bluuebunny/crossref_metadata_2025 huggingface dataset:
One Side Ovarian Rejuvenation: A Quasi-Experimental Study of the Effect of the Autologous Platelet Rich Plasma in Poor Ovarian Responders in IVF
Authors: Fatemeh Keikha  , Saeideh Shahsavari  , Yalda Salari  , Nasibeh Roozbeh  , Fedyeh Haghollahi  , Masoumeh Dehghan Tarazjani  , Maryamalsadat Razavi  , Mamak Shariat  , Maryam Bagheri
Published: July 2024

BACKGROUND: The poor ovarian response is the most important limiting factor in the success of in vitro fertilization (IVF). The aim of this study was to evaluate the outcome of intraovarian injection of autologous platelet-rich plasma (aPRP) on the oocyte number and IVF outcomes in poor ovarian responders (POR).
METHODS: This quasi-experimental study was performed from August 2021 to December 2021, in Vali-e-Asr Infertility Clinic affiliated with Tehran University of Medical Sciences, Tehran, Iran. There were 12 POR patients selected based on the criteria of Bologna group 4 who underwent two IVF cycles with similar antagonist regimens in a 70-day-interval. Immediately after the Oocytes Pick-Up (OPU), there was a 4cc of autologous PRP multifocal intramedullary injection done into their right ovaries in the first IVF cycle (case group). On the other hand, their left ovaries were considered as the control group. The patients underwent the second IVF cycle after 70 days.
RESULTS: Those who had undergone aPRP experienced a significant increase of the mean of antral follicular count (AFC) (from 1.91±0.79 to 2.50±0.90, p=0.043). There was a significant increase in the number of embryos from the right ovary (intervention group) compared to the left ovary (control group) after PRP, but there was no significant difference in the number of embryos in the right ovary before and after the intervention (from 0.25 ±0.45 to 1.08±0.79, p=0.705). There was no significant change in the number of oocytes, AMH, and FSH in the case and control groups before and after the intervention (p>0.05).
CONCLUSION: According to the results of this study, it seems that in females with POR, intraovarian aPRP had no effect on the outcomes (embryos number, number of oocytes, FSH and AMH level), except for an increase in AFC.
The Association between Colorectal Cancer and Colonoscopic Conditions in Saudi Patients: A 10-Year Cross-Sectional-Retrospective Study
Authors: Samah Alharbi  , Arwa F Flemban  , Saeed M Kabrah  , Asim A. Khogeer  , Hanaa Alahmdi  , Ahmed Abu Mansour  , Adwa K Qari  , Ghadi J Alqasimi  , Lama S Almasoudi  , Rahaf S Alotaibi  , Raneem F Alskhairi  , Rozan A AlHarbi
Published: July 2024

BACKGROUND: In Saudi Arabia, colorectal cancer (CRC) is the most common cancer in males and the third most common cancer in females. The current gold standard for colorectal cancer diagnosis is colonoscopy. Several concerns regarding the balance of ordering colonoscopy procedures for patients presenting with signs and symptoms. There are also several concerns regarding over-ordering the procedure when unnecessary. The current study aimed to evaluate the association between colorectal cancer and colonoscopic conditions in Saudi patients.
METHODS: A 10-year cross-sectional study was conducted at Alnoor Specialty Hospital, Makkah, over the last ten years. Colonoscopy reports of patients were evaluated to identify the colonoscopy manifestations associated with mass, polyps, and bleeding.
RESULTS: The current study evaluated 2158 cases admitted to the hospital for colonoscopic diagnosis. Results indicated that most of the patients were males (55.4%). Additionally, results showed a significant statistical association between tumor and bleeding, polyp, and hemorrhage. Moreover, it highlighted the association between polyps and bleeding, inflammation, and diverticulosis.
CONCLUSION: CRC screening in Saudi Arabia is comprehensive; however, there are a few areas for improvement, including standardization of colorectal cancer pathology reporting to improve the health system's quality. Also, the current study identified conditions that are significantly associated with reported colon polyps and tumors, which could aid in stratifying patients selected for screening via colonoscopy.
Screening of Extended Family Members of Thalassemia Major Children as a Thalassemia Preventive Strategy
Authors: Naresh Dattatraya Sonkawade  , Aarti Avinash Kinikar  , Rajesh K Kulkarni  , Rahul M Dawre  , Chhaya T Valvi  , Pragathi A Kamath
Published: July 2024

BACKGROUND: Thalassemia is considered as the most common single gene disorder worldwide. Preventive measures include identification of thalassemia carriers (traits) through screening, genetic counselling and prenatal diagnosis to reduce the incidence. This study aims at estimating the prevalence of carrier status detection among the extended family members of children having thalassemia major so as to use it as a screening prevention strategy with appropriate counselling.
METHODS: This cross-sectional study was conducted in thalassemia unit of Pediatric Department of a tertiary care teaching hospital over a period of 18 months. Blood samples were collected from 117 extended family members (EFM) of 23 children with thalassemia major to carry out investigations such as Complete Blood Counts (CBC), Naked Eye Single Tube Red Cell Osmotic Fragility Test (NESTROFT), Reticulocyte count, High Performance Liquid Chromatography(HPLC) and serum ferritin. Reports were analysed to find out the prevalence of carriers.
RESULTS: Among 117 EFM, 62 (52.9%) were males while 55(47.1%) were females. Mean age distribution in this study was 16.49 years (8.5). Prevalence of thalassemia trait (carrier) was 35%. NESTROFT test was positive in 57(48.7%) participants. The binary logistic regression found only positive NESTROFT test as a predictor (adjusted OR=0.022, P=0.001) of having raised HbA2 (HbA2≥3.5 %).
CONCLUSION: Screening of thalassemia carrier by targeting extended family members of thalassemia major children could yield more carrier cases and targeted counselling could help effectively in decreasing the number of children born with thalassemia major. This strategy could be included in future plan of national prevention programme for thalassemia.
Time to Discharge and its Predictors among Children Aged 1-60 Months with Severe Acute Malnutrition Admitted to the Therapeutic Feeding Center in A Tertiary Hospital, North West Ethiopia
Authors: Mehretie Kokeb  , Abinet Mariyo
Published: July 2024

BACKGROUND: Standard treatment of severe acute malnutrition with medical complication and/or failed appetite test is admission in therapeutic feeding centers for stabilization. Once stabilized, patients will be linked to Outpatient treatment program for rehabilitation. Information regarding time to discharge from inpatient therapeutic feeding centers is limited in Ethiopia. The main objective of this study was to assess the time to discharge and its predictors among children1-60 months with Severe Acute Malnutrition admitted to University of Gondar Hospital.
METHODS: Hospital Based retrospective follow up study was conducted in Gondar University Hospital among 282 children aged 1-60 months admitted to inpatient Therapeutic Feeding Center from June 2018 to December 2020. Participants were selected by Simple random sampling technique. Time to discharge from inpatient treatment was estimated using Kaplan-Meir procedure and Log Rank test was used to test observed difference between covariates. Identification of predictors for time to discharge was done by Stratified cox regression model.
RESULTS: Overall 282 children were studied; 242 (85.8%) were discharged improved and 40 (14.2%) were censored. The median time to Discharge was 13 days (IQR: 9-18) and the Incidence of discharge was found to be 6.4 (95% CI: 5.6-7.2) per 100 person- day observations. Kwash-dermatosis (AHR=2.4, 95% CI: 1.17-4.8), Anemia (AHR=1.7, 95% CI: 1.1-2.6), pneumonia at admission (AHR=1.6, 95% CI: 1.01-2.63) and Hospital acquired infection (AHR=4.4, 95% CI: 2.4-8.2) were predictors of time to discharge.
CONCLUSION: Hospital stay at the stabilization center was prolonged. Pneumonia, anemia, kwash dermatosis and Nosocomial infections were significant predictors of time to discharge.
High Magnitude Advanced Colorectal Cancer at Diagnosis in Ethiopian Patients: Imaging Pattern and Associated Factors
Authors: Assefa Getachew Kebede  , Tesfaye Kebede  , Asfaw Atnafu
Published: July 2024

BACKGROUND: Colorectal cancer (CRC) is one of the most prevalent and incident cancers worldwide with an Increasing prevalence in a younger age in developing countries. The aim of the study was to determine the staging and imaging pattern of CRC at diagnosis.
METHODS: This is a descriptive cross-sectional study including all consecutive cases of CRC found in the departments of radiology and oncology during the study period from March 2016 - February 2017.
RESULTS: A total of 132 CRC cases were studied with M: F = 2.4:1, mean age of  46yrs and  67.4%  </= 50yrs. Left-sided tumors were associated with rectal bleeding (p = 0.001) and bowel habit change (p =0.045) whereas right-side tumors were associated with weight loss ( p = 0.02) and abdominal pain ( p = 0.004).  84.5% of CRC presented at an advanced stage, and 32% had distant metastasis. Young age was associated with the advanced stage (P=0.006) whereas family history was associated with the lower stage (P=0.008). Distance metastasis was associated with Colonic lesions (P=0.003) and emergent presentation (P=0.008). Asymmetric wall thickening with luminal narrowing was significantly associated with left side tumor (95% vs 21.4%) whereas large mass with necrosis was significantly associated with right side tumor (50% vs 5%) (P= 0.004),
CONCLUSION: CRC is presented at a younger age and at an advanced stage. The majority of CRCs were left-sided and rectal. Increasing the index of suspicion for CRC in patients with rectal bleeding and, bowel habit change is recommended.
Laryngeal Cancer Imaging Patterns and Agreement with Laryngoscopy Findings at Tikur Anbessa Specialized Hospital: A Retrospective Study
Authors: Ilili Amin Aliye  , Amal Saleh Nour
Published: July 2024

BACKGROUNS: Head and neck cancer is the commonest cancer among male patients and the third commonest cancer in females at Tikur Anbessa Specialized Hospital from 1998 to 2010.
METHODS: A retrospective cross-sectional study of 90 patients with laryngeal mass who came to oncology and radiology departments at Tikur Anbessa specialized hospital from 2016 to 2019. Medical records were reviewed for clinical data, history, laryngoscope exam and computed tomography (CT) reports. The agreement between imaging and laryngoscope examination were analyzed.
RESULTS: The mean age of presentation was 51.5 years ±14 (SD). The primary patient complaint was hoarseness of voice 77(85.6%) followed by shortness of breath in 28(31.1%). Among 34 cases for which risk factors were indicated, 23 (67.6%) had cigarette smoking. Out of the 79 cases with laryngeal subsites described, 38 (48.1%) were transglottic, 27 (34.2%) were glottic and 12 (15.2%) were supraglottic. Extra-laryngeal spread was seen in 46(51.1%) patients and 42(46.7) were stage IVA. Out of 90 patients only 38(42.2%) patients had laryngoscope findings.
CONCLUSION: Transglottic involvement with extra-laryngeal spread was common with advanced stage at presentation.
A Novel Case Report of Severe Aplastic Anemia with COVID Infection
Authors: Fatemeh Nejatifar  , Ezat Hesni  , Ali Akbar Samadani
Published: July 2024

Aplastic anemia is a rare disease of the hematopoietic system. Although some viral agents have been implicated, the association between COVID-19 and aplastic anemia is unclear. In this way, several cases of aplastic anemia have been reported following infection with COVID-19. Importantly, we reported a 16-year-old girl with severe aplastic anemia with no history of disease following an Omicron infection who did not respond well to treatment despite supportive treatment and immunosuppression.
The Predictors of Clinical Competence among Hospital Nurses: A Cross-Sectional Study in Hamadan, West Iran
Authors: Keivan Babaei  , Efat Sadeghian  , Masoud Khodaveisi
Published: July 2024

BACKGROUND: Nurses' clinical competence (CC) is critical in providing high-quality and safe nursing care. Assessment of nurses’ CC and its predictors is a key step to improve their CC and the quality of their services. The aim of this study was to determine the predictors of CC among hospital nurses in Iran.
METHODS: This analytical cross-sectional study was conducted from September 2020 to May 2021. Participants were purposively selected from four university hospitals in Hamadan, west of Iran. A demographic questionnaire and the 73-item Nurse Competence Scale were used for data collection. A total of 300 questionnaires were distributed and 270 questionnaires (response rate: 90%) were completed and returned to the researcher. Data were analyzed using the SPSS software (v. 16.0) and the one-way analysis of variance, the independent-sample t, the Mann-Whitney U, and the Kruskal-Wallis tests, the Pearson and the Spearman correlation analyses, and the linear regression analysis.
RESULTS: The mean score of CC was 40.28±8.6 (in the possible range of 0–100) and the highest and the lowest dimensional mean scores were for the situation management (56.13±11) and the ensuring quality (25.3±8.1) dimensions, respectively. The mean score of CC had significant relationship with age, work experience, and ward of working and these variables significantly predicted 77% of the variance of CC (adjusted R = 0.778, P<0.05).
CONCLUSION: According to the results of this study, age, work experience and ward of working weresignificant predictors of CC in hospital nurses. Nursing managers should employ strategies such as reducing nurses’ workload, improving their employment status, and providing them with quality in-service education in order to improve their CC and the quality of their services.
Effect of Intranasal Ketamine on Pain Intensity after Cesarean Section: A Single-Center, Double Blind, Randomized Controlled Trial
Authors: Abolfazl Firouzian  , Nafiseh Faghani-Makrani  , Zeinab Nazari  , Mouna Faghani Ahangari
Published: July 2024

BACKGROUND: Although intravenous or intramuscular opioids are widely used for managing postoperative pain after cesarean section (CS), their side effects are bothering and limit their use. The aim of this study was to determine the effect of intranasal ketamine on pain intensity after CS.
METHODS: In a single-center, double-blind, parallel-group, randomized controlled trial, a total of 120 patients who were scheduled for elective CS were randomly assigned into two groups. After birth, 1 mg of midazolam was administered to all patients. In addition, 1 mg/kg intranasal ketamine was administered to patients in the intervention group. For patients in control group, normal saline was administered intranasally as a placebo. The severity of pain and nausea in the two groups was evaluated after 15, 30 and 60 minutes, as well as 2, 6 and 12 hours after the initial administration of the medications.
RESULTS: The trend of changes in pain intensity was decreasing and these changes were statistically significant (time effect; P<0.001). The pain intensity in the placebo group was higher than the intervention and the observed difference was statistically significant, regardless of the time studied (group effect; P<0.001). In addition, it was shown that regardless of the study group, the trend of changes in nausea severity was decreasing and these changes were statistically significant (time effect; P<0.001). Regardless of the time studied, the severity of nausea in the placebo group was higher than the intervention group (group effect; P<0.001).
CONCLUSION: According to the results of this study, it seems that the using of intranasal ketamine (1 mg/kg), can be considered as an effective, well tolerated and safe method in reducing pain intensity as well as the need for postoperative opioid consumption after CS.
Editorial message: The Ethiopian Health Extension Program (HEP) is Still Relevant After 15 Years of Implementation Although Major Transformation is Essential to Sustain Its Gains and Relevance
Authors: Abraham Haileamlak  , Israel Ataro
Published: July 2024

Editorial message
The Effect of Community Health Information System on Health Care Services Utilization in Rural Ethiopia
Authors: Setegn Tigabu  , Girmay Medhin  , Mulusew G. Jebena  , Tegene Legese Dadi  , Daniel Tadesse  , Mekdes Demissie  , Fasil Walelign Fentaye  , Zelalem Tazu  , Shegaw Mulu  , Yibeltal Kiflie Alemayehu  , Alula M. Teklu
Published: July 2024

BACKGROUND: In Ethiopia, the community health information system (CHIS) is implemented at the health post (hp) level with the aim of improving service delivery and use. We conducted a national level assessment of CHIS utilization and explored the associations of CHIS utilization with use of antenatal care (ANC), postnatal care (PNC), institutional delivery and child immunization in rural Ethiopia.  METHODS: We conducted a cross-sectional study measuring community-based health service use and HP based CHIS assessment from March to May 2019. Data were collected from 343 HPs and 2,864 women who delivered in the last five years, and multistage sampling was used to select the study subjects. We used descriptive statistics for CHIS implementation and service utilization and multilevel logistic regression to investigate the association of CHIS implementation with maternal and child health care services use.
RESULTS: Fifty five percent of the HPs were implementing CHIS. These HPs were using a paper-based household data collection tool called family folder (FF).  Of the HPs, one third implemented lot quality assurance sampling (LQAS) based data quality check and 60.4% documented and followed execution of decisions. Overall, among the eligible women, 40% used ANC, close to 50% of currently married women used ANC services; 28% of women that fall in the high wealth index category used PNC within 48 hours after delivery; and 86.1% of women who had at least a high school education delivered at a health facility. Implementation of CHIS and family folder utilization and conducting LQAS based data quality check in the HPs were significantly associated with increased odds of ANC, delivery, and vaccination services use.  
CONCLUSION: We found that better implementation of CHIS was associated with better maternal and child health service use which implies that increasing utilization of CHIS at HPs will improve mother and child health service use.
Does Combining Antenatal Care Visits at Health Posts and Health Centers Improve Antenatal Care Quality in Rural Ethiopia?
Authors: Habtamu Kebebe Kasaye  , Tegene Legese Dadi  , Mekdes Tigistu Yilma  , Mulusew G. Jebena  , Girmay Medhin  , Getnet Mitike Kassie  , Frehiwot Bekele  , Frehiwot Nigatu  , Alula M. Teklu
Published: July 2024

BACKGROUND: Even though quality maternal care is crucial for the well-being of women and their newborns, the inferior quality of antenatal care in rural Ethiopia is a timely concern. This study aimed to investigate the effects of combining antenatal care visits at health posts and health centers on improving antenatal care quality in rural Ethiopia.
METHODS: Using the 2019 Ethiopia Health Extension Program assessment done by MERQ, we extracted and analyzed the survey responses of 2,660 women who had received at least one antenatal visit from a primary health care unit. We measured the cumulative count of quality of antenatal care using the Donabedian model. To model the differences in the quality of antenatal care at health posts and health centers, we used zero-truncated Poisson regression and reported incidence risk ratios with their 95% confidence intervals.
RESULTS: The quality of antenatal care increased by 20% (adjusted IRR= 1.20 [1.12–1.28]) when antenatal care reception was mixed at health posts and health centers, compared to those who received all antenatal care only from health posts. Quality differences based on socioeconomic status and setting variations were observed as predictors of quality of care, even if women received antenatal care at both health posts and health centers.
CONCLUSIONS: Combining antenatal care provision from health posts and health centers should be sustained as one of the antenatal care quality improvement strategies in rural parts of Ethiopia while ensuring the equitable provision of quality care across socioeconomic groups and between agrarian and pastoral settings.
Ethiopian Health Extension Workers’ Training Status and Perceived Competency
Authors: Mekdes Demissie  , Netsanet Abera  , Leake Gebremeskel  , Daniel Tadesse  , Tegene Legese Dadi  , Tadele Zebere  , Setegn Tigabu  , Fasil Walelign Fentaye  , Yibeltal Kiflie Alemayehu  , Alula M. Teklu  , Gimay Medhin  , Seleshi Zeleke
Published: July 2024

BACKGROUND: Training and work experience are critical inputs for delivering quality health services. However, no nationwide assessment has been conducted on the status of training and the competency of Health Extension Workers (HEWs). Therefore, this study aimed to assess HEWs’ pre-service training status and perceived competency in Ethiopia.
METHODS: The study was conducted in all regions and all HEWs training institutions in Ethiopia. We used cross-sectional study design with a mixed method approach that included 585 HEWs, 1,245 HEW trainees, 192 instructors, and 43 key informants. Descriptive statistics and thematic analysis were used to analyse quantitative and quantitative data respectively.
RESULT: Twenty-six percent of the HEWs said that they were competent to deliver all the HEP activities, and 73% of the HEWs said that they could confidently deliver 75% of the HEP activities. Receiving in-service training and having level III/IV qualifications are positively associated with the competency of HEWs. Similarly, HEP trainees perceived themselves as highly competent in executing their professional work, except in using computer and mobile health technology. Both instructors and trainees rated the quality of the curriculum and course materials positively. However, basic services and facilities in most training institutions were perceived to be inadequate. Additionally, individual learning, problem-solving, case-analysis, and assessment methods such as project work and portfolios were rarely practiced.
CONCLUSIONS: Although the perceived competence of HEW trainees is high, the HEWs’ training is not provided as per the curriculum because of limited resources. All the necessary resources should be made available to produce competent HEWs.
Regional Distribution of the Anthropometric Failure among Under-five Children and Its Determinants in India
Authors: Ramendra Nath Kundu  , Juri Borah  , Susmita Bharati  , Premananda Bharati
Published: July 2024

BACKGROUND: Undernutrition in children seems to be one of the major health issues in developing nations including India. Stunting, underweight, and wasting are the three most often used anthropometric indicators to evaluate childhood undernutrition. Children who exhibit one or more indicators of undernutrition are considered as anthropometric failure (AF). The present study aims to determine the distribution and determinants of anthropometric failure in children under the age of five in different regions of India.
METHODS: NFHS-5 data, collected between 2019 and 2021, were utilized for the study. Pearson's chi-square (χ²) test was used to look into the association between categorical variables. Binary logistic regression was used to find the explanatory factors that influence anthropometric failure.
RESULTS: More than half of the under-five children (52.18%) in India are suffering from anthropometric failure, out of these West (57.88%), East (56.58%), and Central (53.94%) regions have covered half of the total occurrence. State-wise, Bihar (61.66%), followed by Gujarat (60.26%), and Jharkhand (58.05%) have recorded the highest rates of anthropometric failure. Anthropometric failure is higher among anemic children, boys, parent not alives, the higher number of birth order, lower educated mothers, rural dwellers, belonging to scheduled tribes and scheduled castes communities, living in nuclear families, and having lower household wealth indexes than their other counterparts.
CONCLUSION: These aspects imply that regional determinants should be taken into consideration when implementing child nutrition development programs.
Cancer Incidence and Mortality in a Tertiary Hospital in Indonesia: An 18-Year Data Review
Authors: Prihantono  , Reski Rusli  , Robert Christeven  , Muhammad Faruk
Published: July 2024

BACKGROUND: Every population, regardless of wealth or social development, faces the major health issue of cancer. Cancer incidence and mortality differ by region and period. Thus, this study aimed to determine the characteristics, incidence, and mortality of various cancers at Dr. Wahidin Sudirohusodo Hospital, a referral center hospital in Makassar, Indonesia.
METHODS: This study employed a descriptive research design using secondary data recorded at Dr. Wahidin Sudirohusodo Hospital in Makassar, Indonesia, between January 2002 and December 2019.
RESULTS: We classified the 7824 cancer patients in our study into solid and non-solid cancer groups. The incidence of solid cancer (79.3%) was higher than that of non-solid cancer (20.7%), causing 1063 deaths, or 61.7%, of all cancer-related deaths. There were 6083 (77.7%) cases of cancer survival. The cancers with the highest incidence were breast cancer (1008 cases [12.9%]), leukemia (683 cases [8.7%]), and cervical cancer (631 cases [8.1%]). Breast, cervical, and ovarian cancers were the most frequent cancers in female patients. Leukemia was the most frequent cancer in male patients, followed by colorectal and liver cancers.
CONCLUSIONS: A region-based statistical record of cancer incidence and mortality is vital and useful to prioritizing cancer treatment at a given time.
Knowledge and Attitudes about Mother-to-Child Transmission of the Human Immunodeficiency Virus in a Context of Social Vulnerability: The Case of the Province of Essaouira, Morocco
Authors: NACER Nezha  , OUZENNOU Nadia  , EL FATIMI Najat  , RKHA Samia
Published: July 2024

BACKGROUND: Despite health education efforts, pregnant women still face major health problems.The aim of this study was to assess the knowledge and attitudes of pregnant women on measures to prevent mother-to-child transmission of the human immunodeficiency virus in a context of social vulnerability.
METHODS: This is a cross-sectional survey of 384 pregnant women randomly selected from the 20 health districts in the province of Essaouira. This study was carried out from January 2022 to June 2022. A questionnaire was used, and bivariable logistic regression analyses were done to identify factors associated with knowledge and attitudes of pregnant women about mother-to-child transmission of the human immunodeficiency virus.
CONCLUSION: A significant number of pregnant women have incomplete knowledge and attitudes about preventing mother-to-child transmission of HIV. Actions to increase the knowledge of pregnant women are essential. The capacity of healthcare providers should also be strengthened to improve the quality of care.
Prevalence of Anemia and Associated Risk Factors among Pregnant Women in Semarang, Indonesia, during COVID-19 Pandemic
Authors: Ani Margawati  , Ahmad Syauqy  , Aras Utami  , Dea Amarilisa Adespin
Published: July 2024

BACKGROUND: The coronavirus disease-2019 (COVID-19) pandemic has caused several changes that affect overall health, including the prevalence of anemia in pregnant women. Several risk factors, including iron deficiency during pregnancy, diabetes, maternal smoking, preterm birth, low birth weight, and multiple pregnancies, can influence poor iron intake in infants. This study aims to analyze the prevalence and factors associated with anemia in pregnant women during the COVID-19 pandemic.
METHODS: A cross-sectional study was conducted on 238 pregnant women from two districts in Semarang, Indonesia. The study population was selected using a cluster sampling technique. Trained enumerators collected data through interviews using the Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ) to estimate participants’ food intake and anthropometric measurements. Additionally, hemoglobin levels were measured by trained nurses during antenatal care (ANC) visits. Univariate and multivariate analyses were performed using logistic regression to estimate the factors associated with anemia in pregnant women during the COVID-19 pandemic.
RESULTS: Among all participants, 14.3% (n=34) were anemic, with 32.3% and 67.6% having moderate and mild anemia, respectively. Moreover, study variables such as less compliance with ANC (antenatal care) guidelines (p = 0.020), excessive phosphorus intake (p = 0.039), inadequate zinc intake (p = 0.003), and inadequate calcium intake (p = 0.043) were associated with anemia among pregnant women.
CONCLUSION: Anemia among pregnant women in Semarang, Indonesia, is a mild public health problem. Less compliance with ANC guidelines, excessive phosphorus intake, and inadequate zinc intake are significantly associated with anemia among pregnant women during the COVID-19 pandemic.
Editorial message
Authors: Abraham Haileamlak
Published: July 2024

Editorial message
Combination Effect of Deferoxamine and Arsenic Trioxide on Viability and Vitality of APL Like Cell Line
Authors: Kazem Ghaffari  , Ali Bayat  , Ali Ghasemi
Published: July 2024

BACKGROUND: Arsenic trioxide is an activist agent in the treatment of acute promyelocytic leukemia (APL), which acts alone, but has an adverse effect on patients. Moreover, deferoxamine has antiproliferative activity and induces leukopenia. In order to enhance antileukemic effectiveness and to reduce the dosage of arsenic trioxide, the combination effect of it with deferoxamine (DFO) was evaluated on the APL cell line (NB4).
METHODS: In this experimental study, to investigate the cytotoxic effects of ATO/DFO in acute promyelocytic leukemia, the NB4 cell line (provided by Pasteur Institute of Iran) was treated with different doses and then at 24, 48, and 72 hrs intervals, the percentage of survival, cell count, metabolic activity and apoptosis induction were investigated respectively. Also, hTERT gene expression was analyzed by the RT-PCR method.
RESULTS: We found that DFO alone and in combination with ATO has cytotoxic and antiproliferative effects, and reduces viability and cell metabolic activity in the NB4 cell line in a dose and time-dependent manner. In addition, this combination causes an increase in apoptosis, up-regulation of Caspase-3, and down-regulation of hTERT genes in cells.
CONCLUSION: Combined ATO/ DFO treatment cooperatively decreased the mRNA levels of the hTERT and increased the mRNA levels of Caspase-3 in a time-dependent manner compared to DFO alone.
Comparison of the Efficacy of Tolterodine versus Oxybutynin in the Treatment of Children with Desmopressin-Resistant Enuresis: A Randomized Controlled Clinical Trial
Authors: Neda Ezodin  , MahboubehJafari Sarouei  , Mohamad Khademlo  , Sevda  Hashemi Milani  , Sahar Yousefi  , Hamid Mohammadjafari
Published: July 2024

BACKGROUND: Enuresis, defined as involuntary nocturnal urination without any underlying organic disorder in a child expected to control urination, poses a common problem. This study evaluated the effectiveness of Tolterodine and Oxybutynin in children presenting with primary desmopressin-resistant enuresis.
MATERIALS AND METHODS: A randomized clinical trial was undertaken involving 68 participants aged between 5 and 16 years, all suffering from primary enuresis. These patients were randomly assigned to one of two treatment groups for a three-month period: Group 1, treated with Oxybutynin and Desmopressin, and Group 2, treated with Tolterodine and Desmopressin. Data on demographics, clinical and laboratory findings, and subjective responses to treatment were gathered. The response was measured based on the frequency of wetting incidents per night and week and compared with pre-treatment data.
RESULTS: Patients were divided into two groups (30 patients in Group 1 and 38 patients in Group 2). The mean age of the patients was 88.97±27.09 months. In the first treatment group, 6 out of 30 patients (20%) experienced a complete treatment response, as did 5 out of 38 patients (13.2%) in the second treatment group. This difference between the groups was not statistically significant. Seven patients (23%) in the Oxybutynin group and 13 patients (34%) in the Tolterodine group reported a lack of response to treatment, a difference that also lacked statistical significance.
CONCLUSION: For patients resistant to Desmopressin, the addition of anticholinergic drugs elicited a significant response in over half of the patients. However, no benefit was observed in using either Oxybutynin or Tolterodine in the treatment of Desmopressin-resistant enuresis.
Establishing and Comparing the Normal apparent Diffusion Coefficient Values of Fetal Organs and Placenta Using 1.5 Tesla and 3.0 T MRI at Various Gestational Age
Authors: Chandrasekhar Priyanka  , Rajeswaran Rangasami  , Chitra Andrew  , N. Paarthipan
Published: July 2024

BACKGROUND: Diffusion-weighted imaging (DWI) is the random Brownian motion of water molecules within a tissue voxel. The apparent diffusion coefficient (ADC) is a quantitative parameter calculated from the DWI that directly reflects the mobility of water molecules in biological tissues. The objective of this study was to establish and compare the normal reference ADC values of fetal organs and the placenta using 1.5 T and 3.0 T MRI at various gestational ages.
METHODS: This was a retrospective and prospective observational study. This study included one hundred and three (103) singleton pregnancies for each magnetic field strength. Diffusion-weighted imaging was performed using single-shot spin-echo-planar imaging (EPI) in the axial plane of the fetal head-trunk with a slice thickness of 4mm and diffusion gradient values of b = 0 and b = 700–800 s/mm².
RESULTS: The mean ADC values of cerebral WM areas were significantly higher than the deep grey areas in the brain. The white-matter regions, lung, and placenta showed a positive and significant correlation with increasing gestational age in both field strengths. A statistically weak negative correlation was observed between increasing gestational age and ADC measurements obtained in the thalamus, cerebellum, pons, and kidney.
CONCLUSION: This study gives the reference values for both 1.5T and 3T MRI of vital organs. The current study shows that diffusion-weighted MRI can offer a promising technique to evaluate the structural development of fetal organs and can potentially act as a biomarker for predicting the functionality of the fetal organs in abnormalities.
The Acute Needs for Palliative Care Services in Ethiopia (Editorial Message)
Authors: Endalew Hailu
Published: July 2024

Editorial message
Demographic Pattern and Clinical Characteristics of Patients Undergoing Haemodialysis in a Tertiary Centre of a Developing Country: A Review of 280 Cases
Authors: Bamikefa T.A  , Uduagbamen P.K  , Adelaja M.A  , Ala O
Published: July 2024

BACKGROUND: Globally, renal replacement therapy especially haemodialysis remains pivotal in the effective care of patients with kidney diseases since its acceptance as a treatment modality. Despite being widely embraced as a therapeutic option, several factors still hamper its utilization. A clinical audit of this modality option will allow elucidation of haemodialysis practises and peculiarities.
METHODS: The charts and records of 280 patients with renal impairments dialyzed between March 1st 2019 and February 28th 2023 were evaluated in retrospect. Data on retrieved demographic and clinical information were analyzed using SPSS 25 and patients’ short-term survival was determined using the Kaplan Meier survival analysis and log rank test.
RESULTS: Out of the 280 patients who had 1716 dialysis sessions, 184 (65.7%) were males. The mean age was 47.9 ± 17.5 years. The majority (80.7%) of the patients had chronic kidney disease (CKD), as 90.2% of the dialysis sessions were for CKD. There was a male preponderance (69.1%) in the population. Hypertension was the commonest cause of CKD (41.2%) while sepsis was the commonest cause of acute kidney injury (50%). The median number of dialysis session was 4.0. The mean pre-dialysis hematocrit was 24.4 ± 7.1% and the mean single pool Kt/V was 0.9 ± 0.02. The femoral vein was the most used vascular access (95.4%). The short-term survival was positively related to the dialysis frequency on Kaplan-Meier analysis.
CONCLUSION: Haemodialytic therapy in patients with renal disease is still of huge impact on survival despite the numerous factors affecting its effective delivery, especially in low-income nations.
Assessment of Epidemiological Indicators for Evaluation of National Malaria Elimination Programme: A Retrospective Study
Authors: Hima Sree Polisetti  , K R Vinay Rajan  , K Eswar Kumar
Published: July 2024

BACKGROUND: Malaria has been one of India's most considerable health problems since 1940. The objective of our study is to determine the status of the National Malaria Elimination Programme in India by using epidemiological indicators.
METHODS AND MATERIALS: The annual reports of malaria for the years 2014-2021 and monthly reports for 2020 and 2021 were collected from the official web portal and were analysed for study specific assessments.
RESULTS: The API has shown a statistically significant reduction from 2017-2021 in all states along with category-1(P=0.003) and category-2(P=0.029) states/UTs, but there was no statistically significant reduction from 2017-2021 in category-3 (P=0.166) states/UTs. The zero indigenous cases had not been achieved in category-1 states/UTs. The overall percentage reduction in number of malaria cases in 2020 at the national level compared with 2014 was 83.6%. Despite states with strong health systems such as Gujarat, Maharashtra and Karnataka, have not shown zero indigenous cases in 2020 and the malaria cases noted were very far from reaching the targets.
CONCLUSIONS: Although we observed a significant drop in malaria incidence from 2014 to 2020, demonstrating that the country is moving nearer to malaria elimination, it is crucial to implement the strategies to reduce Plasmodium falciparum% and re-establish surveillance programmes and execute national and state programmes in order to achieve the success of the National Malaria Elimination Programme. The recategorization of states/UTs are in accordance to the API, and implementation strategies were also needed.
Abdominal Pain of Functional Gastrointestinal Disorders in Dietary Diversity Patterns and Its Determinants among Healthy Adults in Jimma City, Southwest Ethiopia
Authors: Belay Zawdie  , Kalkidan Hassen Abate  , Dessalegn Tamiru  , Tefera Belachew
Published: July 2024

BACKGROUND: Functional Gastrointestinal Disorders (FGIDs) and their risk factors vary from region to region. Therefore, this study aimed to determine the prevalence of abdominal pain of FGIDs in different dietary diversity score (DDS) and its determinant factors among adults in Jimma City, Southwest Ethiopia.
METHODS: A community-based cross-sectional study was conducted from July 17 to October 27, 2019. The study included systematically selected healthy adults aged ≥ 18years. Data were collected on gastrointestinal symptoms (Rome III), and DDS (24-dietary recall).
RESULTS: Of 865 healthy adults, the prevalence of abdominal pain symptoms co-occurrence was 168(19.4%), dyspepsia, 152(17.6%) and IBS, 133(15.4). Similarly, the co-occurrence was distributed as 81(9.4%) in middle, 64(7.4%) in high and 23(2.6%) in low DDS groups. Although this distribution was different in the DDS groups, it is not significantly associated. With potential confounders adjusted, the behavioral factors associated with the co-occurrence with an AOR (95% CI) were khat chewing: 7.37 (1.76 - 30.87), drinking alcohol: 3.24 (1.15 - 9.18), sedentary life: 12.28 (3.19 - 48.40) and less physical activity: 4.44 (1.43-13.75). Moreover, elevated TAG: 5.44 (2.78 - 8.10), elevated LDL: 4.26 (1.61-11.29), central obesity: 2.78 (1.08 -7), low HDL 5.89 (2.22-15.60), positive H.pylori stool test: 2.7 (1.86 -7.72), being diabetic: 2.7 (1.79 -7.79) and hypertensive: 2.79 (1.08 - 7.14) were associated with the co-occurrence.
CONCLUSION: Abdominal pain and FGIDs had significant distribution among adults in Jimma City. Therefore, early screening and managing FGIDs in the community is recommendable.
The Ethiopian National Immunization Technical Advisory Group (E-NITAG): Establishment, Achievements and the Future
Authors: Yemane Berhane  , TelahunTeka  , Meseret Zelalem  , Amha Mekasha  , Bogale Worku  , Genet G/Medhin  , Liya Wassie  , Liya Wondwossen  , Mulat Nigus  , Samuel Teshome  , Shiferaw Mitiku  , Solomon Tessema Memirie  , Teferi Fenta  , Teferi Fenta  , Workeabeba Abebe  , Yirgu Gebrehiwot
Published: July 2024

The National Immunization Program (NIP) was introduced in Ethiopia in 1980. The NIP has expanded the number of vaccines from six to more than 14 in 2023. However, decisions on new vaccine introduction and other vaccine-related matters were not systematically deliberated nationally. Thus, the need to establish a national body to deliberate on vaccine and vaccination matters, in addition to the global immunization advisory groups, has been emphasized in the last decade. This article presents the establishment and achievements of the Ethiopian NITAG. The E-NITAG was established in 2016 and maintained its active role in providing recommendations for new vaccine introduction and improving the delivery of routine vaccines. The external assessment indicated the E-NITAG was highly functional and played a critical role in enhancing the vaccination practice in Ethiopia, especially during the COVID-19 pandemic. The absence of a dedicated secretariat staff was the major bottleneck to expanding the role of the E-NITAG beyond responding to MOH requests. The E-NITAG must be strengthened by establishing a secretariat that can eventually grow as an independent institution to address complex vaccine-related issues the NIP needs to address.
Patient Safety Domains in Primary Healthcare: A Systematic Review
Authors: Hadi Kalantari  , Pouran Raeissi  , Aydin Aryankhesal  , Seyyed Masoud Hashemi  , Nahid Reisi
Published: July 2024

BACKGROUND: Healthcare systems should ensure the provision of quality services to patients without harming them. However, the provision of services is occasionally accompanied by harm or complications, most of which are preventable. Most studies have focused on secondary healthcare rather than primary healthcare (PHC). Thus, this study aimed to identify various dimensions and components of patient safety in PHC worldwide.
METHODS: This systematic review study was conducted in November 2022 based on PRISMA reporting guidelines. Studies were retrieved from PubMed, Scopus, Cochrane Library, Web of Science, and EMBASE and searched for English documents using the keywords “patient safety” and “PHC” from 2000 to 2022. Finally, two reviewers extracted the data independently and analyzed using thematic content analysis.
RESULTS: Overall, 23 out of the initially 4937 identified articles were selected for the final analysis based on the inclusion and exclusion criteria. Most of these studies used a qualitative-quantitative approach (61.9%, seven studies for both), and 64% had been conducted in European countries. Eventually, five dimensions and 22 components were identified for patient safety in PHC, including management measures, quality management, resources and technology, documents, and patient-related factors.
CONCLUSION: The patient safety dimensions and components identified in this research can help develop a clear definition of patient safety and its assessment standards and criteria in PHC. Considering that most previous studies on patient safety in PHC were conducted in European and developed countries, it is suggested that researchers conduct more studies in developing countries to fill this research gap.
Effect of Positive Thinking Skills on Optimism and Death Anxiety of COVID-19 Nurses: A quasi-experimental study
Authors: Mohammadreza Doustinouri  , Mozhgan Rahnama  , Abdolghani Abdollahimohammad  , Mahdieh Poodineh Moghadam  , Elham Shahraki Moghadam  , Elaheh Asadi-Bidmeshki
Published: July 2024

BACKGROUND: The COVID-19 pandemic has placed nurses on the front lines, facing challenging conditions and increased stress levels. The aim of this study was to examine the effect of positive thinking skills training on nurses' optimism and death anxiety while caring for COVID-19 patients.
METHODS: In a quasi-experimental, two-group, pre- and post-test study, a total of 52 eligible nurses working at Amir al-Momenin Hospital in Zabol, Iran, between October and December 2022, were divided into intervention and control groups. The intervention group received positive thinking skills training via email or WhatsApp, with eight, 60-minutes sessions over two months. Data were collected using a demographic questionnaire, the Templer Death Anxiety Scale (DAS), and the Scheier and Carver Life Orientation Test, both before and one month after the intervention.
RESULTS: There were no significant differences in optimism and death anxiety scores between the two groups before the intervention. However, the intervention group showed a statistically significant increase in optimism (from 13.11±3.78 to 19.03±2.58) and decrease in death anxiety (from 55.15±7.06 to 41.76±4.48) after the intervention (P <0.001).
CONCLUSION: Considering the stressful nature of COVID-19 disease, positive thinking skills training can be recommended as an effective method to reduce death anxiety and improve nurses' optimism, thus enhancing their willingness to continue caring for patients.
Advantages of the intradermal lymphoscintigraphy
Authors: Tartaglione Girolamo
Published: July 2024

Lymphoscintigraphy is a nuclear medicine procedure that uses a small quantity of radioactive particles for visualizing the lymphatic system. Traditionally, the radiotracer was injected subcutaneously, but the quality of lymphatic path imaging was scarce due to high background. Intradermal radiotracer injection is considered the modern-day intralymphatic injection. We propose rest/stress intradermal lymphoscintigraphy for the diagnosis, staging and surgical planning of lymphedema. Major and minor findings were described in primary and secondary lymphedema. Based on the in-depth information of the lymphatic pathways, physiotherapists and microsurgeons can obtain important functional information in patients’ selection to treat with physical treatments and/or undergo microsurgery.
Recent advances in the diagnostic methods and therapeutic strategies of transthyretin cardiac amyloidosis
Authors: Kourek Christos , Briasoulis Alexandros , Magouliotis Dimitrios E , Georgoulias Panagiotis , Giamouzis Grigorios , Triposkiadis Filippos , Skoularigis John , Xanthopoulos Andrew
Published: July 2024

Cardiac amyloidosis is a progressive disease characterized by the buildup of amyloid fibrils in the extracellular space of the heart. It is divided in 2 main types, immunoglobulin light chain amyloidosis and transthyretin amyloidosis (ATTR), and ATTR amyloidosis is further divided in 2 subtypes, non-hereditary wild type ATTR and hereditary mutant variant amyloidosis. Incidence and prevalence of ATTR cardiac amyloidosis is increasing over the last years due to the improvements in diagnostic methods. Survival rates are improving due to the development of novel therapeutic strategies. Tafamidis is the only disease-modifying approved therapy in ATTR amyloidosis so far. However, the most recent advances in medical therapies have added more options with the potential to become part of the therapeutic armamentarium of the disease. Agents including acoramidis, eplontersen, vutrisiran, patisiran and anti-monoclonal antibody NI006 are being investigated on cardiac function in large, multicenter controlled trials which are expected to be completed within the next 2-3 years, providing promising results in patients with ATTR cardiac amyloidosis. However, further and ongoing research is required in order to improve diagnostic methods that could provide an early diagnosis, as well as survival and quality of life of these patients.