bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Online Communities and E Word of mouth on Purchase Intention of Generation Y: The Mediating Role of Brand Trust
Authors: Kamalasena B. D. T. M. , Sirisena A. B.
Published: June 2021

Effective marketing and advertising campaigns contribute to customer development, profitability, and business success in the long term. The evolving economies, globalization, and innovative technologies, which have quickly transformed the economic community, make present markets more attractive. Marketing firms are pushed in a new direction by social media marketing, such as Facebook, Twitter, and YouTube. Social media have reached so deeply into millions of people globally and it also has drawn the interest of advertisers. Considering the timeliness and relevance of the phenomenon, this study aims to identify the impact of online communities and e word of mouth on the purchase intention of generation Y. The relevant data were collected through a self-administered questionnaire from 150 individuals aged 25 to 40 years who are residing in the Colombo district based on the convenience sampling method. This study found a positive significant effect of e word of mouth on brand trust and purchase intention and the relationship between e word of mouth and purchase intention is mediate by the brand trust. Further, online communities have a positive significant impact on brand trust and the relationship between online communities and purchase intention is mediated by brand trust. This research fills the gap in the existing literature and provides valuable insights to organizations that use social media marketing as a communication tool.
Factors influencing the Purchase Intention of Green Packaging among Millennials in Gampaha District of Sri Lanka
Authors: Munasinghe P. M. , Shantha A. A.
Published: June 2021

Fast moving consumer goods sector is one of the expanding industries that influences on the green marketing issues. This study seeks to understand how the impact of green packaging on consumer purchasing intention among millennial generation in Gampaha District. The main objective is “to identify the factors that mostly influence on millennial consumer’s green packaging purchase intention”. According to comprehensive literature review, the researcher identified 4 variables of purchase intention namely; Product Characteristics, Environmental Concern, Government Role and Demographic Factors. Further, researcher was able to recognize the most enhancing components for some independent variables. Then, examined the hypothesis by using PLS-SEM except the Demographic Factors. Therefore, Education, Income and Gender under demographic variables tested chi-square test, Pearson correlation and significances by using SPSS. The researcher distributed questionnaires randomly to selected sample of 200 respondents selected under the multi stage sampling method according to a proportion within the 8 GN Divisions out of 37 in Kelaniya DS Division in Gampaha District who age between 18 – 35 years. All examined variables determined positive relationship with Purchasing Intention except Gender. However, the outcomes represented that no significant effect of Government Role, Environmental Concern, Income, Gender and Investment of Government under the Government Role but other mentioned variables recorded 95% significant on Purchasing Intention. The study identified that younger generation has an awareness and knowledge about ecological behavior. The implications of this study formed awareness into buying intention towards ecological packaging which can be used by FMCG businesses in Sri Lanka when deigning product packages.
Employee’s Job Satisfaction with Computer Mediated Communication System
Authors: Gunawardana T. S. L.W. , Sirimanna U. I.
Published: June 2021

To fill the gaps in the computer mediated communication literature and provide useful information on interpersonal relationships within an organization, this study aims to investigate how computer mediated communication (CMC) system have impacted on employee’s job satisfaction of Ceylon Electricity Board, Sri Lanka. An empirical research was conducted to test the hypothesized relationships based on a conceptual framework developed through a comprehensive literature review on CMC and job satisfaction. Through a literature support this model consisted of three independent variables (i.e., electronic mails, instant messaging and computerized maintenance management) in computer mediated communication system and a dependent variable which is job satisfaction. The sample of the study consisted of 100 respondents representing executive and medium level technical service (MLTS) staff of the transmission division of Ceylon Electricity Board in Sri Lanka. Self-administered questionnaire and the web-based questionnaire was used to collect primary data. The data were analyzed with Partial Least Squares path modeling (PLS) to test the hypotheses of the study. The research findings indicated that computerized maintenance management is the most significant factor impacting on the employees’ job satisfaction. Moreover, it also identified that there is a positive and statistically significant impact of instant messaging and electronic mails on employees’ job satisfaction. The results provide valuable input regarding the instant messaging and job satisfaction. Therefore, managers should have to pay their more and more attention in order to improve instant messaging as one of the communication media in an organization. In this research considered only three CMC dimensions which influence the job satisfaction. But there are more CMC dimensions used as organizational communication in future studies.
A Comparative Study of Transdermal Nitroglycerine Patch and Oral Nifedipine in Preterm Labor
Authors: Kaur Prabhleen , Madan Anita , Sharma Sujata
Published: June 2021

Background:

Currently, the main goal for the use of tocolytic therapy is to delay the birth so as to allow the use of corticosteroids for accelerating fetal lung maturity and maternal transfer to a tertiary care center and thereby reducing neonatal morbidity and mortality.

Aims and Objectives:

The aims amd objectives were to compare the safety and efficacy of transdermal nitroglycerine patch with oral nifedipine as a tocolytic agent to arrest preterm labor and prevent preterm birth.

Materials and Methods:

Based on the selection criteria, 50 patients were selected randomly in Group A and Group B. Group A women were given transdermal nitroglycerin patch, which delivered 10 mg Nitroglycerin (NTG) over 24 h and it was applied to the woman's abdomen followed by another patch of 10 mg after 1 h if contractions persisted. After 24 h, it was replaced by a fresh patch. Group B women were given an oral loading dose of nifedipine 20 mg followed by a similar dose if contractions persisted after 1 h. A maintenance dose of 10 mg thrice daily was given if contractions were suppressed. Patients were monitored from the time of admission to the time of discharge.

Results:

The mean duration of prolongation of pregnancy in Group B (3.68 ± 1.91 days) was significantly more than Group A (2.78 ± 1.39 days). Headache was seen significantly more in Group A (42%) than group B (6%). Tachycardia, hypotension, and palpitation showed no statistically significant difference between them. There was no statistically significant difference in the birth weight of the babies in both the groups.

Conclusion:

Nifedipine is a safe and effective drug in prolonging preterm labor and has minimal maternal and neonatal side effects.
Pheochromocytoma and Glucoregulation Disorders
Authors: Derrou Sara , Bouziane Toumader , Salhi Houda , El Ouahabi Hanan
Published: June 2021

Introduction:

Pheochromocytomas are catecholamine-producing tumors presenting with various clinical symptoms and a serious potentially lethal cardiovascular complications due to the potent effects of secreted catecholamines. Glucoregulation disorders could also occur leading to impaired glucose tolerance and diabetes mellitus. The aim of our study was to determine the effects of adrenalectomy on patient recovery with regard to their glycemic status.

Materials and Methods:

Case notes of all patients who underwent adrenalectomy surgery for pheochromocytoma from 2009 to 2018, followed up in the Department of Diabetology, Endocrinology, and Nutrition at University Hospital Center Hassan II of Fez, were retrieved, and data were collected from them to identify those with preoperative diagnosis of glucoregulation disorder and to verify if adrenalectomy can reverse or improve glycemic abnormality.

Results:

Overall, 23 patients underwent surgery for pheochromocytoma, 26% of cases had diabetes mellitus, whereas 34.78% had glucose intolerance. One year after surgery, diabetes and glucose intolerance were cured in 57.14% of cases. We noticed also that patients with large and symptomatic tumors were more likely to develop preoperative diabetes; it was also more likely to persist in patients who had an elevated body mass index (BMI).

Conclusions:

In our data, diabetes and glucose intolerance were found concurrently with pheochromocytoma in 60.78% of patients. Thus, it is important for clinicians to screen for glycemic disorder when pheochromocytoma is diagnosed, especially in patients with other risk factors for developing type 2 diabetes such as elevated BMI. Removal of these tumors can reduce insulin secretion and severe peripheral insulin resistance making early diagnosis important.
Impact of a Longitudinal Faculty Development Program on the Quality of Multiple-Choice Question Item Writing in Medical Education
Authors: Owolabi Lukman Femi , Adamu Bappa , Taura Magaji Garba , Isa Adamu Imam , Jibo Abubakar Muhammed , Abdul-Razek Reda , Alharthi Mufarrah Muhammed , Alghamdi Mushabab
Published: June 2021

Background:

Like many other academic programs, medical education is incomplete without a robust assessment plan.

Objective:

The study aimed to evaluate the impact of longitudinal faculty development program (FDP) on the examination item quality (EIQ) from a cohort of medical college faculty members.

Methods:

Item analysis (IA) of multiple-choice questions (MCQs) from a cohort of medical tutors over a 3-year period (2017 [S1], 2018 [S2], and 2019 [S3]) before and following once-per-week FDP was conducted. The questions were from three randomly selected courses: man and his environment (MEV) from phase 1, central nervous system (CNS) from phase 2, and internal medicine (MED) from phase 3. Data assessed were 480 MCQs from the final exams in the courses. The parameters considered in IA were the difficulty index, index of discrimination, nonfunctional distractors (NFDs), distractor efficiency for each question item, and Cronbach's alpha (CA) for the test as a whole. Comparison over the 3 years was made using Fisher's exact test and repeated-measures ANOVA with Bonferroni test as post hoc test.

Results:

Overall, out of 480 MCQs, 272 had no NFD (52 [19.52%], 104 [38.24%], and 116 [42.65%] in 2017, 2018, and 2019, respectively) with a significant difference between S3, S2, and S1 (P < 0.0001). The mean CA for the exams in S1, S2, and S3, respectively, were 0.51, 0.77, and 0.84, P < 0.0001.

Conclusion:

There was an improvement in EIQ following the implementation of longitudinal FDP. Thus, the need for active training and retraining of the faculty for a better EIQ cannot be overemphasized.
Prevalence of Obesity and Associated Factors in Benue State, Nigeria
Authors: Osunkwo Damaris Amarachukwu , Nguku Patrick M. , Mohammed Amina , Umeokonkwo Chukwuma David , Kamateeka Moreen , Ibrahim Mohammed , Kefas Ibrahim Bekshak , Abolade Oladimeji S. , Nwokeukwu Hulda Ijeoma , Zoakah Ayuba Ibrahim
Published: June 2021

Background:

The prevalence of obesity has risen to over 650 million adults in 2016, and accounts for 41 million deaths globally. It is a major contributor to the burden of noncommunicable diseases. We determined the prevalence and associated factors of obesity to inform policy decisions toward developing robust prevention and management strategies.

Materials and Methods:

We conducted a population-based cross-sectional study in July 2017 among 1265 adults in urban and rural communities in Benue State. We used multistage sampling technique in selecting the participants. The WHO standardized and validated tool were used to collect information on sociodemographic and anthropometric measurements. We calculated age standardized prevalence of obesity and determined factors associated with obesity using logistic regression at 5% level of significance.

Results:

The age standardized prevalence of obesity was 11.1% (rural 4.2%, urban 14.3%). The odds for obesity was higher among females (adjusted odds ratio [aOR]: 3.4; 95% confidence interval [CI]: 2.27–4.99), those with tertiary education (aOR: 3.3; 95% CI: 1.61–6.95), married (aOR: 2.1; 95% CI: 1.37–3.36), and those residing in urban areas (aOR: 3.0; 95% CI: 1.73–5.05) compared to rural dwellers.

Conclusions:

The prevalence of obesity was high among adults in Benue State. It is more prevalent among females, married, educated, and urban dwellers. Interventions targeted at healthy lifestyle choices should be directed at these populations for effective control.
Assessment of Renal Function Using Cystatin C and Creatinine in Saudi Patients after Transplantation
Authors: Jeraiby M
Published: June 2021

Background:

Rapid and accurate assessment of kidney function in patients after transplantation is of utmost importance. The aim of this study was to compare the relationships of serum creatinine and serum cystatin C with an estimated glomerular filtration rate (eGFR) in kidney transplants Saudi patients after a certain period of transplantation.

Materials and Methods:

In this prospective study, 127 patients were categorized into three groups based on their length of survival after kidney transplantation; <1 year, from 1 to 5 years, and above 5 years after transplantation. Results of cystatin C and creatinine levels were compared by eGFR derived from estimation equation chronic kidney disease epidemiology collaboration.

Results:

In the three assessed periods, the mean (standard deviation) cystatin C level was 1.72 (0.57), 1.59 (0.64), and 1.82 (0.82), respectively, being highest after 5 years of transplantation, normal in 9.40%, and elevated in 90.60% of the participants, while creatinine level, decreased from 1.57 (0.53) to 1.52 (0.64) in 1–5 years, then it became the highest at 1.75 (0.69) in more than 5 years. The mean was normal in 21.30% and elevated in 78.70% of the patients. Both serum creatinine and cystatin C levels were negatively correlated with posttransplantation time in kidney transplant patients.

Conclusion:

The cystatin C level was statistically significantly higher after 5 years of transplantation. It is a better parameter to rule out renal dysfunction after transplantation.
Helicobacter pylori and Association between its Positivity and Anatomotopographic Settlement in the Stomach with the Host Age Range
Authors: Ozturk Tuncer , Sengul Demet , Sengul Ilker
Published: June 2021

Helicobacter pylori (H. pylori) is a Gram-negative, helically shaped flagellated bacterium. Major diseases associated with H. pylori infection include peptic ulcer, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. The incidence of H. pylori in the anatomotopographic regions of the stomach, such as antrum, corpus, fundus, and incisura angularis, has been investigated. Do the rates of H. pylori in the settlements change over time according to the age ranges of the hosts? Does this change affect the diseases caused by or related to H. pylori? It is estimated that the outcomes, which have been obtained, may provide a new perspective in terms of understanding the etiopathogenesis of H. pylori-induced diseases. A comprehensive literature search of PubMed/MEDLINE databases had been conducted using a combination of terms, “Helicobacter pylori,” “Sydney System,” “stomach,” “pyloric antrum,” “gastric corpus,” “stomach cancer,” and “Helicobacter pylori and age.” There are very few articles examining the relationship between the topographic locations of H. pylori and host age range in the English language literature. Therefore, it is also purposed to emphasize the outcomes of our current research about the mentioned topic. In our opinion, similar studies should reveal the settlement and age range in the different geographic locations and societies as in our study. We believe that these findings will contribute to the efforts for understanding overtly of H. pylori-induced disease of the stomach.
Spectrum of Urological Cases in a West African Tertiary Hospital
Authors: Mungadi Isma'ila Arzika , Khalid Abdullahi
Published: June 2021

Context:

Urological diseases vary from one geographical location to another worldwide. The knowledge of their distribution in each location could determine local workforce and facility needs and as well guide the areas of subspecialization.

Aims:

The aim of this study is to document the annual frequency and distribution of urological diseases at the Usmanu Danfodiyo University Teaching Hospital, Sokoto.

Settings and Design:

A cross-sectional retrospective study from January 2016 to December 2016 of all new patients seen at the urology outpatient clinic, emergency department as well as inpatient referrals from other departments of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.

Materials and Methods:

The relevant records were extracted from the patient's case notes and entered into a semistructured questionnaire.

Statistical Analysis Used:

Data were analyzed using the SPSS software version 20.

Results:

A total of 607 new patients were seen over the study period. There were 576 (94.9%) males and 31 (5.1%) females, with a male-to-female ratio of 18.6:1. The median age was 45 years, with age range of 1–106 years. Urological emergencies were seen in 35.0% patients. Ninety-one percent of cases were acquired, whereas 8.2% were of congenital etiology. Overall, the most commonly diagnosed urologic diseases among new patients in order of decreasing frequency were benign prostatic enlargement (BPE) (18.6%), bladder tumor (11.8%), upper tract urinary calculi (10.3%), urethral stricture (8.9%), and prostate adenocarcinoma (7.4%).

Conclusions:

BPE, bladder tumor, upper tract urinary calculi, urethral stricture, and prostate adenocarcinoma are common in our environment. Knowledge of these diseases distribution may guide service expansion and workforce needs, inspire subspecialization as well as direct research and government policy in this community. Nongovernmental organizations wanting to have impact will be suitably directed.
The Profile of Autoimmunity in Type 1 Diabetes Patients
Authors: Derrou Sara , El Guendouz Fayçal , Benabdelfedil Yousra , Chakri Imad , Ouleghzal Hassan , Safi Somaya
Published: June 2021

Background:

Type 1 diabetes mellitus (T1DM) is an autoimmune disorder caused by pancreatic β-cells destruction. Anti-pancreatic antibodies are the witness of β-cell destruction and their dosage is mainly used for etiological diagnosis. Patients with T1DM are at increased risk of developing other autoimmune reactions, which may involve other organs, resulting in organ specific autoimmune disease. The most frequently encountered are autoimmune thyroid disease, followed by celiac and gastric disease and other rare autoimmune diseases.

Objectives:

The purpose of this study is to investigate the prevalence of autoimmune markers in patients with T1DM.

Methods:

The study was conducted at the Department of Endocrinology of the Military Hospital Moulay Ismail in Meknes Morocco, from January 2016 to December 2018. All Type 1 diabetes patients consulting during the study period were included in the study. Their clinical and biochemical data were collected at their first presentation, made up of anti-pancreatic antibodies (glutamic acid decarboxylase [GAD] antibody, tyrosine phosphatase antibody, and islet cell antibody) and other organ-specific antibodies: the thyroid (antithyroid peroxidase antibody, antithyroglobulin antibody, and antithyroid-stimulating hormone receptor antibody), the intestine (IgA antitissue transglutaminase antibody), the adrenal gland (anti-21 hydroxylase antibody), and the stomach (antigastric parietal cell antibody and anti-intrinsic factor antibody).

Results:

Fifty-four patients were included, with an average age of 26 years. GAD, tyrosine phosphatase, and islet cell antibodies were detected in 74%, 22%, and 3.7%, respectively, of the 54 patients examined. The prevalence of extrapancreatic autoimmunity was 45% with a large preponderance among different immunities of those from thyroid and celiac diseases (CDs).

Conclusion:

Our results confirm that patients with Type 1 diabetes should be investigated for the presence of autoimmune diseases mainly from thyroid and CDs.
Asymptomatic Bacteriuria among Antenatal Clients in a Secondary Facility in Southwestern Nigeria
Authors: Alao Abayomi Ibukun , Akunaeziri Uche Augustine , Afolabi Adeola Folashade , Pam Samuel , Igwemadu1 Gerald Tochukwu
Published: June 2021

Context:

Asymptomatic bacteriuria (ASB) is the presence of bacteria in the properly collected urine of a patient that has no signs or symptoms of a urinary tract infection (UTI). If diagnosed early, UTI and its grave consequences can be prevented in pregnant women.

Aims:

The goal was to ascertain the prevalence of ASB in pregnant women attending antenatal clinic.

Subjects and Methods:

The study was a cross-sectional descriptive study. Data were collected using the proforma. Clean catch urine samples were taken and sent for microscopy, culture, and sensitivity. The data were analyzed by statistical package for social sciences (SPSS) version 23.

Results:

A total of 42 women had ASB on urine culture, giving a prevalence of 30.4%. The most common organism cultured was Escherichia coli (21[50%]) and most of the organisms isolated were sensitive to nitrofurantoin (88.3%).

Conclusions:

This study found that the prevalence of ASB among antenatal clients was 30.4%. The dominant organism was found to be E. coli. Majority of the organisms were sensitive to nitrofurantoin (88.3%), cefuroxime (78.6%), ceftazidime (78.6%), and ceftriaxone (71.4%). We found a positive association between the density/number of urinary pus cells of the participants and the occurrence of ASB.
A Comparison of the Performance of the Midarm Circumference and the Nelson Weight Estimation Formulas in Nigerian Children
Authors: Igbokwe Obianuju O. , Osuorah Chidiebere D. I. , Ndu Ikenna K. , Iloh Ogochukwu N. , Iloh Kenechukwu K. , Nwaneli Ezinne I. , Nduagubam Obinna C. , Edelu Benedict O. , Nwokeji-Onwe Linda , Anarado Chikodi F.
Published: June 2021

Background:

In emergencies, two commonly used weight estimation methods are Nelson and mid-arm circumference (MAC)-based formulae. Nelson's method requires the child's age while the MAC formula offers weight estimation without any prior details of the child, which is useful in our environment due to the lack of proper vital statistics documentation.

Methodology:

We measured the weight, height, and MAC of 1390 children aged 1–12 years. Values got from the measurements were substituted in MAC and Nelson formulae for weight estimation. The estimated weights were compared to the actual weights of the children.

Results:

A total of 1390 children were enrolled. The mean of enrolled children's actual weight was significantly higher than the mean weight estimated using MAC and Nelson formula. MAC method overestimated weight in children 1–7 years and underestimated weight in those 8–12 years old. On the other hand, the Nelson formula underestimated weights in children 2–11 years and overestimated weight in 1 and 12-year olds.

Conclusions:

Both the MAC and Nelson method have their deficiencies in weight estimation. Though the Nelson formula appears slightly more accurate than the MAC, weight estimates from both methods were mostly within the actual weight agreement limits.
Management of Spontaneous Pneumothorax in Pregnancy in a Low-Income Country During COVID-19 Pandemic
Authors: Akanni Bolaji Abdulazeez , Gold Ikponmwosa , Nwafor Ikechukwu Andrew , Eze John C.
Published: June 2021

Spontaneous pneumothorax is a rare and life-threatening emergency. When it occurs in pregnancy, it poses a serious danger for both the mother and the fetus. A high index of suspicion, early diagnosis, and proper management are recommended. We present the case of a 35-year-old pregnant woman at the 34th week of gestation who presented via the emergency department complaining of sudden onset of dyspnea and chest pain. The clinical and radiologic evaluation confirmed the right-sided pneumothorax. She had a closed tube thoracostomy drainage (CTTD) following which the patient's condition improved. She subsequently had chest tube removal with no recurrence beyond delivery as she had a good outcome.
Outcome of Posterior Lumbar Interbody Fusion for Degenerative Lumbar Spine Spondylolisthesis in a Neurosurgical Centre in Nigeria
Authors: Ndubuisi Chika Anele , Mezue Wilfred Chukwuemeka , Campbell Francis Chukwuebuka , Okwunodulu Okwuoma , Ndafia Ned Michael , Ozoagu Amaka Martha , Ohaegbulam Samuel Chukwunonyerem
Published: June 2021

Introduction:

Posterior lumbar interbody fusion (PLIF) is one of the options for the management of lumbar spine instability and is being increasingly used in Nigeria. The aim of the study is to assess the outcome of cases managed with PLIF in Enugu, Nigeria.

Methods:

Retrospective analysis of all patients that had PLIF for degenerative lumbar spine spondylolisthesis from the year 2016 to 2019 at a single centre the interbody fusion device was polyetheretherketone cage loaded with autologous bone graft. All patients presented with severe low back pain. Patients operated for traumatic spondylolisthesis and those managed with pedicle screw fixation alone were excluded. Patients were followed up for at least one year. The outcome was assessed using Japanese Orthopedic Association (JOA) scoring for back pain, visual analog score (VAS), fusion rate, and the 5-point patient-reported improvement scale.

Results:

A total of 57 patients were analyzed. The mean age was 56.5 ± 7.4 years and the mean duration of back pain was three years (1–15 years). The mean preoperative VAS was 7.9 ± 1.1, while the postoperative VAS score was 3.3 ± 1.7. The JOA scores before surgery and at least 12 months post-surgery were 12.9 ± 2.8 and 22.9 ± 4.9, respectively. The patient recovery rate was 63.3%. A satisfactory outcome was noted in 82.8% of patients, post-surgery. The average fusion rate postsurgery was 88%. The most common postoperative complication was cerebrospinal fluid leak (8.8%). Four obese patients had implant-related complications.

Conclusion:

PLIF for degenerative spine disease is associated with significant improvement in preoperative back pain and neurological outcome. It is also associated with good fusion, recovery, and patient-reported improvement.
Awareness of Ear Health Care among Urban City Residents, in South-South, Nigeria
Authors: Adekanye Abiola Grace , Nja Glory Egom , Mgbe Robert Bassey , Umana Aniefon Ntuien-Udo
Published: June 2021

Background:

Exposure to Sound Pressure Levels (SPL) above 85 dB over 8 hours is potentially damaging to the ears. Unfortunately, many people may be unaware of the adverse effects of such SPL on the ear and quality of life. The level of awareness of hearing test has not been adequately determined in our region, a developing world. Some even seek ear care from unauthorized facilities and persons who often recommended inappropriate medications and treatment. The objectives of this study were to assess specifically the respondents' level of awareness of sound levels that could cause hearing loss, determine the number of respondents who have had a hearing test, and the sources of ear healthcare among residents in an urban city in South-South, Nigeria. Participants and

Methods:

An interviewee-administered questionnaire under three sections: socio-demographics; awareness of damaging sound levels and their sources; hearing testing and ear health care was used to collect data from 274 consenting respondents. Data were analyzed using IBM Statistical Product and Service Solution version 26.0. Results were presented on frequencies, percentages, tables, and figures. A P ≤ 0.05% was considered statistically significant at a 5% level of significance.

Results:

The respondents were aged between 10 and 74 years, and a median age of 24 years. Most 202 (73.7%) were males, while 72 (26.3%) were females, with male: female = 2.8:1. The greater proportion 223 (81.4%) were single; 177 (64.6%) were students; 16 (5.8%) were unemployed and 21 (7.7%) civil servants. Of the 274 consenting participants, only 79 (28.8%) were aware that the numerical value of noise level above 85 dB could cause damage to hearing. Only a small proportion with tertiary education 28 (10.2%) reported having had a hearing test. All the respondents in occupations prone to high levels of noise never had a hearing test. There was a statistically significant association between the types of ear drop/substance used by respondents and the attendant health personnel (P = 0.0001).

Conclusion

/

Recommendation:

There is poor awareness of ear health care among urban city dwellers in Calabar, South-South, Nigeria. Most young adults aged 20–29 years were aware that loud noise is hazardous to hearing. Generally, there was ignorance on objective numerical noise levels for hazard; the importance of hearing testing; and utilization of appropriate ear care facilities for treatment of ear diseases. Public health education on appropriate ear healthcare is highly recommended.
Preferred Approach to Clinical Performance Improvement among Physicians at the University College Hospital, Ibadan Nigeria
Authors: Adewole David Ayobami , Negedu Nelson Simon , Bello Segun
Published: June 2021

Background:

Training needs assessment involves the identification and prioritization of training requirements. The medical practice regulatory authority in Nigeria recommends continuing medical education for physicians. The courses are preplanned and often do not take into consideration the training needs and the preferred method for performance improvement. This study aimed to assess the preferred method for performance improvement among physicians at a tertiary health facility in Southwest Nigeria.

Methods:

This is a descriptive cross-sectional survey carried out among 355 doctors employed in the University College Hospital, Ibadan. Sampling was conducted using stratified random sampling with a proportionate allocation to size across different cadres of doctors in various departments/units. The World Health Organization Hennessy-Hicks Training Needs Analysis Questionnaire was adopted for this study. The self-administered questionnaire consisted of 33 items (assignments) grouped into five subcategories: clinical assignments, communication/teamwork, research/audit, management/supervisory assignments, and administration. Participants were requested to rate each of the 33 items/assignments along with seven-point scales (one = not at all important and seven = very important). The Hennessy-Hicks training manual quadrant chart was adopted for the interpretation of the training needs gap.

Results:

Three hundred and three (85.4%) of 355 participants responded to the survey. The mean age ± standard deviation of participants was 37.62 ± 6.7 years. About four-fifths of the participants were resident doctors. Regarding the most important rating, the clinical assignment subcategory was rated (6.3) as the most important to participants' job, out of the five subcategories. Participants, however, rated their performance best in the communication/teamwork subcategory. The training needs gap was highest (0.82) in the research/audit subcategory and lowest (0.48) in the communication/teamwork category. All subcategories reported a similar score (5.8) on participants' perception of the organization's development as a method to bridge the gap in training needs. Participants also rated the training course method as a better method to improve performance in all five subcategories.

Conclusion:

The research/audit subcategory reported training needs gap that requires close monitoring and possible intervention. This could be done by organizing and sponsorship physicians for training courses.
Pattern, Risk Factors, and Outcome of Acute Stroke in a Nigerian University Teaching Hospital
Authors: Arabambi Babawale , Oshinaike Olajumoke , Akilo Oluwakemi Oluwabunmi , Yusuf Yakub , Ogun Shamsideen Abayomi
Published: June 2021

Background:

This study aimed to document the pattern, risk factors, in-hospital outcomes, and stroke mortality in a hospital over one year.

Materials and Methods:

Acute stroke patients admitted at the Lagos State University Teaching Hospital between October 2019 and September 2020 had their records reviewed. Information including age, sex, risk factors, stroke type, access to neuroimaging, and the in-hospital outcome was extracted and analyzed.

Results:

A total of 230 patient records were included in this study. The proportion of intracerebral hemorrhage (ICH) was 44.8%, while ischemic stroke was 52.2%. Only 9.1% of ischemic stroke cases had an onset-to-arrival time of fewer than nine hours, with just three thrombolytic therapy given. The 30-day mortality was 28.7%, lesser among younger patients and patients managed in the stroke unit.

Conclusion:

The hospital incidence of ICH was close to that of ischemic stroke. Mortality data confirms the importance of management in a stroke unit.
Restricted, optimized or liberal fluid strategy in thoracic surgery
Authors: Licker Marc , Hagerman Andres , Bedat Benoit , Ellenberger Christoph , Triponez Frederic , Schorer Raoul , Karenovics Wolfram
Published: June 2021

Perioperative fluid balance has a major impact on clinical and functional outcome, regardless of the type of interventions. In thoracic surgery, patients are more vulnerable to intravenous fluid overload and to develop acute respiratory distress syndrome and other complications. New insight has been gained on the mechanisms causing pulmonary complications and the role of the endothelial glycocalix layer to control fluid transfer from the intravascular to the interstitial spaces and to promote tissue blood flow. With the implementation of standardized processes of care, the preoperative fasting period has become shorter, surgical approaches are less invasive and patients are allowed to resume oral intake shortly after surgery. Intraoperatively, body fluid homeostasis and adequate tissue oxygen delivery can be achieved using a normovolemic therapy targeting a “near-zero fluid balance” or a goal-directed hemodynamic therapy to maximize stroke volume and oxygen delivery according to the Franck–Starling relationship. In both fluid strategies, the use of cardiovascular drugs is advocated to counteract the anesthetic-induced vasorelaxation and maintain arterial pressure whereas fluid intake is limited to avoid cumulative fluid balance exceeding 1 liter and body weight gain (~1-1.5 kg). Modern hemodynamic monitors provide valuable physiological parameters to assess patient volume responsiveness and circulatory flow while guiding fluid administration and cardiovascular drug therapy. Given the lack of randomized clinical trials, controversial debate still surrounds the issues of the optimal fluid strategy and the type of fluids (crystalloids versus colloids). To avoid the risk of lung hydrostatic or inflammatory edema and to enhance the postoperative recovery process, fluid administration should be prescribed as any drug, adapted to the patient's requirement and the context of thoracic intervention.
The hypoxic pulmonary vasoconstriction
Authors: Licker Marc , Hagerman Andres , Jeleff Alexandre , Schorer Raoul , Ellenberger Christoph
Published: June 2021

More than 70 years after its original report, the hypoxic pulmonary vasoconstriction (HPV) response continues to spark scientific interest on its mechanisms and clinical implications, particularly for anesthesiologists involved in thoracic surgery. Selective airway intubation and one-lung ventilation (OLV) facilitates the surgical intervention on a collapsed lung while the HPV redirects blood flow from the “upper” non-ventilated hypoxic lung to the “dependent” ventilated lung. Therefore, by limiting intrapulmonary shunting and optimizing ventilation-to-perfusion (V/Q) ratio, the fall in arterial oxygen pressure (PaO2) is attenuated during OLV. The HPV involves a biphasic response mobilizing calcium within pulmonary vascular smooth muscles, which is activated within seconds after exposure to low alveolar oxygen pressure and that gradually disappears upon re-oxygenation. Many factors including acid-base balance, the degree of lung expansion, circulatory volemia as well as lung diseases and patient age affect HPV. Anesthetic agents, analgesics and cardiovascular medications may also interfer with HPV during the perioperative period. Since HPV represents the homeostatic mechanism for regional ventilation-to-perfusion matching and in turn, for optimal pulmonary oxygen uptake, a clear understanding of HPV is clinically relevant for all anesthesiologists.
Double lumen tube
Authors: Eldawlatly Abdelazeem A.
Published: June 2021

Double lumen tubes (DLTs) are most commonly used to achieve one lung ventilation (OLV) in most thoracic surgical procedures unless contraindicated. Left-sided DLT (LDLT) is most commonly used nowadays for most thoracic surgical procedures. Though, the use of LDLT dates long back in history, two clinical and technical issues are yet to be resolved. The first issue is the ideal size of DLT which is defined as that which provides near-complete seal of the bronchial lumen without cuff inflation. There are no guidelines in literature which help in selecting the size of DLT. However, general consensus among thoracic anesthesiologists recommends the use of smaller sizes to avoid airway trauma. In our practice and for the last few years, we are using smaller size LDLT 35 F for females and 37 F for males with minimal airway trauma and had encouraging results. The second issue is the insertion depth of the LDLT. We have introduced a height-based formula to predict the insertion depth of LDLT with encouraging results. However, even with the use of the formula, we still recommend the use of fiberoptic bronchoscopic confirmation method for final positioning of the LDLT.
Non intubated video-assisted thoracoscopic lung resections (NI-VATS) in COVID times
Authors: Aymerich H , Bonome C , González-Rivas D
Published: June 2021

The emergence of epidemic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in December 2019 in Wuhan, China causing Coronavirus Disease 2019 (COVID-19) and its rapid expansion around the world, leading to a global pandemic of dimensions not observed at least since the “Spanish influenza” pandemic in 1917-18, has had great consequences at all levels, including social, health and economic spheres. This pandemic situation forces us, as health care workers, to redefine our medical and surgical actions to adapt them to this new reality. It is important, when the rules of the game change, to rethink and to reevaluate if the balance between risk and benefit have moved to a different point of equilibrium, and if our indications of certain surgical interventions need to be redefined. In this article we try to answer the doubts that arise about the suitability of the NI-VATS technique and assess whether its use in these new pandemic circumstances might add advantages, especially in relation to minimize the risks of virus contagion between patients and all healthcare personnel during the surgical procedure, as well as the known advantages described in many articles the last ten years.
YAŞLI BİREYLERİN YAŞAM KALİTESİ VE DEPRESYON DURUMLARININ İNCELENMESİ
Authors: BİRİNCİ Emre
Published: June 2021

Bu çalışmada yaşlı bireylerin depresyon ve yaşam kalitesi durumlarının incelenmesi amaçlanmıştır. Tanımlayıcı tipte olan bu araştırmada 2019-2020 güz yarıyılında Tazelenme Üniversitesi Anadolu Kampüsünde eğitim görmekte olan toplam 121 kişi ile gerçekleştirilmiştir. Araştırma verileri, Kişisel Bilgi Formu, Geriatrik Depresyon Ölçeği ve Dünya Sağlık Örgütü Yaşam Kalitesi Ölçeği Yaşlı Modülü (WHOQOL-OLD) aracılığıyla toplanmıştır. Verilerin analizinde Mann-Whitney U ve Kruskal-Wallis varyans analizi kullanılmıştır. Katılımcıların %70,2'si (n=85) kadın, %29,8'si (n=36) erkektir. Yaş dağılımları 60-64 yaş arası %47,1 (n=57), 65-69 yaş arası %38,1 (n=46), 70-74 yaş arası %14 (n=17) ve 75 yaş üstü %0,8 (n=1)’dir. Katılımcıların çoğu evlidir (%67,8) ve iki (%57,9) çocuk sahibidir. katılımcıların % 73,6’sı sigara ve %85,1’i alkol kullanmamaktadır. Katılımcıların aldıkları puanlar göz önüne alındığında, puan ortalaması en yüksek olan ölçek sosyal katılım (15,63±2,37) olduğu, en düşük puan ise duyusal işlevler (10,22±2,71) bulunmuştur. Katılımcıların cinsiyet ve yaşları ile YKÖ ve alt ölçekleri incelendiğinde aralarında istatistiksel olarak anlamlı bir ilişki bulunamamıştır. Katılımcıların medeni durumlarına göre incelendiğinde, eşinden boşanmış olanların diğerlerine göre puan ortalaması daha yüksektir. Sigara kullananların sigara kullanmayanlara göre puan ortalamasının daha yüksek olduğu gözlemlenmiştir. Alkol kullanım durumları ile alt ölçekler arasında istatiksel olarak anlamlı bir ilişki bulunamamıştır. Araştırmaya katılan yaşlı bireylerin yaşam kalitesi ölçeğinin en düşük puanı sosyal işlevler, en yüksek puanı ise sosyal katılım alt ölçeğinde aldıkları bulunmuştur. Özerklik ile depresyon arasında zayıf negatif ilişki vardır ve özerklik azaldıkça depresyon artmaktadır.
YAŞLI BİREYLERDE KORONAVİRÜS (COVİD-19) KORKUSU; YETİŞKİN BİREYLERLE KARŞILAŞTIRMALI BİR ÇALIŞMA
Authors: ARISOY Azime , ÇAY Murat
Published: June 2021

Tarama modelinde olan bu çalışma yaşlı ve yetişkin bireylerde Koronavirüs (covid-19) korkusunu belirleyerek bunu çeşitli değişkenlere göre inceleme amacı taşımaktadır. Bu amaç doğrultusunda çalışmaya 384 yaşlı birey ve 232 yetişkin birey katılım sağlamıştır. Araştırmada temel demografik bilgi formu ile “Koronavirüs (Covid-19) Korkusu Ölçeği” kullanılmıştır. Elde edilen bulguların analiz edilmesiyle birlikte 59 yaş ve altı katılımcıların 60 yaş ve üstü katılımcılara göre Koronavirüs (Covid-19) Korkusu Ölçeği’nden aldıkları puan ortalamalarının anlamlı biçimde birbirinden farklı (t=-7,407) olduğu saptanmıştır. Koronavirüs (Covid-19) korkusu ile yaş arasında pozitif yönlü, orta düzeyde bir ilişki olduğu bulgusuna ulaşılmıştır. Bununla birlikte Koronavirüs (Covid-19) korkusu cinsiyet, medeni durum, eğitim düzeyi, çocuk sahibi olup olmama ve yerleşim yerine (il,ilçe,köy) göre farklılaşmaktadır. Ayrıca daha önce korona virüs testi yaptırıp sonucu pozitif olan katılımcıların Koronavirüs (Covid-19) Korkusu daha önce test yaptırmayan veya daha önce test yaptırıp sonucu negatif olan katılımcılara göre anlamlı derecede daha fazla olduğu sonucuna ulaşılmıştır.
YAŞLILIKTA SOSYAL DIŞLANMA ARAŞTIRMALARI: BİR İÇERİK ANALİZİ
Authors: KORKMAZ YAYLAGÜL Nilüfer , BARLIN Hande , KIRIŞIK Hande
Published: June 2021

Sosyal dışlanma, sosyal, ekonomik, bireysel ve sağlıkla ilgili risklerin artma eğiliminde olduğu yaşamın yaşlılık döneminde önemli bir konudur. Türkiye’de akademik literatürde sosyal dışlanma ele alınmaya başlanmıştır. Yaşlılık, yaygınlaşmaya başlayan bir alan olmakla birlikte yaşlılıkta sosyal dışlanma üzerine çalışmalar sınırlıdır. Bu araştırmanın amacı uluslararası literatürde yaşlılıkta sosyal dışlanma çalışmalarını ele alarak bunların genel eğilimlerini, kavramsal ve yöntemsel özeliklerini ortaya koymaktır. Araştırma doküman incelemesi olup verilerin analizinde içerik analizi yöntemi kullanılmıştır. Araştırmanın bulguları araştırmalarda ele alınan konular, ölçme araçları ve kavramlar ile sosyal dışlanmanın sınırlarının nasıl çizildiği ve kavramın nasıl ele alındığı çerçevesinde oluşturulmuştur. Bu konularda tek model olmamasına karşın ele alınan konuya göre ölçme araçlarının ve operasyonel tanımlamaların da değiştiği görülmüştür. Sonuç olarak, sosyal dışlanma kavramında bir uzlaşı olmamakla birlikte genellikle sosyal dışlanmanın ana akım toplumun üyelerinin aksine, dışlanan bireylerin ekonomik, sosyal ve sivil hayata katılamama, yaşam ortamındaki bağlantılardan kopma, hizmet ve olanaklardan yararlanama gibi sorunların hepsini veya birkaçını yaşamaları durumu olarak anlaşıldığı ortaya çıkmaktadır.
BİREYLERİN ÇOCUK KAYBI VE YAS SÜRECİNİN AİLE SİSTEM TEORİSİ TEMELİNDE SOSYAL HİZMET PERSPEKTİFİYLE DEĞERLENDİRİLMESİ
Authors: AFYONOĞLU Meliha Funda , KESEN Nur Feyzal , CANPUNAR Medine , YAVUZ Mustafa
Published: June 2021

Bu araştırma çocuğunu kaybetmiş bireylerin yas sürecini aile sistem teorisi temelinde sosyal hizmet perspektifiyle değerlendirmeyi amaçlamaktadır. Bu amaç doğrultusunda araştırma, nitel araştırma deseniyle ve fenomenolojik yaklaşımla tasarlanmış, çocuğunu kaybetmiş on altı bireyle derinlemesine görüşme yapılmıştır. Görüşmeler sonucunda; yas sürecinde sosyal destek sistemleri, yas ve uyum sürecinde profesyonel sistemler, yas ve uyum sürecinde aile sistemleri ve bireysel alt sistemlerin diğer sistemlerle ilişkisiyle geliştirdikleri başetme mekanizmaları çalışmanın birbirleriyle ilişkili dört temel temasını oluşturmuştur. Ortaya çıkan temalar ve alt temalar doğrultusunda, sosyal hizmet uzmanlarının bu müracaatçı grubuyla çalışırken odaklanmaları gereken sistemler ve etkileşimler belirlenmiştir. Uzmanların sistemlerin etkileşimlerine odaklandıkları kadar bu etkileşimin işlevselliğine ve niteliğine odaklanmaları ve sağlık çalışanlarının bir bütün olarak ölüm süreci ve ailelerle iletişim konusunda farkındalıklarını artırıcı çalışmalar yapılması araştırmanın temel önerilerinden olmuştur.
KRONİK ÜVEİT HASTALIĞI OLAN ÇOCUĞA SAHİP EBEVEYNLERİN COVİD-19 PANDEMİSİ SÜRECİNE İLİŞKİN DENEYİMLERİ
Authors: YANARDAĞ Rauf , ÖZKAN Yasemin , YALÇINDAĞ F.nilüfer
Published: June 2021

Bu fenomenolojik araştırmanın amacı, kronik üveit hastalığı olan çocuğa sahip ebeveynlerin Covid-19 Pandemisi döneminde çocuklarının hastalık durumu ve tedavi sürecine ilişkin yaşam deneyimlerini görünür kılmaktır. Nitel araştırma yönteminin kullanıldığı bu çalışmada fenomenolojik desenden yararlanmıştır. Çalışmaya, kronik üveit hastalığı tanısı konulup, Ankara Üniversitesi Tıp Fakültesi Göz Hastalıkları Anabilim Dalı’nda tedavileri devam eden 10 çocuğun 15 ebeveyni katılmıştır. Veri toplama aracı olarak sosyo-demografik bilgi formu ve yarı yapılandırılmış görüşme formu kullanılmıştır. Çalışma kapsamında elde edilen veriler, içerik analizi tekniği kullanılarak analiz edilmiştir. Analiz sürecinde maxqda analiz programı kullanılmıştır. Bu süreçte 4 tema ve 12 kategori oluşturulmuştur. Ebeveynlerin Covid-19 Pandemisi sürecindeki yaşam deneyimlerinde, psiko-sosyal ve ekonomik sorunlar yaşanması, sağlık hizmetlerine erişememe, çocuğunun Covid-19’a yakalanması ve sağlık durumunun kötüleşmesi, gibi endişe ve kaygıların artığı sonucuna ulaşılmıştır. Bu sonuçlar çerçevesinde ailelere ekonomik ve psiko-sosyal desteğin sağlanılması, çocuklarının sağlık hizmetlerinden etkin bir şekilde yararlanabilmeleri için sağlık hizmetlerine erişiminin kolaylaştırılması önemlidir.