Estimates of Uterine Rupture Bad Outcomes Using Propensity Score and Determinants of Uterine Rupture in Mizan-Tepi University Teaching Hospital: Case Control Study.
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ABSTRACT:
SUBMITTER: Dadi TL
PROVIDER: S-EPMC5523553 | biostudies-other | 2017
REPOSITORIES: biostudies-other
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Project description:BackgroundThe COVID-19 vaccines provide renewed hope in the fight against the recent pandemic. To ensure widespread vaccination, it is crucial to analyze vaccine willingness and its determinants among physicians, key health care influencers. This study aimed to assess acceptance rate and identify factors associated with vaccine hesitancy among Thai physicians.MethodsA cross-sectional online-based questionnaire was distributed to all physicians at King Chulalongkorn Memorial Hospital during March 31, 2021 to April 30, 2021 in order to assess their attitudes toward receiving the COVID-19 vaccine. Reasons for vaccine acceptance and refusal as well as predictors of vaccine hesitancy were analyzed by bivariate and multivariable analysis.ResultsA total of 705 complete responses were received with 95.6% (n = 675) of physicians expressing willingness to receive a COVID-19 vaccine. Only one of the 31 physicians (4.4%) who expressed a hesitancy or unwillingness to be vaccinated was a faculty member; the others were physicians-in-training. Approximately one-fifths of physicians surveyed were also not willing to recommend the vaccine to their family members (21.4%, n = 151) or patients (18.7%, n = 132). Using multivariable logistic regression, vaccine hesitancy was independently associated with preference for particular vaccines over the government allocated option, especially for mRNA vaccine (aOR 8.86; 95% CI 1.1-71.54; p = 0.041). Vaccine literacy showed an inverse relationship (aOR 0.34; 95% CI 0.13-0.9; p = 0.029) with vaccine hesitancy. Uncertainty of the vaccine efficacy (83.9%) and fear of adverse events (48.4%) were major concerns contributing to vaccine hesitancy.ConclusionThis study revealed a high rate of physician willingness to take the COVID-19 vaccine especially among staffs; however, a significant proportion would not currently suggest vaccination to their families or patients. Restrictions on vaccine choice and vaccine illiteracy, together with concerns over adverse effects and uncertainty of efficacy, were associated with negative attitudes toward vaccination. To raise acceptance of the vaccination program, efforts should be made to balance individual preference for vaccine type in addition to increasing the availability of accurate data on safety and efficacy for each vaccine.
| S-EPMC8607407 | biostudies-literature
Project description:ObjectiveTo compare depression health state preference scores across four groups: (1) general population, (2) previous history of depression but not currently depressed, (3) less severe current depression, and (4) more severe current depression.Data sourcesPrimary data were collected from 95 general population, 163 primary care, and 83 specialty mental health subjects.Study designStratified sampling frames were used to recruit general population and patient subjects. Subjects completed cross-sectional surveys. Key variables included rating scale and standard gamble scores assigned to depression health state descriptions developed from the Patient Health Questionnaire-9 (PHQ-9) and SF-12.Data collection/extraction methodsEach subject completed an in-person interview. Forty-nine subjects completed test/retest reliability interviews.Principal findingsDepressed patient preference scores for three of six SF-12 depression health states were significantly lower than the general population using the rating scale and two of six were significantly lower using standard gamble. Depressed patient scores for five of six PHQ-9 depression health states were significantly lower than the general population using the rating scale and two of six were significantly lower using standard gamble.ConclusionsDepressed patients report lower preference scores for depression health states than the general population. In effect, they perceived depression to be worse than the general public perceived it to be. Additional research is needed to examine the implications for cost-effectiveness ratios using general population preference scores versus depressed patient preference scores.
| S-EPMC2739035 | biostudies-literature
Project description:BackgroundThis study aims to find out the possible optimal therapy and assess the prognosis properly for patient with spontaneous rupture of hepatocellular carcinoma (HCC).MethodsPropensity score matching (PSM) analysis was used to study the data from 325 patients with ruptured HCC (RHCC) and 2,291 patients with non-RHCC.ResultsThe incidence and hospital mortality of RHCC were 5.1% and 0.8% respectively, with a median overall survival (OS) time of 17 months. There was no difference between ruptured and non-RHCC patients undergoing conservation treatment in terms of OS. Trans-arterial embolization (TAE) was carried out in 69 (21.2%) cases with RHCC, with a median OS of 7 months, which was no difference from that of non-RHCC (pre- and post-PSM). One hundred and sixty-nine (52.0%) RHCC cases underwent one-stage hepatectomy, with a median OS and disease-free survival (DFS) of 30 and 6 months respectively, which were shorter than that of non-RHCC (post-PSM). TAE plus two-stage hepatectomy was performed in 30 RHCC cases, with a median OS and DFS of 28 and 10 months respectively; these outcomes were better than that from RHCC patients undergoing TAE alone or one-stage hepatectomy (post-PSM), which were no difference from that of non-RHCC patients undergoing hepatectomy. The risk of death for RHCC patient undergoing one-stage hepatectomy is 1.545 times higher than that of one undergoing TAE + two-stage hepatectomy.ConclusionsTAE plus two-stage hepatectomy might be the optimal treatment for RHCC patient. Under the premise of the same pathological properties, there is no difference in prognosis between ruptured and non-RHCC patients if the therapy is appropriate.
| S-EPMC9745608 | biostudies-literature
Project description:Sugammadex has several pharmacological advantages over neostigmine, including faster reversal of neuromuscular blockade and fewer adverse effects. However, the economic impact of sugammadex remains controversial due to the considerable heterogeneity of study designs and clinical settings in previous studies. In a post-hoc analysis of a randomized controlled trial, we evaluated patients who underwent elective surgeries and general anesthesia with endotracheal intubation in a medical center in Taiwan between March 2020 and August 2020. Patients were divided into either the sugammadex or neostigmine group based on the neuromuscular blocking drug used. Propensity score matching was used to balance the baseline patient characteristics between the two groups. The patient's recovery from anesthesia and the putative cost-effectiveness of sugammadex versus neostigmine was assessed. Derived cost-effectiveness using personnel costs in the operating room and the post-anesthesia care unit was estimated using multiple linear regression models. A total of 2587 and 1784 patients were included before and after matching, respectively. Time to endotracheal extubation was significantly shorter in the sugammadex group (mean 6.0 ± standard deviation 5.3 min) compared with the neostigmine group (6.6 ± 6.3 min; p = 0.0032). In addition, the incidence of bradycardia was significantly lower in the sugammadex group (10.2%) compared with the neostigmine group (16.9%; p < 0.001). However, the total costs were significantly lower in the neostigmine group (50.6 ± 21.4 United States dollars) compared with the sugammadex group (212.0 ± 49.5 United States dollars). Despite improving postoperative recovery, the benefits of sugammadex did not outweigh its higher costs compared with neostigmine, possibly due to the low costs of labor in Taiwan's healthcare system.
| S-EPMC9859243 | biostudies-literature
Project description:Uterine rupture is a serious public health concern that causes high maternal and perinatal morbidity and mortality in the developing world. Few of the studies conducted in Ethiopia show a high discrepancy in the prevalence of uterine rupture, which ranges between 1.6 and 16.7%. There also lacks a national study on this issue in Ethiopia. This systematic and meta-analysis, therefore, was conducted to assess the prevalence and determinants of uterine rupture in Ethiopia. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic review and meta-analysis of studies. All observational published studies were retrieved using relevant search terms in Google scholar, African Journals Online, CINHAL, HINARI, Science Direct, Cochrane Library, EMBASE and PubMed (Medline) databases. Newcastle-Ottawa assessment checklist for observational studies was used for critical appraisal of the included articles. The meta-analysis was done with STATA version 14 software. The I2 test statistics were used to assess heterogeneity among included studies, and publication bias was assessed using Begg's and Egger's tests. Odds ratio (OR) with a 95% confidence interval (CI) was presented using forest plots. A total of twelve studies were included in this study. The pooled prevalence of uterine rupture was 3.98% (95% CI 3.02, 4.95). The highest (7.82%) and lowest (1.53%) prevalence were identified in Amhara and Southern Nations, Nationality and Peoples Region (SNNPR), respectively. Determinants of uterine rupture were urban residence (OR?=?0.15 (95% CI 0.09, 0.23)), primipara (OR?=?0.12 (95% CI 0.06, 0.27)), previous cesarean section (OR?=?3.23 (95% CI 2.12, 4.92)), obstructed labor(OR?=?12.21 (95% CI 6.01, 24.82)), and partograph utilization (OR?=?0.12 (95% CI 0.09, 0.17)). Almost one in twenty-five mothers had uterine rupture in Ethiopia. Urban residence, primiparity, previous cesarean section, obstructed labor and partograph utilization were significantly associated with uterine rupture. Therefore, intervention programs should address the identified factors to reduce the prevalence of uterine rupture.
| S-EPMC7572500 | biostudies-literature
Project description:BackgroundDespite the apparent benefits of organophosphate compounds (OPCs) acute organophosphate (OP) pesticide poison is an increasing problem worldwide. In a country like Ethiopia, where agriculture is a major component of the economy, these compounds are readily available to the general public. There is paucity of evidence from Ethiopia showing the pattern of organophosphate poisoning (OPP) in healthcare facilities. The objective of this study was to evaluate retrospectively the pattern of acute OPP at the University of Gondar Teaching Hospital in northwest Ethiopia, during September 2010 through December 2014 was conducted. Data was collected through chart review of patients who were admitted due to poisoning. Data was analysed using SPSS 20.ResultsOrganophosphate poisoning in University of Gondar teaching hospital accounts for about 38.46% of all emergency room admissions for poisoning. Out of the 90 cases studied 60% (54) were women, with male to female ratio of 1:1.5. The mean age of the patients was 25.5 with a standard deviation of 9.45. 56.7% of the cases studies lived in an urban environment compared to 43.3% who lived rurally. In the vast majority of patients, 90% (81) patients had ingested OP as an act of suicide. Regarding the route of exposure, oral ingestion was most common in suicidal cases (88.9%). The elapsed time between the time of poison ingestion and the start of the treatment, ranged from 13 min to 1 day. Health care professionals' useds decontamination methods such as gastric lavage and activated charcoal (45.6%) and 36.7% use atropine for OPP treatment. The mean hospital stay was 0.74 days. In the present study family problems were a leading cause of suicides and accounted for 45.8% of all cases.ConclusionAs a developing nation who economy relies heavily on agriculture, Ethiopia continues to have OP compounds remain a common cause of acute poisonings. This is particularly concerning for younger generation who have high rates of OPP and whose numbers continue to raise. This data suggests that it is essential to strengthen Ethiopians regulatory policy concerning the availability of OPCs. Additionally, it will be important to design an appropriate health education program for the prevention of both suicidal and accidental OPPs for the benefit of the public at large.
| S-EPMC5381028 | biostudies-literature
Project description:BACKGROUND:The advent of Highly Active Antiretroviral Therapy (HAART) is associated with improved clinical and laboratory outcomes resulting in prolonged life and well-being of people living with Human Immunodeficiency Virus (PLHIV). However, the needs for life-long therapy, medications' side effects and stigma have raised concerns about their quality of life (QOL). This study assessed the determinants of Health-related quality of life (HRQOL) among HIV-positive patients at Ahmadu Bello University Teaching Hospital (ABUTH) Zaria. METHODS:We conducted a cross-sectional study of 353 HIV-positive adults on HAART attending the HIV clinic of ABUTH, Zaria. The participants were recruited into the study using a systematic sampling technique. Data on socio-demographics, medical parameters, QOL and family functionality were collected using structured, interviewer-administered questionnaire. The World Health Organization (WHO) Quality of Life HIV short form instrument (WHOQOL-HIV BREF) item and Family APGAR tool were respectively used in assessing the QOL and family functionality of the participants. We performed univariate, bivariate and multivariate analysis. RESULTS:Mean age was 39.1(±10.9) years, 239 (67.7%) were females, 208 (58.9%) were Hausa-Fulani, 240 (68.2%) married and up to 210 (59.4%) had at least a secondary education. The overall mean scores on the scale of 4-20 for HRQOL were similar in three domains: environment domain 14.5(±2.8); social relationship 14.4(±3.1) and level of independence 14.4(±2.5). Lower scores were recorded in spirituality/religion/personal beliefs 12.3(±4.3). Identified determinants of HRQOL were spousal HIV- positive status (AOR?=?3.37; CI; 1.46-7.74) and high family function (AOR?=?2.57; CI: 1.51-4.39). CONCLUSION:Having highly functional family and having HIV-positive partner were the major determinants of HRQOL. Routine family counselling and strengthening the HIV social-support network should be incorporated into the routine patients' care in HIV treatment centers.
| S-EPMC7169018 | biostudies-literature
Project description:Background. Jaundice is a common problem in the neonatal period, and it is one of multiple factors found in children who die. Despite the majority of pathological jaundice public health consequences, there is no evidence on risk factors of pathological jaundice among neonates in Southwest Ethiopia. Therefore, this study aimed to identify factors associated with jaundice requiring phototherapy management in neonates admitted to the neonatal unit of a university teaching hospital in Southwest Ethiopia (Mizan-Tepi). Methods. Facility-based, unmatched case-control study was conducted among 240 (80 cases and 160 controls) in the Neonatal Intensive Care Unit of Mizan-Tepi University Teaching Hospital. Neonates with pathological jaundice and neonates without pathological jaundice were considered as cases and controls, respectively. Data were collected using a structured questionnaire, and extraction checklist, including information on maternal demographics, obstetrics, and neonatal factors. Simple random sampling techniques were used to select respondents. Bivariate and multivariable analyses were used to examine the association. Finally, statistical significance was declared at a P-value < .05. Results. In this study, 237 mothers with their neonates were included, making a response rate of 98.7%. The mean birth weight of cases and controls was 2330.3 ± 698.9 and 2699.3 ± 686.7 g, respectively. Hypothermia (AOR = 4.28; 95% CI: [1.72-10.67], cesarean delivery (AOR = 4.09; 95% CI: [1.69-9.93]), breast milk feeding (AOR = 2.97; 95% CI: [1.04-8.47]) and being male (AOR = 2.67; 95% CI: [1.17-6.13]) were significantly associated with jaundice. Conclusion. Most of the risk factors of neonatal jaundice were found to be modifiable. Therefore, early prevention and recognition of identified factors are recommended.
| S-EPMC10710105 | biostudies-literature
Project description:BACKGROUND: Barrett's metaplasia is a premalignant condition for which screening is recommended. AIMS/METHODS: Annual screening endoscopies have been performed on all subjects suitable for surgery for many years. To examine the benefits to patients of continuing this policy 10 years' experience of screening for Barrett's oesophagus was reviewed. RESULTS: Of the 29,374 endoscopies performed over this period, Barrett's metaplasia was present in 1.4%. There was an approximate equal sex distribution with the majority of cases being identified in patients over 50 years old. Thirty five per cent of these patients were suitable to enter a yearly screening programme. During screening, the length of oesophagus involved did not vary over time. As a result of 379 endoscopies performed for screening purposes, only one patient was identified as developing carcinoma solely as a result of the screening programme. Two further patients had carcinoma identified as a result of progressive dysphagia requiring additional endoscopies. All three patients who developed carcinoma while in the screening programme had "long segment" (> 8 cm) regions of Barrett's metaplasia with a stricture present at the initial endoscopy. CONCLUSIONS: The poor yield from this screening programme suggests that the policy should be reconsidered. Resources may be better spent on focusing on patients who present with ulceration or stricture in addition to Barrett's metaplasia.
| S-EPMC1891490 | biostudies-other
Project description:BackgroundPatient's knowledge about dispensed medications is one of the major factors that determine the rational use of medicines.ObjectivesThis study aimed to assess exit-knowledge of ambulatory patients about their dispensed medications and associated factors at the outpatient pharmacy of Mizan-Tepi University Teaching Hospital, Southwest Ethiopia.MethodsA hospital-based cross-sectional study design was conducted from August to October 2021. Study subjects were selected by random sampling technique and were interviewed using a structured interview questionnaire. Binary logistic regression was used to identify factors associated with exit knowledge. At a 95% confidence interval (CI), p≤0.05 was considered statistically significant.ResultOf the total 400 participants, 116 (29.0%) participants had sufficient exit-knowledge about their dispensed medication. Patients with higher educational level had increased exit knowledge of dispensed medications than those with no formal education (AOR: 5.590; 95% CI 1.019-30.666). Also, the nature of illness as being chronic significantly enlarged the odds (AOR 5.807; 95% CI 2.965-11.372) of having sufficient exit-knowledge. Participants who reported, "I do not know" and "I did not get enough information from the pharmacist" had lower odds (AOR 0.374; 95% CI: 0.142-0.982) and (AOR 0.166; 95% CI 0.062-0.445) of sufficient exit-knowledge in comparison to those who responded "I got enough information from the pharmacist" respectively. Furthermore, the odd of sufficient exit-knowledge was 7.62 times higher in those who claimed prescribing doctor as the source of information.ConclusionThe majority of patients had insufficient exit-knowledge about their dispensed medications. Educational status, nature of the disease, perceived sufficiency of pharmacist knowledge, and source of information were significantly associated with exit knowledge.
| S-EPMC9129053 | biostudies-literature