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Marketplace Insertion and Professional Practice of Direct-Entry Midwives in Brazil: A Descriptive Study
Narchi Nadia Zanon,
Silva Bruna Almeida
Issue:
Volume 2, Issue 6, November 2014
Pages:
327-333
Received:
8 October 2014
Accepted:
16 October 2014
Published:
30 October 2014
Abstract: Background: One of the strategies that need to be adopted in Brazil is to train and insert a large number of qualified midwives into the job market in order to promote improvements in indicators related to maternal and perinatal health and the model of care. Considering the recent training of midwives and the lack of studies on their absorption into the healthcare system, this study had the objective of verifying the socioeconomic and demographic characteristics of midwives that graduated in 2008 and 2009 from the Direct-Entry Midwifery Program of the University of São Paulo, characterizing and analyzing their academic and professional trajectory, insertion into the job market, and professional practice in midwifery. Method: From November 2012 to March 2013, a descriptive and quantitative investigation was carried out with a population composed of 82 midwives, 41 of them who graduated in 2008 and 41 in 2009. Data were obtained by means of an on-line questionnaire applied electronically and composed of open-ended and closed-ended questions relative to the socioeconomic and demographic identification of the midwives, their academic and professional trajectory, their insertion into the job market, and professional practice in midwifery. Results: Of the total number of former students, 70.7% agreed to participate in the study and answered the questionnaire. Of this sample, 58.6% fit into the age bracket of 23 to 27 years, 70.7% were single, 96.6% were female, 63.8% lived in the city of São Paulo, 65.5% participated in extracurricular activities during their training, 43.1% participated in specialization or refresher courses after graduating, 51.7% participated in scientific events, 22.4% produced scientific studies, and 19% published in scientific journals. Only 34.5% indicated working or having worked as a midwife. Conclusions: The results allow the conclusion that, despite the effort to improve their academic and professional trajectory, the first midwives, who graduated in 2008 and 2009, faced great difficulties in getting into a healthcare market which needs skilled human resources and is resistant to the incorporation of new professionals and models of care.
Abstract: Background: One of the strategies that need to be adopted in Brazil is to train and insert a large number of qualified midwives into the job market in order to promote improvements in indicators related to maternal and perinatal health and the model of care. Considering the recent training of midwives and the lack of studies on their absorption int...
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Application of Simple Risk Level Estimator to Assess the Fire Risk in Trade Zone of Nyarugenge
Theoneste Ntakirutimana,
Rubuga Kitema Felix,
Serge Bakire,
Wilma Uhorakeye,
Donat Tuyihimbaze,
Osman Ngarukiyintwari
Issue:
Volume 2, Issue 6, November 2014
Pages:
334-337
Received:
30 September 2014
Accepted:
11 October 2014
Published:
30 October 2014
Abstract: A fire risk assessment helps in determining the chances of a fire to occur and the dangers resulted from fire outbreak. Analysing the activities undertaken within the premises; the potential harm of the fire it could cause to the people in, and around the premises is an important issue. The aim of this study was to assess the risk and consequences of a fire outbreak in the trade zone of Nyarugenge. A cross sectional and quantitative methods were used in this study. Fire hazards resulting from readily combustible or highly flammable materials, sources of heat, and people at risk were studied. The likelihood that a fire will occur and the consequences of such a fire on the people in trade zone of Nyarugenge were analysed using a Simple Risk level Estimator. Based on the analysis, 92.71% of the premises had no firefighting equipments in the trade zone 83.33 % of the premises had non-inspected electrical installation and none of them had smoke alarm or heat detectors. Smokers’ materials ranked the highest source of ignition 26% followed by lighting equipments 19%, Cooking Equipment Ranked the third13% followed by Naked flame and misused electrical equipment 12%. The results of the study indicated that the likelihood of a fire in the trade zone of Nyarugenge was high and has significant potential for serious injury or death to occupants.
Abstract: A fire risk assessment helps in determining the chances of a fire to occur and the dangers resulted from fire outbreak. Analysing the activities undertaken within the premises; the potential harm of the fire it could cause to the people in, and around the premises is an important issue. The aim of this study was to assess the risk and consequences ...
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Male Involvement in Prevention of Mother to Child Transmission of HIV and Associated Factors Among Males in Addis Ababa, Ethiopia
Yohannes Abuhay,
Lakew Abebe,
Netsanet Fentahun
Issue:
Volume 2, Issue 6, November 2014
Pages:
338-343
Received:
4 October 2014
Accepted:
16 October 2014
Published:
30 October 2014
Abstract: Background: The importance of male involvement in the prevention of mother-to-child transmission programs is incremental to maintain family health and adherence to human immunodeficiency virus treatment and prevention regimens. Globally, male involvement has been recognized as a priority focus area to be strengthened in prevention of mother-to-child transmission but, it remains a challenge in most low- and middle-income countries including Ethiopia. Objective: To assess male involvement in prevention of mother-to-child transmission of HIV and associated factors among male partners in Addis Ababa. Methods: A Community based cross-sectional study supplemented with qualitative method was conducted from October 1-November 30, 2013 at sixteen districts in Addis Ababa. A total of 431 male participants were involved in the study. Data was analyzed using SPSS version 16.0 statistical package. Multiple logistic regressions analysis was used to identify the predictors of male involvement. Qualitative data were analyzed manually using thematic approach. Result: One hundred ninety six (45.5%) of respondents were in the age group of 35-44 years. Three hundred thirty two (77%) of the participants were knowledgeable about mother-to-child transmission of HIV. From the total respondents, only 121(28.1%) of males had high involvement in PMTCT. Knowledge, income, cultural beliefs, and occupation of the participants were significantly predictor of males’ involvement in the Prevention of mother to child transmission of HIV. Conclusion: Knowledge, occupational status, income and cultural barriers to males’ involvement in the Prevention of mother to child transmission of HIV in Addis Ababa were deterrent and interrelated. Therefore, a potential need to be invested on the components attributable to those independent factors of male involvement there by aware, support empower them towards effective involvement in Prevention of mother to child transmission interventions.
Abstract: Background: The importance of male involvement in the prevention of mother-to-child transmission programs is incremental to maintain family health and adherence to human immunodeficiency virus treatment and prevention regimens. Globally, male involvement has been recognized as a priority focus area to be strengthened in prevention of mother-to-chil...
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Khat Chewing and Self Rated Oral Health Out Comes in Bahir Dar, North West Ethiopia
Issue:
Volume 2, Issue 6, November 2014
Pages:
344-349
Received:
26 September 2014
Accepted:
18 October 2014
Published:
30 October 2014
Abstract: Introduction: Khat, Catha edulis, is a plant where its fresh leaves and buds are consumed due to its stimulant ingredient, cathinone. It is found in Ethiopia, Kenya, and Yemen. Bahir Dar is a city in the north western Ethiopia where three percent of Ethiopia’s total production of khat is originated. So far there is one community based study that has been done in Bahir Dar city on the effect of khat chewing on self rated general health problems. This study was conducted specifically to examine the association of khat chewing behavior on self rated oral health problem among male khat chewers.Objective: The main aim of this study is to determine effects of khat chewing behaviors (onset, frequency and amount of khat chewing) on self rated oral health status among khat chewers. Methods: In this study, a cross-sectional, sellers to sellers survey on the representative sample of 422 male subjects, aged ≥ 16 years, was conducted in Bahir Dar, North western Ethiopia from January to September 2013. Data were collected after khat chewing. Study individuals were selected using systematic random sampling technique and data were collected using self-administered questionnaire. Data analysis was made using SPSS version 16.0 for windows package. Results: A total of 422 male khat chewers were included in study, 422 respond to the questioners, giving a response rate of 100%. The study found that the mean age of participants with standard deviation was 30.31 ± 1.39 years old. Sixty two percent of participants reported oral health problems. Of the 262 self-reported oral problems; 78.6% had dental decay or tooth discolouration, 21.4% gum problems (inflammation, bleeding). Those who started khat chewing at early age(7-15yrs) was found to be associated significantly with self rated oral health problem (AOR: 2.85, CI 95%:1.26-6.45) and P≤0.04. With regard to frequency of khat chewing; frequent khat chewers(≥ 3days) were 7.58 times more likely to be affected by self rated oral health problem compared to those who chewed less frequently (AOR:7.58,95%CI:3.53-16.27). Chewers who chewed 51gm-100gm and ≤ 100gm per session are 1.95 and 4.33 times more likely to be affected by oral health problem compared to those who chewed 25gm-50gm per session and amount of khat chewed per session were found to be significantly associated with self rated oral health (AOR: 1.95, 95%CI: 1.16-3.30), (AOR: 4.33, 95%CI: 2.49-7.53) respectively. Conclusion: There is significant association between Chat chewing behaviors (amounts of khat chewed during khat session, frequency of khat chewing, the level of age khat chewing started) and self rated oral health problem.
Abstract: Introduction: Khat, Catha edulis, is a plant where its fresh leaves and buds are consumed due to its stimulant ingredient, cathinone. It is found in Ethiopia, Kenya, and Yemen. Bahir Dar is a city in the north western Ethiopia where three percent of Ethiopia’s total production of khat is originated. So far there is one community based study that ha...
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Bilateral Effect of Unilateral Isokinetic Concentric Training and Russian Current Stimulation on Quadriceps Strength
Amira Hussin Draz,
Amr Almaz Abdel-aziem,
Mohamed Hisham Abo Elenain
Issue:
Volume 2, Issue 6, November 2014
Pages:
350-355
Received:
13 August 2014
Accepted:
25 August 2014
Published:
30 October 2014
Abstract: Isokinetic training and Russian current stimulation have been advertised to increase muscle strength. So, the purpose of this study was to compare between unilateral isokinetic concentric training and Russian current stimulation on the quadriceps strength of ipsilateral and contralateral limbs. Sixty healthy male subjects were randomly assigned into 3 equal groups; Isokinetic group; received isokinetic concentric training. Russian group; received Russian current stimulation, and control group: did not receive any training program. Isokinetic and Russian groups trained for 4 weeks, 3 session/week on the dominant quadriceps femoris muscle. Biodex Multi-joint System 3, Biodex, Shirley, NY, used to measure the isokinetic concentric peak torque/body weight before and after 4 weeks training for all groups at angular velocity 30°/s. For contralateral and ipsilateral quadriceps strength there was significant increase in the quadriceps strength of isokinetic and Russain group (p= 0.000). However, there was no significant increase in the quadriceps strength of control group (p= 0.214, 0.061) respectively. There was no significant difference between isokinetic and Russian group for the value of increasing of the quadriceps strength (p= 0.391, 0.579) respectively. The percent of improvement of ipsilateral side was significantly higher than the improvement of contralateral side for isokinetic and Russian group (p= 0.004, 0.006) respectively. So, Isokinetic training and Russian current stimulation have equal level of effectiveness in improving the concentric strength of the contralateral and ipsilateral quadriceps muscle. In spite of, the improvement of ipsilateral side was higher than that of the contralateral side.
Abstract: Isokinetic training and Russian current stimulation have been advertised to increase muscle strength. So, the purpose of this study was to compare between unilateral isokinetic concentric training and Russian current stimulation on the quadriceps strength of ipsilateral and contralateral limbs. Sixty healthy male subjects were randomly assigned int...
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Prevalence of Diabetes, Knowledge and Attitude of Rural Population towards Diabetes and Hypoglycaemic Event, Sudan 2013
Siham Ahmed Balla,
Haider Abu Ahmed,
Mohamed Ali Awadelkareem
Issue:
Volume 2, Issue 6, November 2014
Pages:
356-360
Received:
12 September 2014
Accepted:
19 September 2014
Published:
10 November 2014
Abstract: Introduction: The prevalence of diabetes mellitus is rising and needs adequate knowledge for its control. Objectives: The study aim was to identify prevalence of diabetes, population`s knowledge, their attitude towards hypoglycemia event and factors associated with the level of knowledge. Material and Methods: A cross sectional study was carried out in a rural area of Sudan. The study population was 3316 adult males /females above 18 years of age. Structured questionnaire was used including eighteen questions to assess the knowledge about diabetes. Knowledge scores were recorded into adequate knowledge and inadequate knowledge. Attitude of diabetic and non-diabetic population was compared. Seven independent variables were included in logistic regression model to present the factors which contributed to adequate knowledge about diabetes. Results: The study included 1423 (42.9%) males and 1893(57.1%) females. The prevalence of diabetes in rural population was 11.2%. Adequate knowledge about diabetes was 15%. Genetics and nutrition habits were recognized as risk factors of diabetes by the population, 57.2% & 46.9% respectively. Dizziness as a sign of hypoglycemia was mentioned (38.1%) followed by rigors (24.4%), sweating (21.4%) and palpitation (17.1%). Retinopathy (31.1%) and cardiovascular diseases (16.0%) were known by the study population as complications of diabetes. The response of diabetic population towards hypoglycemia event was significantly higher compared to non-diabetic, p-value 0.001. Gender, age, education, family history of diabetes, being a diabetic and smoker were contributory factors to knowledge. Conclusion: The prevalence of diabetes is increasing in rural population of Sudan. Knowledge about diabetes is low. A community based educational program is needed.
Abstract: Introduction: The prevalence of diabetes mellitus is rising and needs adequate knowledge for its control. Objectives: The study aim was to identify prevalence of diabetes, population`s knowledge, their attitude towards hypoglycemia event and factors associated with the level of knowledge. Material and Methods: A cross sectional study was carried ou...
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Predicting Patient Outcomes Via Neural Network Estimation of Discharge APACHE Scores for Traumatic Brain Injury
Cindy Crump,
Christine Tsien Silvers,
Bruce Wilson,
Loretta Schlachta-Fairchild,
Jeffrey Scott Ashley
Issue:
Volume 2, Issue 6, November 2014
Pages:
361-365
Received:
21 October 2014
Accepted:
29 October 2014
Published:
10 November 2014
Abstract: It is highly desirable to be able to predict the likely outcome of critical patients admitted to the intensive care unit (ICU) for traumatic brain injury (TBI). Vital signs, laboratory values, and clinical assessments from throughout a patient’s ICU stay were collected retrospectively in an IRB-approved protocol from a Level I Trauma-Military Medical Center in the Southwest. ICU patients were included if they had been admitted for TBI during a five-year period ending in October 2007. Data were collected for 139 ICU patients with TBI. Admission and discharge APACHE IV scores were then derived from the collected data for each patient. A static back propagation neural network was developed to predict a patient’s ICU outcome vis-a-vis discharge APACHE IV scores. The resulting network, trained using leave-one-out methodology, was able to predict the discharge APACHE score on average within 12.9% of the actual score.
Abstract: It is highly desirable to be able to predict the likely outcome of critical patients admitted to the intensive care unit (ICU) for traumatic brain injury (TBI). Vital signs, laboratory values, and clinical assessments from throughout a patient’s ICU stay were collected retrospectively in an IRB-approved protocol from a Level I Trauma-Military Medic...
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Health System in Bangladesh: Challenges and Opportunities
Anwar Islam,
Tuhin Biswas
Issue:
Volume 2, Issue 6, November 2014
Pages:
366-374
Received:
29 October 2014
Accepted:
10 November 2014
Published:
20 November 2014
Abstract: The health system of Bangladesh relies heavily on the government or the public sector for financing and setting overall policies and service delivery mechanisms. Although the health system is faced with many intractable challenges, it seems to receive little priority in terms of national resource allocation. According to the World Health Organization (WHO 2010) only about 3% of the Gross Domestic Product (GDP) is spent on health services. However, government expenditure on health is only about 34% of the total health expenditure (THE), the rest (66%) being out-of-pocket (OOP) expenses. Inequity, therefore, is a serious problem affecting the health care system. Based on a review of secondary data, the paper assesses the current challenges and opportunities of the health system in Bangladesh. The findings suggest that although the health system faces multifaceted challenges such as lack of public health facilities, scarcity of skilled workforce, inadequate financial resource allocation and political instability; Bangladesh has demonstrated much progress in achieving the health-related Millennium Development Goals (MDGs) especially MDG 4 and MDG 5. Although the country has a growing private sector primarily providing tertiary level health care services, Bangladesh still does not have a comprehensive health policy to strengthen the entire health system. Clearly, the most crucial challenge is the absence of a dynamic and proactive stewardship able to design and enforce policies to further strengthen and enhance the overall health system. Such strong leadership could bring about meaningful and effective health system reform, which will work more efficiently for the betterment of the health of the people of Bangladesh, and would be built upon the values of equity and accountability.
Abstract: The health system of Bangladesh relies heavily on the government or the public sector for financing and setting overall policies and service delivery mechanisms. Although the health system is faced with many intractable challenges, it seems to receive little priority in terms of national resource allocation. According to the World Health Organizati...
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A Rare Case of a Newborn with Urinary Tract Infection by Raoutella Ornithinolytica
Esra Akyuz Ozkan,
Hashem E. Khosroshahi,
Neziha Yilmaz,
U. Aliye Gecit,
Esra Domur
Issue:
Volume 2, Issue 6, November 2014
Pages:
375-377
Received:
8 November 2014
Accepted:
12 November 2014
Published:
17 November 2014
Abstract: Raoultella ornithinolytica is a gram negative aerobic bacillus belonging in the family Enterobacteriaceae that is a known but extremely rare pathogen which causes infections in humans. We report on a newborn with urinary tract infection caused by Raoultella ornithinolytica. The present case is the first newborn patient with urinary tract infection and only the third newborn found infected with Raoultella ornithinolytica reported in the literature.
Abstract: Raoultella ornithinolytica is a gram negative aerobic bacillus belonging in the family Enterobacteriaceae that is a known but extremely rare pathogen which causes infections in humans. We report on a newborn with urinary tract infection caused by Raoultella ornithinolytica. The present case is the first newborn patient with urinary tract infection ...
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Boosting Maternal Health Care Seeking Behavior in Rural Low Income Communities: A Case Study of West Gojam and South Wollo Zones in Amhara, Ethiopia
Issue:
Volume 2, Issue 6, November 2014
Pages:
378-386
Received:
16 November 2014
Accepted:
21 November 2014
Published:
27 November 2014
Abstract: Taking the national scenario in maternal health care, it was taken for granted that Ethiopia would not meet the millennium development goal in the reduction of maternal death: assisted birth at a health institution for example was as low as 10% in 2011. Although, the introduction of the health extension program since has enabled the health sector to make major strides towards health promotion and disease prevention, health facility utilization in maternal health care remained low. An ecologically driven health development army (HAD) of thirty members sub structured into community cell based networking of 1-5 has been introduced to guide social mobilization and community participation in health as of 2012. The networking requires all women and men to be teamed in 1-5 cells, actively participate in learning and practicing good health. The analysis of the effect of the networking on boosting maternal health care seeking behavior in rural communities was made using qualitative data obtained from informant interviews and focus group discussions in Amhara, West Gojam and South Wolo Zones. The data analysis looked into inputs, processes, outcomes/outputs, effects and impacts of the networking in maternal health care. The analysis showed that the networking of communities in HAD of 1-30 and substructures of 1-5 is transformative in boosting health care seeking behavior. Study participants demonstrated, irrespective of age, religion and gender, shared health information and attitude towards pregnancy, birth, and the need to mitigate health risks by attending care and treatment services at health facilities. All stakeholders at community and leadership position give credit to the social network of HDA for enhancing maternal care seeking behavior in beneficiaries and responsiveness of heath providers in health facilities to meet health care needs of mothers. The impact of the networking is that communities are empowered and are assuming ownership with regards to dealing with their health care needs. In effect they are demanding for availability of quality of maternal health care services at closer locations. The lesson learnt is that through the use of innovative methodologies and approaches, communities can assume leadership in producing good health. In such a scenario, it is suggested that governments should mobilize resources, local and as well international to improve the supply side of maternal and child health care services. Failure to meet what communities are demanding in health care service delivery would result in dissatisfaction and lack of trust in the health system.
Abstract: Taking the national scenario in maternal health care, it was taken for granted that Ethiopia would not meet the millennium development goal in the reduction of maternal death: assisted birth at a health institution for example was as low as 10% in 2011. Although, the introduction of the health extension program since has enabled the health sector t...
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The Contribution of Different Risk Factors in the Occurrence of Stroke
Precious Barnes,
Kwabena Nsiah,
Faustina Mensah
Issue:
Volume 2, Issue 6, November 2014
Pages:
387-391
Received:
12 November 2014
Accepted:
27 November 2014
Published:
15 December 2014
Abstract: Background: Although stroke cause substantial morbidity and mortality, it is unclear how individuals are affected, or a group of risk factors contribute to stroke outcomes especially in developing countries. Methods: This study evaluated the risk factors of stroke. This was a cross-sectional study of stroke patients from Komfo Anokye Teaching Hospital; Adult enrolees who were eligible for inclusion were persons who have had stroke within twenty-four hours of onset without any medication. Questionnaires were used to gather information on medical history, demographic features and lifestyle. The lipid profile, fasting blood sugar and blood pressure were measured, likewise the determination of aminotransferases and gamma-glutamyltransferase. Results: Out of 224 stroke patients, of mean age 65.64 ± 1.08 SEM years, used for the study, 56.7% of the patients had hyperglycaemia, whereas 47.2% were known diabetics. Hypertriglyceridaemiawas found in 55.8%, followed by 30.8% of the patients who had a reduced HDL-C and 17.95% of them with increased LDL-C. About 20% of the patients had raised AST, 7.1% raised ALT and 14.7% raised GGT above the normal levels. As high as 63% of stroke patients had high blood pressure. Conclusions: There were a high prevalence of both hypertension and hyperglycaemia among the stroke patients. Based on this study, it is important to stress the need for educating the stroke patients and/or their caregivers, on the aetiology of stroke and the treatment options. The general population should also be educated on primary preventive measures for all age groups and both genders.
Abstract: Background: Although stroke cause substantial morbidity and mortality, it is unclear how individuals are affected, or a group of risk factors contribute to stroke outcomes especially in developing countries. Methods: This study evaluated the risk factors of stroke. This was a cross-sectional study of stroke patients from Komfo Anokye Teaching Hospi...
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Assessment of Endoscopic Role in Management of Facial Fractures
Mohammad Noaman Mohammad Ali,
Abdel-Hay Rashad El-Assy MD,
El-Hussainy El-Hussainy Shreef MD,
Yasser Abd El-wahab Khalil MD,
Yasser Mohmmed Al-Sheikh MD
Issue:
Volume 2, Issue 6, November 2014
Pages:
392-396
Received:
7 November 2014
Accepted:
16 November 2014
Published:
17 December 2014
Abstract: This study evaluates the usefulness of endoscopic repair in certain types of facial fractures (orbital floor, isolated zygomatic arch and isolated anterior table frontal sinus fractures).Endoscopic application in otorhinolaryngology has expanded into many areas including facial plastic surgery and facial trauma (orbital blow-out, frontal sinus, zygomatic arch, and subcondylar fractures), therefore limiting the use of incisions for exposure. Endoscopically assisted facial bone surgery can be performed with many advantages, including: magnified direct visualization, decreased scarring, avoidance of numbness beyond the incision line, greater acceptability to the patient, decreased complication rate and short hospitalization. For assessment of the value of endoscopy in repair of certain facial fractures, we selected 12 consented patients with either orbital floor fracture, isolated zygomatic arch fracture or isolated anterior table frontal sinus fracture to be involved in our study after stabilizing the general condition. The patients were evaluated preoperatively by an ophthalmologist and all had complete CT study including coronal, axial (both bony and soft-tissue windows), sagital and 3D images. The patients were analyzed for sex, age, time of surgery, pre/postoperative symptoms; including ophthalmic symptoms, facial paraesthesia and aesthetic problems. The results of our endoscopic approach were evaluated esthetically and functionally to be classified into good, fair and poor results. We also classified the level of the surgery according to its difficulty into difficult, average and easy surgical performance.Good results were achieved in 8fractures (42%); fair in 8fractures (42%) and finally 3fractures (16%) with poor endoscopic result. The performed surgery considered easy in 9 (41%) patients, average in 6 (31%) patients and difficult in 4 (21%) patients. All patients had no significant complications. Conclusion: Endoscopic repair appears to be a safe and effective technique for repairing certain types of facial fracture.
Abstract: This study evaluates the usefulness of endoscopic repair in certain types of facial fractures (orbital floor, isolated zygomatic arch and isolated anterior table frontal sinus fractures).Endoscopic application in otorhinolaryngology has expanded into many areas including facial plastic surgery and facial trauma (orbital blow-out, frontal sinus, zyg...
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Changes in Serum Liver Enzymes Level after Switching from Stavudine/Lamivudine to Zidovudine/Lamivudine in NNRTIs Based Anti-Retroviral Regimens in Hawassa, Southern Ethiopia
Demissie Assegu Fenta,
Agete Tadewos Hirigo
Issue:
Volume 2, Issue 6, November 2014
Pages:
397-403
Received:
29 November 2014
Accepted:
11 December 2014
Published:
18 December 2014
Abstract: Background: During stavudine phase-out in a resource limited countries, Zidovudine or Tenofovir is used to substitute stavudine. However, data concerning any difference in liver enzymes level after therapy change (switching) in Ethiopia is very limited. Methods: This prospective cohort study was carried out from May 2013 to July 2014 at ART clinic of Hawassa University teaching hospital. Of hundred fifty HIV-infected; immunologically stable adults receiving triple antiretroviral therapy: 120 were patients receiving stavudine based regimen with either of efavirenz or nevirapine during ART initiation (switch group); and the rest 30 patients were receiving zidovudine based regimen with either of efavirenz or nevirapine and also never switched (control group). Lamivudine is common for both groups. Levels of serum liver enzymes were determined and hepatotoxicity assessed according to World Health Organization ART guideline. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) Version 20. Results: Serum mean AST and ALT level in the switch group decreased significantly over the time observed (p=<0.0001 for both enzymes); however ALP level was significantly increased (p=<0.0001). Hepatotoxicity in the switch group was significantly decreased (AST grade > 1 from 35.8% to15.8%; and ALT from 20.8% to 3.3%) after 12 month of therapy change. Conclusion: Significantly a decreased hepatotoxicity was observed at the 12 month of post switch and this indicated that a substitution of stavudine to Zidovudine could have a potential to reverse hepatotoxicity. However, significantly decreased white blood cells count and abnormally increased level of ALP enzyme should require periodic monitoring and further investigations.
Abstract: Background: During stavudine phase-out in a resource limited countries, Zidovudine or Tenofovir is used to substitute stavudine. However, data concerning any difference in liver enzymes level after therapy change (switching) in Ethiopia is very limited. Methods: This prospective cohort study was carried out from May 2013 to July 2014 at ART clinic...
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Epidemiological Report on Acute Encephalitis Syndrome (AES)/Japanese Encephalitis (JE) Outbreak in Bihar & Planning Perspectives for Its Control
Ragini Mishra,
Ganga Kumar
Issue:
Volume 2, Issue 6, November 2014
Pages:
404-410
Received:
4 December 2014
Accepted:
15 December 2014
Published:
19 December 2014
Abstract: Acute Encephalitis Syndrome (AES) is a major public health problem in Bihar claiming thousands of lives every year in Bihar. Initially, the disease outbreak was focused in Muzaffarpur district of Bihar but recent trend shows that disease outbreak has spread its foci in many other districts as well. AES cases were recorded from district reporting units comprising Govt Medical College & Hospitals and few private hospitals in prescribed format under Integrated Disease Surveillance Control Programme of the State. In 2014, till 17th Oct, 928 cases and 314 deaths due to AES was reported in Bihar.JE cases among the AES cases constituted only 2% of the cases. Age group most affected was 0-4 and males were more affected than females. Case fatality rate in the AES outbreak was 34 and no deaths were reported due to JE. Outbreak peak was from 10th June to 19th June. The report overviews analytical comparison of yearly AES outbreak in Bihar based on descriptive epidemiological analysis. JE vaccination coverage in Bihar was also analyzed to co-relate its impact on curbing the AES cases. Although JE vaccination has reduced the incidence of JE cases but it has little impact on curbing AES cases. As the etiological confirmation of the disease outbreak has still not been established, better control strategies are required. Inter-sectoral coordination with various departments may also help in control and management of the disease outbreak.
Abstract: Acute Encephalitis Syndrome (AES) is a major public health problem in Bihar claiming thousands of lives every year in Bihar. Initially, the disease outbreak was focused in Muzaffarpur district of Bihar but recent trend shows that disease outbreak has spread its foci in many other districts as well. AES cases were recorded from district reporting un...
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Assessment of Substance Use and Associated Factors among High School and Preparatory School Students of Ginnir Town Bale Zone, Southeast Ethiopia
Issue:
Volume 2, Issue 6, November 2014
Pages:
414-419
Received:
16 September 2014
Accepted:
11 October 2014
Published:
22 December 2014
Abstract: Substance use remains high among youth and young adolescent in high school and college. The use of alcohol, Khat and Tobacco by high school and college student can be harmful, leading to decrease academic performance, increase risk of contributing HIV and other sexual transmitted disease. However, the magnitude of substance use and other factor associated with it has not been investigated among high school and preparatory school students in the country. The objective of this study is designed to assess the prevalence and associated factor of substance use among high school and preparatory schools of Ginnir town. Cross sectional study using a self administrated questionnaire was conducted to collect information about substance use among high school and preparatory school students in Ginnir town by taking total sample size of students. The result shows that total of 220 students were included in the study out of this most of the respondents were male 125(56%).The prevalence of substance use among male respondents were 31.2% ever drunk alcohol,48% khat chew and 12% ever smoke cigarette .while 8.4%,8% and 7% of female were ever drunk alcohol ,khat chew and smoke cigarette respectively. Problem associated with substance use include violence (39.1%), any medical problem (42.1%), poverty (54.3%). It can be concluded that the prevalence of substance use among high school and preparatory students was high and causes social impact such as violence, crime and poor school performance and medical impact such as unprotected sex, mental problem. Strong measure need to be taken for greater awareness among respondents to reduce its prevalence and impacts. (Social, medical, economic).
Abstract: Substance use remains high among youth and young adolescent in high school and college. The use of alcohol, Khat and Tobacco by high school and college student can be harmful, leading to decrease academic performance, increase risk of contributing HIV and other sexual transmitted disease. However, the magnitude of substance use and other factor ass...
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Trends and Risks Factors Associated to Women Obesity in Cameroon and Gabon
Hénock Blaise Nguendo Yongsi,
Olivier Abondo Ngwa
Issue:
Volume 2, Issue 6, November 2014
Pages:
420-428
Received:
17 November 2014
Accepted:
28 November 2014
Published:
28 January 2015
Abstract: Overweight or obesity sets in when there is a successive increase in body mass. Obesity is quantified or measured using body mass index (BMI) which is calculated using the weight and size of an individual. If the BMI is greater than or equal to 25 kg / m², a person is considered to be overweight, which is a condition associated with excessive fat. The increase in body weight and its corollary (obesity) is a major public health problem, which is becoming increasingly important in developing societies. In Cameroon and Gabon, we note an increase in the proportion of overweight among women: nearly 2.77% between 2004 and 2011 (from Cameroon) and nearly 13.22% between 2000 and 2012 (from Gabon). The objective of this study is to show that overweight women are going to become a public health problem in Central Africa. For this purpose, we decided to study the increased risk of becoming overweight for women in central Africa, namely in Cameroon and Gabon. We focused firstly, on the explanatory sources of the increase in the proportion of overweight women and secondly, the factors associated with the risk of being overweight among women from Gabon and Cameroon. This study is about women aged 15-49 years disseminated throughout the national territory of both countries. Results show that the increase in the proportion of overweight in women is mainly due to a change of lifestyle. The explanatory analysis model highlights that, area of residence, age, place of residence, the standard of living of household, marital status and occupation of women, parity (number of children) and educational level (only in Cameroon) are factors explaining weight increase in women. Therefore, medical and educational workers, as well as opinion leaders, need to educate women about the importance of sedentary lifestyle and the need to have a quality dietary habit and food hygiene (eat organic foods consisting mainly of fruits and vegetables).
Abstract: Overweight or obesity sets in when there is a successive increase in body mass. Obesity is quantified or measured using body mass index (BMI) which is calculated using the weight and size of an individual. If the BMI is greater than or equal to 25 kg / m², a person is considered to be overweight, which is a condition associated with excessive fat. ...
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