bluuebunny/crossref_metadata_2025 huggingface dataset:
Emricasan for the treatment of liver cirrhosis: a meta-analysis of randomized controlled trials
Authors: Jie Yao , Youchun Lei , Jingxiang Chen
Published: October 2023

Introduction: The efficacy of emricasan for liver cirrhosis remains controversial. We conduct a systematic review and meta-analysis to explore the influence of emricasan versus placebo on the treatment of liver cirrhosis.

Methods: We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through August 2021 and included randomized controlled trials (RCTs) assessing the efficacy of emricasan versus placebo for liver cirrhosis. This meta-analysis was performed using the random-effect model.

Results: Four RCTs were included in the meta-analysis. Overall, compared with control group for liver cirrhosis, emricasan treatment had no substantial impact on MELD (SMD=-0.19; 95% CI=-0.44 to 0.06; P=0.14), INR (SMD=0.12; 95% CI=-0.13 to 0.37; P=0.36), total bilirubin (SMD=-0.27; 95% CI=-0.56 to 0.01; P=0.06), serum albumin (SMD=0; 95% CI=-0.25 to 0.25; P=1.00) or adverse events (OR=1.35; 95% CI=0.56 to 3.24; P=0.50).

Conclusions: Emricasan treatment provided no benefit for the treatment of liver cirrhosis.

Keywords: Emricasan; liver cirrhosis; randomized controlled trials; meta-analysis.
Therapeutic outcome of dapagliflozin in patients with type 2 diabetes and non-alcoholic fatty liver disease: a meta-analysis of randomized controlled trials
Authors: Hu Changlun , Qu Tianhua , LI Lin , Huang Yi , Liu Huabao , Rao Chunyan
Published: October 2023

Introduction: The efficacy of dapagliflozin remains controversial for patients with type 2 diabetes and non-alcoholic fatty liver disease. We conduct this meta-analysis to explore the influence of dapagliflozin versus placebo on the treatment efficacy of type 2 diabetes complicated with non-alcoholic fatty liver disease.

Methods: We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through November 2021 for randomized controlled trials (RCTs) assessing the efficacy of dapagliflozin versus placebo for type 2 diabetes complicated with non-alcoholic fatty liver disease. This meta-analysis is performed using the random-effect model.

Results: Four RCTs are included in the meta-analysis. Overall, compared with patients with type 2 diabetes and non-alcoholic fatty liver disease, dapagliflozin treatment is associated with significantly reduced alanine aminotransferase (ALT, standard mean difference [SMD]=-1.27; 95% confidence interval [CI]span style="font-family: ‘Times New Roman'">=-1.60 to -0.95; P<0.00001), aspartate aminotransferase (AST, SMD=-1.37; 95% CI=-2.08 to -0.65; P=0.0002), fasting glucose (SMD=-0.78; 95% CI=-1.28 to -0.27; P=0.003) and HbA1c (SMD=-0.77; 95% CI=-1.21 to -0.34; P=0.0005), but demonstrated no obvious influence on homeostatic Model Assessment of Insulin Resistance (HOMA-IR, SMD=-0.36; 95% CI=-0.86 to 0.14; P=0.16).

Conclusions: Dapagliflozin benefits to improve hepatic function and glucose control in patients with type 2 diabetes and non-alcoholic fatty liver disease, as evidenced by the reduction in ALT, AST, fasting glucose and HbA1c.

Keywords: Dapagliflozin; type 2 diabetes; non-alcoholic fatty liver disease; randomized controlled trials.
The practice of using repurposed medications as chemoprophylaxis for COVID-19 by healthcare workers in a tertiary hospital in Southern Nigeria
Authors: B Udoette Sylvanus , E Onukak Asukwo , A Umoh Victor , A Akpabio Akpabio
Published: October 2023

Background: Coronavirus disease 2019 (COVID-19) is a viral infection that has been reported in virtually every country. Healthcare workers (HCW) are more at risk of COVID-19 than the general population making them a priority group for vaccination. Before the roll out of COVID-19 vaccines in Nigeria, some HCW were using some repurposed, unapproved drugs to possibly prevent the disease. This study evaluated the frequency and pattern of drug use for COVID-19 prevention.

Methods: This was a prospective cross-sectional study of HCW conducted in Southern Nigeria. Data was obtained from the participants using a questionnaire and blood sample was obtained for SARS-CoV-2 antibody testing. Data was analysed using the statistical package for social sciences (SPSS) version 23.

Results: One hundred and sixty-six participants were enrolled in this study. Thirty-two (19.3%) of them had taken a repurposed medication as prophylaxis for COVID-19. The most used drugs were Vitamin C (9%), Azithromycin (8.4%) and Zinc (6.6%). History of contact with patient with confirmed COVID-19 and being a pharmacist were independent factors associated with the use of COVID-19 prophylaxis.

Conclusion: Several HCW in Nigeria take drugs to possibly prevent COVID-19. These medications may not offer significant protection against COVID-19. There is an urgent need to increase uptake of COVID-19 vaccines in HCW in Nigeria.

Keywords: COVID-19; chemoprophylaxis; healthcare workers.
Factors associated with ocular injuries among adult road traffic accident patients presenting at Mulago National Referral Hospital, Uganda
Authors: Nalukenge Caroline , O Sebabi Francis , Okello Bonny , Ntende Jacob , Nakiyingi Lydia , Nakanjako Damalie , Nakubulwa Faith , Kalinaki Abubakar , Mulinde Ben , A Musika Anne
Published: October 2023

Background: Ocular trauma is the leading cause of unilateral blindness globally. Road traffic accidents are among the top risk factors for ocular trauma.

Objectives: This study aimed to evaluate factors associated with ocular injuries among adult road traffic accident patients at Mulago Hospital, Uganda.

Methods: A cross-sectional study was conducted among adult road traffic accident patients. History taking and ophthalmological examination were performed on consenting participants. Data was analysed using STATA version 14.0.

Results: Overall, 428 road traffic accident cases were enrolled, of which majority (84.3%) were male. Age 30-39years (aOR = 0.58, 0.36 – 0.94, p = 0.027), being male (aOR = 2.64, 1.21 – 5.13, p = 0.004) and being a passenger of motor vehicle/cycle (aOR = 3.85, 1.49 – 9.93, p = 0.005) were the factors associated with ocular injuries among the participants.

Conclusions: Age 30-39 years, male gender and being a passenger of motor vehicle/cycle were the factors associated with ocular injuries among the adult road traffic accident patients. Ocular injuries were more common among the road users who did not use safety measures. Use of safety measure by passengers of motor vehicles and cycles is recommended.

Keywords: Ocular injury; road traffic accident; sub-Saharan Africa.
The epidemiology and characteristics of patients with diabetes with or without NASH: a systematic review
Authors: K Aldossari Khaled
Published: October 2023

Introduction: NASH or “Non-alcoholic Steatohepatitis” is related to non-alcoholic fatty liver disease (NAFLD). The simultaneous occurrence of NASH and type 2 diabetes is common. However, only a limited number of studies have focused on the characteristics of patients with diabetes with or without NASH.

Objectives: This systematic review summarises epidemiological evidence related to the prevalence and characteristics of NASH in patients with diabetes.

Methods: Different electronic databases PubMed, Scopus, and Google Scholar were searched for the published articles. Original studies conducted in patients with diabetes published in English were included in this review.

Results: Thirteen studies were eligible for inclusion in this review. In patients with diabetes, increased BMI, overweight/obesity, increased HbA1c, increased serum cholesterol, and elevated liver enzyme levels have been strongly linked with NASH. Other significant characteristics include increasing age, being female, race(white), low HDL, metformin use, increased ferritin, and increased albumin levels. The prevalence of NASH ranged from 12% to 93.8%, the highest percentage was found in studies in Romania (87.1), and lowest in studies in India (12.5).

Conclusion: The incidence of NASH increases with age. Gender differences as a risk factor for NASH still need to be fully understood. This systematic review provides insight and strong indication to all patients with diabetes to visit hepatologists and screen for fatty liver disease. If steatosis is found on baseline ultrasound, a liver biopsy should be performed for timely management. At present, no NAFLD/NASH-specific medication on the market helps in treating the disease. New development of the drugs and ongoing research is important for the cure and treatment of NASH, with specific attention being provided to involve populations at high-risk.

Keywords: NAFLD; NASH; non-alcoholic steatohepatitis; diabetes mellitus; fatty liver; liver disease; systematic review.
The predictive value of eGFR combined with BNP detection in acute kidney injury after acute myocardial infarction
Authors: Geng Chen-Yu , Wang Fang-Ze , Zhang Rui , Liu Yan-Yu , Wang Jian
Published: October 2023

Objective: The combined detection of eGFR and BNP may provide some value in predicting the occurrence of AKI after AMI, and the study is designed to propose and validate this hypothesis.

Methods: In retrospective research, AMI patients hospitalized at Weifang People's Hospital from January to December 2020 were included. Whether AKI occurred within a week of admission, patients were divided into two groups. Clinical data from two groups of patients were collected, and the Logistic regression model analysed the risk factors for AKI after AMI. The association between eGFR and BNP was analysed using Pearson linear correlation. The predictive value of eGFR and BNP alone and combined detection on AKI after AMI was analysed using the receiver operating characteristic (ROC) curve.

Results: Multivariate logistic regression showed that eGFR, BNP, HDLC, UA, and K ions were AKI risk factors (P < 0.05). The eGFR correlates negatively with BNP (R = -0.324, P < 0.05). The area under the curve (AUC) of eGFR and BNP alone and combined prediction for post-AMI AKI were 0.793, 0.826, and 0.831, respectively.

Conclusion: The combined detection of eGFR and BNP has a high predictive value for AKI development in AMI patients.

Keywords: AMI; AKI; eGFR; BNP; predictive value.
Pulmonary artery diameter and NT-proBNP in patients with Covid-19: Predicting prognosis and mortality
Authors: Tastemur Mercan , Olcucuoğlu Esin , Arik Gunes , Ates Ihsan , Silay Kamile
Published: October 2023

Background: The diverse and complex presentations of COVID-19 continue to impact the world. Factors related to prognosis and mortality are still not fully illuminated.

Objectives: We aimed to asses the relationship of N-terminal pro B-type natriuretic peptide (NT-proBNP) and main pulmonary artery diameter (MPAD) with COVID-19 prognosis and mortality.

Methods: 152 COVID-19 patients over the age of 18, were included in the study. Thoracic CT, NT-proBNP values, laboratory and demographic data of these patients were obtained by retrospectively examining the patient files and scanning the results through the patient registry.

Results: According to multivariate logistic regression (LR) analysis, high NT-proBNP level (OR=3.542; 95% CI=1.745-9.463; p=0.021) and MPAD/ascending aortic diameter (AAD) ratio>0.75 (OR=2.692; 95% CI=1.264-9.312; p=0.036) were determined as independent risk factors predicting mortality in COVID-19 patients. A significant positive correlation was observed between NT-proBNP level and MPA diameter (r=0.296, p<0.001). The cut-off value was measured as 27.5 mm for MPA diameter and 742 pg/ml for NT-proBNP.

Conclusions: Accurate and effective interpretation of available radiological and laboratory data is essential to reveal the factors predicting prognosis and mortality in COVID-19. In this study,we evaluated that the thorax CTs and determined that the MPAD/AAD and NT-proBNP level were independent risk factors in predicting mortality.

Keywords: COVID-19; Pulmonary artery diameter; MPAD/AAD ratio; NT-proBNP.
Application of comfort nursing in mother-infant room exerts beneficial effects
Authors: Wang Yan , Li Jingjing
Published: October 2023

Objective: To analyse the clinical application of comfort care in mother-infant room.

Methods: A total of 150 cases of maternal and infant delivery in the same room were selected for the study, randomly divided into two groups, the experimental group and the control group were 75 cases. The control group took conventional nursing intervention measures, and the experimental group implemented the comfortable nursing intervention mode. Under the guidance of comfort concept, nursing management was carried out from environment, physiology, psychology and other aspects. The postpartum negative emotions, comfortable conditions, the growth and development of newborn babies and the satisfaction of nursing work were compared.

Results: After intervention, experimental group had lower scores of HAMD and HAMA as well as higher GCQ scores than those of control group (P < 0.05). The body length, body weight and head circumference of neonates, as well as nursing technology, professional service and environmental satisfaction in experimental group were higher than those in control group (P < 0.05).

Conclusion: Applying the comfort nursing mode in mother-infant room can help improve the maternal physical and mental states, promote the growth and development of newborn, and markedly improve the quality and efficiency of nursing work.

Keywords: Mother-infant co-living; comfort care; application; growth; development.
Effects of metabolic syndrome on bone mineral density in postmenopausal Turkish women
Authors: T Bahtiyarca Zeynep , Serçe Azize
Published: October 2023

Objective: In this study, we aimed to determine the potential effects of metabolic syndrome (MetS) and its components on bone mineral density (BMD) in the lumbar spine and femoral neck in postmenopausal Turkish women.

Patients and methods: 193 postmenopausal women were included in this study. Anthropometric measurements, biochemical blood tests, and T-scores of BMD in the lumbar spine (L1–L4) and femoral neck were recorded. The participants were divided into two groups according to the bone mineral density (BMD) results as osteoporosis group (Group 1, n=109) who had a T-score>−2.5 at the spine or/and femoral neck, and the control group (Group 2, n=84) who had T-score>−2.5 at the spine or/and femoral neck. MetS and its components were screened using the criteria of the Adult Treatment Panel III (ATP III) and National Cholesterol Education Program (NCEP). The effects of the MetS components on T-scores of BMD at the femoral neck and lumbar spine were evaluated by partial correlation test and multiple regression analysis.

Results: MetS was detected in 58 (30.1%) participants. The prevalence of MetS was significantly higher in Group 2 compared to Group 1 (39.3% vs 22.9%, p=0,014). Among the MetS components, especially abdominal obesity showed a significant positive correlation with T-scores of BMD at the femoral neck and spine. A weak but significant correlation was also observed with systolic and diastolic blood pressure, serum triglyceride levels, and fasting blood glucose (FBG). Multiple regression analysis revealed an association between waist circumference and BMD at both femoral neck and spine, and also between serum triglycerides, systolic and diastolic blood pressure, and spine BMD.

Conclusion: Our findings support that MetS is associated with increased BMD at the femoral neck and spine in postmenopausal women. A significant positive association was observed among the MetS components, especially with abdominal obesity, and also a weak positive association with serum triglycerides, and systolic and diastolic blood pressure.

Keywords: Postmenopausal women; bone mineral density; metabolic syndrome; osteoporosis.
The prevalence of sexual violence against African women: a systematic review and meta-analysis
Authors: Xianguo Qu , Hui Cao , Xin Shen , Jing Feng , Zijian Wang , Zhenyu Niu , Yong Gan
Published: October 2023

Background: High rates of sexual violence ratios in low-income countries are recognized as a global public health problem. The incidence of violence against African women has been increasing. However, no study has systematically summarized the global prevalence of sexual violence against African woman.

Methods: We conducted a comprehensive search of PubMed, Embase and Web of Science, databases from their inception through January 2021 for pertinent studies on reporting the prevalence of sexual violence against African women. We included observational studies. The prevalence rate was estimated using a random-effects meta-analysis. The heterogeneity was evaluated using I2 statistic. Differences by study level characteristics were estimated through subgroup analysis and meta-regression.

Results: A total of 9 cross-sectional studies were included (a total of 9,030 participants). The pooled sexual violence rate was 0.33 (95% CI = 0.23–0.42). Subgroup analyses found that there was a higher rates of sexual violence against pregnant woman in east Africa (0.41, 95% CI = 0.24–0.58), pregnant (0.42, 95% CI = 0.05–0.80), and interview (0.40, 95% CI = 0.01–0.78). The analysis found that the major sexual violence types were the physical violence (0.19, 95% CI = 0.07–0.31), psychological violence (0.36, 95% CI = 0.11–0.61), sexual assault (0.25, 95% CI = 0.02–0.47).

Conclusions: Nearly one out of every three (33%) African woman around the world has been a victim of sexual violence in their life. This current study investigated the status and characteristics of sexual violence against women, which could provide an important reference for the African health care provider. Assessing this problem against African women helps government officials, policy makers, program designers and non-governmental organizations to design prevention and controlling strategies.

Keywords: Sexual violence; African women; Meta-analysis.
Editorial: Reducing the risks of nuclear war: the role of health professionals
Authors: Abbasi Kamran , Ali Parveen , Barbour Virginia , Bibbins-Domingo Kirsten , G M Olde Rikkert Marcel , Gong Peng , Haines Andy , Helfand Ira , Horton Richard , Mash Bob , Mitra Arun , Monteiro Carlos , N Naumova Elena , J Rubin Eric , Ruff Tilman , Sahni Peush , Tumwine James , Yonga Paul , Zielinski Chris
Published: October 2023

NIL
Digestive manifestations of Covid-19 in children: a retrospective study
Authors: Jallouli Abderrahmane , El Fakiri Karima , Nassih Houda , EL Qadiry Rabiy , Bourrahouat Aicha , Ait Sab Imane , Rada Noureddine , Draiss Ghizlane , Bouskraoui Mohammed
Published: October 2023

Background: The world is currently facing a pandemic due to a new species of the Coronaviridae family called SARS-CoV-2,discovered in the city of Wuhan in China in December 2019. The WHO has named the resulting disease COVID-19 (CoronavirusDisease 2019). It has been a global health problem due to its major socio-economic damage. The aim of this study was toshow the prevalence of gastrointestinal and hepatic manifestations in symptomatic children with COVID-19.

Methods: We performed a retrospective study, including 36 symptomatic children infected by SARS-CoV-2 hospitalized at themother and child hospital of university hospital of Mohammed VI, Marrakech in Morocco, over a period of 7 months. Clinicaland biological manifestations of the digestive system were evaluated for all patients.

Results: The digestive symptomatology came in second place after the respiratory manifestations. 14 patients (38.89 % ofsymptomatic patients) in our study had digestive symptoms on admission: 12 (33.33%) presented with diarrhea, 4 (11.11%) hadabdominal pain and only one child (2.78%) had vomiting. Aspartate aminotransferase (AST) was elevated in one patient, whilealanine transaminase (ALT) was elevated in 6 patients. The prothrombin level was normal in all patients. All patients were dischargedwith good general condition without morbidity and mortality.

Conclusion: This study concludes with the high prevalence of digestive manifestations of COVID-19 in symptomatic children.There were no severe clinical or biological abnormalities in our study. Digestive manifestations during COVID-19 in childrenare frequent, which requires the awareness of health professionals

Keywords: COVID-19; digestive manifestations; children.
Endoscopic esophageal foreign body removal among children at Lubaga Hospital, Kampala, Uganda
Authors: Okello Michael , Bakeera-Kitaka Sabrina , Ocama Ponsiano , Patience Nabwire Esther , Darshit Dave , Namata Christine , Ainembabazi Tinka Annah
Published: October 2023

Background: Diagnostic upper gastrointestinal endoscopy involves examination of the lining of the esophagus, stomach and part of the duodenum. Interventional endoscopy in addition to evaluating the upper gastrointestinal tract to make a diagnosis, also offers a treatment benefit. Traditionally, esophageal foreign bodies (FBs) in Uganda were removed using rigid endoscopy. We therefore report an emerging trend of using flexible endoscopy to remove these FBs.

Objective: To describe participant characteristics and endoscopic findings among children who underwent esophageal FB removal in Lubaga Hospital in Kampala.

Methods: This was a retrospective review of endoscopy reports for children who underwent endoscopic esophageal FB removal at Lubaga Hospital from December 2014 to March 2022.

Results: Overall, 61 symptomatic children underwent this procedure. The majority of the FBs were removed by flexible endoscopy (n=55, 90.16%). The mean age of the participants was 7.88 (SD=2.12) years old. The majority of the children were females (72.13%) and coins were the most ingested FBs (84%), others included steel crucifix, nails etc. The upper esophageal sphincter was the commonest site for FB impaction (74%).

Conclusion: We report high success rates of 90.16% for endoscopic removal of impacted esophageal foreign bodies among Ugandan children using the now widely available flexible endoscopy.

Keywords: Endoscopy; esophagus; foreign body.
Clinicopathological pattern of oestrogen receptor, progesterone receptor and human epidermal growth factor receptor-2 over-expression of epithelial ovarian carcinomas in Nigeria
Authors: Akanji Ajani Mustapha , Lawan Aliyu , Oke Temitope , Khramtsova Galina , Nwanji Ifeanyichukwu , Salami Ayodeji , Awolude Olutosin , Ebili Henry , E Onwukamuche Michael , Sveen Elisabeth , Yoshimatsu Toshio , I Olopade Olufunmilayo
Published: October 2023

Background: Ovarian cancer is the leading cause of death from all gynaecological malignancies. Only few biomarkers of epithelial ovarian cancer (EOC) prognosis have been studied so far among Nigerian patients.

Objective: To determine the pattern of oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) expression in patients with EOC seen in Nigeria

Materials and Methods: This was a retrospective multicentre study of 102 cases of epithelial ovarian cancers. Relevant clinical information was obtained from hospital-based records in the 3 participating centres. Tissue microarrays were constructed using representative tumour tissue and the ER, PR and HER2 immunohistochemical staining was carried out at the University of Chicago, United States of America.

Results: Serous carcinomas predominated (71% of cases). ER positivity was observed in 31.4%, PR positivity in 21.5% and HER2/neu in 16.7% of tumours. Fifty-two percent of tumours were triple negative. Serous tumours were significantly associated with ER positivity (p=0.001). Mean patient age for EOC was 52.6 ± 13.1 years. There were no statistically significant associations between hormone receptor status and histological grade, FIGO staging or survival.

Conclusion: Serous tumours were significantly associated with ER expression while non-serous tumours tended to be triple negative.

Keywords: Oestrogen receptor; Progesterone receptor; HER-2 over-expression; Epithelial ovarian cancer.
Knowledge of breast cancer, willingness and barriers to mammography screening among rural women in Enugu State, Nigeria
Authors: Ijeoma Abugu Lawreta , Nwanebe Nwagu Evelyn , Ifeoma Okeke Adaustin , Ngozi Odo Amelia
Published: October 2023

Background: Breast cancer is a serious public health threat. Mammography is the most reliable screening method that detectsbreast cancer early, enabling early onset of treatment which improves the prognosis of the disease.

Objectives: To determine women’s knowledge of breast cancer, as well as barriers and willingness of women to participate inmammography screening.

Methods: Using the cross-sectional survey design, we sampled and studied two rural communities of Enugu State, Nigeria.Two researcher-made questionnaires were used for the study. Frequencies, percentages, chi-square and regression analysis wereemployed in data analysis.

Results: Only 11.4 percent of study participants had good knowledge of breast cancer. There were significant differences inknowledge of breast cancer based on level of education (χ2 = 15.670; p =.001), monthly income (χ2 =6.954; p = .021) and everscreened (χ2 =5.242; p =.015). Lack of money (48.0%) and lack of knowledge (30.4%) were the most reported barriers to breastcancer screening. Women that had ever screened were 92.3% less likely willing to be screened than those never screened (aOR:.077, 95%CI .011-.522, p=.009).

Conclusion: Health Education should be combined with improving women’s economic status and subsidizing the cost ofscreening to increase breast cancer screening practice.

Keywords: Mammography; breast cancer; screening practice; knowledge.
Prevalence and predictors of type 2 diabetes complications: a single centre observation
Authors: O Iheanacho Chinonyerem , Folashade Akhumi Tolulope , I H Eze Uchenna , A Ojieabu Winifred
Published: October 2023

Background: Diabetes complications are a major burden on persons living with diabetes and the health care systems.

Objectives: The study assessed the glycemic control, prevalence and predictors of type 2 diabetes complications among patientsin a healthcare centre.

Methods: Two hundred adults who had type 2 diabetes in a general hospital were recruited for the study. Cross-sectional andretrospective surveys were used to determine prevalence, number and types of complications in the patients. SPSS version 21was used for descriptive analysis and Chi-square (p<0.05).

Results: A total of 200 (100%) respondents participated in the study and 97 (48.5%) had poor glycemic control. Mean numberof complications per patient was 2.48 ± 1.22. Number of complications per person and type of complications were significantlyassociated with Age (p = 0.000 and p = 0.000, respectively), Gender (p = 0.008 and p = 0.031, respectively) and Occupation(p=0.000 and p=0.006, respectively). Marital status (p = 0.032) and years of diagnosis (p=0.021) were also associated with typeof complications. The majority of patients 64 (32.0%) were admitted in the previous year for diabetes-related complications.Majority 159 (79.5%) had ≥ 2 number of complications from the observed 497 complications.

Conclusions: Poor glycemic control and high prevalence of complications were observed. Also, socio-demographic characteristicswere likely predictors of number and type of complications. These findings are essential for improved planning andprioritizing of diabetes care.

Keywords: Complications; Nigeria; prevalence; socio-demographics predictors; type 2 diabetes.
A comparative study on the effectiveness of paracervical block and parenteral diclofenac for pain relief during manual vacuum aspiration
Authors: F Osinachi Iyke , O Akaba Godwin , D Adewole Nathaniel , I Omonua Kate , A Ekele Bissallah
Published: October 2023

Objective: To compare the effectiveness of paracervical block with intramuscular Diclofenac for pain relief during manual vacuum aspiration (MVA) for early pregnancy losses.

Methodology: This was an open label randomized controlled trial. Participants were randomized into two therapeutic groups (A and B) using computer generated numbers. Group A received intramuscular Diclofenac 75 mg. Group B received paracervical block using 1% Lidocaine. Participants were asked to rate their pain level on a continuous 10 cm visual analogue scale (VAS) from 0 (no pain) to 10 (the worst pain ever) within 5 minutes of completing the procedure. Participants’ level of satisfaction was assessed within 30 minutes of completing the MVA using Likert scale. Data was analysed using the Statistical Package for Social Sciences (SPSS), Version 20. Test of statistical significance was set at 95% confidence level (P < 0.05). The primary outcome was the level of pain felt by the patient during the procedure (10 cm VAS). Secondary outcomes included patient’s satisfaction and adverse events.

Results: There was significant difference in the mean pain level between the intramuscular diclofenac group; 6.5±1.5 (moderate) and those that received paracervical block; 2.3±1.5 (mild), (p-value=0.005). Patients’ satisfaction was also better in paracervical block group compared to intramuscular diclofenac group, (p-value=0.005). Both groups were comparable in terms of complications and drug side effects.

Conclusion: Findings from the study suggest that the use of paracervical block compared to intramuscular Diclofenac for pain relief during MVA for incomplete miscarriage significantly reduced pain, improved patients’ satisfaction and was comparably safe.

Keywords: Paracervical block; Diclofenac; Pain relief; Manual vacuum aspiration.
Impacts of the Covid-19 pandemic on smoking cessation success
Authors: Ayşe Turan Pakize , Turan Onur
Published: October 2023

Setting-objective: Current COVID-19 outbreak has led to many behavioural changes, including smoking behaviours. We aimed to investigate the success of quitting smoking of smoking cessation outpatients.

Design: Patients who applied to the smoking cessation outpatient clinic of a state hospital during the pandemic were retrospectively analysed. Smoking cessation success, personal views and experiences about COVID-19 were questioned. Hospital Anxiety and Depression (HAD) Scale was applied.

Results: The smoking cessation rate in the study population was 14.7%. The reasons for not being able to quit smoking were; stress (51.9%), drug discontinuation (28.4%) and reasons related to COVID-19 (12.3%). According to HADS scores; 35.8% of the participants were at risk for anxiety and 72.6% for depression. Those with pulmonary symptoms at the time of application (p=0.001), those who continued smoking cessation treatment (p=0.016), and those without depressive symptoms (p=0.040) were significantly more successful in quitting smoking. The rate of continuing smoking was significantly higher in patients with a history of COVID-19 <18.9% of participants>(p=0.013).

Conclusion: Intense stress and depressive symptoms, discontinuation of smoking cessation treatment and being infected with Coronavirus negatively affect the smoking cessation process in pandemic. These parameters should be considered during smoking cessation interviews and behavioural support should be obtained if necessary.

Keywords: Smoking; cessation; pandemics.
Molecular characterization of multidrug resistant (MDR) clinical isolates of Pseudomonas aeruginosa from Nsukka, South Eastern Nigeria
Authors: C Agbo Martina , O Ugwu Kenneth , N Ukwah Boniface , M Ezeonu Ifeoma
Published: October 2023

Background: P. aeruginosa is an important nosocomial pathogen with increasing resistance to antibiotics. Objective: This studywas performed to evaluate the genetic relatedness of MDR clinical isolates of P. aeruginosa.

Method: A total of 1000 samples were analysed in the study. Antibiotic resistance profiles of the isolates were determined usingKirby Bauer disk diffusion method. Polymerase chain reaction (PCR) and sequencing were simultaneously used to detect theconsensus region of 16S rRNA. Genetic relatedness of the isolates was determined using restriction patterns from ALU 1 digestand random amplified polymorphic DNA.

Results: Out of the 192 P. aeruginosa isolates recovered, 136 (78.83%) were multidrug resistant. Sequence analysis of the confirmedisolates (80.68%) revealed that all the isolates shared homology with each other and also showed sequence similarity toknown strains of P. aeruginosa (ATCC 27853; KT 315654; KU 321274 and KT894767). The PCR-Restriction fragment lengthpolymorphism (PCR-RFLP) analysis revealed that there was a lot of genetic relatedness among the isolates. The RFLP fingerprinting technique detected seven distinct RFLP types among the isolates.

Conclusions: Thus, study shows that there is high prevalence of MDRPA and high degree of genetic relatedness among theMDRPA isolates circulating in Nsukka area.

Keywords: MDRPA; PCR-RFLP; RAPD; Sequencing; 16S rRNA gene.
The occurrence of fungi from burn wound patients and antifungal susceptibility patterns: a cross-sectional study in Lusaka, Zambia
Authors: Sikwewa Kapembwa , Simusika Paul , Mumbula Mulowa , M Mwenya Darlington , Mandona Chungu , Mulundu Gina
Published: October 2023

Background: Fungal opportunistic infections in burn wound patients are among the leading cause of morbidity and mortality.Attention remains focused on preventing bacterial infection at the expense of increasing fungal infection in burn wound patients.

Objective: To determine the occurrence of common fungi in admitted burn wound patients and their environment: and theirantifungal susceptibility patterns at the University Teaching Hospitals, Lusaka, Zambia.

Methods: This laboratory-based cross-sectional study enrolled a total 101 participants whose pus swab specimens were collectedfrom their burn wounds as well as 50 environmental swabs collected from strategic points. Wet mount, gram stain, culture onSabouraud dextrose agar, Corn meal agar and Germ tube were used to identify possible fungal isolates. Agar based disc susceptibilitytest was carried out using fluconazole. Data was analysed using Excel and STAT version 14.

Results: Median age was 3 years and median burn % of TBSA was 18 in participants’ who had burn wound fungal infectionand consisted of 3 males and 6 females. Organisms isolated included Candida albicans from 8(7.9%) participants and 2(4%) from50 environmental swabs. 1(1%) Candida spp was isolated from pus swabs. Out of the total 11 Candida isolates, 4 (36.4%) weresusceptible to fluconazole and 7 (63.6%) were resistant.

Conclusion: The isolation of Candida albicans and Candida spp from burn wound patients and the hospital ward environmentsuggests presence of fungi in burn wound patients and hospital ward environments. Candida isolated showed varying susceptibilitypatterns to fluconazole.

Keywords: Burns; Candida albicans; CLSI; fungal infection; Susceptibility patterns.
Preoperative bowel preparation promotes intestinal functional recovery after esophagectomy
Authors: Ma Junliang , Chen Shaolin , Ren Xiaoying , Han Hao , Gong Ming , Song Yongxiang , Liu Lijuan
Published: October 2023

Background: Patients are prone to intestinal dysfunction after esophagectomy. The value of preoperative bowel preparation before esophagectomy is controversial. There is a lack of evidence as to whether preoperative bowel preparation can help patients improve bowel function and shorten the recovery time of bowel function.

Objectives: The objectives of this study were to explore whether preoperative bowel preparation can promote the recovery of intestinal function after esophagectomy.

Methods: We analysed 139 patients who underwent elective radical esophagectomy in the Department of Thoracic Surgery at the Second Affiliated Hospital of Xi'an Jiaotong University from May 2016 to December 2018. The enrolled patients were divided into the study group (bowel preparation group) and the control group (no bowel preparation group) of 71 cases and 68 cases. Patients in the study group were given dissolved polyethylene glycol electrolyte powder and a cleansing enema the day before surgery. Patients in the control group were neither given polyethylene glycol electrolyte powder nor cleansing enemas before surgery. The postoperative recovery of the two groups were compared.

Results: Postoperative bed rest time, bowel function recovery time and the time of first flatus and defecation after surgery were significantly shorter in patients with bowel preparation than in those without bowel preparation, and the differences were statistically significant. (P=0.038, P﹤0.001, P﹤0.001, P﹤0.001; respectively).

Conclusions: Preoperative bowel preparation can promote the recovery of patients with esophageal cancer, especially the recovery of bowel function, which can reduce the pain caused by abdominal distension and improve the quality of life of patients.

Keywords: Intestinal dysfunction; esophagectomy; retrospective cohort study.
Application value of high-frequency ultrasound combined with ultrasonography in the diagnosis of neonatal esophageal atresia
Authors: Ge Yurong , Xu Baoyue , Shi Jing , Tang Weiwei
Published: October 2023

Objective: To explore the application value of high-frequency ultrasound combined with ultrasonography in the diagnosis of neonatal esophageal atresia (EA)

Methods: Seventy neonates with suspected EA who received healing in our hospital from August 2019 to April 2022 were retrospectively selected as the study subjects and their preoperative esophageal high-frequency ultrasound and ultrasound hydrography data were analysed. The diagnostic value of high-frequency ultrasound, ultrasound hydrography and combined detection in neonatal EA was analysed using intraoperative findings as the gold standard;

Results: (1) Among the 70 children with suspected EA, 62 were confirmed to be positive and 8 were negative; 59 were positive and 11 were negative by ultrasound hydrography alone; 61 were positive and 9 were negative by high-frequency ultrasound alone; 62 were positive and 8 were negative by combined detection.(2) The accuracy of combined detection was 97.14%, which was notably different from 92.86% by high-frequency ultrasound and 84.29% by ultrasound hydrography (P < 0.05).(3) The diagnostic AUC of ultrasound hydrography, high-frequency ultrasound, and combined detection for EA was 0.6125, 0.6500, and 0.6563, respectively (P < 0.05).(4) There was no significant variation in the distance between preoperative high-frequency ultrasound, ultrasound hydrography, and intraoperative measurements of distal and proximal blind ends of type IIIA and IIIB EA esophagus (P > 0.05);

Conclusion: High frequency ultrasound and super fresh water injection angiography have good application value in the diagnosis of neonatal EA. There is no significant difference between the distance between the distal and proximal blind ends of the esophagus before and during the operation of type III EA and that during the operation of super fresh water injection angiography. However, in consideration of the risk of radiation and poisoning caused by esophagography, it is recommended that high-frequency ultrasound be selected first for diagnosis and if necessary, esophagography be supplemented for joint diagnosis.

Keywords: High frequency ultrasound; Ultrasound angiography; Neonatal esophageal atresia; Application value.
Effects of 0.15% ropivacaine alone and combination with sufentanil on epidural labor analgesia and adverse reactions
Authors: Zhong Huanhui , Wang Yongdong , Wang Yiqun , Li Heng
Published: October 2023

Objective: The aim of this study was to compare the impacts of 0.15% ropivacaine alone and 0.15% ropivacaine combined withsufentanil on epidural labor analgesia.

Methods: A total of 297 eligible primiparae were randomly divided into group A (n=149, 0.15% ropivacaine + sufentanil) andgroup B (n=148, 0.15% ropivacaine). Visual analogue scale (VAS) scores prior to analgesia and 20 min following epidural medication,the maximum VAS score during labor, dosage of analgesic drugs, modified Bromage score, satisfaction degree, laborduration, delivery mode, 1-min and 5-min Apgar scores of newborns, adverse reactions during analgesia, and fever during laborwere recorded.

Results: Group A and B had similar VAS scores 20 min following epidural medication and maximum score during labor(P>0.05), which significantly fell compared with those before labor analgesia (P<0.05). The occurrence rates of nausea andvomiting were of significant difference (P<0.05).

Conclusion: 0.15% ropivacaine alone achieves a comparable epidural labor analgesia effect to that of 0.15% ropivacaine + 0.05μg/mL sufentanil on primiparae.

Keywords: Ropivacaine; sufentanil; epidural labor analgesia; adverse reaction.
Non-specialized care of skin disorders: a cross-sectional survey of new patients attending dermatology clinic in a tertiary hospital in Jos, Northcentral Nigeria
Authors: O Adah Ruth , John Collins , Uhunmwangho Courage , U Adah Gabriel , N Okolo Seline
Published: October 2023

Background: Given the paucity of skin health specialists in Nigeria and the low level of awareness amongst its populace, patients seek for care for skin related disorders from different sources and are given a variety of remedies before accessing specialist care.

Objectives: This study was aimed at describing outlets visited and medication received by patients with skin disorders prior to attending the dermatology outpatient clinic in JUTH.

Methods: This was a cross sectional study conducted over one year. Information on socio-demography, sources and medication received prior to presentation was obtained and analysed using SPSS 23.

Results: The male: female ratio among 166 consenting new patients was 1:1.4. Prior to presentation patients sought care most frequently from Health facilities (68.1%), Patent medicine vendors-PMV (30.7%) and Traditional healers (21.7%). Overall, different steroid preparations were the most commonly used medications (56.6%) across all age groups with fixed combination preparations most frequently used (32.5%). Unconventional substances reportedly used by patients for skin disorders were urine, toothpaste, tomatoes, salt, water in which a life catfish had been kept and fats from a dead dog. Only 21.1% of the patients did not use any medication prior to presentation.

Conclusion: There is need to increase capacity in the care of common skin diseases at all levels of the health care system to decrease patronage of unconventional providers. Raising awareness of the general public on the potential dangers of inappropriate treatment of skin diseases and strengthen referral system is imperative to reduce the burden of skin diseases in the country.

Keywords: Non-specialized; skin diseases; unorthodox; treatment; dermatology; clinic.
Prevalence, causes and associated factors of visual impairment and blindness among older population in outreach site, Northwest Ethiopia. A dual center cross-sectional study
Authors: Temeselew Tegegn Melkamu , Kegne Assaye Aragaw , Tilahun Belete Gizachew
Published: October 2023

Purpose: The study aimed to determine the prevalence, causes, and associated factors of visual impairment and blindnessamong the older population in Outreach sites, Northwest Ethiopia.

Methods: A community-outreach-based cross-sectional study was conducted on 821 older population which were selectedusing a systematic random sampling technique. Face-to-face interviews and ocular examinations were performed to collect thedata. A binary logistic regression was performed.

Result: A total of 821 participants were recruited for the study with a median age of 57 years, with a range of 40-91 years. Outof 821 participants, 41.8% had visual impairment, and 11.7% were blind. Sixty-four and fifty seven percent of visual impairmentand blindness were caused by cataract. Age ≥70years (AOR=15.0; 95%CI: 8.4-26.9), rural residency (AOR=2.3; 95%CI: 1.5-3.6),non-formal education (AOR=3.0; 95%CI: 1.6-5.6), unemployed (AOR=1.5;95%CI:1.05-2.4) and history of eye examination(AOR=1.7;95%CI:1.1-2.8) were positively associated with visual impairment. Similarly, blindness was significantly associatedwith age ≥ 70years (AOR=7.2; 95%CI: 3.1-16.6), rural residency (AOR=2.2;95%CI:1.2-4.2), and history of eye examination(AOR=1.9; 95%CI: 1.1- 3.3).

Conclusion: The prevalence of visual impairment and blindness in this study was found to be high. Age, residency, educationalstatus, occupational status, and history of eye examination were significantly associated with visual impairment and blindness.

Keywords: Visual impairment; blindness; older population; Northwest Ethiopia.
The relationship between weight self-stigma, depression and loneliness in people with obesity
Authors: A Özdemir Aysel , Türkben Hilal
Published: October 2023

The research was conducted to determine the level of weight self-stigma, depression loneliness and whether is there a relationshipbetween them. This was a descriptive correlational study. The study was conducted in a diet outpatient clinic of auniversity hospital. Participants had moderate weight self-stigma, depression and loneliness. Weight self-stigma sub-dimensionsself-devaluation (β=0.28; p<0.001) and fear of enacted stigma (β=0.28; p<0.001) equally predicted depression. Fear of enactedstigma predicted social loneliness negatively (β=-.44; p<0.001). Fear of enacted stigma (β =.16, p<.005) and depression (β =.44,p<.001) predicted emotional loneliness positively. Weight self-stigma was positively correlated with depression and loneliness(p<0.001).

Keywords: Obesity; weight self stigma; depression; loneliness.
Factors influencing public and private healthcare utilisation in Uganda
Authors: Turyamureba Medard , L Yawe Bruno , Oryema John Bosco
Published: October 2023

Background: In Uganda, health care utilisation remains very low despite a number of government reforms that have beenimplemented in the health sector since the 1990’s such as decentralization and removal of user fees in public health facilitiesamong others.

Objective: To examine the factors influencing public and private health care utilisation in Uganda.

Methods: The study used cross sectional data from the Uganda National Household Survey collected between July 2016 andJune 2017. Anderson’s conceptual framework was used to identify explanatory variables associated with choice of health careproviders and a multinomial logistic regression model was estimated.

Results: Out of the 17,912 individuals who sought care, 36% used a government facility, 60% used private facility while 4% hadself- care/treatment. The results show that out of pocket health expenditure, age, level of education, marital status, residence,and type of illness significantly influenced choice of public healthcare providers. Similarly, utilisation of private healthcare providerswas associated with household welfare, level of education, residence, marital status, illness days, and type of illness.

Conclusion: The findings highlight the need for a national health insurance scheme to reduce out of pocket payments for healthcare and enable the poor and vulnerable patients visit the modern health facilities.

Keywords: Utilisation; multinomial logit; health care provider, policy; Uganda.