Pattern of headache in school going children attending specialized clinic in a tertiary care hospital in bangladesh.
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ABSTRACT:
SUBMITTER: Hoque MA
PROVIDER: S-EPMC3472579 | biostudies-other | 2012 Sep
REPOSITORIES: biostudies-other
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Project description:ObjectiveThis study is aimed to investigate drug utilization pattern among pregnant women attending maternal and child health clinic of tertiary hospital in eastern Ethiopia from March 1 to April 20, 2018.ResultA total of 369 pregnant women medical records were reviewed. The mean age of pregnant women was 24.34 (±?4.48) years and the majority of them were within the age of 18-25 years. About three-fourths (n?=?277, 75.1%) of them were urban residents. Besides, 314 (85.1%) women had taken at least one drug with a total of 377 drugs prescribed. From which, supplemental drugs accounted majority of the drug therapy (84.88%) whereas non-supplemental drugs (15.12%) were used by 41 pregnant women during the review period. According to Food and Drug Administration FDA pregnancy risk classification, 320 (84.88%) drugs were prescribed from category A; 33 (8.75%) drugs were from category B; 19 (5.04%) drugs were from category C and 5 (1.33%) drugs were from category D. There was no drug prescribed from category X. As this result indicated, there is a decrease in the prevalence of drug use from Category A to X as the possibility of potential risk to fetus might outweigh the potential benefit to the mother. Some drugs were utilized from category D for treatment of chronic illnesses.
| S-EPMC6280540 | biostudies-literature
Project description:ObjectivesHypertensive disorders of pregnancy contribute significantly to maternal and neonatal morbidity and mortality globally. Health-seeking behaviour is influenced by adequate knowledge of the condition. However, current data on pregnant women's knowledge of the condition and health-seeking behaviour are relatively scant in Ghana and has not been previously studied in the Central Region where hypertensive disorders of pregnancy was the leading cause of maternal mortality from 2016 to 2018. The study sought to generate data to fill this knowledge gap.MethodsA cross-sectional study was conducted among 404 pregnant women attending antenatal clinic at the Cape Coast Teaching Hospital from 1 April to 30 September 2020. Data on sociodemographic characteristics, including age, level of education and parity, and knowledge of hypertensive disorders of pregnancy, including its risk factors, clinical presentations and complications, were collected using structured questionnaires. The outcome variable, knowledge of hypertensive disorders of pregnancy, was a composite variable categorized as adequate and inadequate knowledge. Descriptive statistics were generated and association between independent and outcome variables were explored using chi-square and Fisher's exact tests and logistic regression methods.ResultsSixty-two participants (15.4%) showed adequate knowledge of hypertensive disorders of pregnancy. About 62% (251/404) of respondents had heard about hypertensive disorders of pregnancy. Of those who had heard of hypertensive disorders of pregnancy, 29.4% (72/245) correctly indicated the condition was underlined by hypertension in pregnancy ⩾ 20 weeks gestation. Women with tertiary education were six times more likely to have adequate hypertensive disorders of pregnancy knowledge than those with basic education. Women with parity 1-4 were 52% less likely to have adequate knowledge compared to nulliparous women.ConclusionThe remarkably low proportion of pregnant women with adequate knowledge of hypertensive disorders of pregnancy in the study is worrisome because of its potential adverse implication for the health of mothers and their babies. Re-packaging the antenatal health education programme and its delivery is needed for greater impact as far as hypertensive disorders of pregnancy morbidity/mortality is concerned.
| S-EPMC8943573 | biostudies-literature
Project description:Emerging evidences hypothesized that patients with heart failure are susceptible to experience treatment burden. Despite this fact, no attempt was made so far to address this neoteric construct in the sub-Saharan African health care context. Hence, this study aimed to assess patients' and health care providers' perspectives on how to decrease treatment burden among patients with heart failure attending the adult cardiac clinic of Tikur Anbessa Specialized Hospital (TASH). An explanatory sequential mixed methods study was conducted at the adult cardiac clinic of TASH, Addis Ababa, Ethiopia from August 01 to September 30, 2021. Simple random and purposive sampling techniques were employed to select participants for quantitative and qualitative studies, respectively. Descriptive analysis was done to summarize the quantitative data. Logistic regression analysis was performed to identify predictors of treatment burden. P value < 0.05 was considered to declare statistical significance. Qualitative data were analyzed by using thematic analysis. A total of 325 patients were enrolled in the quantitative study. For the qualitative study, 14 patients and 11 health care providers (five nurses and six medical doctors) were included. Participants mean global Treatment Burden Questionnaire (TBQ-15) score was 27.22 ± 19.35. Approximately 12% (n = 38) patients indicated high treatment burden (TBQ-15 global score ≥ 59) with a median global score of 63(60-69). Higher education level (adjusted odds ratio [AOR] = 6.66, 95% confidence interval [CI]: 1.16-38.43), presence of two and more comorbidities (AOR = 2.74, 95%CI: 1.02-7.39), daily intake of more than five pills (AOR = 7.38, 95%CI: 2.23-24.41), poor medication availability (AOR = 3.33, 95%CI: 1.33-8.36), presence of medication adverse effects (AOR = 4.04, 95%CI: 1.63-10.03), and higher monthly cost of medication (AOR = 5.29, 95%CI: 1.46-19.18) were predictors of treatment burden. Patients and healthcare providers' propositions were primarily focused on improving self-care management, structural organization of the clinic and hospital, and healthcare system provision. Our findings demonstrated that a substantial proportion of patients faced low levels of treatment burden. This study unveiled that improving self-care management, structural organization of the clinic, and healthcare system provision had paramount importance to reducing treatment burden. Hence, factors affecting treatment burden should be considered when designing tailored healthcare interventions for patients with heart failure.
| S-EPMC9640606 | biostudies-literature
Project description:To educate physicians about appropriate acute migraine treatment guidelines by determining (1) where headache patients were first prescribed opioids and barbiturates, and (2) the characteristics of the patient population who had been prescribed opioids and barbiturates.Several specialty societies issued recommendations that caution against the indiscriminate use of opioids or barbiturate containing medications for the treatment of migraine. These medications are still being prescribed in various medical settings and could put headache specialists in a difficult position when patients request these agents.Patients presenting to a headache center comprised of eight physicians were asked to complete a survey that assessed headache types, comorbid conditions, and whether they had ever been prescribed opioids or barbiturates. If they responded affirmatively to the latter question, they were asked about the prescribing doctor, medication effectiveness, and whether they were currently on the medication. Data collection took place over a one month period.Two hundred forty-four patients were given the survey and 218 of these patients completed it. The predominant diagnosis was migraine (83.9%). More than half of the patients reported having been prescribed an opioid (54.8%) or a barbiturate (56.7%). About one fifth were on opioids (19.4%) or barbiturates (20.7%) at the time of completing the survey. Most patients reported being on opioids for more than 2 years (24.6%) or less than one week (32.1%). The reasons most frequently cited for stopping opioids were that the medications did not help (30.9%) or that they saw a new doctor who would not prescribe them (29.4%). Among patients who had previously been on barbiturates, 32.2% had been on these for over 2 years. Most patients (61.8%) stopped barbiturates because they did not find the medication helpful, while 17.6% said they saw a new doctor who would not prescribe them. The physician specialty most frequently cited as being the first prescriber for opioids was emergency medicine (20.2%) with family doctors and general neurologists the next groups at 17.7% each. General neurologists were the most frequent (37.8%) first prescribers of barbiturates.Approximately 20% of patients presenting to a headache center reported current use of opioids and/or barbiturates. ED physicians were reported to be the most frequent first prescribers of opioids and general neurologists were the most frequent first prescribers of barbiturates. Taken as a whole, these data provide a useful snapshot of the wide variety of physician specialties that might benefit from additional education on the appropriate use of opioids and barbiturate-containing medications in patients with headaches.
| S-EPMC4757493 | biostudies-literature
Project description:IntroductionEpilepsy has been found to affect caregivers' quality of life, lifestyle, psychological health, social well-being, and working time. Caregivers in Uganda as in the rest of the world are important in assisting a person with epilepsy in complying with medical directions and are actively involved in communicating with healthcare professionals. Little is known about the lived experiences of caregivers of persons afflicted with epilepsy in Uganda. The purpose of this study was to determine the lived experiences of caregivers of persons with epilepsy attending the epilepsy clinic at Mbale regional referral hospital, eastern Uganda.Methods and materialsThe caregivers' lived experiences were elicited directly from them and their health workers who work with them in the care of the patients. Forty participants which consisted of 30 caregivers and 10 key informant health workers were selected for the study through purposive sampling. Face-to-face in-depth interviews with an unstructured interview guide were conducted to gather participants' information. The principal investigator conceptualized the interview guide, the guide was then reviewed by co-investigators, and revised and approved as the final data collection instrument after an extensive and comprehensive literature review. The interview guide comprised two sections; the first section comprised the questions that elicited the participants' social-demographic information. The second section comprised questions that explored caregivers' experiences of persons afflicted with epilepsy. Notations were taken and a digital recorder was used purposely for audio recordings. All interviews lasted for an hour and were audio-recorded with the participant's consent. An inductive thematic analysis was employed and adopted to identify the patterns emerging from the texts.ResultsThe caregivers majorly perceived epilepsy as a burden. Four main themes were revealed from the analysis and these are: psychological burdens which included, worries about the future of the patient, being looked down upon; social burdens which entailed, affected public relations, feelings of stigma; an economic burden which included interference with the source of income, affected productivity at work; and physical burdens which included, Feelings of uneasiness and disrupted sleep among others.ConclusionThe caregivers majorly perceived epilepsy as a serious burden. This burden can be psychological, social, economic, and physical. Therefore, services and plans targeting patients with epilepsy need to consider the burden that caregivers encounter to comprehensively manage epilepsy.
| S-EPMC10353802 | biostudies-literature
Project description:BackgroundBreast cancer is one of the leading cancers among the Bangladeshi women. Coping helps these patients to adjust with this life-changing disease. Each individual has unique and different coping mechanism. But we know a little regarding their coping strategies. This study aims to explore the different coping strategies adopted by the women with metastatic (stage IV) breast cancer attending the palliative care unit and their relationship with the common mental health issues like anxiety and depression.MethodsThis cross-sectional study was conducted among 95 patients with metastatic (stage IV) breast cancer attending the Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Bangladesh from April 2021 to September 2021. Data was collected by face-to-face interview using a structured questionnaire adapted from Hospital Depression and Anxiety Scale (HADS), Brief COPE inventory and Eastern Cooperative Oncology Group (ECOG) performance scale. Pearson correlation test was used to find the relationships between various domains of coping strategies and psychological variables. Correlation matrix was done to observe the internal correlation among different coping strategies. Kruskal-Wallis H test was done to find the relationship between different coping strategies and ECOG performance status.ResultThe mean age of the respondents was 48.9 ± 9.9 years. Most of them were married (94.7%), Muslim (92.6%) and homemakers (82.1%). Commonly used coping strategies by the patients were: acceptance (median 10; IQR 10), religion (median 9; IQR 8-10) and instrumental support (median 9; IQR 6-10). Significantly strong positive correlation was found between emotional and instrumental support (R = 0.7; p = 0.01), planning, acceptance and active coping (R = 0.7; p = 0.01); behavioral disengagement, self distraction and denial (R = 0.5; p = 0.01). Significantly fair negative correlation was observed between active coping and depression (R = -0.4, p <0.001). Patients with better performance status on ECOG scale (Grade 0-2) leaned more on the positive coping strategies like instrumental support, emotional support, positive reframing and venting.ConclusionDifferent coping strategies, especially positive coping helps the patients to adapt with their disease over time. All women suffering from breast cancer should be routinely screened and assessed for psychological distress and ensure early intervention and management to promote a better quality of life.
| S-EPMC9838864 | biostudies-literature
Project description:BACKGROUND:Sleep is a natural, restorative, physiological process that is characterized by perceptual disengagement from and unresponsiveness to whatever going around, which is reversible. Sleep quality refers to a sense of being rested and refreshed after waking up from sleep. People living with HIV/AIDS (PLWHA) are vulnerable to poor sleep quality as they suffer from social stigma and Anti-Retroviral drug side effects. The study aimed to examine the quality of sleep and its associated factors among people living with HIV/AIDS attending Anti-Retroviral Therapy (ART) clinic at Hawassa University comprehensive specialized hospital. METHOD:Institutional based cross-sectional study was conducted among PLWHA attending ART clinic at Hawassa University comprehensive specialized hospital from May 1-30, 2019. A systematic random sampling technique was used to select an estimated 422 study participants and data was collected using interviewer-administered technique. Sleep Quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Data were entered and analyzed using SPSS 22 software. Bivariable and multivariable logistic regression model was fitted to identify factors associated with quality of sleep. An adjusted odds ratio with a 95% confidence interval was computed to determine the level of significance with P-value less than 0.05. RESULT:Out of 422 respondents, 389 participated in the study giving a response rate of 92.1%. The prevalence of poor quality of sleep among study participants was found to be 57.6% (95% CI: 54.72, 60.48). 31.9% (124) and 30.6% (119) of study participants had anxiety and depression respectively. Being between the age of 55-64 years (AOR = 5.7, 95% CI (1.9, 17.8), Age ? 65 (AOR:6.6, 95% CI (1.2, 36.9), Monthly income <1656 Ethiopian Birr (ETB) (AOR = 2.17, 95% CI (1.06, 4.4), having anxiety (AOR = 4.4, 95% CI (2.12, 9.2), having depression (AOR = 4.97, 95% CI (2.28, 10) and poor social support (AOR = 2.9, 95% CI (1.16, 7.3) were factors associated with poor quality of sleep. CONCLUSION:The prevalence of poor quality of sleep among PLWHA was significantly high. Average monthly income, age, anxiety, depression, and social support were found to be significantly associated with poor sleep quality. Health care professionals working at the ART clinic need to assess the sleep pattern of ART clients, give psychoeducation on the prevention and management of sleep pattern problems.
| S-EPMC7272010 | biostudies-literature
Project description:INTRODUCTION:Anemia during pregnancy has a significant adverse effect on both the mother and fetus. Iron and folic acid supplementation (IFAS) is the feasible and cost effective strategy to control and prevent anemia in pregnancy. However, the success of this strategy is suboptimal due to poor maternal adherences to the regimen. The aim of this study was to assess prevalence of anemia, rate of adherence to IFAS and associated factors among pregnant women at Tikur Anbessa Specialized Hospital (TASH), Ethiopia. METHOD:Institution based cross sectional study was conducted among 250 pregnant women who were selected using systematic random sampling from antenatal care clinic (ANC) attendants of TASH. Data was collected through interview and medical chart review by using structured questionnaire. The data was analyzed by SPSS v.24. Binary logistic regression was used to identify the associated factors for IFAS and P < 0.05 was used to declare the association. RESULTS:The prevalence of anemia was 4.8% and half of the study participants were knowledgeable about anemia. The rate of adherence to IFAS was 63.6%. Forgetfulness and fear of side effect were the commonest reasons for poor adherence to IFAS. Gestational age at first ANC visit and educational level were significantly associated with adherence to IFAS. Thus, pregnant women who started their ANC follow up at first trimester (AOR = 1.87, 95% CI (1.18-3.36)) and education level of college and above (AOR = 4.236, 95% CI (1.35-13.25)) and completed secondary education (AOR = 4.09, 95% CI (1.39-12.02)) were more likely to be adherent to IFAS compared with their comparators. CONCLUSION:Even though anemia prevalence was very low among the study participants, adherence to IFAS was still a challenge during pregnancy. Therefore, counseling about IFAS and anemia prevention and promoting the benefits of early ANC visit are recommended to improve adherence to IFAS.
| S-EPMC7197778 | biostudies-literature
Project description:PurposeTo investigate the trends, prevalence and distribution of ocular trauma in a Zimbabwean Tertiary Teaching Hospital (Parirenyatwa).MethodA hospital-based retrospective cross-sectional study was conducted at the Parirenyatwa Group of Hospitals, Sekuru Kaguvi Eye Department in Harare, Zimbabwe, to review medical records of patients with ocular trauma visiting for treatment at the outpatient department between January 2017 and December 2021. Information on patients' demographics, presenting visual acuity, type of ocular trauma, and the number of eyes affected were collected and analysed using descriptive and inferential statistics.ResultsA total of 863 patients (1007 eyes) were identified to have experienced ocular trauma of one kind or another, with the youth (18-35 years) reporting with most cases (331, 38.4%). About 71.2% of patients were classified as having open-globe injuries and of that number, 90% were caused by blunt trauma, while the rest were caused by penetrating, intraocular, and perforating injuries. Patients with open-globe injuries were about 10 times more likely to develop blindness than those with closed-globe injuries after adjusting for age and gender, and this was statistically significant (ARR = 9.65, 95% CI: 5.53-16.84, p < 0.001). The prevalence of distance vision impairment due to ocular trauma was 60.1% (95% CI: 56.8%-63.4%), with majority resulting in blindness (22.0%, 95% CI: 19.4%-24.9%).ConclusionThere is a high prevalence of open-globe injuries in Zimbabwe with blunt trauma being the most significant cause. This suggests the need to promote and intensify public eye health awareness and sensitisation on safety strategies for the prevention of ocular trauma throughout the country.
| S-EPMC10550172 | biostudies-literature
Project description:BackgroundStatin-associated muscle symptoms (SAMS) are the major side effects reported for statins. Data from previous studies suggest that 7-29% of patients on statin had associated muscle symptoms. In the UK, there is a lack of corresponding data on SAMS and factors associated with the development of SAMS.ObjectiveThis analysis is aimed at establishing the prevalence of SAMS and identifying major contributory risk factors in patients attending a lipid clinic.MethodsClinical records of 535 consecutive patients, who visited the lipid clinic in the University Hospitals of Leicester, were studied retrospectively between 2009 and 2012. SAMS were defined by the presence of muscle symptoms with two or more different statins. Patients who reported muscle symptoms to statin with one or no rechallenge were excluded. The association of SAMS with clinical characteristics such as age and BMI, sex, smoking, excess alcohol, comorbidities, and medications was tested for statistical significance. A binomial logistic regression model was applied to adjust for risk factors significantly associated with SAMS.ResultsThe prevalence of SAMS was found to be 11%. On unadjusted analysis, the mean age of patients who had SAMS was significantly higher than those without SAMS (59.4 ± 10.5 years vs. 50.3 ± 13.4 years, respectively, P < 0.001). Nonsmokers were more likely to develop SAMS in comparison to active smokers (P = 0.037). Patients taking antihypertensive medications were more likely to develop SAMS (P = 0.010). In binomial logistic regression analysis, only age was positively and significantly associated with SAMS after adjusting for other risk factors (β = 0.054, P = 0.001).ConclusionTo the best of our knowledge, this study is the largest cohort of patients with SAMS in the United Kingdom. Our data suggest that the prevalence of SAMS is 11% and increased age is a risk factor associated with the development of SAMS in our cohort of patients.
| S-EPMC7997746 | biostudies-literature