bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatial Modelling of Risk Factors for Malaria Prevalence in SNNP Regional State, Ethiopia
Authors: Shammena Aklilu Toma  , Baleh Wubejig Eneyew  , Goshu Ayele Taye
Published: July 2024

BACKGROUND፡ Malaria is one of the most severe public health problems worldwide with 300 to 500 million cases and about one million deaths reported to date of which 90% were from world health organization (WHO) Sub Saharan Africa (SSA) countries. The purpose of this study was to explore the spatial distribution of malaria parasite prevalence (MPP) among districts of Southern Nations Nationalities and Peoples Regional State (SNNRS) in Ethiopia by using 2011 malaria indicator survey (MIS) data collected for 76 districts and to model its relationship with different covariates.METHOD: Exploratory spatial data analysis (ESDA) was conducted followed by implementation of spatial lag model (SLM) and spatial error model (SEM) in GeoDa software. Queen contiguity second order type of spatial weight matrix was applied in order to formalize spatial interaction among districts.Results: From ESDA, we found positive spatial autocorrelation in malaria prevalence rate. Hot spot areas for MPP were found in the eastern and southeast parts of the region. Relying on specification diagnostics and measures of fit, SLM was found to be the best model for explaining the geographical variation of MPP. SLM analysis demonstrated that proportion of households iving in earth/local dung plastered floor house, proportion of households living under thatched roof house, average number of rooms/person in a given district, proportion of households who used anti-malaria spray in the last 12 months before the survey, percentage household using mosquito nets and average number of mosquito nets/person in a given district have positive and statistically significant effect on spatial distribution of MPP across districts of SNNPRS. Percentage of households living without access to radio and television has negative and statistically significant effect on spatial distribution of MPP across districts of MPP.CONCLUSION: Malaria is spatially clustered in space. The implication of the spatial clustering is that, in cases where the decisions on how to allocate funds for interventions needs to have spatial dimension.
Investigation of LAMP Technique in Diagnosis Type of Plasmodium Species in Anopheles Mosquitoes :A Fast and Practical Technique to Detect Malaria Pathogens in the Field
Authors: Hadi Mirahmadi  , Nadia Kazemipour  , Anis Yazdiani  , Ahmad Mehravaran  , Hamid Reza Basseri  , Leili Mohammadi  , Ebrahim Alijani
Published: July 2024

BACKGROUND፡ Malaria is one of the main parasitic diseases and a major health issue in some countries. This study aims to determine the rate and type of infections of Anopheles mosquitoes with malaria parasites using the molecular LAMP method in the Southeastern Iran.METHODS: In this study, 400 Anopheles mosquitoes were collected by the Zahedan Medical Insecticide Center in Nikshahr City, a high-risk area of malaria transmission in Sistan-Baluchestan Province. The mosquitoes were caught manually (by hand) in domestic (humans and animals), natural, and artificial outdoor places (Shelter pits). After DNA extraction, the LAMP method was used, which was compared with Multiplex Nested- PCR as a standard method.RESULTS: Out of 400 samples collected from Nikshahr City, 6 samples (1.5%) were infected with Plasmodium vivax. No Plasmodium falciparum or a mix (Plasmodium vivax and Plasmodium falciparum) was detected in this study.CONCLUSIONS: The results of this study indicate that in places with transmission of both species, i.e. Plasmodium vivax and Plasmodium falciparum, detection of malaria parasites by the LAMP method could be very useful in spotting infections in the field. Thus, molecular epidemiological studies could be conducted annually to monitor malaria in endemic regions. The results of this research show that contamination with mosquito malaria vectors is increasing in Nikshahr City, and it seems that more studies will be required to eliminate malaria until 2026.
Determinants of Delayed Treatment-seeking for Diarrheal Diseases among Mothers with under-five Children in North Western Ethiopia, 2020: A case-control Study
Authors: Abebaw Getu Kbede  , Mulunesh Alemayew  , Yilkal Tafere  , Getaneh Baye Mulu
Published: July 2024

BACKGROUND፡ Delays in seeking timely proper care pay a large number of deaths from diarrhea in children. Timely and appropriate health care seeking in under-five children with diarrhea reduces life-threatening complications. This study aimed to investigate determinants of delayed treatment-seeking for diarrheal diseases among mothers with under-five children.Method: In Debre Markos public health facilities, a facility-based case-control study was conducted among 412 mothers ((137 cases and 274 controls) from September 1 to October 15, 2020. Consecutive sampling was employed to select cases and controls. Data was collected using a semi-structured intervieweradministered questionnaire. Data were entered into Epi- Data version 4.2.1 and exported to STATA version 14 for analysis. Predictors with P-value <0.25 in the bivariable logistic regression model were candidates for multivariable logistic regression. Pvalue <0.05 was used to declare statistical significance. Finally, results were presented in the form of texts and tables.RESULT: From 412 selected participants, 408 mothers (136 cases and 272 controls) were included. Female children [AOR 1.85(95% CI 1.15-2.98)], Child age < 24 months [AOR 1.64 (95% CI 1.01-2.65)], mothers’/caregivers without formal education [AOR 4.61 (95% CI 2.03-10.44)], poorest wealth index category [AOR 4.24 (95% CI 1.90-9.48)], absence of health insurance [AOR 3.04 (95% CI 1.60-5.78)], and self-medication [AOR 3.6 (95% CI 1.75-7.4)] were determinants of delayed treatmentseeking.CONCLUSION: Being female, young age, educational status of the mother, lowest wealth index category, self-medication, and absence of health insurance were determinants of delayed treatment-seeking for diarrheal diseases. Preventive care programs should target age, low socioeconomic status, and a low educational class of the mother.
Pediatric Surgical Volume at the TASH: Experience after the Expansion of Pediatric Surgery Program
Authors: Samuel Negash  , Workiye Tigabe  , Woubedel Kiflu  , Miliard Derbew
Published: July 2024

BACKGROUND፡ Ethiopia has a high unmet need for pediatric surgical conditions. Over the past 5 years, new changes have been introduced to the pediatric surgery division at Addis Ababa University to overcome this issue. The changes include initiation of pediatric surgery residency, allocating operating room for pediatric surgery, weekend surgical campaign and starting ultrasound guided hydrostatic reduction. We conducted this study to evaluate the pattern and outcome of pediatric surgical cases after these changes.METHODS: The study was a retrospective review conducted at Tikur Anbessa Hospital from Jan – Dec 2019. Data was collected from duty report forms that included emergency procedures, admissions and mortalities. Data on elective procedures was collected from operation theater log books.RESULTS: Overall, a total of 1590 pediatric surgical procedures were performed during 2019 of which 942 cases were elective and 648 were emergency. This was an increment in number of surgeries performed by 75%. The leading emergency procedure was aerodigestive foreign body removal which increased by 46%. Surgery for intussusception has decreased by 30% with increasing use of hydrostatic reduction. Overall, average morbidity and mortality was 3.5% and 6.9% respectively. Morbidity and mortality rates were similar throughout the year.CONCLUSION: The study shows increased productivity over the past year with the changes made in the department. There is also no increment in morbidity and mortality during the start of the academic year. This implies adequate consultant supervision of residents during transition.
Molecular Evaluation of Chlamydia trachomatis Infection and Its Association with Tumor Necrosis Factor-α Polymorphism in Recurrent Spontaneous Abortions
Authors: Fatemeh Darvishi Kolor  , Jalil Vand Yousefi  , Reza Ranjbar
Published: July 2024

BACKGROUND፡ The rate of infections in the intensive care units (ICUs) is rising, mainly because of the increasing use of invasive procedures. Several bacterial infections and host genetic backgrounds, including TNFα SNP polymorphisms, play important roles in recurrent spontaneous abortions (RSA). So, this study aimed to evaluate C. trachomatis infection and its relation with TNFα -308 and -238 polymorphism for early detection and treatment of RSA.METHODS: The blood samples were taken from 63 Iranian women with a history of RSA and 59 ethnically matched healthy controls with at least two successful pregnancies and no history of abortion. Then, DNA was extracted from all samples and detection of C. trachomatis and TNFα -308 and -238 polymorphism was determined by multiplex amplificationrefractory mutation system (ARMS)-PCR. Finally, the statistical analysis to detection C. trachomatis and host genetic roles in RSA were analyzed by Epi Info TM software by X2 test.RESULTS: C. trachomatis was detected in 22 and 3% of the RSA and the control group, respectively. Moreover, in comparison with healthy controls, C. trachomatis infection was closely correlated with TNFα -308 genotypes, whereas no significant association was observed between TNFα -238G/A and RSA. In addition, statistical analysis of TNFα -308 genotypes showed that the frequency of genotype AA was higher in patients with C.trachomatis infections than healthy individuals and the difference was statistically significant.CONCLUSIONS: This study demonstrated that molecular analysis of TNF -308 genotypes is important in early detection and treatment of RSA with C. trachomatis infection.
Antibiotic Resistance Profile of Common Bacteria Isolated from Blood Stream, Lower Respiratory Tract and Urinary Infections in Intensive Care Unit in Saudi Arabia: A Retrospective Study
Authors: Ahmed M. Kabrah  , Saeed M. Kabrah  , Fayez S. Bahwerth  , Naof F. Alredaini
Published: July 2024

BACKGROUND፡ The rate of infections in the intensive care units (ICUs) is rising, mainly because of the increasing use of invasive procedures and specialized devices. This study aimed to identify the antibiotic resistance profile of common bacteria isolated from lower respiratory tract infections (LRTIs), bloodstream infections (BSIs), and urinary infections (UTIs) in ICUs in Saudi Arabia.METHODS: In the current retrospective study, the isolates and antibiotic resistance were collected from the Electronic Medical Record (EMR) for respiratory, blood, and urine samples. The study sample compromised 96 patients admitted to the ICU at least for 48 hours and have a central venous catheter (CVC)between November 1, 2020, and January 31, 2021.RESULTS: 66 (68.8%) of the study sample were males, and 30 (31.2%) were females. LRTIs were the most common isolates (51 samples), followed by BSIs (28 samples) and UTIs (17 samples). The isolated pathogens in this study were Klebsiella pneumoniae (K. pneumoniae) (59.4%), Coagulase-negative staphylococci (CoNS) (11.5%), Escherichia coli (E. coli) (8.4%), Acinetobacter baumannii (A. baumannii) (7.3%), and Staphylococcus aureus (S. aureus) (6.2%). BSI were frequently caused by CoNS (35.7%) and K. pneumoniae (35.7%), while Methicillin-resistant Staphylococcus aureus (MRSA) represented 10.7% of BSI. Vancomycin, Synercid, and Teicoplanin were the commonly used antibiotics and showed 100% sensitivity among S. aureus, including MRSA, while almost 100% resistance was observed for penicillin and oxacillin against the same organisms. The maximum resistance was observed with aztreonam (96.4%), ampicillin (87.3%), followed by co-amoxiclav (83.9%), cotrimoxazole (79.5%) and cephalosporin group antibiotics.CONCLUSIONS: Strict adherence to infection prevention practices and wise use of antibiotics are recommended to slow the spread of antimicrobial resistance (AMR).
Prevalence of Ventriculostomy Related Infections and Associated Factors in Low Income Setup
Authors: Mulualem Wondafrash  , Abenezer Tirsit
Published: July 2024

BACKGROUND፡ Ventriculostomy, a lifesaving and emergency procedure, is used to address raised intracranial pressure. In resource limited set-up like Tikur Annbessa Specialized Referral Hospital, properly designed closed system for ventriculostomy is not available; a device made with sterile pediatric nasogastric tube connected to urine bag is used.METHODS: Institutional based retrospective cross-sectional study conducted on 93 patients with ventriculostomy from January 1, 2009 to June 30, 2018. Ventriculostomy related infection risk described in descriptive statistics and Binary Logistic Regression analysis.RESULTS: The prevalence rate of Ventriculostomy related infection is 25.8% at Tikur Annbessa Specialized Referral Hospital. Identified risk factors: Ventriculostomy stay for five or more days (AOR=7.676, 95% CI: 1.424, 41.367) and cerbro-spinal fluid leak (AOR=4.592, 95% CI: 1.279, 16.488). Ventriculostomymanipulation showed association on bivariate analysis. K.Pneumoniae (34.6%) and Acinetobacter spp. (30.8%) identified as the main organisms. They were sensitive to combined ceftazidime and vancomycin in 19.2% and meropenem in 42.3%. Based on Tängdén’s criteria, 11.8% of patients died of Ventriculostomy related infection while 43% of the patients died in total. Mortality from Ventriculostomy related infection is 45.8% once diagnosed.CONCLUSION: The prevalence rate of Ventriculostomy related infection is 25.8% at Tikur Annbessa Specialized Referral Hospital. The duration of external ventricular drain and Cerebrospinal fluid leak are identified risk factors. Ventriculostomy related infection is responsible for one third of mortality related with external ventricular drain. The remaining two third exact causes are not known.
Adolescent Riding Behavior During the COVID-19 Pandemic in Urban Area, Indonesia: A Cross-sectional Study
Authors: Intan Zainafree  , Suharyo Hadisaputro  , Agus Suwandono  , Bagoes Widjanarko
Published: July 2024

BACKGROUND፡ According to police reported crash, in 2020 there have been 510 road traffic accidents among adolescents aged 16-25 years. The problem is that although restrictions on social activities have been implemented, 9.80% of accidents have caused deaths in Semarang City. There were many factors that influence the occurrence of road traffic accidents; one of those is the poor knowledge about safe riding behavior. The aim of this study is to determine the factors that contribute to the occurrence of road traffic accidents in adolescents during the pandemic.METHODS: This was a cross-sectional study, collected data using an online questionnaire distributed to adolescents aged 15- 20 years in Semarang City, Indonesia. It was distributed during February-April 2021. The data included participant’s demographic information, riding behavior, and knowledge about safe riding. We analyzed using chi-square and logistic regression to determine the most influential factors.RESULTS: The sample included 725 participants with a mean age of 17.4 years (SD=0.97); 260 (35.9%) males. We have found that gender was associated with the incidence of road traffic accidents (AOR=1.455, 95% CI [1.048–2.020], P=0.025) after adjusting for experience road safety education, vehicle type, andknowledge of safe riding.CONCLUSION: It is necessary to carry out Road Safety Education efforts to male students during the pandemic to reduce the incidence of traffic accidents.
Vaccine Breakthrough Infections of SARS-Cov-2: A Case Report
Authors: Ramprakash Kaswa
Published: July 2024

BACKGROUND: Novel mRNA vaccines provide a high degree of protection against COVID-19 infection, hospitalisation, and death. However, no vaccine claimed 100% effectiveness and it is expected that a small proportion of vaccinated individuals may develop a breakthrough infection. There is a concern relating to the ability of variants to evade vaccine-induced immunity that leads to asymptomatic infection or occasionally progress to disease. The extent of this ability is largely unknown.CASE REPORT: An 88-year-old male patient was brought to the emergency department on July 25, 2021, with a presentation of a lower respiratory tract infection. He was screened for SARS-CoV-2, and tested positive for the reverse transcription-polymerase chain reaction (RT-PCR) test for SARS-CoV-2. According to the patient, he was diagnosed with benign prostatic hyperplasia (BPH) after a prostate biopsy in 2015 but, at the time of admission, he was not taking any chronic medication. He received the first dose (batch no. FA7812) of the Pfizer-Biotech vaccine on June 8, 2021, and the second dose (batch no. FE2090) on July 20, 2021. He was admitted to the isolation ward with a diagnosis of vaccine breakthrough COVID-19 infection and BPH.CONCLUSION: This case report highlights the issue of vaccine breakthrough infections and the potential risk of contracting the COVID-19 disease despite successfully receiving two doses of the Pfizer-BioNTech vaccine six weeks apart.
Guillain-Barré Syndrome Associated with SARS CoV-2 Infection: Case Report
Authors: Dereje Nigatu  , Tsion Tigabu  , Meron Awraris  , Andargew Yohannes  , Dawit Kebede
Published: July 2024

BACKGROUND፡ Since the outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV2) in December 2019, there have been some case reports of Coronavirus disease 19 (COVID 19) associated Guillain-Barré Syndrome (GBS). GBS is an inflammatory polyradiculoneuropathy associated with numerous viral and bacterial infections. Here we describe the case of an Ethiopian man with a typical clinical and electrophysiological manifestation of GBS.CASE PRESENTATION: A 70-year-old male presented with four days history of progressive and ascending bilateral limbs weakness which end up with respiratory failure. He had an antecedent headache, loss of appetite, and generalized fatigue. Electrophysiological studies showed Acute Motor and Sensory Axonal Neuropathy whereas and cerebrospinal fluid analysis revealed albuminocytologic dissociation with positive preintubation SARS CoV2 test. He was treated with supportive care and recovered successfully.CONCLUSION: This case illustrates one of the few occasions when patients with mild COVID-19 develop severe neurologic manifestations. Seemingly, early identification and management can improve clinical outcomes. We would like to emphasize the need to consider screening for SARS CoV-2 in patients presenting with GBS.
The Combinational Role of Vitamin D and Other Conditions in Multiple Sclerosis Patients
Authors: Chrissa Sioka
Published: July 2024

Letter to the editor.
Chronic Kidney Disease and Associated Factors among Diabetic Patients at the Diabetic Clinic in a Police Hospital, Addis Ababa
Authors: Muna Abdulkadr  , Hailu Merga  , Biru Abdissa Mizana  , Gemechu Terefe  , Lamessa Dube
Published: July 2024

BACKGROUND Diabetes mellitus remains the leading cause of end-stage renal disease in most countries in the world. In Ethiopia, renal complications of diabetes may remain unrecognized due to limited diagnostic resources. As a result, the prevalence of chronic kidney disease among adult diabetics in Ethiopia has not been well described. Hence, this study was aimed at assessing the prevalence of chronic kidney disease and associated factors among diabetic patients who attended the federal police hospital diabetic clinic in Addis AbabaMETHODS: A cross-sectional study was conducted among 362 Diabetes Mellitus. Data were collected using face-to-face interviewing questionnaires and analyzed using SPSS version 21.0. Binary logistic regression analyses were performed to identify predictors.RESULTS: The prevalence of chronic kidney disease diagnosed by Cockcroft-Gault equation and Modification of Diet in Renal Disease equation was 14.6% and 7.7% respectively. This finding shows the prevalence of chronic kidney disease among Diabetic patients was low. Age 50-59 years [(AOR= 4.0; 95% CI:(1.2, 13)] by Cockroft-Gault equation (CG), age 60-69 years [(AOR=5.8 95% CI:(1.5,21.0)] by Modification of Diet in Renal Disease (MDRD) and (AOR;22.9 95%CI:7.1,74.2) by CG, age 70 years and above (AOR=4.7; 95 CI: 1.1, 19.7) by MDRD and (AOR= 22.9; 95%CI:7.1,74.2) by CG, BMI (AOR=0.2; 95% CI:0.1,0.4) by CG, and previous kidney disease (AOR=6.2 95%CI:2.0,8.4) by MDRD and (AOR;4.6 95%CI:1.9,10.8) C-G equation have a significant association with chronic kidney disease after an adjustment done.CONCLUSION: The prevalence of chronic kidney disease among Diabetic patients in this study was lower. Age, BMI, and previous recurrent kidney disease were associated with chronic kidney disease. Preventive measures like giving health education and screening of patients with risk factors should get more attention.
Knowledge, Attitude and Decision-making of Nurses in the Resuscitation Team towards Terminating Resuscitation and Donot- Resuscitate Order
Authors: Afshin Goodarzi  , Efat Sadeghian  , Keivan Babaei  , Masoud Khodaveisi
Published: July 2024

BACKGROUND: Making appropriate decisions for cardiopulmonary resuscitation (CPR) is very challenging for healthcare providers. This study aimed to evaluate knowledge, attitude, and decision making about do-not-resuscitate (DNR) and termination of resuscitation (ToR) among nurses in the resuscitation team.METHODS: This descriptive cross-sectional study was conducted in April–September 2020. Participants were 128 nurses from the CPR teams of two hospitals in Kermanshah and Hamedan, Iran. A valid and reliable researcher-made instrument was used for data collection. Data were analyzed using the Chi-square, Fisher’s exact, and Mann-Whitney U tests, the Spearman’s correlation analysis, and the logistic and rank regression analyses.RESULTS: Only 22.7% and 37.5% of participants had adequate knowledge about ToR and DNR. The significant predictor of DNR and ToR knowledge was educational level and the significant predictors of decision making for CPR were educational level, gender, and history of receiving CPR-related education (P<0.05). When facing a cardiac arrest and indication of DNR or ToR, 12.5% of participants reported that they would not start CPR, 21.5% of them reported that they would terminate CPR, and 14.8% of them reported that they would perform slow code. The DNR decision had significant relationship with educational level, DNR knowledge, and ToR knowledge (P< 0.05), while the ToR decision had significant relationship with educational level and ToR knowledge (P<0.05).CONCLUSION: Nurses’ limited DNR and ToR knowledge and physicians’ conflicting orders and documentation can cause ethical challenges for nurses. Clear guidelines for DNR orders or TOR is necessary for nurses, in order to prevent any potential confusion, legal or psychosocial issues and concerns surrounding CPR and improve their involvement in CPR decision making process.
The Unusual High Origin Radial Artery in a Black Kenyan Population: A Cadaveric Study
Authors: Brian N. Bundi  , Victor Mutua  , Isaac Cheruiyot  , Jeremiah Munguti  , Chris von Csefalvay  , Khulud Mahmood Nurani  , Julius Ogeng’o
Published: July 2024

BACKGROUND: The anatomy of the radial artery draws great interests among anatomists for its frequent involvement in variations. Equally, these variations have gained significant attention from clinicians because of the preference to use the radial artery for catheterization. The commonest of radial artery variations involve its site of origin. In published literature, data on this variations exist, but the prevalence of such variations in a Kenyan population has hitherto been unknown.METHODS: Sixty-two upper limbs from 50 formalin-fixed cadavers were studied during dissection in the Department of Human Anatomy, University of Nairobi.RESULTS: Fifty-four (87.1%) radial arteries arose within the cubital fossa, while eight (12.9%) had a high origin. Out of the eight high arteries, two (3.2%) branched off from the axillary artery, another two (3.2%) were branches of the proximal third of the brachial artery and four (6.5%) arose from the middle third of the brachial artery. The high origin radial arteries were more common on the right upper limbs (5 out of the 8 cases). Both axillary and brachial origins were seen bilaterally.CONCLUSION: The present study details important variations in the anatomy of the radial artery in a Kenyan population. With the radial artery being utilized during clinical, surgical and radiological interventions so frequently, an increased understanding and anticipation of such topographic variances is paramount.
SARS-CoV-19 Mutations: is a Blessing or a Curse for Human Being?
Authors: Zohreh Jadali
Published: July 2024

Letter to the editor.
Postpartum Care Behavior Improvement during COVID-19 Pandemic in Indonesia Using Mobile-Health Interactive Message
Authors: Respati Wulandari  , Agus Suwandono  , Martha Irene Kartasurya  , Sri Achadi Nugraheni
Published: July 2024

BACKGROUND: Since 2018, maternal mortality in Semarang City, Indonesia, has mostly (75%) occurred during the postpartum period. Therefore, a health intervention is necessary to improve safe and effective postpartum care. During the Covid-19 pandemic, a mobile-based health intervention is preferred due to the government’s regulation of COVID-19 safety prevention. This study aimed to determine the effectiveness of the mobile-health interactive message on the postpartum care behavior of mothers and their husbands.METHODS: The study was conducted in a quasi-experimental design. It includes the treatment group and the control group, in which each group consists of 46 pairs of pregnant women in the third trimester and their husbands. The research subjects were chosen through the purposive sampling technique. Data collection was conducted via interviews and observations. The m-health intervention is carried out in the form of text messages, images, videos, and interactive mentoring. The latter was carried out through group messaging via the WhatsApp application for the treatment group. Meanwhile, the control group received regular counseling from the local Community Health Center. Data analysis was performed by Mann-Whitney test, unpaired T-Test, Chi-Square Test dan Fisher Exact Test.RESULTS: Intervention for 2.5 months increased the knowledge of mothers and husbands. The intervention for 3.5 months improved the mother’s attitude, but not the husband’s attitude. The intervention also improves maternal practices related to postpartum visits, such as Early Initiation of Breastfeeding assistance requests from health workers, iron tablets and nutritious food consumption, personal hygiene, postpartum danger signs monitoring, and the husband’s practice of accompanying mothers during postpartum visits.CONCLUSION: Mobile-Health interactive messages effectively improved postpartum care behavior for mothers and their husbands.
Knowledge of the Therapeutic Goals of Diabetes Care among Patients with Type 2 Diabetes at a Tertiary Hospital in Ethiopia
Authors: Melaku Taye  , Kehabtimer Shiferaw  , Paulos Efrem  , Getahun Tarekegn
Published: July 2024

BACKGROUND: A comprehensive cardiovascular risk control reduces diabetes-associated complications but achieving the triplet goals (blood glucose, blood pressure (BP), and low-density lipoprotein (LDL-C)) remains a clinical challenge. Patients’ knowledge of these diabetes therapeutic goals has been shown to improve glycemic control. However, this is not well studied in Ethiopia.METHODS: A cross-sectional study was conducted from March to June 2020 in Tikur Anbessa Specialized Hospital among randomly selected 419 patients with type 2 diabetes. Data was collected using a pretested, structured questionnaire. A multivariable binary logistic regression was fitted to identify determinants of knowledge.RESULTS: The mean age (±SD) of study participants was 57.4 (±10.8) years and the median duration (IQR) of diabetes was 12 (7, 20) years. A quarter of them achieved fasting glycemic control, a fifth of them attained the A1c goal and only 3% achieved the  triple targets. Patients who reported knowing their target goals for BP, fasting blood sugar (FBS), A1C, and LDL-C were 79.5, 77.3, 11.7, and 7.2% respectively. The factors associated with knowledge of the therapeutic goals were longer diabetes duration, increased household income, age, being divorced as compared to married, having no formal education, and primary education.CONCLUSION: The majority of participants knew their BP and FBS targets while only a minority understood their A1c and LDLC targets. It highlighted the need for the provision of patientcentered diabetes education to improve knowledge of the therapeutic targets.
Spiritual Experiences of Patients in the Cancer Trajectory: A Content Analysis
Authors: Mahboobeh Khosravani  , Nazi Nejat
Published: July 2024

BACKGROUND: Introduction: Patients with cancer as a life-threatening illness have needs in various dimensions. One of the most crucial dimension is spiritually. The present study was conducted to elucidate the spiritual needs of  patients with cancer.
METHODS: A qualitative approach involving face to face semi-structured interviews conducted in Arak city, Iran. In total, 24 participants were recruited through purposive sampling. All interviews were recorded and transcribed verbatim. The data were analyzed using content analysis.
RESULTS: Patients' experiences of spirituality were classified into four themes, including spiritual needs (need to be in nature, need to communicate with others, need to perform religious practices, need for solitude and reflections, need to trust and security), strategies to address spiritual needs (physical activity, achieving inner peace, communication with the nurse or physician, doing dhikr (Zikr) and pray, reading the religious book and texts, making vows, paying attention to and loving others), reasons for not using spiritual resources (lack of belief in the healing powers of praying, believing in a better life after death), and impacts of spiritual beliefs (hope of Life, belief in divine destiny, trusting in God’s support, accepting the divine test).
CONCLUSION: Exploring the experiences, perceptions, and spiritual needs of cancer patients is of great importance in providing spiritual care as one of the critical aspects of holistic care. Nurses should be educated for assessing spiritual needs of patients to provide spiritual care.
The Effect of Preoperative Oral Melatonin on Postoperative Pain after Lumbar Disc Surgery: A Double-Blinded Randomized Clinical Trial
Authors: Afshin Gholipour Baradari  , Mohammad Reza Habibi  , Mohsen Aarabi  , Samira Sobhani  , Anahita Babaei  , Amir Emami Zeydi  , Faraz Ghayoumi
Published: July 2024

BACKGROUND: Despite advances in surgical and anesthesiology techniques, many patients continue to experience postoperative pain after lumbar disc surgeries. The aim of this study was to investigate the effect of preoperative oral melatonin on the severity of postoperative pain after lumbar laminectomy/discectomy.
METHODS: In this double blinded randomized controlled clinical trial 80 patients undergoing an elective mini-open microdiscectomy surgery at Imam Khomeini educational hospital in Sari, Iran, were selected and randomly assigned into one of four groups. Patients in group A, B, C, and D received 3, 5 and 10 mg melatonin or placebo tablets one hour before surgery, respectively. Using the visual analogue scale (VAS) the severity of pain, nausea and vomiting, pruritus, and use of narcotics were assessed immediately after surgery and before leaving the post-anesthesia care unit, 6, 12 and 24 hours postoperatively.
RESULTS: In all three groups receiving melatonin at all three different doses, postoperative pain was significantly less than the placebo group (P<0.01). There were no statistically significant differences in postoperative pain level between the three groups receiving melatonin (P>0.05). The amount of opioid received by the patients within 24 hours after surgery had statistically significant differences within the groups (P=0.043, F=2.58). The results of post hoc analysis in terms of postoperative pain intensity showed statistically significant differences between the two groups receiving melatonin at a dose of 5 mg and the placebo group (P= 0.04). No serious side effects reported in four groups.
CONCLUSION: The use of oral melatonin with a dose of 5 mg, 1 hour before the surgery as an inexpensive method can effectively reduce pain intensity as well as the amount opioid use after lumbar laminectomy and discectomy.
Burnout among Emergency Nurses during COVID-19 Pandemic at Hail Governmental Hospitals in the Kingdom of Saudi Arabia
Authors: Bahia Galal A. Hassan Siam  , Latifah Nawaf Alrasheedi
Published: July 2024

BACKGROUND: Nurses’ burnout is an extended response to stressors at work, which leads to a negative self-concept and reduces the professional outcome. This study aimed to evaluate the level of burnout among emergency nurses during the COVID-19 pandemic.
METHODS: This cross-sectional study was conducted from October 2021 to December 2021. A total of 77 emergency nurses from King Khalid hospital 42 (54.5%), and King Salman Specialist hospital 35 (45.5%) in Hail city of Saudi Arabia, were selected using a convenient sampling method and included in the study. A self-administered questionnaire consisted of the socio-demographics data sheet, and the Copenhagen Burnout Inventory (CBI) tool to evaluate nurses’ burnout.
RESULTS: The overall rate of burnout among the studied nurses was moderate, with mean scores of 39±10. The highest rate was for personal burnout with mean scores of 41.4±16.5, while the lowest score was for client-related burnout with mean scores of 37.8±10.5. The total burnout mean scores for all dimensions of CBI are higher in divorced (46.7), older age (44.5), nursing technicians (43.4), low years of experience (42.5), lower educational level (41.9), non-Saudi (41.0), and males (40.5).
CONCLUSION: The prevalence of burnout among nurses in government hospitals in Hail city was moderate, which should be considered. No statistically significant association were found between socio-demographic variables and the mean scores of CBI. Therefore, it is necessary to investigate the factors associated with the occurrence of burnout, provide a training program to reduce it, and improve the mental and physical health of the emergency nurses.
COVID-19 Vaccine Side Effects among Early-Vaccinated Healthcare Workers: Correspondence
Authors: Won Sriwijitalai  , Viroj Wiwanitkit
Published: July 2024

Letter to the Editor
Ultrasound Measurement of Foetal Kidney Length during Healthy Pregnancy: Relationship with Gestational Age
Authors: Enefia K. Kiridi  , Peter C. Oriji  , Datonye C. Briggs  , Johnpatrick U. Ugwoegbu  , Chioma Okechukwu  , Adedotun D. Adesina  , Akaninyene E. Ubom  , Panebi Y. Bosrotsi  , Abednigo O. Addah  , Isaac J. Abasi
Published: July 2024

BACKGROUND: Foetal kidney length (FKL) measurements and comparisons to normal charts can be used to assess the development of the foetal kidneys throughout the entire course of pregnancy. This study was designed to assess FKL between 20 – 40 weeks’ gestation, establish reference ranges for FKL and determine the relationship between FKL and gestational age (GA) in normal pregnancy.
METHODS: This descriptive, cross-sectional study was conducted between March-August 2022, at the Obstetric Units and Radiology Departments of the two tertiary health facilities, one secondary facility and one radio-diagnostic facility in Bayelsa State, Southern Nigeria. Transabdominal ultrasound scan was used to evaluate the foetal kidneys. The relationship between foetal kidney dimensions and GA was explored using Pearson's correlation analysis. Linear regression analysis was done to define the relationship between GA and mean kidney length (MKL). A nomogram predicting GA from MKL was constructed. Level of significance was set at p<0.05.
RESULTS: There was a very strong significant correlation between foetal renal dimensions and GA. The correlation coefficient between GA and mean FKL, width and anteroposterior diameter were 0.89 (p=0.001), 0.87 (p=0.001) and 0.82 (p=0.001), respectively. A unit change in mean FKL corresponded to a 79% change in GA (ɼ2), showing a very strong association between mean FKL and GA. The regression equation: GA = 9.87 + 5.91 x MKL, was derived for estimation of GA for a given MKL.
CONCLUSION: Our study revealed a significant relationship between FKL and GA. The FKL can therefore be reliably used to estimate GA.
A Multiple-Center, Retrospective Study of Characteristics and Outcomes of Hospitalized COVID-19 Patients with Cardiovascular Disease in North Iran
Authors: Abazar Pournajaf  , Mehrdad Halaji  , Farzin Sadeghi  , Mohammad Chehrazi  , Mostafa Javanian  , Masoumeh Bayani  , Mahmoud Sadeghi Haddad Zavareh  , Mehran Shokri  , Mohsen Mohammadi  , Iraj Jafaripour  , Roghayeh Pourkia  , Mehrdad Saravi  , Kamyar Amin  , Naghmeh Zieaie Amiri  , Mohammad Taghi Hedayati Goudarzi  , Farzad Jalali  , Yousef Yahyapour
Published: July 2024

BACKGROUND: In this retrospective study, we investigated the outcomes and demographic characteristics of COVID-19 patients with and without a history of CVD.
METHODS: This large retrospective, multicenter study was performed on inpatients with suspected COVID-19 pneumonia who were admitted across four hospitals in Babol, Northern Iran.
Demographic data, clinical data, and cycle threshold value (Ct) results of Real Time PCR were obtained. Then, participants were divided into two groups: (1) cases with CVDs, (2) cases without CVDs.
RESULTS: A total of 11097 suspected COVID-19 cases with a mean ± SD age of 53 ±25.3 (range: 0 to 99) years were involved in the present study. Out of whom 4599 (41.4%) had a positive RT-PCR result. Of those, 1558 (33.9%) had underlying CVD. Patients with CVD had significantly more co-morbidities such as hypertension, kidney disease, and diabetes. Moreover, 187 (12%) and 281 (9.2%) of patients with and without CVD died, respectively. Also, mortality rate was significantly high among the three groups of Ct value in patients with CVD, with the highest mortality in those with Ct between 10 and 20 (Group A = 19.9%).
CONCLUSION: In summary, our results highlight that CVD is a major risk factor for hospitalization and the severe consequences of COVID-19. Death in CVD group is significantly higher compared to non-CVD. In addition, the results show that age-related diseases can be a serious risk factor for the severe consequences of COVID-19.
Sonographic Evaluation of Maternal Renal Echogenicity in Healthy Pregnant Women in the Niger Delta Region of Nigeria
Authors: Peter Chibuzor Oriji  , Enefia Kelvin Kiridi  , Emily Gabriel Enefia Kiridi  , Obiora Chibundu  , Lukman Obagah  , Johnpatrick Uchenna Ugwoegbu  , Akaninyene Eseme Ubom  , Panebi Yao Bosrotsi  , Abednigo Ojanerohan Addah  , Adedotun Daniel Adesina
Published: July 2024

BACKGROUND: Increased renal echogenicity is a non-specific ultrasound finding. It may be a normal variation or suggestive of various underlying conditions like renal amyloidosis, chronic kidney disease, sickle cell disease and HIV associated nephropathy (HIVAN).
Objective: To study maternal renal echogenicity in normal pregnancy, and explore its relationship with maternal baseline characteristics in our subregion.
METHODS: This descriptive, cross-sectional study was conducted in the Obstetrics and Radiology Units of the two tertiary health facilities, one secondary facility and one radio-diagnostic facility, all in Bayelsa State, South-South Nigeria, between March-August 2022. The relationships between maternal renal echogenicity and age, parity and gestational age were explored using Chi-square test of proportion, while with an analysis of variance (ANOVA), the mean difference of age, weight and height between the grades of renal echogenicity was investigated. Kruskal Wallis test was deployed to examine parity in the grades of renal echogenicity. The level of significance was set at p<0.05.
RESULTS: The study participants that had Grade 0, 1 and 2 renal echogenicity were 160 (39.7%), 403 (58.3%) and 8 (2.0%), respectively. There were statistically significant relationships between maternal renal echogenicity and maternal age (ꭓ2=36.94; p=0.001), parity (ꭓ2=64.29; p=0.001), gestational age (ꭓ2=16.03; p=0.003) and body mass index (BMI) (ꭓ2 = 45.15; p – 0.001).
CONCLUSION: Our study revealed a significant relationship between maternal renal echogenicity in normal pregnancy and maternal baseline characteristics (age, parity, gestational age and weight).
Clinical and Epidemiological Profiles of Patients with End Stage Kidney Disease on Dialysis at Dialysis Centers in Addis Ababa, Ethiopia
Authors: Lissane Seifu  , Seifemichael Getachew  , Bezaye Abebe  , Zerihun Debay
Published: July 2024

BACKGROUND: End-stage kidney disease is increasing worldwide, primarily in the developing countries. It is affecting mainly the productive age group. Though the prevalence of the disease is increasing in Ethiopia, there are few studies. We therefore sought to describe the clinical and epidemiological characteristics of hemodialysis patients.
METHODS: A descriptive cross-sectional study was conducted at 17 hemodialysis centers in Addis Ababa. Patients who received hemodialysis for at least three months were included in the study. Socio-demographic and clinical data were collected via questionnaires from October to November 2021.
RESULTS:  This study involved 318 participants with males making up 197 (61.9%) of the participants. Among the total, 248 (78.0%) were in the age group of 20 to 60 years and 155 (48.7%) were unemployed. Hypertension and diabetes mellitus were the major risk factors for end-stage kidney disease. The mean duration of dialysis was 2.26 years. The frequency of dialysis was twice weekly in 150 (47.2%) of the patients and thrice weekly in 138 (43.4%) of the patients. Arterio veneous fistula was used in approximately three-quarters of patients, i.e. 237 (74.5%). The majority of the patients on hemodialysis, 193 (60.7%), pay their own expenses, and 52 (16.4%) of the patients received hemodialysis at public hemodialysis centers. More than two-third of the patients were not in the process of undergoing a kidney transplant due to a variety of factors, including inability to find a donor, 106 (47.7%), being unfit for surgery, 56 (25.2%), and financial constraints, 38 (17.1%).
CONCLUSION: The majority of the patients on dialysis were men, middle-aged, and unemployed. The majority of the patients underwent dialysis in private institutions and were self-funded, and most of them had inadequate dialysis doses. The inability to find a living donor was the most difficult aspect of undergoing kidney transplantation.
Self-Management and Its Predictors in adult Patients with Epilepsy: A Cross-Sectional Study
Authors: Keivan Babaei  , Mahnaz Khatiban  , Mojtaba Khazaei  , Leili Tapak  , Farshid Shamsaei
Published: July 2024

BACKGROUND: Appropriate self-management (SM) is crucial in controlling epilepsy and improving self-efficacy, medication adherence and avoidance of seizure triggers in patients with epilepsy (PWE. The aim of this study was to evaluate SM and its predictors among adult PWE in Iran.
METHODS: This cross-sectional study was conducted in 2021. The participants were 335 adult PWEs that were selected from healthcare settings in Hamadan, Iran. Epilepsy Self-Management Scale (ESMS) was used to measure patients' self-management behaviors. Data were analyzed using the independent samples t-test, Pearson’s and Spearman’s correlation analyses and multiple linear regression analysis.
RESULTS: The mean score of SM was 114.37±11, indicating moderate level of SM, and the mean scores of SM in the medication management, seizure management, and safety management subscales were significantly more than the mean scores of the other subscales (P < 0.05). Age, place of residence, marital status, seizure type, seizure frequency, and epilepsy duration significantly predicted 53% of the variance of SM (adjusted R square = 0.532).
CONCLUSION: PWEs have moderate SM and need SM-related education, particularly about lifestyle management and information management. Predictors of SM should be considered to boost SM practice.
The Relationship between Capital Domains and Resilience in Facing the COVID-19 Pandemic in Indonesia
Authors: Arief Hargono  , Febi Dwirahmadi  , Kurnia Dwi Artanti  , Erni Astutik  , Siti Shofiya Novita Sari  , Febriyanti
Published: July 2024

BACKGROUND: Strengthening disaster resilience is important to protect existing development and in anticipation of various disasters and risks due to disasters such as the COVID-19 pandemic. This study aims to determine resilience among individuals in dealing with the COVID-19 pandemic in Indonesia based on the capital domains.
METHODS: This study used a cross-sectional design with 97 Indonesian people and was conducted using an online survey in May–December 2020. Data were analysed using multivariable logistic regression.
RESULT: The results showed that 45.36% of the respondents had low resilience. Respondents whose expenses increased had 6.36 times higher odds of good resilience compared to respondents whose expenses decreased (AOR=6.36,95%CI=1.26–32,p=0.025). Respondents whose expenses were not affected had 12.32 times higher odds of having good resilience than respondents whose expenses were reduced (AOR=12.32,95%CI=1.82–83.40, p=0.01). Respondents with larger families had 32% lower odds of having good resilience than those with fewer family members (AOR=0.68, 95%CI=0.47–0.98, p=0.038). Respondents with no quarantine facilities had 65% lower odds of good resilience than those with quarantine facilities (AOR=0.35, 95%CI 0.13–0.95, p=0.04).
CONCLUSION: Economic and physical capital as the part of capital domains showed a significant association with resilience during COVID-19 pandemics. Economic capital variables that had association with resilience were money expenses and the number of family members in household. Physical capital had a relationship with resilience were the availability of quarantine facilities. Government could encourage cooperation within the community to share economic resources. Local government could provide isolation facilities in local area.
The Impact of Psychiatric Care Program on Empathy of Neonatal Intensive Care Nurses in Iran
Authors: Mohammad Heidarzadeh  , Haydeh Heidari  , Shima Heidary  , Ali Ahmadi
Published: July 2024

BACKGROUND: The main role of nurses is not only to inform about the disease and treatment of the patient but also to establish an effective therapeutic relationship to address concerns and provide empathy, comfort, and support. This issue is very prominent in neonatal intensive care units (NICUs) and doubles the importance of empathetic communication between nurses and parents and promoting empathy skills in nurses working in neonatal intensive care units. AIM: This study aimed to evaluate the effect of a support program on the empathy of neonatal intensive care nurses across the Iran.
METHODS: This study was conducted in 2021 as a semi-experimental intervention in a group of 166 nurses working in the neonatal department all over Iran who met the inclusion criteria. Jefferson's empathy questionnaire was completed electronically by the participants before and after the online education program start. Data were analyzed using SPSS software (V 24.0). 
RESULTS: The empathy score of nurses was 60.31 ± 5.76 before and 66.47 ±6.60 after the intervention. The empathy scores of nurses after the intervention increased statistically significantly.
CONCLUSION: Nurses can communicate empathically with parents by training their verbal and nonverbal communication skills and gaining a common understanding of the feelings of parents of premature infants.