bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Extended-Spectrum Beta-Lactamase–Producing Enterobacteriaceae and Associated Clinical Implications at the University Teaching Hospital of Kigali in Rwanda
Authors: Kayinamura Muhirwa Patrick , Muhirwa Alphonse , Kamaliza Aimee Claudine , Bigirimana Yves , Rutare Samuel , Hahirwa Innocent , Nkubana Théoneste , Dusabe Angelique , Munyemana Jean Bosco
Published: July 2024

Extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae poses a global problem and complicates therapeutic choices. The paucity of data in resource-poor countries undermines the understanding of the problem’s extent, and cases of antimicrobial treatment failure continue to accumulate. This study aimed to determine the prevalence and clinical implications of ESBL-producers at the University Teaching Hospital of Kigali in Rwanda. A 1-year cross-sectional retrospective study was conducted on Escherichia coli and Klebsiella pneumoniae isolated in blood and urine from January 1 to December 31, 2022. In total, 1,283 isolates were recorded. The results showed an overall prevalence of ESBL phenotypes at 300/1,283 (23.4%). Extended spectrum beta-lactamase–positive E. coli was more frequently detected than K. pneumoniae in both urine (20.6% versus 10.1%) and blood (8.8% versus 6.2%). These isolates were 100% resistant to amoxicillin-clavulanic acid, third-generation cephalosporins, piperacillin, sulbactam ampicillin, ampicillin, cefuroxime, and cefoxitin. The least resistance was observed to amikacin (18%), meropenem (10%), and polymyxin B (3%). Hospital stays ranging from 8 to 21 days were the most frequent, and the mortality rate was 10.3% in patients with ESBL cases, which was more than double the general hospital mortality rate in the same period. In conclusion, our findings indicate a high prevalence of ESBL phenotypes, high antibiotic resistance rates, prolonged hospital stays, and an increased mortality rate. These findings suggest the need for continued surveillance, planning appropriate interventions, and caution during empirical therapy.
Demographic and Clinical Factors Associated with Bacterial or Nonbacterial Etiologies of Acute Undifferentiated Febrile Illness: Findings from a 3-Year Observational Study in Thailand, 2017–2020
Authors: Wodniak Natalie R. , Bhengsri Saithip , Skaggs Beth , Uttayamakul Sumonmal , Sawatwong Pongpun , Sangwichian Ornuma , Gregory Christopher J. , Chuenchom Nuttagarn , Peanumlom Pongpot , Khemla Supphachoke , Lertwitayakumjorn Tanaphat , Chaoprasert Samkan , Piralam Barameht , Simmali Tuwan , Chara Chuwattana , Bloss Emily , MacArthur John R. , Heffelfinger James D.
Published: July 2024

Acute undifferentiated febrile illness (AUFI) is often undiagnosed in Thailand, resulting in delayed or ineffective treatment. We compared the demographic, exposure history, and clinical characteristics of AUFI patients with laboratory evidence of bacterial and nonbacterial pathogens. Patients aged 2–80 years presenting to 12 hospitals in Nakhon Phanom and Tak provinces were enrolled from April 2017 through May 2020. Interviews were conducted and blood, urine, and sputum were collected for culture as well as rapid diagnostic and molecular testing. A total of 1,263 patients tested positive for one or more bacterial, viral, or parasitic pathogens and were included in the analysis. Multivariable logistic regression was performed to compare factors associated with bacterial infections versus nonbacterial infections. Bacterial infections were more commonly identified in participants from Nakhon Phanom than Tak. Bacterial infections were independently associated with several factors including age ≥50 years (adjusted odds ratio [95% CI]): (4.18 [2.85–6.14]), contact with farm animals (1.82 [1.29–2.57]), antibiotic use within 72 hours of hospital presentation (2.37 [1.50–3.74]), jaundice (2.31 [1.15–4.63]), existing comorbidities (2.77 [1.93–3.96]), contact with febrile individuals (0.42 [0.31–0.57]), muscle pain (0.44 [0.31–0.64]), and rash (0.45 [0.29–0.70]). Bacterial infections were also associated with longer hospitalization (2.75 [2.08–3.64]) and lower odds of recovery at the time of discharge (0.14 [0.07–0.31]). Consideration of patient characteristics and signs/symptoms may help to inform targeted laboratory testing for suspected infectious etiologies. Understanding factors associated with bacterial and non-bacterial causes of AUFI may aid diagnosis and judicious use of antibiotics in resource-limited settings.
Neonatal Azithromycin Exposure and Childhood Growth: Long-Term Follow-Up of a Randomized Controlled Trial
Authors: Bountogo Mamadou , Ouermi Lucienne , Dah Clarisse , Sié Ali , Coulibaly Boubacar , Zakane Alphonse , Ouedraogo Thierry , Ouattara Mamadou , Lebas Elodie , Fetterman Ian , Kimfuema Aimée , Doan Thuy , Lietman Thomas M. , Oldenburg Catherine E.
Published: July 2024

Single-dose azithromycin is being considered by the WHO as an intervention for prevention of child mortality. However, concerns have emerged related to longer term unintended consequences of early life antibiotic use, particularly among infants. We conducted a long-term follow-up in a random sample of children who had been enrolled in a trial of neonatal azithromycin versus placebo for prevention of mortality to assess whether neonatal azithromycin exposure led to differences in child growth up to 4 years of age. We found no evidence of a difference in any anthropometric outcome among children who had received a single oral dose of azithromycin compared with placebo during the neonatal period. These results do not support long-term growth-promoting or deleterious effects of early life azithromycin exposure.
Generative Design in Aerospace and Automotive
Structures
Authors: Muelaner Jody Emlyn
Published: July 2024

Semi-automated computational design methods involving physics-based simulation,
optimization, machine learning, and generative artificial intelligence (AI)
already allow greatly enhanced performance alongside reduced cost in both design
and manufacturing. As we progress, developments in user interfaces, AI
integration, and automation of workflows will increasingly reduce the human
inputs required to achieve this. With this, engineering teams must change their
mindset from designing products to specifying requirements, focusing their
efforts on testing and analysis to provide accurate specifications.

Generative Design in Aerospace and Automotive Structures discusses
generative design in its broadest sense, including the challenges and
recommendations regarding multi-stage optimizations.

Click
here to access the full SAE EDGETM
Research Report portfolio.
Illness and Treatment Perceptions of Patients with Epilepsy Attending Treatment at a Tertiary Hospital in Addis Ababa – A Qualitative Exploration
Authors: Bezawit N. Demissie  , Abenet T. Mengesha  , Bruck M. Habte
Published: July 2024

BACKGROUND: Epilepsy can be a large economic burden in countries where appropriate treatment is not taken due to religious and psychosocial beliefs. The objective of this study was to explore the perceptions and experiences of patients with epilepsy attending their treatment at Tikur Anbessa SpecializedHospital about their illness and treatment.METHODS: A qualitative exploratory design with an in-depth interview was followed. Fourteen purposively selected patients were used until saturation of key emerging themes was achieved.RESULTS: The finding showed that study participants expressed perceptions towards their illness including about its cause, timeline, severity and psychosocial consequences which at times may be considered different from the biomedical version. They also expressed concerns about their treatment, reported aboutsocial and psychological issues and in certain cases dissatisfaction with their healthcare providers. Such issues may have led to delays in treatment-seeking and non-adherence to recommended treatment regimens and as well use of traditional medicine and spiritual healing. On the other hand, reasons that were reported to positively influence their treatment experiences include necessity perceptions about their medications, family support and use of spiritual healing alongside their biomedical treatment.CONCLUSION: The healthcare provision should improve to cater to these groups of patients including instituting chronic care management and appropriate health education provision.
Serum Vitamin D Level among Multiple Sclerosis Patients in the Tropics: Experience from a Private Clinic in Addis Ababa, Ethiopia
Authors: Biniyam A. Ayele  , Mehila Z. Wuhib  , Betesaida G. Zenebe  , Guta Z. Metaferia
Published: July 2024

BACKGROUND፡ Multiple sclerosis (MS) is an immune mediated disabling neurological disorder. Very little is known about MS in Ethiopia. The objective of this study was to determine the prevalence of hypovitaminosis D and associated factors in cohort of MS patients in Ethiopia.METHOD: A cross-sectional observational study was conducted among 25 multiple sclerosis patients at Yehuleshet Specialty Clinic, Addis Ababa, Ethiopia.RESULTS: The prevalence of vitamin D deficiency was 96% (n=24). The average serum vitamin D was 14.8 (±10.4) ng/mL. The mean age was 35.8 (±10) years. Females accounted for 80% (n=20). Relapsing and remitting MS was the commonest variant. Motor, sensory, and mixed symptoms accounted for 40% (n=10), 20% (n=5), and 24% (n=6), respectively. Cold or hot weather and stress were reported as worsening factors in 24% (n=6). Relapse rate was 44% (n=11). Fatigue and seizure disorder were reported by 80% (n=20) and 16% (n=4) respectively. Steroid is the commonest prescribed medication for the patients. A negativecorrelation was found between serum vitamin D and age (r = -0.062, p = 0.7). Similarly, a negative association was observed between vitamin D and duration of illness (r = -0.311, p = 0.1). Fatigue was reported by those with moderate hypovitaminosis compared to those having severe hypovitaminosis (p=0.002). Seizure was reported more by those with vitamin D below 10ng/mL compared to those having above 10 ng/mL (p=0.004).CONCLUSION: Our study demonstrates a high prevalence of hypovitaminosis D in Ethiopian MS patients. Hypovitaminosis D was associated with increment in age and duration of illness.
Antimicrobial resistance and ESBL profile of Uropathogens among pregnant women at Edna Adan Hospital, Hargeisa, Somaliland
Authors: Hussein Mohamoud  , Senait Tadesse  , Awoke Derbie
Published: July 2024

BACKGROUND: The emergence and spread of antimicrobial resistance (AMR) among uropathogens is increasing, especially in resource limited settings due to a number of reasons. The production of Extended Spectrum β-Lactamase (ESBL) by some strains of E. coli and methicillin resistant Staphylococcus species, limits the choice of antimicrobials in the treatment of urinary tract infection (UTI) globally. However, little is known about the type of uropathogenes and their current AMR profile among pregnant women in Hargeisa, Somaliland.METHODS: Clean-catch mid-stream urine samples were collected and processed for bacteriological culture and antimicrobial sensitivity testing (AST). Ceftazidime (30μg) and Cefotaxime (30μg) disks were used for ESBL screening as per CLSI guideline and each ESBL screening positive isolate were phenotypically confirmed by a combination disk test.RESULTS: Among 376 study participants, 79 (21.0%) had significant bacteriuria (SBU). Majority at 58(73.4%) of the isolates were Gram-negative. The most predominant isolate was E.coli, 36(45.6%) followed by K. pneumonea 16(20.3%) and S. aureus at 9(11.4 %). The proportion of ESBL producing isolates was 25(32.9%). Gram-negatives showed high level resistance to ampicillin, amoxicillin, cefotaxime, and cephalexin at 87%, 85%, 57%, and 52%, respectively. Previous history of UTI, monthly income, educational status and having dysuria were significantly associated with SBU (p<0.05).CONCLUSION: Relatively high prevalence of uropathogens and an increased level of drug resistance were documented. Therefore, continued surveillance on the type of uropathogens and their AMR pattern is needed to ensure appropriate recommendations for the rational empirical treatment of UTI and for policy input.
Comparing the Protective Effects of Curcumin and Ursodeoxycholic Acid after Ethanol-Induced Hepatotoxicity in Rat Liver
Authors: Azam Letafat Farashbandi  , Mehrdad Shariati  , Mokhtar Mokhtari
Published: July 2024

BACKGROUND፡ Alcohol consumption can cause hepatitis and long-term cirrhosis of the liver. The aim of this study was to evaluate the protective effects of curcumin (CUR) and ursodeoxycholic acid (UDCA) alone and together in the prevention and treatment of liver damage caused by overuse of ethanol.METHODS: Adult Wistar rats were divided into 8 groups of 5, including the control group and various combinations of ethanol, CUR and UDCA groups. Twenty-eight days after the oral treatment, serum levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), gammaglutamyltransferase (GGT) and Arginase I (ArgI) as well as serum levels of Albumin (Alb), total protein (TP) and Blood Urea Nitrogen (BUN) were measured, and liver tissue was evaluated histopathologically.RESULTS: The solo administration of CUR, UDCA and CUR+UDCA had no effect on the blood parameters and liver tissue compared to the control group (p˃0.05). The solo administration of CUR and UDCA in ethanol-treated rats significantly reduced ALT, AST, ALP, GGT, ArgI and BUN levels (p˂0.05), while the solo administration increased Alb and TP levels compared to the ethanol group (p˂0.05). In these groups, a significant decrease in cell necrosis and local inflammation of hepatocytes was observed, and the liver damage was mild. However, co-administration of ethanol, CUR and UDCA made significantly greater decrease in ALT, AST, ALP, GGT, ArgI and BUN levels (p˃0.05), while the co-administration greatly increased Alb and TP levels compared to the ethanol group (p˂0.05). Histopathologically, a decrease in structural changes in liver tissue and inflammation was observed, resulting in the improvement of liver tissue.CONCLUSION: The solo administration of CUR and UDCA could reduce ethanol-induced liver damage in rats and improve liver’s serum and blood parameters. However, the coadministration of CUR and UDCA has a greater efficacy.
Spatial Distribution of Road Traffic Accident at Hawassa City Administration, Ethiopia
Authors: Shamenna AkliluToma  , Bedane Ashenafi Senbeta  , Bedane Ashenafi Senbeta  , Ali Anteneh Bezabih
Published: July 2024

BACKGROUND፡ Globally, road traffic accidents (RTAs) are the leading killer of young people and are projected to be the 7th leading cause of death by 2030. This study is aimed at analyzing the spatial distribution of road traffic accident and identifying hotspot areas across Kebeles (smallest administrative division in Ethiopia) of Hawassa city administration in Ethiopia.Method: Secondary data on daily traffic accident record from October 2013 to June 2018 was obtained from Hawassa city administration police department. The spatial clustering and hotspots identification were carried through Moran’s I and Getis- Ord Gi* statistics. Data analysis was conducted using GeoDa 1.16.0.0 and ArcGIS 10.2 softwares.RESULTS: Drivers within age group of 18-30 years, who were hired by private business owners and who had no driving license committed the highest number of traffic accidents. The majority of traffic accidents were caused due to careless driving, failure to give priority for pedestrian, high speed and driver failure to give priority for each other. In addition, about 82.01% of traffic accidents were recorded on asphalts road and 11.51% by gravel road. Spatial clustering of road traffic accidents for accidents occurred on gravel road and in sunny weather conditions found to be significant. Different hotspot areas were identified for gravel type of road and sunny weather condition.CONCLUSION: The concerned government bodies involved in policymaking are recommended to give special attention to young driver who were hired by private business owners. Interventions to mitigate the occurrence of traffic accident would take in to account the identified hotspot areas.
Has the COVID-19 Pandemic Impacted Healthcare Service Uptake at Hospitals in Addis Ababa?
Authors: Tariku Shimels
Published: July 2024

BACKGROUND፡ The novel coronavirus has caused a profound impact on service utilization or delivery practices of health facilities globally. This study aims to evaluate the trend of health service utilization before and during the COVID-19 pandemic at selected hospitals in Addis Ababa, Ethiopia.METHOD: A facility-based cross-sectional study was conducted from 1st through 30th of August 2020 using a mixed-methods design. For the quantitative evaluation, ten months' time-series data, starting from September 2019 to July 2020 was retrieved from the HMIS unit of each hospital. Microsoft excel v.2010 was used to analyze quantitative data. Qualitative data was collected using a semi-structured key-informant interview guide and analyzed using QDA-minor software.RESULTS: Twelve service delivery departments were included in the evaluation of each hospital. Of all, OPD, ART, VCT, PICT, and EPI services showed major disruption in both hospitals following the COVID-19 outbreak. Noticeable change was recorded in March and April for most units. Qualitative exploration showed multiple challenges namely; inadequate supply, poor infrastructure, low service utilization, staff workload, increased risk, poor job satisfaction of health professionals, and perception or attitude-related problems to be persistent at the hospitals.CONCLUSION: Main service delivery units of the hospitals, such as OPD, ART, VCT, PICT, and EPI have faced massive depression during the COVID-19 pandemic. The facilities had also encountered multifaceted challenges most from the internal environment. Immediate action should be in place to halt the negative impacts of the pandemic on the identified spots and challenges.
Variation of Ultrasonic Renal Volume between Hypertensive and Non-Hypertensive Individuals in Relation to Body Size Parameters
Authors: Mesfin Zewdu  , Mesfin Zewdu  , Elias Kadir  , Melkamu Berhane  , Tilehun Alemayehu
Published: July 2024

BACKGROUND፡ Estimation of renal size is vital for the diagnosis of abnormal structural change on the kidneys due to the adverse effects of chronic diseases like hypertension. This study evaluated renal volume by ultrasound in relation to body size parameters, notably body mass index (BMI) and body surface area(BSA) in hypertensive and non-hypertensive individuals.METHODS: A hospital-based comparative cross-sectional study was conducted from February to September 2018 at the Radiology department of the Jimma University Medical Center (JUMC). The study included consecutively selected samples of 85ambulatory hypertensive patients and 60non-hypertensive controls recruited consecutively on voluntary basis. After receiving verbal consent, each subject underwent abdominal ultrasound examination and length, width and thickness of both kidneys were measured and used for estimation of renal volume. The statistical evaluation included independent samples t-tests for mean differences with regard to ultrasonic renal measurements between hypertensive and non-hypertensive groups.RESULTS: A total of 145 adults aged 16 - 80 years (mean ±SD=44 ±17) participated in the study. In the hypertensive group, mean renal volume of 97.7cm3 for the right kidney and104.4cm3 for the left kidney whereas in the control group, it was 101.1cm3 for the right and 111.8 cm3 for the left kidney. The mean right renal volume to BSA ratio was 58.2cm3/m2 in hypertensive group, while it was 62.6cm3/m2 among the control group (p=0.076). The mean left renal volume to BSA of the patients was 62.2cm3/m2 and significantly (p=0.012) lower than that of the non-hypertensive group, which was 69.3 cm3/m2.CONCLUSION: Slightly smaller bilateral renal volume among hypertensive patients as compared the controls was obtained.
Burden of Fluoroquinolone Resistance in Clinical Isolates of Escherichia coli at the Ho Teaching Hospital, Ghana
Authors: John Gameli Deku  , Kwabena Obeng Duedu  , Emmanuel Ativi  , Godsway Edem Kpene  , Patrick Kwame Feglo
Published: July 2024

BACKGROUND: The growing burden of antibiotic resistance is a threat to the management of infections. Infections by Escherichia coli are routinely treated with fluoroquinolone antimicrobial agents. Due to their frequent use, there has been increasing resistance to these drugs. We set out to determine the burden of fluoroquinolone resistance among clinical E. coli isolates at the Ho Teaching Hospital, Ghana.METHODS: This was a cross-sectional study conducted from July 2018 to June 2019. One hundred and thirty-five E. coli isolates were cultured from various clinical samples. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method with discs of nalidixic acid (NAL), ciprofloxacin (CIP), norfloxacin (NOR) and levofloxacin (LEV). Deoxyribonucleic acid (DNA) was extracted from the resistant isolates for the detection of fluoroquinolone resistant genes by polymerase chain reaction.RESULTS: Ninety of the 135 isolates (66.7%) were resistant to at least one of the four fluoroquinolone drugs investigated. Resistance to NAL, CIP, NOR, and LEV was 51.0%, 51.1%, 38.8% and 35.7% respectively. Out of the fluoroquinolone resistant isolates, 69 carried one or more fluoroquinolone resistant genes. The predominant resistant genes were aac(6’)-Ib-cr (48.9%) and qnrD (25.6%). Seven of the isolates carried both qnrS and aac(6’)- Ib-cr genes. Two isolates carried 5 different fluoroquinolone resistant genes.CONCLUSION: High prevalence of resistance to 4 fluoroquinolone drugs was recorded with associated resistant genes. This is a threat to current efforts to control the spread of antibiotic resistance and calls for concerted efforts to curb the spread of these resistant organisms.
Knowledge and Attitude of Iranian Medical University Students about Organ Donation and Transplantation: A Cross-Sectional Study
Authors: Shohreh Kolagari  , Javad Bayei  , Vahid Asoodeh  , Siamak Rajaee  , Zahra Mehbakhsh  , Mahnaz Modanloo
Published: July 2024

BACKGROUND: Medical professionals' knowledge of and attitudes toward organ donation and transplantation have positive impact on donation rates. The aim of this study was to determine the knowledge and attitude of medical university students in Iran about organ donation and transplantation.METHODS: This cross-sectional study was carried out on 1078 undergraduate students in Golestan University of Medical Sciences, Gorgan, Iran, from January to June 2019. All eligible students were recruited using convenient sampling. Data were gathered using knowledge and attitude toward organ donation and transplantation questionnaire. The higher scores of both subscales, the knowledge subscale (range from 0 to 13) and the attitude subscale (range from 13 to 65), indicate the better knowledge and attitude toward organ donation and transplantation.RESULTS: The mean age of students was 22.24±5.16 years. Finding showed that the mean score of students' knowledge and attitude toward organ donation and organ transplantation were 8.48±1.71 and 48.55±8.11 respectively. Also, the mean score of students’ knowledges in females (P<0.001), married (P=0.001) and who had organ donation card (P<0.001) was significantly higher. Nearly all of the students had heard about organ donation (98.3%) and organ transplantation (98.4%). Majority of them pointed that their source of information about organ donation and transplantation was television (TV) program (47.1%). Most of the students (73.8%) reported that they agree to donate their organs but most of them (67.5%) did not know how to obtain organ donation card and only 9.6% of them had the organ donor card as a volunteer donor.CONCLUSION: According to finding, despite the awareness and favorable attitude about organ donation and transplantation among medical students, the number of registered donors was low. In addition to promoting college students’ awareness about organ donation for increasing registered donors, it is needed to aware and pursue lay people through social media.
Morphometric Anatomy of the Tibia Plateau in Nigerians
Authors: Dennis Erhisenebe O. Eboh
Published: July 2024

BACKGROUND: There are increasing cases of osteoarthritis and associated disabilities with age, hence the need for knee replacement to restore the anatomy and function of the knee. The objective of this study was to determine the dimensions of the tibial plateau in dry human tibias of Nigerians. This will serve as a guide for the tibia components during total knee replacement procedure.METHODS: This study adopted the descriptive method of the quantitative design and utilized 133 dry tibias. Total transverse width, total anteroposterior length of intercondylar region, transverse widths of medial and lateral tibia plateaus, and anteroposterior length of the plateaus were measured in millimeter (mm). Statistical analysis of the data was done using mean (SD), t-test and correlation, with the aid of SPSS 23. Statistical significance was fixed at p<0.05.RESULTS: Statistically, the differences between the right and left parameters were not significant. The mean total transverse width was longer than the total anteroposterior length. The mean anteroposterior length of the medial tibia plateau was significantly longer than that of the lateral tibia plateau. The difference between the transverse width of both the medial and lateral tibia plateau was not statistically significant.CONCLUSION: This study showed that the tibial plateau dimensions can act as guiding tools to the orthopedic surgeon during a knee replacement procedure; and those involved in the fabrication of knee replacement prostheses for Nigerians. The physical anthropologists will also find the anthropometric data invaluable in population studies.
Do Patients with Major Non-Communicable Diseases Receive Advice on Health Behaviors from Healthcare Professionals in the Gaza Strip, Palestine?
Authors: Ahmed Hassan Albelbeisi  , Ali Albelbeisi  , Abdel Hamid El Bilbeisi  , Amany El Afifi
Published: July 2024

BACKGROUND: NCDs tend to be long-term and are caused by genetic, physiological, environmental, and behavioral factors. Currently, NCDs account for 71% of deaths globally. The current study aimed to explore whether patients with NCDs receive advice on health behaviors from healthcare professionals in the PHCs inthe Gaza Strip, Palestine.METHODS: This research applied a cross-sectional survey design in five PHCs from October 2019 to December 2019, with 360 patients selected using a convenience sampling technique. A structured questionnaire on sociodemographic, history and patients’ views on receiving advice on health behaviors from health care professionals was developed and collected. Data were analyzed using descriptive analyses and a One-way ANOVA test through SPSS-v22.
RESULTS: The patients reported receiving advice as follows: in terms of regular physical activity (54.5% ±13.6), in terms of eating a heart-healthy diet (49.3% ±11.5), in terms of treatment adherence (86.1% ±8.1), and in terms of stop tobacco for smokers’ patients (43.9% ±16.8). Statistically significant differences were found between the five Gaza strip governorates in terms of regular physical activity, eating heart-healthy, and treatment adherence (P values <.05 for all).CONCLUSION: Participants claimed that the vast majority of them had received advice from healthcare professionals regarding attending regular follow-up and treatment adherence. In contrast, participants reported receiving advice from health care professionals regarding regular physical activity, eating a healthy diet, and stopping tobacco are suboptimal. There is a need to develop a strategy to ensure that healthcare professionals are committed to providing advice on health behaviors.
Factors Associated with EEG Slowing in Individuals with Parkinson's Disease
Authors: Biniyam A. Ayele  , Heera Tesfaye  , Mehila Z. Wuhib  , Guta Zenebe
Published: July 2024

BACKGROUND: A plethora of scientific studies has shown diffuse slowing on electroencephalograph (EEG) study is a frequent occurrence in Parkinson’s disease (PD) patients, compared to the healthy controls. Little is known about EEG slowing and PD in the sub-Saharan Africa, especially in Ethiopia. The objective of this study was to assess factors associated with EEG slowing in individuals with Parkinson’s disease.METHOD: A cross-sectional observational study was conducted in 40 PD patients at Yehuleshet Specialty Clinic, Addis Ababa, Ethiopia. Both descriptive and analytical statistics were used to analyze the data.RESULTS: Total of 40 patients with PD was included in the present survey. The median age was 66 (IQR: 52.5 – 72.5 years) and young onset PD accounted 20%. Males accounted for two-third of the participants. Diffuse EEG slowing was observed in 52.5% (n=21) of participants. Majority (85%) were on levodopa treatment. Hypovitaminosis D was observed in 93.1% of the study participants. White matter hyperintensity (WMH) and global brain atrophy were seen in 47.5% and 27.5% respectively. Even though statistically not significant, PD patients with EEG slowing, reported more forgetfulness and had WMH on their brain MRI, compared to those with normal EEG. Age was associated with diffuse EEG slowing when adjusted for forgetfulness and WMH (Adjusted OR 1.18 95% CI (1.01 - 1.37) p=0.03).CONCLUSION: The present study indicates high prevalence of diffuse EEG slowing in PD patients. Age was associated with diffuse EEG slowing. Higher proportion of patients with EEG slowing reported forgetfulness and hypovitaminosis D compared to those with normal EEG recordings.
World Facing the latest variant of Concern---------Omicron
Authors: Muhammad Mohsin Javaid  , Ayesha Fazal  , Mawra Hyder  , Farooq Ahmad Chaudhary  , Shahab Ud Din
Published: July 2024

Letter to the editor.
Correlation between Radiological Images and Histopathological Type of Meningioma: A Cohort Study
Authors: Andi Ihwan  , Rauf Rafika  , Muhammad Husni Cangara  , Kevin Jonathan Sjukur  , Muhammad Faruk
Published: July 2024

BACKGROUND: Histologically affirmed meningiomas represent 37.6% of all essential central nervous system tumors and half of all types of critical central nervous system tumors. This study compares computed tomography (CT) scans of the head with histological findings to establish the characteristics of different types of meningiomas observed in eastern Indonesia.Methods: This prospective study evaluated 224 patients by examining the correlation between histological and CT data collected from January to December 2020 at Wahidin Sudirohusodo Hospital, Makassar, Indonesia. We assessed data including the location of pre- and post-contrast CT scans, number of tumors, margin, density, contrast enhancement, bony reaction, calcification, and perifocal edema. Patients underwent biopsies followed by an examination of the anatomical pathology tissue.RESULTS: The female-to-male ratio of participants was 4.2 to 1, and the highest incidence was observed in participants of both genders aged 40–60 years. The most common meningioma subtype was meningothelial, while the most commonly observed locations involved the convexity and sphenoid regions. Most meningiomas had well-defined margins on CT imaging: 54.5% of patients exhibited isodense lesions on pre-contrast scans, and 64.7% exhibited high-contrast enhancement. Bone destruction developed in 4.1% of patients, while hyperostosis was observed in 17.4%, and calcification was present in 10.3% of the participants. Edema was identified in 65.2% of cases, of which moderate edema was the most common manifestation.CONCLUSION: Meningioma should be highly suspected in female patients aged 40–60 with isodense lesions on pre-contrast CT scans and high-contrast enhancement on post-contrast CT scans. Meningiomas were primarily classified as convexity meningiomas with well-defined margins. The presence of hyperostosis, calcification, and brain edema supported the meningioma diagnosis.
Bacterial Sepsis among Children with Congenital Heart Disease in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
Authors: Edomgenet Tesfaye  , Henok Tadele
Published: July 2024

BACKGROUND: Bacterial Sepsis is a serious medical problem affecting children with Congenital Heart Disease (CHD). The pattern and factors predicting outcome of bacterial sepsis have not been studied in Africa. The study aimed to describe the pattern and outcome of bacterial sepsis among children with CHD in Tikur Anbessa Specialized Hospital (TASH).METHODS: A cross-sectional study was carried out among children with CHD and sepsis at TASH between May 2017 and July 2020. Structured questionnaires were used for data collection. Statistical significance was set at P value < 0.05, and multivariable logistic regression was used to determine predictors.RESULTS: This study included 384 CHD children with sepsis. Proportion of culture proven bacterial sepsis was 17.1 % (66) (95% CI: 13.6- 21.3). Coagulase negative staphylococcus aureus 7% (27), Staphylococcus aureus 4.4% (17) and Actinobacteria 1.8% (7) were the common isolated bacteriological agents. Death was documented in 25% (96) of study subjects. Down syndrome subjects were 2.4 times [aOR=2.416 (95%CI: 1.367-4.264)] more likely to die from sepsis. Those with associated comorbidities (Apert syndrome, Cerebral palsy, Chiari 2 malformation, Patau syndrome, Noonan syndrome, Congenital Rubella, Portal vein thrombosis, HIV, Scoliosis and VACTERL association) were 4.4 times more likely to die from sepsis [aOR=4.418 (95%CI: 1.617-12.072)].CONCLUSION: Bacterial sepsis is a common problem among children with CHD. Gram positive bacteria were common causes. Down syndrome and other co morbidities predicted bacterial sepsis mortality. Blood culture and sensitivity tests are recommended to halt the high mortality seen in Down syndrome or those with co morbidities.
The Role of Perceived Social Support on Quality of Life in People with Cardiovascular Diseases
Authors: Chollou Khalil Maleki , Shirzadi Shayesteh , Pourrazavi Sara , Babazadeh Towhid , Ranjbaran Soheila
Published: July 2024

Background: Cardiovascular Diseases (CVDs) are one of the major causes of hospitalization and mortality worldwide. Strengthening perceived  social support and quality of life can reduce these problems. This study aimed to describe the role of perceived social support on cardiovascular  patients' quality of life.Methods: This cross-sectional study was conducted from September 2020 to February 2021. We selected 150 cardiovascular patients through  convenience sampling. The questionnaires included: the Persian version of the WHOQOL-BREF, Perceived Social Support, and demographic  variables. Hierarchical linear regression was used to explore the association between perceived social support and quality of life. Data were  analyzed by SPSS version 21.0 software. A P-value less than 0.05 is considered statistically significant.
Results: The demographic variables could predict 12.2% of the variance of quality of life in the first step. In the second step, after adjusting control  variables and dimensions of social support, the predictability increased to 29% of the variance with the addition of variables. All dimensions of social  support, excluding tangible assets support, were significant predictors of quality of life and monthly income status. Self-esteem support (β=  0.387) was the strongest predictor of quality of life in cardiovascular patients.
Conclusion: Patients with higher perceived social support have a better quality of life than the other patients. Perceived social support is one of the  strategies that can be utilized to improve quality of life and overcome disease in cardiovascular patients.
Intention to Use Maternal Waiting Homes and Related Factors among Pregnant Women in Metu Woreda, Western Ethiopia
Authors: Yismaw Worke , Teklu Tigist , Fantahun Addishiwot , Dugassa Boka , Merid Rodas , Bizuwork Ketema
Published: July 2024

Background: Maternity Waiting Homes are houses built in the healthcare settings that lodge pregnant women in their term state of pregnancy to  prevent labor and delivery-related complication. This study aimed to estimate the extent of pregnant women’s intention to use Maternal Waiting  Homes and identify its associated factors in Metu Woreda, Western Ethiopia.
Methods: A community-based cross-sectional study was conducted from March 1-30, 2018. We used a systematic sampling method to select the  study participants and Binary logistic regression analysis was used to identify factors associated with the intention of the women to use Maternal  Waiting Homes.
Results: A total of (97%) of respondents’ questionnaires were found complete and analyzed for this study. Almost half (48.8%) of  the pregnant women who participated in the study were planned to use Maternal Waiting Homes in their prospective delivery. Based on  multivariate logistic regression analysis; being illiterate and/or less educated in their educational status, having a history of using Maternal Waiting  homes, and receiving a number of times antenatal care services were found statistically significantly associated with intention of the women to use Maternal Waiting Homes.
Conclusion: It is trivial that more than half of the pregnant women who participated in the study were unintended to use Maternal Waiting  Homes. Educational status, a number of times attending antenatal care services and experience of using Maternal Waiting Homes were found  statistically significantly associated with women’s intention to use Maternal Waiting Homes.
Awareness and Knowledge of Glaucoma among Health Workers in Butajira General Hospital, South Ethiopia
Authors: Negussie Asteway , Alemu Abiye M.
Published: July 2024

Background: Raising awareness and knowledge of glaucoma is a key means of enhancing people alertness, increasing regular eye screening  practice, and the chance of identifying undetected cases. Health professionals other than ophthalmologists are often the first point of contact when  patients seek medical advice. However, little is known about the awareness and knowledge of glaucoma among health care professionals in  Ethiopia.The objective of this study was to determine general awareness and knowledge of glaucoma among health workers in Butajira General Hospital.
Methods: Hospital-based cross-sectional study was conducted at Butajira Hospital in September and October 2021 among health care providers. All  health workers except those on leave and the staff in the department of Ophthalmology were included in the study. The awareness and knowledge  were assessed using a selfadministered questionnaire. Descriptive statistics was computed to describe the study variable, and logistic regression  was conducted to see associations between dependent and independent variables. Significant associations were declared at p-values <0.05.
Result: This study showed that 184 (91.1%) had an awareness of glaucoma among the study participants, whereas 8.9% had never heard about  glaucoma. Of those who were aware, only 42% have good knowledge.Professionals who had a history of eye examinations and family history of  glaucoma were about 3.0 times more likely to have good knowledge.
Conclusion: Fifty-eight percent of clinical professionals from Butajira Hospital had no awareness at all or had poor knowledge about glaucoma.  Being a physician, history of eye examinations, and having a family history of glaucoma were factors related to glaucoma knowledge.
Pediatric Cardiac Surgery in Ethiopia: A Single Center Experience in a Developing Country
Authors: Yayehyirad Mekonen Ejigu  , Hiwot Amare
Published: July 2024

BACKGROUND: In developing countries, the diagnosis of congenital heart diseases (CHD) is growing as the availability of echocardiography is increasing with most diagnoses made after birth. However, the access to pediatric surgery is still low and is mainly done by global surgical campaigns rather than local surgeons. Ethiopia has trained its local surgeons, and this is expected to improve the care of children with CHD. We aimed to evaluate the experience of local pediatric CHD surgery and its outcome in a single-center in Ethiopia.
METHODS: A hospital-based retrospective cohort study was done by including all patients with CHD and acquired heart disease in patients under the age of 18 operated at children’s cardiac center in Addis Ababa Ethiopia. We set in-hospital mortality, 30-day mortality, and the prevalence of complications including major complications after cardiac surgery as the primary outcomes.
RESULTS: A total of 76 children were operated. The mean age at the time of diagnosis and surgery was 4 (±5) and 7 (±5) years, respectively. Forty-one (54%) were female. Ninety five percent of the 76 operated children were with the diagnoses of congenital heart diseases while the rest (5%) with acquired heart disease.  Of those with congenital heart disease, Patent ductus arteriosus (PDA) accounted for (33.3%), Ventricular septal defect (VSD) for 29.5% and Atrial Septal Defect (ASD) for 10% and Tetralogy of Fallot (TOF) for 5%. According to the RACS-1 category, 26 (35.1%) were in category 1, 33 (44.6%) were in category 2, 15 (20.3%) were in category 3 and none of the children were in category 4 and 5. In-hospital mortality was 2.6% whereas there was no patient who died within 30 days after discharge. Operative mortality was 2.6%.
CONCLUSION: Various types of lesions were treated in the hands of the local teams with VSD and PDA ligations as the commonest of all. The 30day mortality was within acceptable range and this outcome shows congenital and acquired heart diseases can be operated on in developing countries with good outcome despite the limited resources.
The Effectiveness of Mostafa Maged Technique in Closure of the Episiotomy during Vaginal Delivery
Authors: Mostafa Maged Ali
Published: July 2024

BACKGROUND: This study is done to assess the effectiveness of Mostafa Maged technique in suturing the episiotomy.
METHODS: At the time of delivery, this technique will be applied to all women with episiotomy or perineal or vaginal tears. The technique employs absorbable vicryl threads with 75 mm round needles. Mostafa Maged technique includes the continuous suturing of the vaginal epithelium and the muscle layer. Evaluation of the perineal region within the next twenty-four hours prior to discharge searching for (edema-hematoma-septic wound - continence - ecchymosis - dyspareunia).
RESULTS: The current study included 50 patients. All patients had an episiotomy during delivery; 25 patients' episiotomies were sutured using Mostafa Maged technique, while the remaining patients' episiotomies were by regular traditional technique. Mostafa Maged technique has demonstrated efficacy in achieving adequate hemostasis and avoiding dead space formation during an episiotomy. It was found that 100 % of patients with Mostafa Maged technique have no dead space, and 95.8% of Mostafa Maged patients do not have vulval edema. The technique of Mostafa Maged has also proven effectiveness in achieving postoperative hemostasis. Unlike patients with regular maneuvers, 83.3% do not have dead space, and 83.3 % do not have vulval edema.
CONCLUSION: Mostafa Maged technique is a simple technique and easy to apply when suturing episiotomy. Mostafa Maged technique is significantly superior to conventional maneuvers in preventing bleeding at the episiotomy site and preventing formation of dead space so achieving good hemostasis; therefore, it is highly recommended. I recommend more studies on efficacy of Mostafa Maged maneuver on large sample of patients.
The Quality of Logistics Management Information System and the Availability of Tracer Drugs at Health Posts in Rural Ethiopia: A Mixed-Method Study
Authors: Bisrat Fantaye Denberu  , Merga Belina  , Mekdes Demissie  , Netsanet Abera  , Girmay Medhin  , Alula M. Teklu  , Melody Kelemu  , Yibeltal Kiflie Alemayehu
Published: July 2024

BACKGROUND: Proper implementation of the logistics management information system (LMIS) would facilitate access to essential pharmaceutical products. It also prevents wastage at health posts. The aim of this study was to assess the implementation of the LMIS and the availability of tracer drugs at health posts in rural Ethiopia.
METHODS: We employed a cross-sectional descriptive design with a mixed-method approach. The data used for this paper was collected from March to May 2019 as part of the National HEP assessment. The study involved 343 health posts randomly selected from nine regions of Ethiopia.  Women’s Development Army members and household heads participated in the qualitative study (i.e. in FGD and KII). The quantitative data were exported from Open Data Kit (ODK) to Stata 15.1 for statistical analysis, and the qualitative data were entered into NVivo 12 and analyzed using thematic content analysis.
RESULTS: Of the health posts, 59.4% had a space for storing drugs; less than half (41.9%; 95% confidence interval (CI) [36%, 48%]) had a functioning refrigerator. The mean percentage of the availability of selected tracer drugs at health posts was 59.6%, with a 95% CI (58.9%, 60.3%). Bin cards were available at 43% (95% CI [40%, 46%]) of health posts, and among these, only 27.5% of the health posts adequately used the bin cards.
CONCLUSION: The absence and poor use of LMIS tools was observed at health posts. Proper implementation of the LMIS has the potential to improve the availability of essential drugs that, in turn, improve health post level delivery of health services.
Sexual Satisfaction among Married Women in Tiro Afeta District: A Cross-sectional Study
Authors: Tigist Abebe Gelashe  , Aderajew Nigusse Teklehaymanot  , Bekelu Teka Worku
Published: July 2024

BACKGROUND: Sexual satisfaction is directly related to marital sustainability and quality of life. This study assessed the magnitude of sexual satisfaction and associated factors among married women.
METHODS: A community-based cross-sectional study was conducted from May 18 to June 8/2021 using mixed data collection methods. The sample was calculated using single population proportion formula for the quantitative part while data saturation was applied for the qualitative part. Simple random and purposive sampling techniques were used to get participants for the quantitative and the qualitative parts respectively. The quantitative data were analyzed using Statistical Package for Social Science (SPSS) version 25, and the qualitative data were analyzed manually. Ordinal logistic regression was applied to explore the model. P-value <0.05 and AOR with a 95%CI were used to identify the statistical significance of the association.
RESULT: About 398 married women participated in the study, making a response rate of 94.3% and 44.7% of them were moderately satisfied with their sexual life. Sexual satisfaction among the married women was significantly associated negatively with attending elementary education 99.9% [AOR=0.1, 95%CI:0.0,0.4)], positively with having social responsibility 19[AOR=19.3, 95%CI:  1.8, 28.3], and negatively with having poor sexual attitude 97%[AOR=0.1, 95%CI: 0.0, 0.3]. The qualitative finding showed that the majority of women engage in sexual intercourse for the satisfaction of their partners, without their needs.
CONCLUSION: Sexual satisfaction among married women was low in the study area. Comprehensive sexual and reproductive health awareness and strengthening of the prevention of harmful traditional practices are recommended.