation in Ethiopian public universities has not been satisfactory. Therefore, the objective of this study was to explore the experience and challenges of OSCE implementation from the perspective of clinical year-II medical students and their examiners in Ob-Gyn Department of Jimma University.METHODS: Forty-nine students and seven examiners voluntarily participated in Ob-Gyn Department where OSCE has been used as one of summative assessment methods. Qualitative study design using structured open-ended questionnaire as a tool and descriptive phenomenology as underpinning method were employed. Collaizzi’s descriptive analysis was used as phenomenological analysis approach.RESULT: Poor organization, inadequate student preparation time, and inadequate number and duration of stations were thematically emerged as umbrellas of factors negatively affecting OSCE implementation. Satisfaction with OSCE was the only theme with findings that encourage OSCE implementation.CONCLUSION: There should be team approach, shared responsibility and proper planning among faculty to minimize hindering factors of OSCE implementation. Besides faculty development on OSCE, the department should improve skill lab utilization arranging schedule for both students and faculty members to increase guided students’ exposure to simulation-based learning and ultimately enhance OSCE implementation.
The Effectiveness of Aromatherapy in the Management of Labor Pain and Anxiety: A Systematic Review
Authors: Mahbubeh Tabatabaeichehr  , Hamed Mortazavi
Published: October 2020

BACKGROUND: Aromatherapy as an alternative and complementary medicine is a well-known method for reducing the symptoms of various physiological processes such as labor experience. The aim of this study was to systematically review the currently available evidences evaluating the use of aromatherapy for management of labor pain and anxiety.METHODS: In a systematic review, 5 databases (PubMed, SCOPUS, Web of Science, Google Scholar and Scientific Information Database [SID]) were searched, from database inception up to December 2019. Keywords used included (aromatherapy OR "“essential oil” OR "aroma*") AND (pain OR anxiety) AND (labor OR delivery). Using the Cochrane Collaboration's 'Risk of bias' method; the risk of bias in the included studies was evaluated.RESULTS: A total of 33 studies were verified to meet our inclusion criteria. Most of the included studies were conducted in Iran. Aromatherapy was applied using inhalation, massage, footbath, birthing pool, acupressure, and compress. The most popularly used essential oil in the studies was lavender (13 studies), either as a single essential oil or in a combination with other essential oils. Most of included studies confirmed the positive effect of aromatherapy in reducing labor pain and anxiety.CONCLUSION: The evidences from this study suggest that aromatherapy, as a complementary and alternative modality, can help in relieving maternal anxiety and pain during labor.
Postnatal Care within One Week and Associated Factors among Women Who Gave Birth in Ameya District, Oromia Regional State, Ethiopia, 2018: Cross Sectional Study
Authors: Teshome Melesse Belihu  , Ababe Tamirat Deressa
Published: October 2020

BACKGROUND: Globally recorded large number of maternal and neonatal deaths are related to complications during pregnancy, childbirth and post-partum. Most neonatal deaths occur during the first week of life. It is also evidenced that the level of postnatal care utilization in Ethiopia is very low. This study aimed to assess postnatal care utilization within one week and associated factors among women who had given birth in the last six weeks in Ameya district, Oromia, Ethiopia.METHODS: Cross sectional study design was employed on 332 study participants who were selected by systemic sampling method and interviewed using structured questionnaires. The data were analyzed using SPSS version 23.0. Bivariate and multivariate logistic regression analysis was used to identify the associated factors with the outcome variable. Figures, tables and sentences were used for the presentation of descriptive statistics.RESULT: The finding revealed that the proportion of postnatal care utilization within one-week in the study area is 25.3%. Partner occupation[AOR=5.575, 95% CI= (1.071, 29.023)], mothers who had complication during labor and delivery[AOR=7.841, 95% CI= (2.287, 26.879)], distance from mothers to health facilities[AOR=5.127, 95% CI= (1.149, 22.878)] and awareness on postnatal care within one week services[AOR=4.161, 95% CI= (1.300, 13.314)] were the main contributing factors of postnatal care utilization within one-week.CONCLUSION: Postnatal care utilization within one-week is very low (25.3%). Partner occupation, complication during labor and delivery, distance from health facilities and awareness on postnatal care within one week service were the associated factors.
Vitamin D Levels in Patients Presenting with Non-Specific Neuromuscular Pain and Fatigue in Ethiopia
Authors: Guta Zenebe
Published: October 2020

BACKGROUND: Vitamin D is an important micronutrient impacting multiple physiologic functions including calcium, phosphorus and bone metabolism. Various studies demonstrate low vitamin D levels in non-specific neuromuscular pain disorders and chronic-fatigue-syndromes. This observation was supported by significant improvement of these disorders following Vitamin D supplementation. Several studies demonstrate low serum vitamin D levels in healthy adult Ethiopians despite availability of abundant sunlight.METHOD: Retrospective medical records review of 62 patients presented to Yehuleshet Specialty Clinic between March 2014- August 2015 with non-specific neuromuscular pain and fatigue. Serum vitamin D levels were obtained at initial clinic visit.RESULTS: The mean (±SD) age was 51.5 ±15.5 years. Two-third (69.4%) of the participants were female. The majority (56.5%) presented with mixed symptoms, including generalized body ache, paresthesia, neck and back pain, while 45.2% reported fatigue. Fifteen (24.2%) participants were on antiepileptic drugs. All patients had initial serum vitamin D levels < 30 ng/ml, among these 62.9% demonstrated severe deficiency (< 12 ng/ml). Thirty (48.4%) participants reported symptomatic improvement after treatment with standard doses of vitamin D and calcium. Age > 50 years, being housewife, use of antiepileptic medications (AEDs), and higher serum parathyroid hormone are associated with severe vitamin D deficiency.CONCLUSION: This study demonstrated high prevalence of vitamin D deficiency among patients with non-specific neuromuscular pain and fatigue. Vitamin D replacement resulted in significant clinical improvement. It is important to screen vitamin D in individuals with limited sunlight exposure and patients on AEDs when presenting with neuromuscular pain and fatigue.
Willingness of Family Caregivers to Consent to Relative’s Postmortem Examination that Die Suddenly in a Nigerian Tertiary Hospital
Authors: Samuel Anu Olowookere  , Adegboyega Adeleke Abiodun  , Joseph Gbenga Omole  , Akinwumi Oluwole Komolafe  , Akintunde Julius Olowookere  , Emmanuel Akande  , Ayodeji Babalola  , Oriyomi Sanni  , Joshua Ajala  , Thomas Ifogah
Published: October 2020

BACKGROUND: Postmortem examination is necessary to diagnose the cause of sudden death, and family caregivers are expected to consent to this examination. This study assessed knowledge, attitude, practices and willingness of family caregivers to consent to postmortem examination of their relative if they die suddenly in a Nigerian tertiary hospital.METHODS: Descriptive cross-sectional study of family caregivers of our patients that completed an interviewer administered semistructured questionnaire assessing their knowledge, attitude, practices and willingness to consent to postmortem examination of their relative if they die suddenly. Data were analyzed using descriptive and inferential statistics.RESULTS: A total of 224 caregivers were interviewed. The mean age (SD) was 34.95 (11.74), ranging 22-75 years. They were parents (32.6%), siblings (37.9%), spouses (11.2%) and other relatives (18.3%). Only 17% had adequate knowledge, 44.6% positive attitude and 11.2% good practices to postmortem examination of sudden death. The majority (75.9%) would consent to postmortem examination of their relatives if they die suddenly. Sociodemographic variables associated with willingness to consent to postmortem examination after relative’s sudden death include being male (AOR 3.61; 95%CI 3.09-8.92; p=0.001), having tertiary education (AOR 4.83; 95%CI 1.01-8.29; p=0.034), Christianity (AOR 2.59; 95%CI 1.25-5.35; p=0.010) and skilled worker (AOR 1.43; 95%CI 1.33-3.80; p=0.020).CONCLUSION: Some family caregivers would not consent to postmortem examination of their relatives when they die suddenly. Sensitization programs targeting family caregivers are necessary to increase knowledge and enhance prevention of sudden death as well as improve willingness to consent to postmortem examination when their relatives die suddenly.
The Effect of an Educational Plan Based on the Roy Adaptation Model for Fatigue and Activities of Daily Living of Patients with Heart Failure Disease
Authors: Mahdieh Abdolahi  , Mohammad Mahdi Doustmohamadi  , Hojjat Sheikhbardsiri
Published: October 2020

BACKGROUND: Cardiac failure is one of the most common chronic diseases with high rate of morbidity and mortality. Fatigue and decreased ability to perform daily activities are of the most common complications of this disease. The purpose of this study was to determine the effect of an educational plan based on Roy adaptation model on fatigue and daily activities in patients with heart failure.METHODS: This experimental study was performed on 60 heart failure patients admitted in two educational hospitals supervised by the Kerman University of Medical Sciences in 2019. Sample was randomly assigned into two intervention and control groups. The intervention group received the care plan through a face-toface and group training program in 6 sessions at one month. Interval followed by a follow-up period for 4 weeks later. Fatigue level was calculated based on piper fatigue scale, and daily activities were calculated by Barthes scale.RESULTS: The finding indicated that there was a significant difference between the two groups (control and intervention) after the intervention. The result showed that the intervention group had significantly lower mean scores in fatigue and higher mean scores in daily activities compared to the control group after intervention P ≤ .05. There was a significant relationship between fatigue and daily activities of life with frequency of hospitalization and duration of disease in both groups, P ≤ .05.CONCLUSION: Implementation of Roy model-based education program as a low-cost, effective, and non-aggressive nursing intervention can reduce fatigue, and improve daily activities in patients with heart failure.
Knowledge and Associated Factors of Medical Students Regarding Radiation Exposure from Common Diagnostic Imaging Procedures at the University of Gondar, Ethiopia
Authors: Dagnachew Eyachew Amare  , Henok Dagne
Published: October 2020

BACKGROUND: Physicians’ knowledge about radiation exposure and risks was previously reported as inadequate. Therefore, the aim of this study was to assess knowledge and associated factors regarding radiation exposure among medical students from common diagnostic imaging procedures at the University of Gondar.METHODS: A cross-sectional study was conducted to assess knowledge and associated factors regarding radiation exposure among medical students. A total of 473 medical students (first through sixth years of study) completed a structured questionnaire. Univariate and multi-variable binary logistic regression was used to see the factors associated with knowledge of medical students on radiation sources, exposure and risks. Variables with p-value < 0.2 during the bivariable binary logistic regression were tested in the multivariable binary logistic regression. P-value<0.05 was used to declare significant association at the final model.RESULTS: Response rate was 100%. Two hundred fifteen (45.5% 95% confidence interval (CI )(41.0%-50.3%)) participants had good knowledge regarding radiation exposure from diagnostic imaging procedures. Only 177(37.4%) participants correctly knew that Computer Tomography (CT) use X-ray. However, subjects incorrectly named magnetic resonance imaging (MRI) as if it used x-ray (12.1%) and source of ionizing radiation (19.5%). Being female [Adjusted-odds-ratio (AOR)=1.57,95% CI(1.05,2.36)], 18-20 years of age [AOR=2.18, 95% CI(1.26, 3.76)], and 1st to 3rd year of study [AOR=3.64, 95% CI(2.23,5.95)] were predictors of knowledge identified.CONCLUSION: The results highlight that medical students need to be trained well with sufficient radiological education that enable them later to adhere to safe practices.
Prevalence of Poor Diabetes Self-Management Behaviors among Ethiopian Diabetes Mellitus Patients: A Systematic Review and Meta- Analysis
Authors: Teshome Tesfaye Habebo  , Ebrahim Jaafari Pooyan  , Ali Mohammad Mosadeghrad  , Getachew Ossabo Babore  , Blen Kassahun Dessu
Published: October 2020

BACKGROUND: Diabetes has no cure so far, but appropriate self-management contributes to delay or control its progression. However, poor self-management by diabetic patients adds to disease burden. The pooled prevalence of overall, and its main components of poor self-management among Ethiopian diabetic patients remain elusive. Hence, this study aimed to determine the prevalence of poor diabetes self-management behaviors among diabetic patients in Ethiopia.METHOD: by using different combinations of search terms, we accessed articles done until February 15, 2020 through Pubmed, Scopus, Web of Science and Embase databases. Newcastle-Ottawa quality assessment scale was used for quality assessment, and STATA version 14 software along with the random-effects model was employed for statistical analyses. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA.) guideline was followed to report the results.RESULT: Twenty-one studies with 7,168 participants were included in this meta-analysis. The overall pooled prevalence of poor self-management behavior among diabetic patients in Ethiopia was 49.79% (95% CI: 43.58%, 56.01%). Based on subgroup analysis, the estimated magnitudes of poor selfmanagement by regions were 68.58% in Tigray, 55.46% in Harari, 54.74%, in Amhara, 40.90%, in SNNPRS and 37.06% in Addis Ababa. The worst (80.91%) and relatively better (24.65%) self-management components were observed on self-blood glucose monitoring and medication adherence, respectively.CONCLUSION: One in two diabetic patients in Ethiopia had poor self-management. Thus, we strongly recommend to the ministry of health and universities to train diabetes health educators, and the health facilities to deliver tailored diabetes health education.
Human Immunodeficiency Virus Infection among Exposed Infants in Selected Primary Health-Care Facilities in Nigeria: A Retrospective Cohort Study
Authors: Aishat Bukola Usman  , Esther Asekun-Olarinmoye
Published: October 2020

BACKGROUND: Nigeria is the second largest country with paediatric HIV infections. Mother to Child transmission of HIV remains a major source of paediatric infection in Nigeria. This study was conducted to determine the outcomes of HIV exposed infants in selected Primary Health Care Centres.METHODS: A retrospective cohort study on HIV exposed infants between January 2015 to July 2016. A proforma was used to abstract information from clinic records on socio-demographics characteristics, ARV prophylaxis, mode of delivery, birth weight, infant prophylaxis, early infant diagnosis (EID), referral to ART. Descriptive and multivariate analysis was done to determine predictors of HIV infection among exposed infants.RESULTS: 170 exposed infants were recruited, and more than two-third of the infants were males (74.1%) with median age 4±3months ranging from (0 -11months). One hundred and fifty (88.2%) received infant prophylaxis and 116 (68.2%) had EID done at 6weeks. Of the 170 exposed infants 19(11.1%) were positive at 18months. Predictors of HIV infection were age of mothers ≥30years (Adjusted Odd’s Ratio = 2.5,95%CI 1.9 – 16.93), Vaginal tear (Adjusted OR= 2.7,95%CI 2.1- 19.21), infants whose maternal CD4 count < 500(Adjusted OR= 3.5,95%CI 1.7 -15.02) and infant received prophylaxis other than daily Nevirapine for 6weeks (Adjusted OR=3.0,95%CI 2.4-12.74).CONCLUSION: The positivity rate among studied exposed infants was high. Continuous placement of younger HIV positive mothers and exposed infants on recommended prophylaxis and timely early infant diagnosis will go a long way in reducing the burden of paediatric HIV.
Surgical Outcome of Chronic Pulmonary Aspergilloma: An Experience from Two Tertiary Referral Hospitals in Addis Ababa, Ethiopia
Authors: Berhanu N. Alemu
Published: October 2020

Background: Surgical management of pulmonary aspergillosis is challenging and controversial. This study is designed to assess the clinical profile, indications and surgical outcome of Pulmonary aspergilloma.Methods: A retrospective cross-sectional analysis of 72 patients who underwent pulmonary resection for pulmonary aspergilloma over the period from November, 2014, to November, 2019 was done. Data on demographic, clinical and surgical out come were retrieved. Analysis was done using SPSS version 23. Chi-square test was used to assess for significance of the association between variables and surgical outcome.Results: There were 46(63.9%) males and 26(36.1%) female patients with a mean age of 35.2+/-11.6 years (Range 16– 65 years). All patients were previously treated for tuberculosis. Cough, hemoptysis, and shortness of breath were the main symptoms identified. A ball of fungus together with the surrounding lung was removed. Accordingly, 32(44,4%) lobectomies, 12(16.7%) pneumonectomy, 7(9.7%) Bi-lobectomy,and 21(29.2%) cavernostomy were done. Intraoperative and Postoperative complications were seen in 8(11.1%) and 21(29.1%) patients respectively. Major morbidity encounters included massive intraoperative blood loss, prolonged air leak, empyema, air space, bronchopleural fistula, and wound infection. The hospital mortality was 3(4.2%) and the average hospital stay was 14.8days. Postoperative complications were evaluated for the difference in socio-demographic characteristics and other variables and a statistically significant difference was detected only for the location of aspergilloma, site of the lung involved and type of surgery done. (P-value <0.05.)Conclusion: Pulmonary resection done for pulmonary aspergilloma showed favorable outcomes when done with good patient selection, meticulous surgical techniques, and good postoperative management. However, its long term outcome and role of antifungal treatment as adjunctive therapy for surgical resection need further investigation.
Work-Related Musculoskeletal Disorders among Office Workers in Higher Education Institutions: A Cross-Sectional Study
Authors: Okezue Obinna Chinedu  , Anamezie Toochukwu Henry  , John Jeneviv Nene  , John Davidson Okwudili
Published: October 2020

BACKGROUND: Work-related musculoskeletal disorders (WMSDs) currently pose a challenge to public health and elicit considerable financial, physical and social problems for workers. There is a need to attain a deeper understanding of this predicament among office workers, in order to tackle it successfully. This study sought to investigate the prevalence of WMSDs among office workers in Higher Education Institutions (HEIs) as well as discover its associations with their personal/work details and reported risk factors.METHODS: A cross-sectional survey was executed among 217 office workers in different HEIs, who filled self-report questionnaires on WMSDs. Data were analyzed via descriptive and inferential statistics.RESULTS: The overall prevalence rate of WMSDs was 71.9% among these staff. The lower back, wrists/hands and shoulders were the most reported body regions for these disorders. WMSD prevalence had significant associations with sex (p = 0.004), age (p= 0.028), working hours (p = 0.003) and work experience (p =0.014). There were significant positive relationships (p < 0.05) between WMSD prevalence and these risk factors: awkward posture, sustained body position, improper bending, workplace stress, inappropriate furniture and inadequate rest breaks.CONCLUSION: Most of the study participants were affected with WMSDs, which were primarily reported in the back and upper extremities. Office workers who were older, female, more experienced and work for longer hours, displayed higher risks for these disorders and should be given special attention. Several factors reported by these HEI staff were revealed to significantly influence WMSD prevalence, emphasizing the need for their effective detection and curtailment.