Student's Journal of Health Research Africa

KNOWLEDGE, ATTITUDE AND PRACTICES TOWARDS CERVICAL CANCER SCREENING AMONG WOMEN OF REPRODUCTIVE AGE ATTENDING LUWEERO GENERAL HOSPITAL, LUWEERO DISTRICT. A CROSS-SECTIONAL STUDY.

Judith Gladys Nalubega — 2024-03-16

Introduction

Cervical cancer is the cancer of the uterine cervix it is the second most common cancer in women worldwide and the leading cause of cancer deaths in developing countries. In Uganda, cervical cancer is the leading cancer and cause of premature death among women aged 15-49 years.

Study objective

The study aims to determine knowledge, attitude, and practice toward cervical screening among women of reproductive attending Luweero General Hospital, Luweero district.

Methodology

A descriptive cross-sectional study design was carried out with both quantitative & qualitative data. The study was conducted at Luweero General Hospital in Luweero district from December 2022 to January 2023, and the sample was calculated. The simple random technique was employed in this study. A self -self-administered questionnaire that was specifically structured was used as a data collection tool. Data was analyzed with SPSS software version 17, by use of double entry.

Results

Concerning knowledge, 57 out of the 67 (85.1%) had heard about cervical cancer screening. In terms of attitude, 56(83.3%) agreed that they can go for cervical cancer screening when told that it is painless, simple, and good for early detection of cervical cancer. As for the practice, 32(52.2%) had never gone for cervical cancer screening.

Conclusion

The knowledge was average given majority 85.1% had heard about cervical cancer screening. The attitude was fairly good as well because 83.6% of the women agreed to get checked. However, the practice was very low given that 52.2% had never gone for cervical cancer screening.

Recommendation

Efforts should be made to have periodical screening against cervical cancer, offering health education on HPV, tobacco use, and condom promotion. Moreover, creating awareness about the availability of cervical cancer services to women of reproductive age attending Luweero General Hospital, Luweero district

Study of highly sensitive C-reactive protein in type 2 diabetes mellitus and prediction of cardiovascular risk with glycemic status

Rakesh Kumar — 2024-03-31

Background: hs-CRP measurement may be useful for assessment of the risk of complication in diabetes patients. So, the present study is conducted to measure plasma hs- CRP level in T2DM and to determine adequate glycaemic control reduces hs-CRP level.

Aims and objectives: The objectives of this study were to correlate HbA1c and hs-CRP in T2DM and predict cardiovascular risk with glycaemic status.

Methods: Authors took 50 diabetic patients. The investigation includes FBS, PPBS, hs- CRP and HbA1c. hs-CRP is measured by immunoturbidimetry method. The reports were collected and compared with normal reference range.

Results: The correlation between hs-CRP levels and HbA1c level after six months show a significant relationship where mean HbA1c values on day 1 and after 6 months were 8.088±1.219 and 7.518±0.693 respectively. The hs-CRP values were 2.508±1.050 on day 1 and 2.15±0.927 after 6 months proving that better glycaemic controls decrease hs-CRP thereby decreasing cardiovascular risk.

Conclusions: hs-CRP values are directly related to HbA1c and better glycaemic control reduces risk of CVD.

EMERGING BIOMARKERS FOR CARDIOVASCULAR DISEASE PROGNOSIS IN DIABETIC PATIENTS: A NARRATIVE REVIEW.

Hem Shanker Sharma — 2024-03-19

Cardiovascular disease (CVD) is the leading cause of morbidity and death among patients with diabetes, presenting a significant global health challenge. Traditional biomarkers have limitations in accurately predicting CVD risk in this population, highlighting the need for novel biomarkers that offer improved precision and specificity. The review aims to critically evaluate current research on novel biomarkers for CVD prognosis in diabetic patients, synthesizing evidence on genetic, proteomic, metabolic, and inflammatory markers. An organized literature search was managed across multiple electronic databases, yielding a comprehensive selection of studies investigating biomarkers associated with CVD prognosis in diabetic individuals. Findings reveal emerging biomarkers with potential predictive value, such as genetic variants, inflammatory proteins, and metabolic metabolites. These biomarkers offer insights into the pathophysiological mechanisms underlying CVD in diabetes and show promise for improving risk stratification and early detection. The integration of novel biomarkers into clinical practice could revolutionize the management of CVD in diabetic patients by enabling personalized risk assessment and targeted interventions. However, challenges such as validation, standardization, and integration into existing clinical workflows need to be addressed. Future research should focus on longitudinal studies to elucidate the dynamic nature of biomarkers and leverage technological advancements to enhance their predictive value. The identification and validation of novel biomarkers hold potential implications for clinical policy and development. Incorporating these biomarkers into risk assessment algorithms and treatment guidelines could optimize patient outcomes and contribute to more efficient healthcare resource allocation. However, education and training for healthcare providers on biomarker interpretation and clinical implications are essential for successful implementation.

INSULIN-INDUCED WEIGHT GAIN AS A POTENTIAL RISK FACTOR FOR CARDIOVASCULAR DISEASE: A NARRATIVE REVIEW.

Mithilesh Jha — 2024-03-19

Diabetes mellitus, a chronic metabolic disorder characterized by high blood glucose levels, is a significant global health concern. Insulin therapy, essential for managing diabetes, is often linked with weight gain. This weight gain, while beneficial in some patients, poses risks for overweight or obese individuals, particularly in terms of cardiovascular disease (CVD), the leading cause of mortality in this population. This review aims to combine current research on the relationship between insulin-induced weight gain and cardiovascular disease risk, exploring mechanisms, clinical implications, and management strategies. The several pathways of insulin-induced weight gain are covered in the review, including impacts on anabolism, increased adiposity, and fluid retention. It explores the pathophysiological mechanisms that relate weight gain to cardiovascular disease (CVD), including endothelial dysfunction and oxidative stress, and looks at how weight gain impacts cardiovascular risk factors like hypertension, dyslipidemia, and inflammation. In addition, the review assesses data from clinical trials and epidemiological studies, contrasting various insulin dosage schedules and their relationships to CVD outcomes. Lastly, it discusses how to control weight gain while on insulin therapy, with a focus on dietary changes, exercise, medication modifications, and patient education. The review highlights the need for further research to clarify the causal relationships and to develop more effective strategies for managing weight gain in insulin-treated patients. It suggests exploring personalized medicine approaches and newer pharmacological agents to optimize diabetes care while minimizing cardiovascular risks. This review underscores the importance of incorporating weight management into the clinical management of diabetes. It advocates for a holistic approach that includes regular monitoring, patient education, and tailored treatment plans to mitigate cardiovascular risks associated with insulin-induced weight gain.

UNLOCKING THE LINK: PROTEINURIA SHIFTS AND HEART ATTACK RISKS IN DIABETES AND PRE-DIABETES - A PROSPECTIVE COHORT STUDY.

Akash Kumar Ambashtha — 2024-03-31

Background

A major area of clinical concern is the complex link between renal failure, which is characterized by proteinuria, and cardiovascular disease (CVD), specifically myocardial infarction. To investigate predictive markers for cardiovascular problems in this high-risk population, the study examines the association between variation in proteinuria levels and the risk of myocardial infarction in people having diabetes or pre-diabetes.

Methods

240 people were enrolled in the research. There were four categories for proteinuria levels: incident, chronic, remittent, and no proteinuria. Over 2 years, follow (MI), in patients having diabetes or pre-diabetes. To identify potential-up evaluations were carried out to monitor changes in the incidence of myocardial infarction and proteinuria levels. After addressing relevant confounders, statistical analyses were carried out to evaluate the correlation between variations in proteinuria and the risk of myocardial infarction.

Results

People with persistent proteinuria demonstrated a substantially elevated risk of myocardial infarction compared to those with no proteinuria (HR 2.5, 95% CI 1.8-3.4). Similarly, individuals with incident proteinuria also exhibited an enhanced risk of MI (HR 2.0, 95% CI 1.5-2.7), while those with remittent proteinuria showed a modestly elevated risk (HR 1.3, 95% CI 1.0-1.8). Subgroup analyses based on diabetes status yielded consistent findings. Sensitivity analyses (2.48) confirmed the robustness of the results.

Conclusion

The research emphasizes how changes in proteinuria levels have a predictive value in predicting myocardial infarction risk in those having diabetes or pre-diabetes. Persistent and incident proteinuria emerged as strong predictors of myocardial infarction, emphasizing the importance of proteinuria monitoring for cardiovascular risk stratification in this population.

Recommendations

To identify myocardial infarction risk factors, diabetics and pre-diabetics should have their proteinuria levels checked regularly. Medication and lifestyle adjustments can minimize proteinuria and cardiovascular risks. More study is needed to understand the causes and investigate targeted therapies for cardiovascular outcomes.

PREVELENCE OF DEPRESSION AMONG TYPE II DIABETES PATINETS IN A MEDICAL COLLEGE HOSPITAL IN JHARKHAND.

Anil Kumar — 2024-03-31

Background

Diabetes and depression are both very serious chronic conditions that decrease the quality of life, increase functional disability, and decrease life expectancy. Though this association is well established, results from developing country like India and especially eastern India, where poor socio-economic status, lower literacy and patient compliance is a major factor hindering treatment are limited. We aim to study the prevalence of depression among type 2 diabetes patients’ in our center

Methods

This prospective study was conducted in a SBMC Hazaribagh. Ninety-nine previously diagnosed Type II diabetes patients aged 30years and above and not meeting the exclusion criteria between1^st July2021 and 30^th September2021 were interviewed. Patients with known psychiatric disorders on treatment were excluded from the study. Patient Health Questionnaire (PHQ)-9 questionnaires was used to screen for depression.

Results

Our cohort comprised of 99 patients with median age of 55years (Range: 19-82years) with a Male: Female of 1.06:1. Our study found an incidence of 70% of varying grades of depression among type 2 diabetes patients, with 40% having mild and 54% moderate depression. None of our patients had severe depression. No statistically significant association between incidence of depression among various age and gender groups was found. A significant association was noted for the incidence with duration of illness. No significant association between incidence of depression and socio- economic status, regular follow-up, co-existing hypertension and co- existence of other diabetes related complications were noted.

Conclusion

Depression is a significant problem among diabetic patients. Early identification and referral for further evaluation and management can remarkably improve the quality of life of such patients’ and decrease the care given burden.

Point of facial nerve vulnerability during mastoidectomy among Indian patients

Rajarshi Datta — 2024-03-31

Background: The petrous part of temporal bone houses the major part of intracranial courses of facial nerve. The nerve might be injured during surgery involving the mastoid and tympanic region. The damage may cause facial asymmetry and impairment of facial muscle function. It may ruin a patient's face, affecting their mental and social health. This research seeks to identify the anatomical site most susceptible for facial nerve injury during surgical treatment of mastoid and tympanic cavity.

Methods: A retrospective analysis of 198 mastoidectomies conducted by 10 surgeons was done. The number of mastoidectomies by each surgeon, the location of the injury, the grade of the nerve injury, and the number of recoveries were recorded. Statistical analysis was performed on the data obtained.

Results: Nine facial nerve injuries were reported among the 198 cases analyzed. The second genu was the most vulnerable site of nerve injury in our study. A Grade 3 injury was most found in the case of mastoidectomies. More than 70% of the cases recovered from the ‘facial nerve’ injury.

Conclusion: Injury of the nerve during mastoidectomy is the major complication faced by an otolaryngologist. Also, the injury paralyses the facial muscle, having a significant impact on the patient’s life. The injury can be best avoided by the thorough study of the anatomy of the nerve. In our study, it is found that the second genu is the prominent site of the injury. The otolaryngologist should be careful while performing the mastoidectomies and monitor the facial nerve simultaneously.

GRIN AND GLUCOSE: THE TWO-WAY STREET OF DIABETES AND ORAL HEALTH.

Aushili M — 2024-03-30

Background:

The bidirectional association between diabetes and oral health affects the management of both, as high blood sugar promotes oral bacteria growth and gum disease, while periodontal issues can worsen diabetes control, emphasizing the need for integrated care. The study aimed to explore the mutual influence of diabetes and oral health on each other, particularly examining how gingival health and glucose levels impact the progression and severity of both conditions.

Methods:

This multicenter study enrolled 120 type 2 diabetes mellitus patients, categorized by glycemic control status based on their HbA1c levels. Employing personal interviews with structured questionnaires, the study investigated demographic characteristics, periodontal treatment experience, self-care behaviors, oral health knowledge, attitude towards periodontal health, and oral health-related quality of life (OHQoL). Logistic regression models analyzed the relation between glycemic control status and various periodontal care behaviors.

Results:

The study revealed a notable link between poor glycemic control and periodontal disease (OR = 2.5, p < 0.05), and showed that regular dental visits improve glycemic control (OR = 0.4, p < 0.05). Participants had a moderate understanding of oral health and positive attitudes toward it. Good glycemic control was also associated with better OHQoL scores (95% CI [1.5, 4.5], p < 0.001), yet the quality of periodontal care did not significantly alter OHQoL outcomes, indicating effective periodontal treatment does not negatively impact life quality.

Conclusion:

The study underscores the bidirectional association between glycemic control and periodontal health, emphasizing the importance of integrated care approaches that incorporate both dental and diabetes management strategies.

Recommendations:

Healthcare providers should foster closer collaborations between dental and health professionals to ensure comprehensive care for patients with T2DM. Further research should explore the effectiveness of integrated care models in improving both glycemic control and oral health outcomes.

FACTORS AFFECTING ADHERENCE TO IRON AND FOLIC ACID SUPPLEMENTATION DURING ANTENATAL CARE: A CROSS-SECTIONAL STUDY.

Dr. Mousumi Pradhan — 2024-03-23

Background:

Iron deficiency anemia in pregnancy persists despite Ministry of Health efforts. Pregnant women, needing more iron for the growing foetus, benefit from iron-folic acid supplementation, a cost-effective intervention. Adherence to Iron and folic acid (IFAS) is crucial for anemia prevention and management. The objective is to estimate the level of adherence to assess the factors affecting adherence to IFAS tablets among pregnant women and to study the social factors influencing it.

Methodology:

The cross-sectional study was carried out on a convenient sample of 135 pregnant women attending the Anganwadi Center for Antenatal check-ups. Data collection was done by pre-tested case record form based on the Medication Adherence Rating Scale (MARS) questionnaire. Qualitative data was analyzed by manual content analysis. Results are presented as percentages.

Results:

A total of 135 pregnant women were included, and the adherence to IFAS among the antenatal mothers was 91.12%. A high level of adherence was found among pregnant women in the age group of 21-25 years (65 out of 69, 94.20%) and in women who are homemakers (83 out of 95, 87.37%). Primigravida (92 out 104, 88.46%) were associated with a higher level of adherence with IFAS.

Conclusion:

Adherence to IFAS among pregnant mothers was good. Adherence is directly influenced by age, occupation, gravida status, regularity in ANC visits, and no. of dosage taken.

Recommendations:

High adherence to IFAS among pregnant women, is influenced by factors like age, occupation, gravidity, ANC visits, and dosage intake. Targeted interventions for younger, homemakers, and primigravida can enhance adherence and reduce anemia. Education, counseling during ANC, and community outreach can promote adherence and ensure maternal-fetal health.

Sudden Natural Death: Autopsy-Based Cross-Sectional Study at SCB Medical College, Cuttack, Odisha

Chaman Kumar Bisoyi — 2024-03-31

Background: Sudden natural death represents a critical area of medical and forensic investigation, encompassing instances where death occurs suddenly without preceding symptoms. Despite advancements in diagnostic techniques, sudden natural deaths continue to pose significant challenges, particularly in understanding their underlying causes and associated risk factors.

Methods: The cross-sectional study aimed to determine the causes of sudden natural death and assess the epidemiological and sociodemographic parameters linked to it. Data were collected from various sources including inquest reports, autopsy records, and histopathological examinations.

Results: Among the 250 cases (35.87%) identified as sudden deaths, with males constituting 86% of the cases compared to females at 14%. The demographic distribution showed a predominance of Hindus (60%), followed by Muslims (30%) and Christians (10%). Geographically, approximately two-thirds of cases originated from rural areas. Cardiovascular disease emerged as the leading cause (40%), with myocardial infarction being the most prevalent subtype. Other significant causes included cerebrovascular accidents, pulmonary embolism, respiratory, gastrointestinal, and central nervous system causes.

Conclusion: This study provides valuable insights into the demographics, place of occurrence, and causes of sudden natural deaths. Understanding these factors is crucial for implementing effective preventive strategies and improving access to timely medical care, particularly in rural and residential settings.

Recommendations: Based on the findings, recommendations include the implementation of targeted preventive measures to address modifiable risk factors for cardiovascular disease, enhancing access to healthcare facilities in rural areas, and promoting awareness about the signs and symptoms of sudden natural death among the general population.

Integrative Approaches in the Management of Chronic Pain: A Comprehensive Review of Complementary and Alternative Medicine Therapies

Neeraj Kumar — 2024-03-31

Background: Chronic pain poses a significant global health burden, necessitating effective management strategies. Complementary and integrative medicine (CIM) modalities, including acupuncture, mind-body interventions, and dietary therapies, have emerged as promising approaches for chronic pain management. Understanding their effectiveness and underlying mechanisms is crucial for optimizing patient care.

Objective: The review aims to synthesize the current evidence on the effectiveness and mechanisms of CIM modalities in managing chronic pain and associated conditions. Additionally, it explores future implications, clinical policy, and development in this rapidly evolving field.

Review Summary: A systematic literature review was conducted, encompassing studies published from January 2010 to January 2024. Electronic databases were searched using relevant keywords, and studies meeting predefined inclusion criteria were included. The review identified a diverse range of studies evaluating CIM modalities, including acupuncture, mind-body interventions, and dietary therapies, in chronic pain management. Mechanisms underlying the effects of these modalities were explored, highlighting their potential to modulate neurological, circulatory, immune, and psychological pathways involved in pain perception and management. Clinical evidence supported the efficacy of CIM modalities in improving pain outcomes and enhancing overall quality of life.

Future Implications: The review underscores the need for further research to elucidate the mechanisms of CIM modalities and their integration into mainstream healthcare practices. Future studies should focus on rigorous methodologies, including randomized controlled trials and mechanistic investigations, to validate and optimize the use of CIM in chronic pain management.

Clinical Policy and Development: Integration of CIM modalities into clinical practice guidelines and healthcare policies is essential to ensure comprehensive and patient-centered chronic pain care. Clinicians should be educated about the evidence-based use of CIM modalities and encouraged to incorporate them into multimodal treatment approaches.

A Prospective Study on Exploring Micronutrient Deficiency in Non-Ischemic Cardiomyopathy Among the Young: Potential for Correction

Aman Sinha — 2024-03-31

Background: Micronutrient deficiencies are increasingly recognized as significant yet often overlooked factors in the pathogenesis and progression of non-ischemic cardiomyopathy (NICM), especially among young populations. This study aims to explore the prevalence and effects of micronutrient deficiencies in young patients with NICM, assessing the relationship between micronutrient levels and disease severity, and evaluating the efficacy of nutritional interventions.

Methods: A prospective cohort study was conducted, enrolling 64 participants aged 18-35 years diagnosed with NICM. Exclusion criteria included ischemic heart disease, primary valvular heart disease, and chronic diseases affecting micronutrient levels. Baseline assessments included medical history, physical examination, dietary assessment, blood tests for key micronutrients, and cardiac imaging. Participants with identified deficiencies received tailored supplementation plans. Follow-ups were conducted monthly, with repeat assessments at 6 and 12 months.

Results: At baseline, 56% of participants had at least one micronutrient deficiency, with vitamin D being the most common. After 6 months of supplementation, significant improvements in micronutrient levels and mean left ventricular ejection fraction (LVEF) were observed (from 45% to 52%, p < 0.001). Quality of life improved significantly, and a reduction in cardiovascular event rates was noted, although not statistically significant.

Conclusion: This study highlights the high prevalence of micronutrient deficiencies among young individuals with NICM and demonstrates that tailored nutritional interventions can significantly improve cardiac function and quality of life. These findings underscore the importance of screening for and addressing micronutrient deficiencies in this population, suggesting a potential avenue for improving cardiovascular outcomes in NICM.

Recommendations: Healthcare providers should screen young NICM patients for micronutrient deficiencies and incorporate tailored nutritional interventions into their management. This can potentially improve cardiac function and quality of life, though further research is needed to establish comprehensive guidelines.

FACTORS ASSOCIATED WITH DIABETES AMONG ADULTS AGED 45 TO 60 YEARS AT ORUM HEALTH CENTER IV, OTUKE DISTRICT.

SOLOMON OMACH — 2024-03-01

Background

Diabetes is a chronic metabolic disorder characterized by the presence of elevated levels of blood glucose which leads over time to serious damage to the heart, blood vessels, eyes, kidneys, and nerves.

Purpose

Determined the prevalence, knowledge, and health facility-related factors associated with diabetes among adults aged 45 to 60 years at Orum Health Center 1V, Otuke district

Methodology

A descriptive cross-sectional study design was employed where 67 respondents were obtained by simple random sampling method. Data was collected by face-to-face interview using a questionnaire.

Results

prevalence of diabetes was 28(33%) among the respondents, 61(91%) had heard about diabetes and knew something about diabetes, 06(9.0%) were not sure, majority 34(50.8%) reported obesity as a major risk factor whereas few 05(7.5%) reported smoking with most 23(34.3%) reporting excessive thirst as symptom, least 04(6.0%) stated numbness, majority of respondents 34(50.8%) would take more than thirty-one minutes to reach the facility while few 07(10.4%) would take between 1-10 minutes 36(54%) reported health workers attitude was good, 04(6%) reported bad attitude towards diabetic patients, with transport 31(46.3%) most hindrance to the facility, whereas the least 07(10.4%) reported health workers absence, most respondents 24(36%) would wait 30 minutes to 2 hours whereas few would wait for less than 30 minutes before attended to.

Conclusion

Prevalence of diabetes was high with a high number of respondents between 56-60 years, the knowledge of respondents about diabetes was good because the majority had heard and knew about diabetes, and health workers' attitude towards diabetic patients was good because most of them were willing to help the patients.

Recommendations

Government through the Ministry of Health should avail more resources for screening diabetes, carry out public awareness campaigns, train health personnel, and other measures that improve service delivery and the burden of disease in the nation.

KNOWLEDGE, ATTITUDE, AND PRACTICES TOWARDS PROSTATE CANCER SCREENING AMONG MEN AGED 40-60 YEARS ATTENDING KISENYI HEALTH CENTRE IV, KAMPALA. A CROSS-SECTIONAL STUDY.

JOSHUA KAMWESIGE — 2024-03-01

Background:

Purpose of the study: The purpose of the study was to determine the knowledge, attitudes, and practices toward prostate cancer screening among men aged 40-60 years attending Kisenyi Health Centre IV, in Kampala.

Objectives: The objectives of the study were to determine the knowledge, attitudes, and practices towards prostate cancer screening among men aged 40-60 years attending Kisenyi Health Centre IV, Kampala, whereas the specific objectives were to, determine the knowledge, assess the attitudes, and determine the practices of men aged 40-60 years towards prostate cancer screening.

Methodology:

The study employed a descriptive cross-sectional study design. it facilitated the collection of adequate data despite the limited time frame that was allocated as well as the limited resources that were available for the study.

Results:

Study findings revealed that the majority 90% were urban residents and 10% were rural residents,72 (62%) respondents were between (40-49) years and 44(38%) were between (50-60) years,111(96%) respondents were married and 5(4%) were divorced. 114(98%) had good knowledge, 106(91%) had positive attitudes and 95(82%) had never been screened for prostate cancer.

Conclusion:

From the findings majority of the respondents had sufficient knowledge about prostate cancer and positive attitudes toward prostate cancer screening practices however screening practices were still very poor.

Recommendations:

With support, and funding from the Government of Uganda and the non-government organizations through the Ministry of Health, I recommend that more prostate cancer screening departments be established on a health Centre level, services provided should be free of charge, prostate cancer screening messages should be broadcasted in all languages to the public.

CARDIOVASCULAR IMPLICATIONS OF CUMULATIVE RADIOIODINE DOSES IN PATIENTS WITH DIFFERENTIATED THYROID CANCER AND TYPE 2 DIABETES MELLITUS, BIHAR, INDIA: A RETROSPECTIVE STUDY.

Sajjad Ahsan — 2024-03-23

Background:

The study aims to investigate the cardiovascular effects associated with cumulative doses of radioiodine therapy in people diagnosed with differentiated thyroid cancer (DTC) and comorbid Type 2 diabetes mellitus, with a focus on elucidating potential risks and outcomes for this patient population.

Methods:

A retrospective cohort study was conducted, enrolling 75 female participants categorized into DTC/−T2DM (Category I) and DTC/+T2DM (Category II). Data on demographic characteristics, radioiodine therapy, cardiovascular outcomes, and clinical parameters were collected from medical records. Statistical analyses were accomplished using SPSS software ver. 18.

Results:

Patients with DTC and without T2DM (DTC/−T2DM) exhibited higher average age (60 ± 6.3 years) and BMI (28.5 kg/m²) compared to patients with both DTC and T2DM (55 ± 5.2 years, 25.1 kg/m²). Patients with both DTC and T2DM received higher cumulative doses of radioiodine (200 mCi ± 25) over a longer duration (14 months) compared to patients with DTC and without T2DM (180 mCi ± 20, 12 months). The prevalence of hypertension, arrhythmias, and myocardial infarctions was higher in patients with DTC and without T2DM than in patients with both DTC and T2DM. Statistical analysis revealed significant variations in hypertension incidence (p < 0.001) and myocardial infarction occurrence (p = 0.03) between the groups. Multivariate regression analysis showed an independent association of T2DM with a higher risk of hypertension (p < 0.001) and myocardial infarction (p = 0.015) among DTC patients.

Conclusion:

The study highlights the importance of considering cardiovascular risks associated with radioiodine therapy in DTC patients, particularly those with T2DM. Personalized treatment strategies balancing cancer management and cardiovascular risk mitigation are crucial for optimizing patient outcomes.

Recommendations:

Clinicians should adopt a multidisciplinary approach integrating endocrinology, oncology, and cardiology to optimize the management of DTC patients with T2DM.

Influence of 20-Year Reduction in Door-to-Balloon Times on Outcomes of Patients with Anterior ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: A Prospective Study

Vikas Kumar — 2024-03-31

Background: The biggest cause of death worldwide is cardiovascular disease. This 20-year study at the tertiary care center examined how reduced door-to-balloon timings (DBT) affected patient outcomes for anterior STEMI (ST-elevation myocardial infarction) patients from 2003 to 2022. This study aimed to examine clinical features, hospitalization, mortality, and DBT's effect on anterior STEMI patients' long-term survival over two decades.

Methods: In the study 829 anterior STEMI patients were examined who received PPCI within 12 hours of presentation. Patient data were divided into four five-year quartiles (2003-2007, 2008-2012, 2013-2017, and 2018-2022). Analyses included demographic, clinical, and mortality data. Age, hypertension, smoking status, obesity, hospital stay, diabetes, and DBT were important. Multivariate analysis accounted for gender, age, comorbidities, clinical shock, ejection fraction, mitral regurgitation.

Results: The study found a substantial drop in patient age (63.4 to 60 yrs, p<0.01), with hypertension, smoking, and obesity prevalence increasing across all quartiles. Diabetes prevalence remained unchanged. Median hospital stays decreased (7 to 4.6 days, p<0.01), and median DBT fell significantly (216 to 37 minutes, p<0.01). Both 30-day and 1-year mortality improved (p=0.01), from 13.4% to 6.8% and 19.5% to 12.9%, respectively. Three-year mortality fell from 24.3% to 15.5% (p=0.02). Compared to DBT < 60 minutes, shorter DBT was related with reduced mortality over time after controlling for numerous variables.

Conclusion: Long-term prognosis for anterior STEMI patients at our center have improved over the previous two decades. DBT decreased with these changes. This study emphasizes the need to optimize door-to-balloon timeframes for anterior STEMI care and prompt intervention.

Recommendation: Healthcare providers should target anterior STEMI door-to-balloon time reduction based on this study. To improve results in this patient population, smoking, hypertension, and obesity should be addressed. Additional research is needed to improve anterior STEMI patient treatment and care.

PHENOTYPES OF COPD PATIENTS WITH RESPIRATORY FAILURE AND THEIR RESULTS IN ICU SETUP: A ONE-YEAR OBSERVATIONAL STUDY.

Devendra Prasad Singh — 2024-03-30

Background:

Airflow restriction and persistent respiratory symptoms are characteristic features of Chronic Obstructive Pulmonary Disease (COPD), a diverse disease. The intricacy of the disease is shown by the phenotypic diversity of individuals with COPD who are experiencing respiratory failure in the Intensive Care Unit (ICU). The study aimed to investigate the phenotypes of COPD patients with respiratory failure and analyze their outcomes over one year.

Methods:

An observational study was carried out enrolling 80 COPD patients admitted to the ICU due to respiratory failure. Patients aged 40 years and above with confirmed COPD diagnosis were included. Data on demographics, COPD severity, exacerbation history, comorbidities, and ICU admission details were collected. Pulmonary function tests, arterial blood gas analysis, and information on respiratory support modalities were documented. Phenotypic characterization was performed using established criteria, and outcome measures included mortality rates and ICU stay duration.

Results:

The study population was 65% male and averaged 65 years old. Patients were 40% emphysema-dominant, 30% chronic bronchitis-dominant, and 30% mixed. Emphysema-dominant patients had worse airflow limitation. Hypertension, coronary heart disease, and diabetes were frequent. Hypoxemia and hypercapnia were seen in pulmonary function tests. Mechanical breathing was needed by 70% of patients, and ICU mortality was 25%. In long-term survival study, exacerbation frequency and comorbidities significantly predicted a 40% one-year mortality rate.

Conclusion:

The study highlights the diverse phenotypes of COPD patients with respiratory failure and their associated outcomes. Personalized management strategies tailored to specific phenotypes and addressing comorbidities are crucial for improving patient outcomes. Further research is needed to refine treatment approaches and enhance long-term survival in this population.

Recommendations:

Clinicians should consider phenotypic variations and comorbidities when managing COPD patients with respiratory failure. Interventions targeting exacerbation prevention and comorbidity management may improve outcomes.

ASSOCIATION BETWEEN SELF-CARE BEHAVIOUR AND GLYCAEMIC CONTROL AMONG PATIENTS WITH DIABETES MELLITUS.

Amit Kumar Mishra — 2024-03-31

Background:

Self-care behavior improves the glycemic control and prevents the progression and worsening of the outcomes of this disease. There is a lack of consistency in the research about how self-care impacts glycemic control in the Indian setting. This study is carried out to find the association of self-care behavior and progression of diabetes

Method:

This was a cross sectional study carried out at Department of General Medicine of IGIMS, Patna, Bihar, India. The duration for this study was from December 2023 to February 2024. There were 100 participants selected from those visiting IGIMS for follow-up on diabetes. Socio-demographic characteristics, such as age and sex of the patients were recorded. Lab reports were reviewed for duration of diagnosis, diabetes-related complications and HbA1c. Summary of Diabetes Self-Care Activities Questionnaire (SDSCA) was used to determine details regarding self-care. Association was determined statistically.

Results:

Among the 100 patients participating 60 had poor self-care score and 40 had moderate score. The score was higher in those with more than 40 years of age, had HbA1C less, than 7 BMI less than 25, and duration of diabetes more than 10 years.

Conclusion:

From this study it is found that patients with lesser HbA1C are more inclined towards the self-care habits that helps in management of diabetes.

Recommendation:

Self-care habits prevents the worsening of diabetes it should be recommended in encouraged in each diabetic individual.

TYPE 2 RESPIRATORY FAILURE AND LUNG RECRUITERS IN ICU SETUP: A ONE-YEAR OBSERVATIONAL STUDY.

Devendra Prasad Singh — 2024-03-30

Background:

Respiratory failure is a critical condition commonly encountered in intensive care units (ICUs), with Type 2 Respiratory Failure (T2RF) posing significant challenges in management. This study investigates the correlation between T2RFand the effectiveness of lung recruiters in an ICU setting through a one-year observational study.

Methods:

The study employed an observational design and was conducted and 80 individuals meeting inclusion criteria were enrolled, while standardized data collection procedures were implemented to minimize bias. Demographic, clinical, and respiratory support data were collected and analyzed using SPSS version 21.0.

Results:

Participant characteristics revealed a mean age of 65 years (± 8.2), with 65% being male. Various degrees of COPD severity were observed, with significant p-values associated with severe COPD (p<0.001) and AE-COPD (p<0.001). Upon ICU admission, participants exhibited clinical features indicative of T2RF, including mean PaO2 of 55 mmHg (± 10.2), PaCO2 of 65 mmHg (± 8.5), and pH of 7.28 (± 0.03). Statistical analysis revealed significant associations between the use of lung recruiters and improvements in oxygenation (χ²=18.23, p<0.001) and reductions in PaCO2 levels (χ²=15.87, p<0.001). Among participants who received lung recruitment strategies, 75% demonstrated improvements in oxygenation, while 65% experienced a decrease in PaCO2 levels. Complications such as ventilator-associated pneumonia occurred in 15% of cases.

Conclusion:

The study underscores the importance of tailored interventions for T2RFin the ICU. Lung recruiters showed efficacy in improving respiratory parameters, with implications for optimizing patient outcomes. Vigilant monitoring for complications remains imperative.

Recommendations:

Future research should focus on refining management strategies and exploring additional interventions to enhance patient care in T2RF. Additionally, investigating long-term outcomes and the impact of early intervention on mortality and morbidity rates could further guide clinical practice in ICU settings.

A COMPARATIVE ANALYSIS OF CLINICAL CHARACTERISTICS AND ENDOSCOPIC FINDINGS IN SYMPTOMATIC DYSPEPSIA: RURAL VS. URBAN PATIENTS.

Shaibal Guha — 2024-04-01

Background:

Symptomatic dyspepsia poses a significant burden on healthcare systems globally, with potential variations in clinical features and endoscopic findings between rural and urban populations. Understanding these differences is crucial for optimizing diagnostic and management strategies. Therefore, the study aimed to investigate and compare the clinical characteristics and endoscopic findings among symptomatic dyspepsia patients residing in rural and urban settings.

Methods:

A retrospective comparative study was carried out involving 120 individuals, aged 16 to 75 years, presenting with symptoms of dyspepsia, were included. Data collection involved reviewing medical records for patient demographics, clinical features, endoscopic findings, and histopathological results. Endoscopy was performed using standard protocols, and statistical analysis was conducted using SPSS version 24.

Results:

The study comprised patients from both urban and rural areas, with mean age of 45 years. Epigastralgia/epigastric burning was the most prevalent clinical feature (90%). Endoscopic examinations revealed inflammation (50%), erosions (35%), and reflux (30%) as the most common findings. No significant disparities were found in clinical features or endoscopic findings between rural and urban patients (p>0.05). Histopathological examination identified benign lesions in 80% of cases and malignant pathology in 20%, with no significant differences between rural and urban patients.

Conclusion:

The study highlights the uniformity in clinical features, endoscopic findings, and histopathological results among symptomatic dyspepsia patients in rural and urban settings. These findings underscore the need for standardized diagnostic and management approaches, irrespective of geographical location.

Recommendations:

Further research is warranted to explore additional factors contributing to dyspeptic symptoms and to evaluate the effectiveness of tailored interventions based on geographical and demographic factors.

EARLY NEUROLOGICAL COMPLICATIONS FOLLOWING VARICELLA: INITIAL FINDINGS FROM NALANDA MEDICAL COLLEGE AND HOSPITAL, PATNA, INDIA.

Baidyanath Kumar — 2024-03-31

Background:

Varicella infection, commonly known as chickenpox, can lead to various neurological complications. The study aimed to investigate the clinical characteristics, imaging findings, and outcomes of neurological complications following varicella infection.

Methods:

An observational study was conducted involving sixty patients presenting with neurological abnormalities subsequent to acute varicella infection were included. Data collection involved comprehensive neurological examinations and investigations, including imaging studies and cerebrospinal fluid analysis. Treatment outcomes were assessed through a multi-disciplinary approach and follow-up evaluations over a 3-month period. Statistical analysis was performed using SPSS version 21.0, emphasizing descriptive and inferential statistics.

Results:

The participants had a mean age of 38 years and 60% males. Encephalitis (41.7%), meningitis (25.0%), and Guillain-Barré Syndrome (16.7%) were the most prevalent complications. Complications peaked 30 days after varicella infection. Intravenous Immunoglobulin (IVIG) improved Guillain-Barré Syndrome more than plasmapheresis. Complication severity increased neurological symptom duration. In 60 patients, demographic characteristics were significantly associated with post-varicella neurological sequelae. Older patients had increased encephalitis and meningitis risks (p < 0.05), but gender did not significantly affect risk (p > 0.05). Post-infection complications peaked within 30 days and then decreased (p < 0.01). IVIG was more effective than plasmapheresis in treating Guillain-Barré Syndrome (p < 0.05). Corticosteroids improved cerebellitis symptoms faster (p < 0.01). Prolonged symptoms were linked to severe consequences (p < 0.001), increasing our understanding of post-varicella neurological sequelae.

Conclusion:

The study underscores the diverse spectrum of neurological complications following varicella infection. Early recognition and appropriate management are essential for favorable outcomes. The findings contribute to better understanding and management strategies for these complications.

Recommendations:

Further research with larger sample sizes is warranted to validate these findings and explore additional prognostic factors. Multicenter studies could provide broader insights into the epidemiology and outcomes of varicella-associated neurological complications.

EXAMINING THE MORPHOLOGICAL AND CLINICAL IMPORTANCE OF NUTRIENT FORAMINA IN THE HUMAN ULNA: A CROSS-SECTIONAL STUDY.

Divyanjali Singh — 2024-04-01

Background:

Nutrient foramina in human ulna bones play a crucial role in bone vascularization and are of significant clinical importance. Understanding their morphological characteristics and distribution is essential for various medical applications. The aim of the investigation was to evaluate the clinical significance of the morphological features of nutritional foramina in the human ulna.

Methods:

A total of 100 ulna bones were examined without specific age or sex determination, and NF were identified, characterized, and quantified. Data collection included measurements of bone length and foraminal index using standardized techniques. Statistical analysis was performed to assess correlations and differences between variables.

Results:

Nutrient foramina were identified in 85% of the ulna bones, predominantly distributed along the diaphysis with variations in location and dimensions. The average number of foramina per ulna bone was 1.2, with an average diameter of 1.5 mm. A positive correlation was found between bone length and foraminal index, indicating a potential relationship between bone size and vascularization. Additionally, the distribution of foramina was associated with their likelihood of duplication and showed bilateral symmetry. No significant differences were observed by sex or age group.

Conclusion:

The study provides valuable insights into the morphological features and distribution patterns of NF in human ulna bones. These findings have implications for understanding bone vascularization, bone growth, and development, as well as clinical applications in orthopaedic surgery and bone health assessment.

Recommendations:

Further research is warranted to explore the clinical significance of NF in various orthopaedic conditions and to investigate potential correlations with bone health indicators.

SUDDEN NATURAL DEATH: AUTOPSY-BASED CROSS-SECTIONAL STUDY AT SCB MEDICAL COLLEGE, CUTTACK, ODISHA.

Suryakanta Pati — 2024-03-31

Background:

Sudden natural death represents a critical area of medical and forensic investigation, encompassing instances where death occurs suddenly without preceding symptoms. Despite advancements in diagnostic techniques, sudden natural deaths continue to pose significant challenges, particularly in understanding their underlying causes and associated risk factors.

Methods:

The cross-sectional study aimed to determine the causes of sudden natural death and assess the epidemiological and sociodemographic parameters linked to it. Data were collected from various sources including inquest reports, autopsy records, and histopathological examinations.

Results:

Among the 250 cases (35.87%) identified as sudden deaths, with males constituting 86% of the cases compared to females at 14%. The demographic distribution showed a predominance of Hindus (60%), followed by Muslims (30%) and Christians (10%). Geographically, approximately two-thirds of cases originated from rural areas. Cardiovascular disease emerged as the leading cause (40%), with myocardial infarction being the most prevalent subtype. Other significant causes included cerebrovascular accidents, pulmonary embolism, respiratory, gastrointestinal, and central nervous system causes.

Conclusion:

This study provides valuable insights into the demographics, place of occurrence, and causes of sudden natural deaths. Understanding these factors is crucial for implementing effective preventive strategies and improving access to timely medical care, particularly in rural and residential settings.

Recommendations:

Based on the findings, recommendations include the implementation of targeted preventive measures to address modifiable risk factors for cardiovascular disease, enhancing access to healthcare facilities in rural areas, and promoting awareness about the signs and symptoms of sudden natural death among the general population.

A CROSS-SECTIONAL STUDY ON ENHANCING SURGICAL SAFETY: INVESTIGATING ANTIBIOTIC USE IN ENDOUROLOGICAL SURGERY PERIOPERATIVE CARE.

Pratyush Ranjan — 2024-03-31

Background

Surgical safety is paramount in healthcare, particularly in endourological surgery, where perioperative antibiotic use plays a crucial role in preventing postoperative infections. The objective of the study was to assess the patterns and efficacy of perioperative antibiotic usage in endourological surgery. This was achieved through a cross-sectional analysis aimed at elucidating current practices and evaluating their impact on patient outcomes and antimicrobial stewardship.

Methods

A cross-sectional study was conducted involving 150 participants undergoing elective endourological procedures. Data on demographics, preoperative antibiotic usage, perioperative antibiotic administration, infectious complications, and surgical details were collected using standardized protocols. Statistical analyses were employed to examine associations and outcomes with a significance level set at p< 0.05.

Results

Involving 150 participants with diverse demographics, the study found a mean age of 57 years (range: 35-75 years), with 65% male and 35% female representation. Preoperatively, 45% of participants exhibited positive urine cultures for urinary tract infections (UTIs), despite 60% receiving antibiotic prophylaxis. Intraoperatively, 25% received additional antibiotics, primarily due to prolonged surgical duration and complications. Postoperatively, 40% required prolonged antibiotic therapy, with 20% experiencing UTIs. Significant correlations were found between preoperative antibiotic use and postoperative UTIs (p < 0.05) and prolonged surgery duration and infectious complications (p < 0.01). No significant differences in UTI rates were observed across different procedures.

Conclusion

Despite prophylactic antibiotic administration, UTIs remained prevalent, emphasizing the need for optimized antibiotic regimens. Prolonged surgery duration emerged as a risk factor for infections, underscoring the importance of surgical efficiency. Tailored approaches to antibiotic prophylaxis and antimicrobial stewardship programs are warranted to mitigate the risk of antimicrobial resistance and improve patient outcomes.

Recommendations

The development of evidence-based guidelines, implementation of antimicrobial stewardship programs, enhancement of surveillance systems, and ongoing education for healthcare providers are proposed to optimize perioperative antibiotic usage in endourological surgery.

EXPLORING ANATOMICAL VARIATIONS OF RENAL ARTERIES THROUGH CADAVERIC STUDY: A CROSS-SECTIONAL STUDY.

Divyanjali Singh — 2024-03-30

Background:

The anatomical variations of the renal artery are of paramount importance in medical sciences, impacting surgical interventions, diagnostic imaging, and the understanding of renal pathologies. This study aims to document the variations in renal artery anatomy through cadaveric dissection, shedding light on their clinical implications.

Methods:

A cross-sectional study was conducted involving 50 cadavers. Cadavers with intact renal arterial anatomy were included, while those with major congenital anomalies or damage were excluded. Standard dissection protocols were followed to observe and document variations in the renal arteries, including number, course, origin, and morphology.

Results:

The demographic analysis of the 50 cadavers (54% male and 46% female) revealed a mean age of 67 years (± 8.2), indicating a broad age spectrum. Anatomical variations in the renal arteries were identified in 39 cadavers, showcasing a diverse range of alterations from the typical arterial anatomy. The study's detailed dissection process uncovered a notable prevalence of accessory renal arteries in 21% of the cases, with these arteries predominantly originating from the abdominal aorta (30%). Other origins included the inferior mesenteric artery (12.5%) and the common iliac artery (7.5%). The branching pattern analysis further highlighted a trifurcation pattern in 9% of the cases, contrasting with the more commonly observed bifurcation pattern in 31%.

Conclusion:

The high prevalence of renal artery variations underscores the necessity for detailed anatomical knowledge among clinicians and surgeons to navigate these differences effectively during surgical and diagnostic procedures.

Recommendations:

Further studies are recommended to explore the clinical implications of these variations in renal artery anatomy, particularly in the context of renal surgeries and interventions. Enhanced imaging techniques should be developed to better identify and characterize these variations preoperatively.

A CASE-CONTROL PERSPECTIVE STUDY ON EXPLORING DIASTOLIC DYSFUNCTION IN ASYMPTOMATIC TYPE 2 DIABETES MELLITUS PATIENTS WITH PRESERVED SYSTOLIC FUNCTION, BIHAR, INDIA.

Sajjad Ahsan — 2024-03-23

Background:

Asymptomatic individuals with Type 2 Diabetes Mellitus (T2DM) often exhibit diastolic dysfunction, a precursor to symptomatic heart failure (HF), despite preserved systolic function. The study aims to investigate the incidence and severity of diastolic dysfunction (DD) in this population and its association with diabetes duration, glycemic control, and cardiovascular risk factors.

Methods:

A case-control prospective study was carried out enrolling 82 participants: 55 with T2DM and 27 non-diabetic individuals. Echocardiographic evaluations were performed to assess diastolic function parameters. Statistical analysis was conducted using SPSS version 24.

Results:

The study revealed a high incidence of diastolic dysfunction, with 54.9% of participants affected, ranging from mild to severe impairment. Individuals with T2DM exhibited a significantly higher incidence of diastolic dysfunction compared to non-diabetic participants (p < 0.05). Diabetes status independently contributed to impaired diastolic function, with a positive correlation observed between diabetes duration and severity of dysfunction (r = 0.42, p < 0.01). Subgroup analysis hinted at a trend towards significance between poorly controlled diabetes and increased diastolic dysfunction prevalence (p = 0.08). Uncontrolled hypertension was associated with heightened diastolic dysfunction severity.

Conclusion:

Asymptomatic individuals with T2DM and preserved systolic function demonstrate a substantial burden of diastolic dysfunction, which is independently associated with diabetes status and duration. Early detection and management of diabetes, glycemic control, and blood pressure are crucial in mitigating the risk of diastolic dysfunction and improving cardiovascular outcomes in this population.

Recommendations:

Clinicians should emphasize early screening for diastolic dysfunction in asymptomatic individuals with T2DM, particularly focusing on glycemic control and blood pressure management. Future research should explore targeted interventions aimed at preserving diastolic function and reducing cardiovascular morbidity and mortality in this high-risk population. Diastolic dysfunction (DD)

ADVANCEMENTS IN NON-INVASIVE VENTILATION TECHNIQUES FOR MANAGING ACUTE RESPIRATORY DISTRESS: A NARRATIVE REVIEW.

Santanu Kumar Ghosh — 2024-03-31

Acute respiratory failure (ARF) presents a significant clinical challenge, often necessitating invasive mechanical ventilation (IMV). Non-invasive ventilation (NIV) has emerged as a valuable alternative, but recent innovations and advancements in NIV strategies warrant exploration to optimize its clinical utility. The review aims to synthesize recent innovations in NIV strategies for the management of ARF, assess their clinical applications and efficacy, discuss challenges, and outline future directions for research and clinical practice. Recent advancements in NIV devices, interfaces, and ventilation modes have enhanced patient comfort, improved outcomes, and expanded the applicability of NIV across various clinical settings. Smart ventilation systems driven by artificial intelligence (AI) and machine learning algorithms, portable and wearable NIV devices, and the integration of telemedicine have revolutionized the delivery of respiratory support. Clinical studies have demonstrated the efficacy of NIV in specific populations, such as COPD exacerbations, cardiogenic pulmonary edema, and COVID-19 pneumonia, further solidifying its role in respiratory care. Future research in NIV is focused on refining personalized ventilation strategies, integrating NIV with other therapeutic modalities, and developing next-generation ventilators capable of real-time adaptation to patient needs. These advancements hold promise for improving outcomes, enhancing the quality of care, and reducing the burden of respiratory failure. The outcomes of this review have implications for clinical policy and development, highlighting the importance of incorporating recent innovations in NIV into clinical practice guidelines and protocols. Healthcare providers should remain abreast of technological advancements and evidence-based practices to optimize the management of ARF and improve patient outcomes.

A CASE SERIES OF PIGGY BACK DISEASE CHARACTERISED BY BLACK ESCHAR FOLLOWING COVID-19 RHINO-ORBITAL CEREBRAL MUCORMYCOSIS.

Souvagini Acharya — 2024-03-30

Purpose

This case series focused on examining the clinical profile of individuals suspected of having Post COVID Mucormycosis. These patients were admitted with the presence of black eschar on their face and eyes.

Methods

This case series includes six individuals who were suspected to have Post COVID Mucormycosis. They presented with black eschar. The cases were examined over a span of six months, from May 2021 to October 2021, at the Ophthalmology Department of Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Burla.

Results

All the cases included in the case series exhibited symptoms of black eschar and were in the age group of over 40 years. All the cases had a history of Type II Diabetes mellitus (T2DM) in their medical records. Two individuals had undergone oxygen therapy and steroid therapy as part of their treatment for COVID-19. In addition, one case had a previous admission to the Intensive Care Unit (ICU). Upon admission, all patients underwent Diagnostic Nasal Endoscopy (DNE) and were subsequently administered liposomal amphotericin B (AMB) for a duration of 21 days, followed by oral Posaconazole. Two patients underwent skin grafts, while another patient required exenteration. Unfortunately, four patients did not survive, but there were positive outcomes for three patients who experienced improved visual activity. Additionally, two patients only had the disease affecting one eye.

Conclusion

The simultaneous occurrence of T2DM, a history of steroid use, and oxygen therapy were significant factors contributing to the development of Post COVID Mucormycosis. Despite implementing timely interventions, the mortality rate for Post COVID mucormycosis was significant, reaching approximately 50%. Indeed, a fungus in the realm of viruses caused widespread devastation.

STUDY OF RENAL INVOLVEMENT PREVALENCE AND COURSE OF ACUTE TROPICAL FEVER

Bijaya Kumar Behera — 2024-04-01

Background:

Equatorial contamination is very frequent in our country. The main purpose of this research is to examine the incidence of acute kidney injury in serious fever disorder and analyze the results at the time of hospitalization and follow-up for two months.

Materials and Methods:

This research was carried out in the Department of General Medicine at SCB Medical College and Hospital, Cuttack, Odisha from June 2021 to October 2022. 100 patients were included in this research. All the detailed history of the patients was recorded. Symptoms such as high temperature, sore head, convulsion, body pain, stomachache, loose stools, and decreased urine output were examined

Result: 10 cases were present under 20 years. 40 cases were in the age range of 20-30 years, 10 patients were in the age range of 30-40 years, 12 cases were in the age range of 40-50 years, and 18 cases were in the age range of 50-60 years. 10 cases were in the age range of 60-70 years. 65 patients were male, and 35 patients were female. 35 male and 27 female patients had acute kidney injury and 30 male, and 8 female patients had an absence of acute kidney injury.

Conclusion:

It has been seen that 62% of the patients had acute kidney injury in which 0% of the patient’s needed dialysis. 78% of the patients had good improvement and 16% of patients developed chronic kidney disease.

Recommendation:

Importance should be given to the treatment as soon as possible. Experienced doctors should be appointed for the proper detection and management of the disease.

A RETROSPECTIVE COHORT STUDY OF LONG-TERM MONITORING OF ADULT PATIENTS WITH NON-SEVERE RHEUMATIC MITRAL STENOSIS, DELHI, INDIA: INSIGHTS INTO DISEASE PROGRESSION.

Anil Kumar Singh — 2024-03-31

Background

Long-term monitoring of adult patients with non-severe rheumatic mitral stenosis is crucial for understanding disease progression and optimizing patient care. The study aimed to assess the long-term outcomes and progression patterns of adult patients diagnosed with non-severe rheumatic mitral stenosis, providing insights into the natural history of the disease and guiding clinical management strategies.

Methods

The retrospective cohort study involved 118 adult patients over a period spanning from 2022 to 2023. Participants were assessed for demographic characteristics, clinical conditions, lifestyle factors, and echocardiographic parameters. Patients were distributed into two groups based on disease progression status: indolent disease (n=78) and progressive disease (n=40). Statistical analyses were performed to calculate differences between groups and identify predictors of disease progression and clinical complications.

Results

The study cohort had an average age of 52 years, with a balanced gender distribution. Clinical evaluation revealed that dyspnea on exertion was the most common symptom, and comorbidities such as hypertension and diabetes mellitus were prevalent. Initial echocardiographic assessment showed preserved left ventricular function, with a mean mitral valve area of 1.8 cm² and a mean gradient over the mitral valve of 6 mmHg. During follow-up, 66% of patients exhibited an indolent disease course, while 34% demonstrated progressive disease.

Conclusion

Regular echocardiographic evaluation, combined with appropriate medical management, is essential for optimizing results in patients with non-severe rheumatic mitral stenosis. Early detection of disease progression and timely intervention are crucial in mitigating long-term adverse outcomes.

Recommendations

Healthcare providers should emphasize the importance of regular follow-up and adherence to medical therapy in individuals with non-severe rheumatic mitral stenosis. Furthermore, efforts should be made to address modifiable risk factors like hypertension and diabetes mellitus to prevent disease progression and reduce the risk of clinical complications.

TELEMEDICINE DISRUPTION: A COMPREHENSIVE NARRATIVE LITERATURE REVIEW ON PHYSICIANS' PERSPECTIVES.

Pramod Kumar — 2024-03-31

Telemedicine, the delivery of healthcare services via telecommunications technology, has evolved significantly since the early 20th century. This evolution has been propelled by advancements in digital technology and heightened by the demands of modern healthcare challenges, including the COVID-19 pandemic. Telemedicine offers enhanced access to care, improved patient engagement, and potential cost savings, but it also introduces unique challenges and disruptions to traditional medical practice. This literature review aims to systematically examine and synthesize existing research on physicians' perspectives regarding the disruptions caused by telemedicine, identifying common themes, challenges, and opportunities that influence its integration into routine clinical practice. The review traces the evolution of telemedicine, highlighting key milestones from early radiologic image transmission to the integration of AI-driven tools. Theoretical frameworks like Innovation Diffusion Theory, Technology Acceptance Model, and Disruptive Innovation Theory are explored to understand telemedicine adoption among healthcare providers. The adoption by physicians is influenced by factors such as technological literacy and organizational support, with barriers like data security concerns. Various telemedicine models, including store-and-forward, real-time video consultations, and remote monitoring, are discussed in the context of services ranging from primary care to chronic disease management. Physicians' experiences with telemedicine reveal challenges in quality of care and technical issues, emphasizing the need for comprehensive training and education. The review highlights the necessity for ongoing Continuing Medical Education, certification, and licensure standardization in telemedicine. It suggests a future where telemedicine is seamlessly integrated into healthcare systems, with physicians adept in its use through tailored, hands-on training experiences. To optimize the use of telemedicine in clinical practice, policies must focus on standardizing training and licensure, ensuring data security, and addressing reimbursement issues. Emphasis should be placed on developing clinical guidelines that adapt to the evolving landscape of telemedicine.

RAPID UREASE TEST POSITIVITY BY ENDOSCOPY IN ADULT PATIENTS WITH DYSPEPSIA IN A TERTIARY CARE HOSPITAL.

Dr . Deepak — 2024-03-31

Background:

Dyspepsia, a common gastrointestinal complaint among adults, necessitates efficient diagnostic methods for tailored treatment. The Rapid Urease Test (RUT) during endoscopy offers a cost-effective and prompt approach for identifying H. pylori infection, a prevalent cause of gastritis. This study evaluates the diagnostic value and clinical utility of RUT in adults with dyspepsia.

Methods:

A diagnostic study was conducted, enrolling 500 adult patients undergoing upper gastrointestinal tract endoscopy. Demographic data, indications for endoscopy, and endoscopic findings were collected. The RUT was performed using the RUT Test kit. Random positive samples were subjected to histopathological examination to see accuracy of the kit and significance of test accuracy was judged by statistical analyses.

Results:

In this study of 500 adult dyspeptic patients, a balanced gender distribution (54% vs 46%) with preponderance of rural background (66.7%) was observed. Common indications for endoscopy were pain abdomen, RUQ pain, and epigastric burning, with multifocal and mild antral gastritis being predominant endoscopic findings providing insights into dyspepsia and diagnostic methods. Other notable findings included esophageal and duodenal abnormalities, a history of hepatitis (25.6%), and chronic liver disease (15.5%). H. pylori infection was detected in 32.4% of cases on RUT. Sedation was administered in 39.1% of cases.

Conclusion:

The RUT during endoscopy is a valuable diagnostic tool for H. pylori-associated gastritis in dyspeptic patients. Its high sensitivity and specificity enable prompt and early targeted therapy for better outcome. We should consider RUT during endoscopy for dyspeptic patients, especially in populations with a high prevalence of H. pylori infection.

STUDY ON SERUM PROCALCITONIN AND SERUM C-REACTIVE PROTEIN IN PULMONARY TUBERCULOSIS PATIENTS, AND ITS ASSOCIATION IN A TERTIARY CARE HOSPITAL, ODISHA: A CROSS-SECTIONAL STUDY.

Surjya Shankar Meher — 2024-03-23

Background:

Pulmonary tuberculosis, a highly contagious bacterial lung infection, remains a significant global health issue. Given its prevalence and impact, this study seeks to analyze the baseline characteristics and distribution of Serum C-reactive protein (Sr. CRP) and Serum Procalcitonin (Sr. PCT) in individuals diagnosed with pulmonary tuberculosis (TB). Additionally, the research aims to elucidate the relationship between Sr. CRP and Sr. PCT levels in individuals with pulmonary TB.

Methods:

The research consisted of 50 adult individuals diagnosed with pulmonary tuberculosis, with 80% being male and 20% female. The study employed a hospital-based descriptive and cross-sectional study design to evaluate the baseline characteristics and distribution of Serum CRP and Serum PCT levels among the participants. Participation in the study was voluntary, and individuals were required to provide informed consent before being included in the research.

Results:

Among participants, females had a mean age of 29.70 years (±6.75, range: 21-40 years), while males had a mean age of 43.20 years (±11.88, range: 24-61 years). Sputum microscopy showed most cases at 2+ (50%). Hemoglobin, leukocyte count, CRP, Erythrocyte Sedimentation Rate, and Sr. PCT were significantly associated with Pulmonary Tuberculosis (p<0.001). Neutrophils peaked at 70 (26% of cases), and lymphocytes at 28 (18% of cases). CRP correlated positively with sputum microscopy (p=0.004) and Sr. PCT (p=0.001).

Conclusion:

The study findings indicate that the concentrations of Serum CRP and Serum PCT among the clinically diagnosed groups of study subjects showed a highly significant association. Moreover, there is evidence of a positive correlation between CRP and Sr. PCT levels, as well as between CRP and sputum microscopy results, in the context of pulmonary tuberculosis.

Recommendations:

Implement routine screening for serum CRP and PCT levels in diagnosed pulmonary TB patients, enhance TB awareness, and explore CRP and PCT as treatment biomarkers.

A RETROSPECTIVE STUDY ON NEUROPSYCHOLOGICAL AND AUTONOMIC OBSERVATIONS OF CASPR2-RELATED MORVAN SYNDROME.

Rashmi Singh — 2024-03-01

Introduction:

The defining feature of Morvan syndrome is cerebral, autonomic, and peripheral hyperexcitability; this is caused by the antibody against contactin-associated protein 2 (CASPR2). The study aimed to examine the cognitive, autonomic, electrophysiologic, polysomnographic, and clinical spectrum of Morvan syndrome patients associated with CASPR2.

Methods:

A retrospective study was conducted. Samples of serum and CSF positive for CASPR2 antibodies for three years were evaluated. Those with Morvan syndrome, identified by clinical and electrophysiologic basis, were among them.

Results:

Among the patients with Morvan syndrome, 28 (M: F = 10:4) had an onset of 37.1 ± 17.5 years. Clinical characteristics included spastic speech (4), dysphagia (4), behavioral abnormalities (4), seizures (2), cold intolerance (2), muscular twitching (24), sleeplessness (24), pain (22), paresthesias (18), hyperhidrosis (14), hypersalivation (12), double incontinence (6). Myokymia (24), hyperactive tendon reflexes (20), and tremor (12) were found during the neurologic examination. Neuromyotonia (24) and higher spontaneous activity (14) were seen on the EMG. Six cases of insomnia, two cases of absentee deep sleep, two instances of high-frequency beta activity, one point of REM behavior disorder, and one case of periodic leg movements were found in the polysomnography results of twelve patients.

Neuropsychological testing showed slight temporal and left frontal involvement. No cancers were identified during the workup. Each patient received steroids. Ten neuropathic pain patients had complete neurologic remission at follow-up.

Conclusion:

This work has advanced the understanding of Morvan syndrome linked to CASPR2. It is critical for greater awareness and early detection because immunotherapy may be able to treat it.

Recommendation:

Regularly get evaluated for the majority of common investigations, including brain MRIs, EEGs, PET scans, and CSF analyses. Individuals who should undergo regular evaluations are those presenting characteristic symptoms such as spastic speech, dysphagia, behavioral abnormalities, seizures, and neuromuscular issues.

A CROSS-SECTIONAL OBSERVATIONAL STUDY ON RURAL INSIGHTS: MATERNAL BODY METRICS, PRE-PREGNANCY BODY MASS INDEX, AND FETAL DEVELOPMENT.

Chandra Kiran — 2024-03-01

Background:

Understanding the association between maternal health and fetal development is crucial, especially in rural settings where healthcare and nutritional resources are often limited. This study explores the impact of maternal anthropometric measurements and pre-pregnancy Body Mass Index (BMI) on fetal growth parameters, focusing on a rural population to highlight unique challenges and patterns that might differ from urban experiences.

Methodology:

A cross-sectional study was conducted with 240 pregnant women in their first trimester. Comprehensive sociodemographic and anthropometric data were collected, and the study focused on maternal pre-pregnancy weight, height, and BMI as primary variables. Data analysis was performed using SPSS 17.0.

Results:

The study found no instances of macrosomia but noted a significant number of low birth weight (LBW) babies. Significant differences were observed in the mean pre-pregnancy weight and BMI (18.95 ± 1.75 kg/m² vs. 19.85 ± 2.80 kg/m², p=0.003) between the LBW and normal birth weight groups, indicating that lower maternal weight and BMI before pregnancy are related with a greater risk of LBW. Established correlations between maternal pre-pregnancy weight/BMI and neonatal metrics, along with sociodemographic data, highlighted the significant impact of low education and income levels on LBW risk, emphasizing socioeconomic factors' importance in maternal and fetal health.

Conclusion:

The study confirms the significant impact of maternal anthropometric measurements on neonatal outcomes, particularly in a rural context. It emphasizes the need for comprehensive maternal healthcare services focusing on nutrition and education to improve fetal growth outcomes.

Recommendations:

Policies and healthcare strategies should be tailored to meet the needs of rural populations, ensuring better maternal and child health. Future research should incorporate detailed dietary and health behavior data to elucidate the pathways linking maternal health to fetal outcomes and explore the impact of interventions targeting maternal nutrition and healthcare access.

PULMONARY TUBERCULOSIS AND IRON DEFICIENCY ANEMIA, IN A TERTIARY CARE HOSPITAL, ODISHA: A CROSS-SECTIONAL STUDY.

Debaranjan Das — 2024-03-01

Background:

Tuberculosis is a pulmonary infection that is a global health concern it affects a wide range of people worldwide. This infectious disease is contagious and spreads through droplets in the air.

Methods:

52 patients participated in this study 19 among them female and 33 were males. The study was conducted O.P.D. and I.P.D. in the P.G. department of Pulmonary, Hitech Medical College and Hospital, Bhubaneswar. In the period of 7 months from January 2023 to July 2023. This was a cross-sectional study in a hospital setting. The participants were analyzed for tuberculosis and hematological parameters. The data obtained was statistically analyzed and the correlation was determined.

Results:

Female patients' ages ranged from 21 to 64, averaging 31 years, while males were 28 to 85 years old, averaging 52. Approximately 45% had +1 sputum microscopy results. Significant associations with tuberculosis diagnosis were found in hemoglobin levels, leukocyte count, serum ferritin, iron levels, CRP, and total iron-binding capacity (p < 0.01). Neutrophil and lymphocyte counts peaked at 70 and 28, respectively. The study showed increased ferritin and CRP levels, indicating inflammation and infection, and a notable anemia prevalence, underscoring the need for an integrated treatment approach.

Conclusion:

The study reveals elevated ferritin and CRP levels, alongside a significant prevalence of anemia in tuberculosis patients, highlighting the disease's systemic impact. These findings advocate for incorporating hematological parameters in tuberculosis diagnostics, underlining the need for integrated treatment approaches to enhance patient care and outcomes.

Recommendation:

Anaemia is often associated with pulmonary tuberculosis. Iron supplementation can help in the management of tuberculosis with anemia.

Histopathological Analysis of Nasal Masses in Patients Visiting a Tertiary Care Hospital

Aman Buriuly — 2024-03-31

Background: Disorders of adenoidal space involve infection of viruses, bacteria, or fungus, adenoidal space cancer also swelling of adenoidal mucous membrane. The prime purpose of this study is to detect the association between clinical signs and cytopathological characteristics, to detect the commonness of several cancerous growths of adenoidal space, and nasal pharynx, and to contrast the cytology of several kinds of nasal polyp.

Methods Materials: The study was conducted in Rajendra Institute of Medical Science, Ranchi. 150 patients were included in this study and carried out for 1 year. Detailed history of the patients was recorded and cytological examination was done.

Results: 21 patients of age group 1-10 years had nasal polyps. 42 patients of the age range 11-20 years had nasal polyps, in the age range of 21-30 18 patients were present. 23 patients in the age range of 31-40 years had nasal polyps. 18 patients in the age range 41-50 years had nasal polyps. 10 patients in the age range 51-60 years had nasal polyps. 17 and 1 patients in the age range 61-70 years and 71-80 years had nasal polyps. 88 patients were male and 62 patients were female. 112 patients' surface epithelium was ulcerated and 38 patients' surface epithelium was non-ulcerated

Conclusion: In the current research, it is apparent that nasal and paranasal growths comprise a composite of structures that vary from the non – neoplastic reactive conditions to benign and malignant tumors. It is not possible to differentiate simple nasal growth only based on cellular infiltrate. All the cases with nasal growth are under histopathological evaluation because sometimes benign or malignant growths are also present as polyps.

Recommendation: In any kind of nasal or paranasal growths histopathological examination is important. Sometimes benign and malignant growths are also present which can be differentiated by histopathological examination.

A RETROSPECTIVE ANALYSIS OF CALCINOSIS CUTIS: A COMMON ENTITY AT UNCOMMON ANATOMICAL SITES.

Pallavi Mehra — 2024-04-08

Background

Calcinosis cutis can be defined as a condition of calcium salts deposition on the surface of the skin including the deepest layer called hypodermis. Many interesting medical data about calcinosis cutis are available in pathological and clinical literature. This condition can be subdivided into five types, they are dystrophic, metastatic, idiopathic, iatrogenic, and calciphylaxis. Among these types, dystrophic calcification is the major cause and it is interlinked with the levels of phosphorus and calcium.

Objective

This study aims to spotlight the numerous clinical and pathological characteristics of calcinosis cutis from various lesions in medical history.

Methods

A complete investigation of the clinical and pathological characteristics of calcinosis cutis in all the selected cases was performed. The type of the study was retro-prospective where the data of seven years i.e. from July 2016 to June 2023 were collected from the Department of Pathology, PMCH, and Patna.

Results

A total of 17 cases with the condition of calcinosis cutis were selected for the study. Among these, the sites of the lesion were different (from 1 mm to 5 cm) in measurements and location in a few patients. The scrotum was the common location of the lesion. The selection of treatment was “wide surgical excision”. The histopathological treatment was hardly challenging.

Conclusion

This study showcased various measurements and locations of the lesions site of the histopathological construction, and therefore this study spotlights the numerous clinical and pathological characteristics of calcinosis cutis from various lesions.

CYTOLOGICAL, ULTRASOUND AND BIOCHEMICAL CORRELATION IN HASHIMOTO’S THYROIDITIS, FARIDABAD, INDIA: A RETROSPECTIVE CROSS-SECTIONAL ANALYSIS.

Malika Mehta Aggarwal — 2024-03-31

Background

Hashimoto’s thyroiditis, an autoimmune disorder that impairs thyroid hormone production via antibody-mediated destruction of thyroid cells, affects women more frequently and presents symptoms like weight gain and fatigue. This study investigates the correlation between cytomorphological, biochemical, and radiological findings in diagnosing this condition, utilizing Fine Needle Aspiration Cytology (FNAC) as a key diagnostic tool.

Materials and methods

A retrospective analysis of cytological, radiological, and biochemical parameters was done for 84 patients who underwent FNAC for Hashimoto’s Thyroiditis. The blood concentration of thyroid hormones was evaluated by the Thyroid Function Test (TFT). Thyroid ultrasound was done using a high-frequency linear ultrasound transducer.

Results

This study found Hashimoto's thyroiditis more common in females (95%) and primarily in those aged 20-40 years. Biochemical hypothyroidism (Thyroid function test) was observed in 50% of the selected patients, euthyroidism was observed in about 43% of the patients, and hyperthyroidism was observed in 7 % of the patients. Cytological findings showed mild, moderate, and dense lymphocytic infiltration in 32.15%, 41.66%, and 26.20% of patients across Grades I, II, and III, respectively. Moreover, 51% of the patients were affected with diffuse thyroiditis, 35% of the patients were affected with goiter, 8% of the patients were affected with thyroid nodules, and the remaining 6% of the patients were seen to be normal in the ultrasound findings.

Conclusion

Hashimoto’s thyroiditis, characterized by reduced thyroid hormone production, links elevated biochemical results to higher grades in cytology. Early detection is possible through diffuse thyroiditis, even before clinical symptoms emerge.

Recommendation

For early detection and precise staging of Hashimoto’s Thyroiditis, integrating cytomorphological, biochemical, and radiological diagnostics is advised. Future research should aim at refining treatment strategies based on these findings.

CLASSIFYING SALIVARY GLAND LESIONS BASED ON MILAN'S SYSTEM FOR REPORTING SALIVARY GLAND CYTOPATHOLOGY AND EVALUATING THE RISK OF MALIGNANCY: A RETROSPECTIVE COHORT STUDY AT PRM MEDICAL COLLEGE & HOSPITAL, BARIPADA, INDIA.

Atanu Kumar Bal — 2024-03-31

Background

Fine needle aspiration cytology (FNAC) is a very vital mode in the detection for defects in salivary glands (SG). The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is classified into 6 groups which help the doctors to account for the chances of cancer in every group. The prime goal of this research is to utilize MSRSGC for the categorization of SG tumors.

Methods and materials

A retrospective cohort analysis was carried out at PRM Medical College & Hospital, Baripada. 200 patients were included having suspicion of salivary gland lesions in this research. After taking the patient history, sample for FNAC, histopathological findings, their pathological characteristics were examined and subjects were grouped as group 1 (Non-diagnostic), group 2 (Non-neoplastic), group 3 (Atypia of undetermined significance, group 4a (Neoplasm benign), group 4b (salivary gland neoplasm), group 5 (suspicious of malignancy), group 6 (Malignant).

Results

In this study, 110 male and 90 female subjects participated, with 30 under 20 years old, 80 aged 20-40, 44 aged 41-60, and 36 aged 61-80. Parotid gland involvement was predominant (119 cases), followed by the submandibular gland (60 cases) and minor salivary glands (21 cases). Salivary gland lesions were categorized via the Milan system as Group 1 (n=18), Group 2 (n=17), Group 3 (n=4), Group 4a (n=2), Group 4b (n=32), Group 5 (n=43), and Group 6 (n=84).

Conclusion

The responsiveness of 95% and precision of 98.9% to differentiate between non-cancerous and benign tumors and malignancy proclaimed the great correctness of SG fine needle aspiration cytology.

Recommendation

FNAC has great precision and responsiveness which differentiates benign and malignant tumors. Milan's system of categorization is also very effective and valuable.

A NARRATIVE REVIEW ON EVALUATING THE SAFETY OF JANUS KINASE (JAK) INHIBITORS IN DERMATOLOGICAL PRACTICE: A CLINICAL AND LABORATORY PERSPECTIVE.

Seeba Hussain — 2024-03-31

The introduction of Janus kinase (JAK) inhibitors has modernized the treatment of various dermatological conditions by targeting the JAK-STAT signaling pathway, essential in the pathogenesis of inflammatory and auto-immune diseases. Despite their therapeutic potential, concerns regarding their safety and tolerability necessitate a comprehensive review. To synthesize current knowledge on the safety and tolerability of JAK inhibitors in dermatology, focusing on adverse effects, to advise clinical practice and guide future research. A systematic literature search identified studies reporting on the adverse effects of JAK inhibitors in dermatological treatments. The review highlights common adverse effects, including infections, hematological changes, and increased risks of malignancies and cardiovascular events. Despite these concerns, JAK inhibitors are generally well-tolerated, with most adverse effects being manageable. Quality assessments of included studies indicate a moderate level of evidence, pointing to the need for ongoing surveillance and research. The findings underscore the importance of careful patient selection, monitoring, and management strategies to mitigate the risks associated with JAK inhibitor therapy. Further long-term studies are essential to fully understand the safety profile of these drugs and their impact on patient outcomes. The review supports the development of clinical guidelines for the use of JAK inhibitors, emphasizing risk assessment, patient education, and regular monitoring. It also highlights the need for post-marketing surveillance to capture real-world data on the long-term safety and efficacy of these treatments.

UNLOCKING THE INTRIGUING DERMOSCOPIC INSIGHTS INTO ACUTE CUTANEOUS LUPUS ERYTHEMATOSUS: A RETROSPECTIVE STUDY.

Seeba Hussain — 2024-03-31

Background

Acute Cutaneous Lupus Erythematosus is a significant manifestation of systemic lupus erythematosus (SLE), characterized by various dermatological symptoms. Dermoscopy has emerged as a valuable tool in the assessment of skin lesions, providing insights into the microvascular and morphological changes associated with ACLE. The study investigated and characterized the dermatoscopic features of acute cutaneous lupus erythematosus, aiming to enhance diagnostic accuracy and provide valuable insights into this condition.

Methods

Retrospective study aimed to investigate the dermatoscopic features of ACLE and their associations with clinical manifestations. Sixty patients diagnosed with ACLE, meeting the Systemic Lupus International Collaborating Clinics criteria for SLE, were included. A dermoscopic examination was conducted to identify characteristic features, and statistical analysis was performed to assess associations between dermatoscopic findings and clinical characteristics.

Results

In a study of 60 ACLE patients, dermatoscopic analysis revealed key features: scale crust in 80%, follicular plugs in 70%, erythema in all, dotted vessels in 60%, and linear vessels in 45%. Scale crust strongly correlated with malar rash, and follicular plugs with photosensitivity and oral ulcers, highlighting the diagnostic relevance of these dermatoscopic signs in ACLE.

Conclusion

The study highlights the diagnostic and prognostic implications of dermoscopy in ACLE, emphasizing its role in enhancing diagnostic accuracy and guiding personalized treatment strategies. Integration of dermoscopy into clinical practice can improve the understanding and management of ACLE, leading to better patient outcomes.

Recommendations

Dermoscopic examination should be routinely performed in patients with suspected or confirmed ACLE to facilitate early diagnosis and monitoring of disease activity. Training in dermoscopy for dermatologists and rheumatologists is recommended to enhance proficiency in recognizing and interpreting dermatoscopic features associated with ACLE. Further research is needed to validate the diagnostic utility of dermoscopy in larger patient cohorts and to explore additional dermatoscopic features that may aid in the management of ACLE.

TAILORING TREATMENT FOR ELDERLY PATIENTS WITH DISPLACED FEMORAL NECK FRACTURES: A NARRATIVE REVIEW.

Sunil Kumar — 2024-04-01

Background:

Displaced femoral neck fractures in the elderly pose significant medical and social challenges due to their association with high morbidity, mortality, and healthcare costs. The increasing incidence of these fractures, driven by global population aging and osteoporosis prevalence, underscores the urgent need for effective management strategies.

Objective:

This review aims to comprehensively analyze the management strategies for displaced femoral neck fractures in elderly patients, focusing on evaluating surgical treatments and rehabilitation methods.

Review Summary:

The review synthesizes evidence from studies assessing surgical interventions, rehabilitation strategies, and patient outcomes. Surgical management options, including THA and hemiarthroplasty, are evaluated in terms of functional outcomes, complication rates, and long-term durability. Rehabilitation strategies, such as home-based versus institutional-based rehabilitation, are analyzed for their impact on functional recovery and quality of life. Patient-specific factors influencing treatment decisions and future directions in fracture management are also discussed.

Future Implications:

The findings of the review have implications for enhancing clinical practice and improving outcomes in elderly people with displaced FNFs. Understanding the comparative effectiveness of surgical interventions and rehabilitation strategies can guide healthcare professionals in personalized treatment planning, ultimately leading to better patient outcomes and quality of life.

Clinical and Policy Development:

Clinical decision-makers can benefit from the review's insights when choosing surgical techniques and rehabilitation plans for senior patients with displaced femur neck fractures. These results can also be used by policymakers to develop protocols and guidelines that will optimize fracture management techniques and enhance the quality of care provided to this susceptible population

ASSESSING FUNCTIONAL OUTCOMES OF VARIOUS TREATMENTS FOR INTRA-ARTICULAR FRACTURES OF THE DISTAL RADIUS IN ADULTS, BHAGALPUR, INDIA: A RETROSPECTIVE CROSS-SECTIONAL STUDY.

Uday Shankar Bhagat — 2024-03-31

Background

Assessing the functional outcomes of various treatments for intra-articular fractures (IAF) of the distal radius in adults is crucial for optimizing patient care and recovery. The study objective was to estimate and compare the functional results of different treatment modalities utilized for IAF of the distal end of the radius in adult patients.

Methods

The retrospective study comprised a total of 80 adult patients. Data on demographic characteristics, fracture type, treatment modalities, postoperative complications, radiological outcomes, pain scores, and functional scores were gathered from medical records. Statistical analysis was accomplished using STATA-17 software.

Results

Among the 80 patients, 50% opted for conservative management, while the remaining 50% underwent surgical intervention, including pinning, external fixation, or plating. Surgical intervention was related to better functional outcomes compared to conservative management, with significant differences observed in functional scores (p < 0.05). However, no significant variation was recorded in pain scores among the two groups. Postoperative complications were observed in 22.5% of patients, predominantly in the plating group. Radiological union was achieved in the majority of cases, with a small percentage experiencing nonunion or residual deformities.

Conclusion

Surgical intervention, particularly pinning, external fixation, and plating, demonstrated superior functional outcomes compared to conservative management for IAF of the distal radius. Patient education and rehabilitation play crucial roles in enhancing functional recovery and compliance with postoperative protocols.

Recommendations

Surgeons should carefully select the appropriate surgical technique based on fracture characteristics and patient factors to optimize outcomes and minimize complications. However, the choice of surgical technique should be carefully considered to minimize postoperative complications and residual deformities. Emphasis should be placed on patient education and rehabilitation to ensure compliance with postoperative protocols and enhance functional recovery.

OPTIMIZING OUTCOMES IN UNDISPLACED FEMORAL NECK FRACTURES AMONG ELDERLY PATIENTS: A NARRATIVE REVIEW.

Abhishek — 2024-03-30

Background:

Femoral neck fractures (FNF) in the elderly represent a formidable clinical challenge, often resulting from low-energy incidents such as falls. The increasing incidence of osteoporosis and other age-related diseases that negatively impact treatment outcomes adds to the complexity of addressing these injuries. The particular concern with undisplaced fractures lies in achieving fracture healing while minimizing the risk of complications such as non-union and avascular necrosis.

Objective:

The review aims to synthesize current evidence on the treatment modalities for undisplaced FNFs in elderly patients, focusing on optimizing union rates and minimalizing the risk of avascular necrosis, to guide clinical practice and policy development.

Review Summary:

The comprehensive review highlights the crucial role of early, tailored surgical intervention in promoting fracture healing. Internal fixation remains the ideal treatment for non-displaced fractures in patients with good bone healing potential, whereas hemiarthroplasty and total hip arthroplasty are favored in cases with a high risk of avascular necrosis or in patients with pre-existing hip pathology. The significance of early postoperative rehabilitation and a multidisciplinary approach to care in enhancing recovery and functional outcomes is also emphasized.

Future Implications:

The insights gained underscore the need for further research into surgical innovations and rehabilitation strategies to improve outcomes for this vulnerable population. Future studies should aim at refining surgical techniques to reduce the incidence of complications and at developing comprehensive, patient-centered care plans.

Clinical Policy and Development:

The findings advocate for the integration of multidisciplinary care pathways and personalized treatment plans in clinical policies to address the holistic needs of older patients with undisplaced FNFs. Such policies should emphasize the importance of rapid surgical intervention, where appropriate, and the early initiation of rehabilitation programs.

ASSESSMENT OF FUNCTIONAL AND CLINICAL OUTCOME OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING IPSILATERAL AUTOLOGOUS HAMSTRING GRAFT- A PROSPECTIVE STUDY.

Nilesh Kumar Agrawal — 2024-03-31

Background

Anterior Cruciate Ligament Reconstruction using Autologous Ipsilateral Hamstring Graft is one of the commonest procedures performed for restoration of Knee Stability. The ACL is the main support of the knee joint and averts it against anterior movement. It also helps in preventing rotatory and valgus pressure. The chief goal of the present research is to investigate the functionality of ACL remodeling with conventional hamstring autograft.

Materials and Methods

This is prospective research that includes 40 subjects which was carried out in IGIMS, Patna, Bihar, India. The study was conducted for 1 year. The patients were utilizing the endo button and absorbable intervention screw to limit movement, post-surgery knee strength, and internal knee performance. Tegner Lysholm's knee scoring system was utilized for the evaluation of functioning results.

Result

The majority of the harm was caused by sports. The patients were followed up for 2 years after the surgery. Lysholm's score was upgraded postoperatively. All in all, fine outcomes followed after six months. The majority of the patients went back to their routine activity. 20 patients' injuries occurred on the right side and for the other 20 patients, injuries were on the left side. 24 patients had initial symptoms of lack of stability in the knee. 12 patients had pain and 4 patients suffered from locking.

Conclusion

In this research, it was deduced that arthroscopy-aided anterior cruciate ligament remodeling utilizing hamstring autograft gives stability to the knee, decreases post-surgery injuries, and provides speedy recovery. The outcomes regarding functionality are great, the patient activity becomes normal after some time and the patient can use the staircase easily.

Recommendation

Standard hamstring autograft is a great choice in the remodeling of the anterior cruciate ligament.

INVESTIGATING THE EFFICACY OF CONTACT LENS CULTURES IN IDENTIFYING PATHOGENS IN KERATITIS CASES: A RETROSPECTIVE COHORT STUDY.

Bhawna Kumari — 2024-03-31

Background

The incidence of microbial keratitis, a severe corneal infection, is increasingly prevalent among contact lens users. This study investigates the efficacy of different culture methods in identifying causative pathogens, a critical step for effective treatment, particularly when traditional corneal cultures are inconclusive or unavailable.

Methods

A retrospective analysis was conducted and involved 60 patients diagnosed with contact lens-related microbial keratitis. The methodology centered on the examination of cultures obtained from corneal scrapings, contact lenses, and lens cases. Additionally, demographic data, clinical treatment, outcomes, and antibiotic susceptibility patterns were analyzed. The data was also analyzed accordingly.

Results

Findings highlighted a higher rate of pathogen detection in contact lens and lens case cultures (43% and 36.7%, respectively) compared to corneal cultures (20%). The majority of infections were bacterial, with Pseudomonas spp. being the most prevalent. Antibiotic susceptibility testing revealed a high effectiveness of fluoroquinolones and aminoglycosides. Notably, the study observed a post-treatment preference shift from contact lenses to glasses in 60% of patients, indicating the significant impact of the infection on patient lifestyle choices.

Conclusion

This study underlines the importance of including contact lens and lens case cultures in the diagnostic process for microbial keratitis. The higher yield of pathogens in these cultures suggests their critical role in accurate pathogen identification.

Recommendations

Early clinical intervention and a comprehensive diagnostic approach are recommended for the effective management of contact lens-related microbial keratitis. Emphasizing patient education on lens hygiene and regular ophthalmological check-ups could also be crucial in prevention strategies.

Clinical outcome of Surgically treated acetabular fracture: A prospective study

Raman Kumar — 2024-03-31

Background: Fractures in the acetabulum usually require surgical intervention. The surgical procedure is to reduce the fracture and its fixation internally. Intraoperative and postoperative complication associated with the surgery makes the surgery challenging.

Method: This study was carried out prospectively at the Department of Orthopaedics, IGIMS, Patna for 4 years. In total 50 patients participated in the study. All of them had fractures in their acetabulum. They were treated with open reduction internal fixation surgery for their fractures. screws and plates were used for the reconstruction. The patients followed up for a period of 2 and a half years.

Results: In total 50 patients participated in the study, the outcome of the last follow-up showed that in 80% of the patients, the functional abilities of the hip bone were restored. As for the complications, osteoarthritis was found in 3 patients, Heterotopic ossification was reported in 2 patients, nerve injury in 1, dermal infection in 2, necrosis of the blood vessel in 2, and imperfect reduction in 1 patient.

Conclusion: Early treatment and longer follow-up improve the outcome of the reduction fixation irrespective of the age and bone health of the patients

Recommendation: Early diagnosis, treatment, and longer duration of effective follow-up improves the outcome of acetabular fracture reduction.

A RETROSPECTIVE COHORT STUDY ASSESSING MORTALITY RISKS IN PATIENTS WITH CRANIOMAXILLOFACIAL TRAUMA AND POLYTRAUMA USING THE INJURY SEVERITY SCORE (ISS) AND THE NEW INJURY SEVERITY SCORE (NISS).

Vinay Prabhat — 2024-03-31

BACKGROUND

There is no consistent difference in postoperative complications between early and delayed therapy for craniomaxillofacial trauma and polytrauma patients. Prognosis and fatality risk drive treatment selection. Two assessment scores, Injury Severity Score (ISS) and New Injury Severity Score (NISS) gauge trauma severity objectively, but their accuracy details remain scarce. Data on concurrent craniomaxillofacial trauma patients are limited, with conflicting conclusions among researchers.

OBJECTIVE

To determine and contrast the threshold (critical) values of the ISS and NISS evaluation scales that indicate the likelihood of a fatal outcome in patients suffering from polytrauma and craniomaxillofacial trauma.

MATERIALS AND METHODS

A retrospective analysis was conducted. Patients with facial bone fractures, soft tissue traumas, and concurrent injuries were included. Data on demographics, injuries, treatments, and outcomes were collected. ISS and NISS were calculated, and statistical analyses were performed to determine threshold values for predicting fatal outcomes.

RESULTS

Thirty patients were included, with assaults (43.3%), falls (20%), and motor vehicle accidents (16.7%) being the leading causes of trauma. Craniocerebral traumas (30%) and extremity traumas (23.3%) were common. Fifteen fatal cases (3%) were identified, with cerebral edema (73.3%) being the primary cause of death. Median ISS was 34 (25-41.5) for lethal cases and 4 (2-16) for the overall patient group. Median NISS was 48 (43-57) for lethal cases and 6 (3-22) for the overall patient group.

CONCLUSION

Both ISS and NISS show comparable efficacy in predicting the likelihood of fatal outcomes.

RECOMMENDATIONS

In specialized facilities, both signs could be routinely employed to evaluate patient status and prioritize the next steps in therapy.

GRAFT TYPE IMPLICATIONS IN POSTOPERATIVE CARE FOLLOWING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A NARRATIVE REVIEW.

Soman Kumar Chatterjee — 2024-03-31

Anterior cruciate ligament (ACL) reconstruction is a pivotal procedure for restoring knee stability and function in patients with ACL injuries. The choice of graft type—autograft, allograft, or synthetic—plays a critical role in the long-term outcomes of the surgery, influencing factors such as knee stability, the risk of osteoarthritis, and patient satisfaction. To systematically review and synthesize current literature on the long-term implications of different graft choices in ACL reconstruction, focusing on knee stability and function, osteoarthritis risk, and patient satisfaction. The review analyzed studies identifying significant differences in long-term outcomes associated with various graft types. Autografts, particularly patellar tendon and hamstring tendon grafts were generally associated with superior knee stability and function and lower osteoarthritis risk compared to allografts and synthetic grafts. However, the choice of graft did not significantly alter the risk of developing osteoarthritis. Patient satisfaction was highest among those receiving autografts, attributed to the perceived naturalness of the repair and the restoration of pre-injury activity levels. The findings underscore the need for future research to explore innovative graft materials and surgical techniques that could optimize long-term outcomes. Additionally, studies focusing on patient-centered outcomes and the psychological aspects of recovery could further inform clinical practice. The review highlights the importance of individualized graft selection in ACL reconstruction, considering patient-specific factors such as activity level, lifestyle, and personal preferences. Clinicians should incorporate evidence-based practices into their decision-making process, balancing the benefits and limitations of each graft type to optimize patient outcomes.

EFFECTS OF MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS (MIPO) ON PATIENTS WITH DISTAL TIBIA FRACTURES

Subhash Chand — 2024-04-01

Background:

Distal tibia fracture accounts for around 6-11% of tibia fractures. A distal tibia fracture is also known as a Pilon fracture. A distal tibia fracture is not easy to handle. The prime motive of this research is to examine the result of minimally invasive plate osteosynthesis for distal tibia fractures.

Materials and Methods:

This is retrospective research and was carried out in Pt JLN govt medical college, Chamba. 107 patients were included in this research. All the detailed history of the patients was recorded. Complete lesion detersion is first done. Advance soft tissue covering is performed if needed. Plates are arranged on the lateral side of the tibia. If it is required, extra cortical screw utilizing minimally invasive plate osteosynthesis.

Results:

70 patients were male and 37 patients were female. The majority of the patients were in the age range of 30-40 years. 13 patients were in the age range of 20-30 years. 45 patients were in the age range of 30-40 years. 40 patients were in the age group of 40-50 years. 9 patients were in the age range of 50-60 years.

Conclusion:

According to the present study minimally invasive plate osteosynthesis method does not affect blood circulation and therefore leads to low intervention with the hematoma and trauma recovery. The unification of the bone is also quick in minimally invasive plate osteosynthesis. The time required for the minimally invasive plate osteosynthesis method is very little and no special instruments are needed for this procedure.

Recommendation:

Minimally invasive plate osteosynthesis is a safe and useful method for the treatment of distal tibia fracture. It has great results with the early union of bone and mobility of the leg. The procedure is also less complicated and provides sufficient blood supply to the periosteum.

COMPARING PATELLAR RESURFACING VERSUS NON-RESURFACING TOTAL KNEE ARTHROPLASTY OUTCOMES: A PROSPECTIVE STUDY.

Kanhaiya Lal Gupta — 2024-03-31

Background

The use of patellar resurfacing in total knee arthroplasty (TKA) is still contentious. The study has sought to elucidate the differences in outcomes between patellar resurfacing and patellar non-resurfacing total knee arthroplasty procedures in individuals undergoing knee replacement surgery.

Methods

This prospective observational study conducted from July 2021 to July 2023, enrolled 140 patients aged over 50 years undergoing primary TKA for knee osteoarthritis. Based on predetermined criteria, patients were categorized into two groups: those undergoing patellar resurfacing and those not. Validated scoring systems were utilized to assess clinical outcomes, functional gains, and patient satisfaction. The visual analog scale (VAS) was employed to measure pain intensity. Version 21.0 of the SPSS program was used to conduct the statistical analysis.

Results

Following surgery, both groups (n = 70) showed a considerable increase in functional results, pain relief, and clinical outcomes. Additionally, both groups had high patient satisfaction rates—above 90%. On the other hand, neither the clinical nor functional Knee Society scores (p = 0.185) significantly differed between the two groups. In a similar vein, there was no discernible variation between the two groups' rates of pain relief (p = 0.215) or patient satisfaction (p = 0.467). The frequency of minor problems was similar in each group.

Conclusion

Both patellar resurfacing and non-resurfacing techniques yielded favorable outcomes in terms of clinical improvement, functionality, patient satisfaction, and pain reduction in individuals undergoing TKA for knee osteoarthritis. Resurfacing the patella should be decided individually, taking the patient's preferences and circumstances into account.

Recommendations

Further research is warranted to identify specific patient populations that may benefit most from patellar resurfacing or non-resurfacing techniques. Surgeons should weigh the potential benefits and drawbacks of each approach and tailor the treatment strategy accordingly.

A RETROSPECTIVE STUDY COMPARING RADIOLOGICAL AND FUNCTIONAL OUTCOMES OF VARIOUS TREATMENT OPTIONS FOR UNSOLVED FRACTURES IN THE ELDERLY: A STUDY OF FEMORAL NECK FRACTURES.

Mohammad Ekram — 2024-04-01

Background:

Femoral neck fractures in the elderly present a significant clinical challenge, requiring effective management strategies to optimize outcomes. This study aimed to evaluate and compare the radiological and functional outcomes of different treatment options for unsolved femoral neck fractures in the elderly population.

Methods:

A retrospective study design was employed over a 24-month period. Sixty participants meeting inclusion criteria underwent treatment for intracapsular femoral neck fractures. Demographic data, radiological findings, surgical techniques, and postoperative outcomes were collected and analyzed. Statistical analysis was conducted to compare outcomes between treatment groups.

Results:

The average age was 74.5 years, with a majority being female (66.7%). Treatment modalities included cemented bipolar hemiarthroplasty (41.7%), CC screw fixation (33.3%), and total hip arthroplasty (25.0%). Radiological assessments demonstrated satisfactory fracture reduction in 80% of participants undergoing cemented bipolar hemiarthroplasty, 75% in the CC screw fixation group, and 90% in the total hip arthroplasty group. Total hip arthroplasty showed superior functional outcomes, with higher Harris Hip Scores (HHS) and Modified Barthel Index (MBI) scores compared to other modalities. Complication rates were lowest in the total hip arthroplasty group (12%).

Conclusion:

Total hip arthroplasty emerged as the preferred treatment modality for unsolved femoral neck fractures in the elderly, offering superior radiological and functional outcomes with lower complication rates compared to cemented bipolar hemiarthroplasty and CC screw fixation.

Recommendations:

Clinicians should consider total hip arthroplasty as the primary treatment option for intracapsular femoral neck fractures in elderly patients, based on the findings of this study.

IMPACT OF OTHER MEDICAL CONDITIONS ON PAIN AND FUNCTIONALITY FOLLOWING TOTAL HIP ARTHROPLASTY: A PROSPECTIVE COHORT STUDY.

Vinay Prabhat — 2024-03-31

Background

Total hip arthroplasty is the procedure carried out for patients suffering from arthritis. Arthritis is a painful bone inflammation that severely affects the functional ability of the hip bone. Total hip arthroplasty helps in reduction of the painful inflammation and it also helps in restoring the functional ability of the hip bone

Method

This was a prospective study including individuals who underwent total hip arthroplasty at Rajendra Institute of Medical Sciences, Ranchi. The 30 patients participating in the study underwent the total hip arthroplasty. Patients were asked to follow up after 3 months, 6 months, 12 months, and 24 months of the surgery. Preoperatively, after the surgery and during the follow-up the hip bone was assessed using WOMAC score survey form 36.

Results

Comorbidities increased with age, affecting postoperative outcomes. Higher CCI values led to poorer functional improvements and more complications, sometimes necessitating conservative measures. Older patients and those with higher CCIs had higher complication rates and readmissions. CCI rose with age, from 0.29 for patients <40 to 5.42 for those >70. Significant improvements in WOMAC and SF-36 scores were seen at the third-month follow-up, but higher CCI patients declined after six months. Patients with CCI >3 had three surgical complications, while CCI 2 patients had two complications related to infection. No complications occurred in patients with CCI 0 and 1, but one patient with a higher CCI died.

Conclusion

From this study, it was found that the occurrence of comorbidity after the THA significantly decreased patient satisfaction. Also, the higher preoperative CCI resulted in the occurrence of comorbidity, delayed improvement, decreased recovery, increased rate of readmission, and decreased satisfaction of the patient.

Recommendation

This association can guide clinicians in taking appropriate steps to intervene in the occurrence of comorbidities and treatment of the comorbidities to improve patient satisfaction.

A COMPARATIVE OBSERVATIONAL STUDY OF CEMENTED VS. UNCEMENTED TOTAL HIP ARTHROPLASTY: ASSESSING FUNCTIONAL OUTCOMES.

Kumar Rahul — 2024-03-31

Background

Total hip arthroplasty (THA) is a common surgical procedure to address hip joint degeneration and related conditions. The choice between cemented and uncemented THA is a matter of debate, influenced by patient characteristics and surgical preferences. This study aims to compare the functional outcomes of cemented and uncemented THA to provide insights into their effectiveness.

Methods

This hospital-based, comparative observational study included 50 cases randomized into Group A (cemented THA) and Group B (uncemented THA). Participants aged 50-80 years with THR indications were selected. Data on demographics, medical conditions, and surgical history were collected. Follow-up assessments were conducted at 6 weeks, 3 months, 6 months, and 2 years post-surgery, measuring pain scores and Harris Hip Scores (HHS). Statistical analysis was performed to compare outcomes.

Results

Group A showed superior early pain relief and function at 6 weeks and 3 months post-surgery, but these differences became statistically insignificant at 6 months. Both groups achieved comparable long-term hip function, with no radiological evidence of complications. Surgical complications were minimal, and a majority of patients in both groups achieved excellent or good HHS scores.

Conclusion

Cemented and uncemented THA approaches offer viable options for patients. While cemented THA initially provides advantages in pain relief and function, uncemented THA ultimately yields similar long-term outcomes. Individual patient factors and preferences should guide the choice between these techniques.

Recommendations

Surgeons and patients should consider individual factors, such as age and bone quality, when deciding between cemented and uncemented THA. Further research with extended follow-up periods is warranted to comprehensively assess long-term outcomes.

COMPARING THE RESULTS OF TOTAL KNEE ARTHROPLASTY BETWEEN POSTERIOR CRUCIATE LIGAMENT SUBSTITUTION METHOD AND RETENTION METHOD, VISAKHAPATNAM, INDIA: A PROSPECTIVE STUDY.

Kola Sagar — 2024-03-19

Background:

During arthroplasty, the cruciate ligament is either removed or kept in place because it is vital to the knee's kinematics. There are conflicting results; in some studies, the preserved cruciate ligament is found to improve bone function, while in other studies, the substituted cruciate ligament is found to improve knee function.

Method:

This was a prospective comparative study conducted at the NRI Institute of Medical Sciences, Sangivalasa, Bheemunipatnam from January 2022 to January 2024. In total 40 patients participated in the study. 20 patients underwent cruciate retaining arthroplasty and the other 20 patients underwent cruciate substituting arthroplasty. Postoperatively the knee was examined radiologically, and the pain score, swelling, redness, and difficulty in motion were assessed during follow-up after .2, 4, and 12 weeks.

Results:

The clinical outcomes and WOMAC score obtained for the knee of the patients in both groups were compared statistically and the p-value was more than 0.05, indicating that the difference in the values obtained from both groups was not statistically significant (p=0.07).

Conclusion:

In this study, it was found that TKA performed by the PCL retaining method and PCL substituting method do not have significant differences in the clinical outcome.

Recommendation:

Comparative studies on the TKA by PCL retaining and PCL substituting method should be done with a longer duration of follow-up and a larger sample size of the population. Also, the study of TKA for different pathological conditions should be considered.

A COMPARATIVE RETROSPECTIVE STUDY: BIOABSORBABLE MAGNESIUM SCREW VERSUS TRADITIONAL TITANIUM SCREW FIXATION IN TREATING MEDIAL MALLEOLAR FRACTURES.

Uday Shankar Bhagat — 2024-03-23

Background

The management of medial malleolar fractures has evolved with the emergence of bioabsorbable magnesium screws as an alternative to traditional titanium screws, driven by concerns about hardware removal surgeries due to magnesium's potential for gradual degradation within the body. The study aimed to compare bioabsorbable magnesium screw fixation with traditional titanium screw fixation for treating medial malleolar fractures, assessing outcomes to determine magnesium screws' potential advantages in promoting healing and functional recovery.

Methods

This retrospective study compared bioabsorbable magnesium screw fixation with traditional titanium screw fixation for treating medial malleolar fractures. Eighty patients meeting inclusion criteria underwent operative treatment. Data on demographics, fracture characteristics, radiological assessments, clinical outcomes, and complications were collected and analyzed using statistical methods.

Results

Most of the patients presented with isolated medial malleolar fractures (75%). Fracture union rates were comparable between the two groups, but the magnesium screw fixation group exhibited a substantially lower incidence of malunion (6% vs. 20%, p=0.041) and superior functional outcomes as assessed by the AOFAS Ankle-Hindfoot scale (p=0.019). Although complication rates were lower in the magnesium group, the variation was not statistically relevant. Serial imaging showed progressive degradation of bioabsorbable magnesium screws over time.

Conclusion

Bioabsorbable magnesium screw fixation demonstrated comparable fracture union rates with titanium screws while offering advantages such as lower malunion rates and better functional outcomes. The gradual degradation of magnesium screws suggests potential benefits in reducing the need for hardware removal surgeries and minimizing long-term complications. These findings support the utility of magnesium-based fixation in medial malleolar fractures.

Recommendations

More prospective studies with larger sample sizes and longer follow-up times are recommended to validate findings and investigate screw breakdown rate and bone healing. Comparative biomechanical and long-term investigations of magnesium-based fixation are needed for clinical assessment.

A RETROSPECTIVE EVALUATION OF TREATMENT STRATEGIES FOR UNSTABLE INTERTROCHANTERIC FEMORAL FRACTURES IN THE ELDERLY: COMPARING PROXIMAL FEMORAL NAIL ANTI-ROTATION VERSUS PRIMARY HIP HEMIARTHROPLASTY.

Subhash Chand — 2024-03-31

Objectives

The present investigation aims to contrast the outcomes of proximal femoral nail anti-rotation (PFNA) and primary hemiarthroplasty for treating unstable intertrochanteric femoral fractures in geriatric patients, focusing on functional outcomes, complication rates, and postoperative rehabilitation protocols.

Methods

The retrospective study, conducted at Pt. JLN Govt. Medical College, Chamba, Himachal Pradesh, contrasted the outcomes of proximal femoral nail anti-rotation (PFNA) and cemented hemiarthroplasty for unstable intertrochanteric femoral fractures (IFFs). Patients with American Society of Anesthesiologists (ASA) Grades II and III, aged over 65 years, in addition to having AO types A2 and A3 fractures were included in this study. Surgical procedures involved PFNA device insertion or hemiarthroplasty, followed by standardized post-operative protocols.

Results

The comparative analysis between the PFNA group (n = 50) and the Primary Hemiarthroplasty of the Hip (PHH) group (n = 43) revealed significant differences in treatment outcomes. Notably, the PFNA group exhibited a higher Harris Hip score at the 12-month follow-up (90.26 vs. 82.4, p = 0.016), with a larger proportion achieving excellent outcomes (36 vs. 23). Moreover, secondary outcomes, including surgical time, intra-operative blood loss, post-operative hemoglobin levels, and duration of hospital stay, favored the PFNA group, showing statistically significant differences (p < 0.00001, except for perioperative blood transfusions, p = 0.00536).

Conclusion

The findings of the investigation implied that PFNA fixation gives rise to superior clinical outcomes when compared to PHH for unstable intertrochanteric femoral fractures. This has been proven by the identification of better functional scores and reduced post-operative complications in the case of patients treated with PFNA.

Recommendation

The study recommends prioritizing PFNA fixation over primary hemiarthroplasty for unstable intertrochanteric femoral fractures based on superior functional outcomes and fewer post-operative complications.

CLINICAL OUTCOME OF SURGICALLY TREATED ACETABULAR FRACTURE: A PROSPECTIVE STUDY.

Raman Kumar — 2024-03-30

Background:

Fractures in the acetabulum usually require surgical intervention. The surgical procedure is to reduce the fracture and its fixation internally. Intraoperative and postoperative complication associated with the surgery makes the surgery challenging.

Method:

This study was carried out prospectively at the Department of Orthopaedics, IGIMS, Patna for 4 years. In total 50 patients participated in the study. All of them had fractures in their acetabulum. They were treated with open reduction internal fixation surgery for their fractures. screws and plates were used for the reconstruction. The patients followed up for a period of 2 and a half years.

Results:

In total 50 patients participated in the study, the outcome of the last follow-up showed that in 80% of the patients, the functional abilities of the hip bone were restored. As for the complications, osteoarthritis was found in 3 patients, Heterotopic ossification was reported in 2 patients, nerve injury in 1, dermal infection in 2, necrosis of the blood vessel in 2, and imperfect reduction in 1 patient.

Conclusion:

Early treatment and longer follow-up improve the outcome of the reduction fixation irrespective of the age and bone health of the patients

Recommendation:

Early diagnosis, treatment, and longer duration of effective follow-up improves the outcome of acetabular fracture reduction.

The Dry needling versus steroid injections in plantar fascitis : A metaanalysis

Dr Lal Bahadur Prasad — 2024-03-31

Introduction: Plantar fasciitis is a prevalent condition causing heel pain in adults, particularly affecting individuals in the age group of 40-60 years, and stands as a significant contributor to occupational impairment. Treatment options can be broadly categorized into non-invasive and invasive modalities. Invasive modalities, such as local injections and surgical interventions, are recommended for individuals who do not respond to non-invasive conservative treatments. Local Steroid Injection (LSI) is the prevalent invasive treatment method, while Dry Needling (DN) has emerged as a novel treatment modality more recently.

Aim : The aim of this systematic review is to critically analyze the literature to ﬁnd the effect of dry needling when compared with corticosteroid injection in treating Plantar Fascitis.

Method: This systematic review was directed according to “Preferred Reporting Items for Systematic Reviews and Meta-analysis”

guidelines. The principal research question that was studied “Is dry needling better than corticosteroid injections in treating plantar fascitis?” Various different electronic databases were used to search relevant articles using different keywords. Articles were collected altogether and selected on the basis of eligibility criteria. The closing sets of articles were selected after complete screening.

Result: Both dry needling and corticosteroid injections are effective in treating tendinopathy for both short term whereas dry needling is more signiﬁcantly effective in long-term use.

Conclusion: Dry needling is superior to corticosteroid injection in treating plantar fascitis.

A PROSPECTIVE COMPARATIVE COHORT STUDY: FUNCTIONAL RESULTS OF INTERTROCHANTERIC FEMUR FRACTURES TREATED WITH DYNAMIC HIP SCREW VERSUS PROXIMAL FEMORAL NAIL, BHAGALPUR, INDIA.

Kanhaiya Lal Gupta — 2024-03-31

Background

Dynamic Hip Screw (DHS) and Proximal Femoral Nail (PFN) are two commonly used devices for managing intertrochanteric femur fractures (ITF), each with its advantages and limitations. Understanding their relative efficacy is essential for informed treatment decisions. The study aims to compare the functional outcomes of intertrochanteric femur fractures managed with DHS versus PFN.

Methods

A prospective comparative cohort study was carried out from July 2021 to July 2023. One hundred participants with ITF were enrolled, with equal distribution between the DHS and PFN treatment groups. Demographic data, fracture classifications, surgical details, functional outcomes, complications, and radiographic assessments were recorded. Statistical analysis was achieved to compare outcomes between the two groups.

Results

The mean age of participants in the DHS group was 72 years, while in the PFN group, it was 69 years, with no significant difference observed. Fracture classifications and surgical durations were comparable between groups. Functional outcomes, assessed using the Harris Hip Score (HHS) at 3, 6, and 9 months post-surgery, showed similar improvement trends with no significant variation between DHS and PFN groups. Complication rates and rates of radiographic union were also similar.

Conclusion

Both DHS and PFN fixation techniques demonstrated comparable efficacy in promoting functional recovery and fracture healing for intertrochanteric femur fractures. The choice between the two methods should be based on individual patient factors, fracture characteristics, and surgeon preference.

Recommendations

Further research should explore long-term outcomes beyond the 9-month follow-up period, including patient-reported quality-of-life measures. Randomized controlled trials with larger sample sizes may provide additional insights into the optimal management of intertrochanteric femur fractures. Surgeons should consider factors such as fracture stability, bone quality, and patient comorbidities when selecting the most appropriate fixation device.

COMPARATIVE ANALYSIS OF FUNCTIONAL AND RADIOLOGICAL OUTCOMES BETWEEN PROXIMAL FEMORAL NAIL ANTI-ROTATION 2 AND CONVENTIONAL PROXIMAL FEMORAL NAIL AT SCHOOL OF MEDICAL SCIENCE AND RESEARCH, SHARDA UNIVERSITY GREATER NOIDA: A PROSPECTIVE OBSERVATIONAL STUDY.

faizan khalid Shah — 2024-03-01

Introduction

The PFNA (Proximal Femoral Nail Antirotation) was developed to achieve improved stabilization of the femoral head and neck. The PFN (Proximal Femoral Nail) is a well-established treatment approach for proximal femoral fractures. A more recent alternative in the management of such fractures is the PFNA2 (Proximal Femoral Nail Anti-rotation 2), which incorporates a helical blade for improved bone compaction.

Aim and objectives

To evaluate the surgical and functional outcomes associated with the use of PFN and PFNA2 for the treatment of these fractures.

Material and methods

Following ethical clearance from the Ethical Committee of Sharda University, we conducted a prospective observational study involving 50 patients who were admitted to the School of Medical Science and Research, Sharda University and Medical College Greater Noida, India. The inclusion and exclusion criteria were applied to select eligible patients between Sept 2022 and Sept 2023.

Result

in the PFN group, out of the 25 study subjects 11 cases had fair modified Harris hip scores, 9 cases had good Harris hip scores, and 5 subjects had excellent modified Harris hip scores. In the PFNA2 group, out of 25 study subjects, 14 had a good modified Harris hip score, 6 had an excellent modified Harris hip score and 5 had a fair modified Harris hip score.

Conclusions

PFNA2 emerges as the preferred implant choice for elderly patients with osteoporotic bone, as it offers several advantages. Its shorter operative time is particularly beneficial for patients who may have medical comorbidities, making it a marginally superior option over PFN.

Recommendation

A larger sample size with a longer follow-up period and a multicentric approach would have provided a more comprehensive assessment of the long-term outcomes of this clinical issue

A RETROSPECTIVE COHORT ANALYSIS: NEUROLOGICAL COMPLICATIONS IN PAEDIATRIC SCORPIONISM CASES, BIHAR, INDIA.

Sanjay Kumar — 2024-03-31

Background

Scorpion stings pose a significant public health concern, particularly among vulnerable populations such as children. Neurological complications resulting from scorpion envenomation can range from mild to severe, necessitating comprehensive understanding and management strategies. This retrospective study investigated the incidence, nature, and outcomes of neurologic complications in pediatric patients.

Methods

The study comprised of 130 children diagnosed with scorpionism. Data were collected from medical records, including demographic information, Glasgow Coma Scale (GCS) scores, clinical presentations, and therapeutic interventions. Statistical analysis was performed using SPSS version 20.

Results

The mean age of the participants was 10.5 years, with a male predominance (65%). Local signs (Class I) were observed in 45% of cases, followed by systemic symptoms (Class II) in 35% and severe complications (Class III) in 20%. Neurological manifestations were present in 40% of cases, with disturbed consciousness levels (15%) and convulsions (10%) being common. Priapism was reported in 5% of male patients. All patients received antivenin and supportive care, with 80% initially managed in the intermediate care unit. Laboratory investigations revealed elevated creatine phosphokinase levels (30%) and hepatic abnormalities (15%). Pulmonary edema (10%) and shock (8%) were documented. Statistical analysis indicated significant associations between scorpionism severity and neurological manifestations (p < 0.05).

Conclusion

Paediatric scorpionism presents diverse clinical manifestations, including neurological complications, which warrant prompt recognition and management. Despite the severity of envenomation, favorable outcomes were achieved with appropriate therapeutic interventions. Continued efforts in awareness, education, and research are essential for enhancing the management of scorpion envenomation.

Recommendations

Enhanced public and healthcare provider education regarding scorpion envenomation, timely administration of antivenin, and standardized management protocols are recommended to mitigate the impact of pediatric scorpionism.

DETERMINANTS OF MALNUTRITION IN HIV-EXPOSED AND POSITIVE CHILDREN AGED 3 MONTHS -12 YEARS AT BOMBO GENERAL MILITARY HOSPITAL, LUWERO DISTRICT; A CROSS-SECTIONAL STUDY.

ABBY SOLOMON SEBULIBA — 2024-03-16

Background

The main objective of the study was to investigate the determinants of malnutrition in HIV-positive children aged 3 months to 12 Years at Bombo General Military Hospital, Luwero District.

Methodology

A cross-sectional descriptive study design was employed, utilizing both qualitative and quantitative data collection methods.

Study results

In line with whether parents were staying with the child, results showed that the vast majority (92.65%) agreed while (7.35%) disagreed. Regarding the child's health history, a substantial portion (29.41%) of the children had experienced long-term diseases, while the majority (70.59%) had not. As for hand washing before serving food, a significant number (91.18%) reported doing so, while 8.82% did not.

Conclusion

Individual-related factors included age distribution, gender balance, the impact of parental status, and the importance of caregiver support. Environmental factors were also scrutinized, highlighting the importance of healthcare access and delivery. While a majority lived near healthcare centers, access challenges were evident, emphasizing the need for improved healthcare services. A significant portion of children had experienced long-term diseases and delayed treatment, signaling the urgency of enhancing healthcare delivery. Health system-related factors included clean water access (41.18% from taps) and hygiene practices (88.24% hand washing after latrine use, 91.18% before serving food).

Recommendation

Shortly, the Government of Uganda through the Ministry of Health should enhance Pediatric Nutrition Programs by developing and implementing targeted nutrition initiatives tailored to the diverse age groups of HIV-exposed and positive children, with a specific emphasis on early childhood nutrition (1 year to 5 years). Collaborations with healthcare facilities will be fostered to ensure the provision of comprehensive nutritional counseling and support.

ETIOLOGY AND OUTCOME OF CONGESTIVE HEART FAILURE IN CHILDREN IN A TERTIARY CARE HOSPITAL OF JHARKHAND.

Chhitiz Anand — 2024-03-31

Background:

Congestive heart failure (CHF) is an important, growing public health problem causing substantial morbidity and mortality in paediatric patients. The causes vary between developed and developing countries, age and geographical location. Congenital heart diseases and cardiomyopathy are the most common offenders in developed countries, while infections and anaemia are more common in developing areas.

Objective:

To determine the etiology and outcome of Congestive heart failure in the department of Paediatrics, SBMC, Hazaribagh.

Methods:

This is a descriptive, cross-sectional retrospective study using medical records of the included patients (diagnosed with heart failure), from august 2021 to July 2023.

Results:

Study includes 82 patients. The mean age at presentation of these patients was 13.72 months. The female: male ratio was 1.1:1 with mild female predominance. Most of the patients were in the first year of life 75.6%.

Conclusion:

We found that common causes of heart failure were heart diseases; representing (87.8%), while non cardiac causes were 12.2%. Congenital heart diseases were detected in 77.8%, while acquired heart diseases represented 22.2 %. The most common congenital cause of heart failure in the study was ventricular septal defect followed by patent ductus arteriosus (PDA), dilated cardiomyopathy (DCM), myocarditis and anaemia with chest infection in that order. Overlapping causes were present in 16 cases (19.5%). Twelve patients died during the study; this constituted a mortality rate of 14%.

KNOWLEDGE, ATITTUDE AND PRACTICES TOWARDS PREVENTION AND CONTROL OF DIARRHEA DISEASES AMONG CHILDREN UNDER 5 YEARS AT PEADIATRIC WARD RAKAI GENERAL HOSPITAL RAKAI DISTRICT. A CROSS SECTIONAL STUDY.

PHIONAH NALUYIMA — 2024-03-04

Background

The broad objective was to examine the knowledge attitude and practices of caretakers towards the prevention and control of diarrhea among children under five years at the pediatric ward of Rakai Hospital in Rakai district.

Methodology

The cross-sectional study was carried out on all caretakers of children less than five years at Rakai General Hospital. The Questionnaire was used to collect data and was analyzed using a tally; the sample size of 62 respondents also was analyzed using tables and pie charts.

Results

The study revealed that majority 48.3% of the respondents had good knowledge on contaminated food/water as the cause of diarrhea in children under five years, 87.1% had good knowledge on general weakness, failure to feed, irritability, vomiting everything as the consideration to their children for treatment, 18% of the respondents had poor knowledge on treatment of diarrhea at home, 20% respondents had poor knowledge on what is needed to make ORS, 18% respondents had poor knowledge on how to prevent diarrhea in their children, 61.8% respondents poor attitude on exclusive breastfeeding.

Conclusion

The study concluded that mothers had good knowledge of the causes of diarrhea among children under five years and identified the danger signs. 18.0% had poor knowledge of how to treat diarrhea at home, the requirements to make ORS and how to prevent diarrhea in their children.

Recommendation

Consequently, the study suggests that caregivers should get ongoing health education on how to treat diarrhea at home, what's needed to create ORS, how to stop diarrhea in children, and how to breastfeed children who have diarrhea.

EXAMINING NEUROLOGICAL COMPLICATIONS IN PAEDIATRIC MOYAMOYA DISEASE PATIENTS FOLLOWING GENERAL ANAESTHESIA, PATNA: A RETROSPECTIVE COHORT ANALYSIS.

Sanjay Kumar — 2024-03-31

Background

Moyamoya disease (MMD) is a rare cerebrovascular disorder characterized by arterial narrowing, particularly affecting paediatric populations. General anaesthesia in paediatric MMD patients presents challenges due to the risk of neurological complications. This study investigates the incidence and factors associated with neurological complications in paediatric MMD patients undergoing general anaesthesia.

Methods

A retrospective analysis was carried out on 130 paediatric MMD patients who underwent general anaesthesia. Demographic characteristics, preoperative status, surgical procedures, anaesthetic management, intraoperative events, and postoperative neurological complications were analyzed. Statistical tests (logistic regression analysis or chi-square testing), were used to identify correlation between variables using SPSS version 20.0.

Results

The cohort had a mean age of 8.5 years, with 85% presenting ischemic symptoms. Revascularization procedures were predominant (90%), with 15% encountering intraoperative complications. Postoperatively, 20% experienced neurological complications, most commonly transient ischemic attacks (10%). Significant associations were found between intraoperative hemodynamic instability and prolonged surgical duration with a raised risk of postoperative neurological complications.

Conclusion

Paediatric patients with MMD undergoing general anaesthesia are at risk of neurological complications, particularly with prolonged surgeries and intraoperative hemodynamic instability. Optimal perioperative management strategies are essential to mitigate these risks and improve patient outcomes.

Recommendations

Multidisciplinary collaboration, meticulous intraoperative monitoring, and tailored anaesthetic management are recommended to optimize outcomes in paediatric MMD patients undergoing general anaesthesia.

PREVALENCE OF CELIAC DISEASE AMONG CHILDREN WITH SHORT STATURE IN A TERTIARY CARE HOSPITAL.

Rajiv Kumar Mahli — 2024-03-31

Back ground:

Celiac disease (CD) is the most common genetically related food intolerance worldwide and is triggered by a well-identified environmental factor (gluten and related prolamines present in wheat, rye, and barley), and the autoantigen is also well known (i.e., the ubiquitous enzyme tissue transglutaminase).

Methods:

A retrospective cross sectional study was carried out at the department of Pediatrics, SBMC, Hazaribagh. All children who were evaluated for short stature in a period between November, 2021 to October, 2023 were included in the study as per inclusion criteria. Their medical documents were retrieved from the medical records section and analyzed. Enzyme immunoassay was used to determine IgA tTG using microplate tests as per standard unit protocol and those children with concentrations >20U/mL were defined as positive. Patients with positive anti-tTG serology had also been subjected to endoscopy and biopsy as per standard celiac disease work up.

Results:

Medical documents of 103 patients with short stature were evaluated. 40 of them were included in our study according to inclusion criteria; 26(65%) were female and 14 (35%) were male. Median age was 9 years (from 2 - 18 years).The anti-tTG assays were positive in 20% of patients (8/40). Out of 8 patient who had positive titres of anti-tTG, 6 (75%) were diagnosed as celiac disease by endoscopy and biopsy according to modified Marsh classification. All children diagnosed to have celiac disease were kept on a gluten-free diet. Follow-up anthropometric data for six months as recorded in medical documents were analyzed and showed improvement in growth rates.

Conclusion:

Celiac disease is a cause of short stature that should be included in diagnostic investigations of short stature.

FACTORS CONTRIBUTING TO HIV TRANSMISSION AMONG CHILDREN BELOW 12 YEARS ATTENDING HIV CLINIC AT MPIGI HEALTH CENTRE IV, MPIGI DISTRICT, UGANDA

RICHARD KAVUBU — 2024-03-31

This study explored the factors contributing to the transmission of HIV among children below 12 years in Mpigi, Uganda. Human Immunodeficiency Virus (HIV) is a retrovirus that damages the body’s immune system and weakens its ability to fight opportunistic infections and diseases (NHS, 2021). HIV infection remains a major global public health problem and particularly in low and middle-income countries (Osório, Munyangaju, Nacarapa, Muhiwa, Nhangave, Ramos, 2021). Of the estimated 36.7 million people living with HIV worldwide, 69.4 percent live in sub-Saharan Africa (UNICEF, 2020; UNAIDS, 2019). Worse still, an estimated 2.1 million children are living with HIV/AIDS worldwide, with more than 80% of them living in sub-Saharan African countries (UNAIDS, 2019) .

KNOWLEDGE, PRACTICES, AND ATTITUDE TOWARDS NEWBORN CARE BY THE MOTHERS AGED 18-49 YEARS IN THE POSTNATAL WARD AT RUKUNYU HOSPITAL IN KAMWENGE DISTRICT. A CROSS-SECTIONAL STUDY.

Innocent Tumushabe — 2024-03-01

Introduction

Essential newborn care refers to a series of time-bound and chronologically ordered care that a baby receives at birth and early days of his or her life.

Objectives of the study

The main objective was to determine the knowledge, practices, and attitudes towards newborn care by mothers aged 18-49 years in the post-natal ward at Rukunyu Hospital in Kamwenge district.

Methodology

A cross-sectional descriptive study design was used while using a quantitative approach at the post-natal ward of Rukunyu Hospital in Kamwenge district. The researcher conveniently sampled 96 respondents from 18th June 2023 to 30th July 2023. Data was collected using self-administered questionnaires.

Results

Of the 96 respondents, the majority (90.6%) had heard about newborn care and all of the mothers (100%) accepted that newborn care was very important and that all babies should receive this essential care. Furthermore, 68.8% of the mothers agreed to the fact that essential newborn care practices are 100% effective in ensuring infant’s survival and well-being in their initial days of life. Finally, the respondents’ attitude towards newborn care was generally good because all mothers (100%) agreed that all newborns should be taken good care of.

Conclusion

The study generally revealed that at least many mothers have learned some of the common essential newborn care practices especially exclusive breastfeeding (87.5%), provision of warmth (96.9%), and bathing neonates(93.7%) but still have a challenge with performing other practices, especially cord care(84.4%) due to knowledge gap.

Recommendation

Government through the Ministry of Health should increase public sensitization about newborn care practices. More of the recommendations are presented in chapter five of this report.

FACTORS ASSOCIATED WITH NEONATAL SEPSIS AMONG NEONATES AT KISENYI HEALTH CENTRE IV IN KAMPALA DISTRICT. A CROSS-SECTIONAL STUDY.

Angellah Wanjjiro — 2024-03-01

Background

Neonatal sepsis is a systemic bacterial illness that affects neonates under the age of 28 days with or without bacteremia and in Uganda, 18.2% of the 19 per 1000 neonatal deaths are contributed by neonatal sepsis affecting the progress in improving maternal and child health. The purpose of the study was to determine the factors associated with neonatal sepsis among neonates in Kisenyi Health Centre IV, Kampala District.

Methods

The study used a descriptive cross-sectional study design that used quantitative data collection methods. A simple random sampling method was used to select 40 respondents. Data was analyzed and presented using Microsoft Excel 2013 that presented it in the form of frequency tables, pie charts, and graphs.

Findings

The findings of the study on maternal factors associated with neonatal sepsis were; that 70% had never attended antenatal care, 80% had untreated UTI during pregnancy and 60% had bathed the baby with herbs. Neonate-related factors included; 60% had babies born before 8 months and 70% had second to fifth order. Health facility–related factors; 60% had more than three vaginal examinations, 70% had not received antibiotics before delivery and 90% reported that wards were congested.

Conclusion

The study concluded that factors associated with neonatal sepsis were maternal factors, neonate-related, and health facility-related factors. Therefore, health education on appropriate neonatal care practices and adjustment of the quality of maternal and neonatal care practices should be done to reduce incidences of neonatal sepsis.

Recommendations

Ministry of Health should offer refresher training to health workers regarding the management of mothers in labor like avoiding unnecessary vaginal examinations. Furthermore, antibiotics should be supplied to health facilities to ensure routine provision among neonates.

KNOWLEDGE, ATTITUDES, AND PRACTICES ASSOCIATED WITH MALNUTRITION IN CHILDREN UNDER 5 YEARS OF AGE AT RUKUNYU HOSPITAL, KAMWENGE DISTRICT. A CROSS SECTIONAL STUDY.

BENSON BYAMUKAMA — 2024-03-01

Introduction:

The main objective was to assess the knowledge, attitudes, and practices of caretakers on malnutrition among children less than 5 years at Rukunyu Hospital, Kamwenge district.

The specific objectives were to assess the knowledge of caretakers, to determine the attitudes of caretakers, and to identify the practices of caretakers towards malnutrition among children below five years at Rukunyu Hospital, Kamwenge district.

Methodology:

A cross-sectional descriptive study design was used, using a quantitative approach at Rukunyu Hospital Kamwenge district. The researcher conveniently sampled on 86 respondents from 25th June 2023 to 27th July 2023. Data collection was done by using self-administered questionnaires.

Results:

Out of the 86 respondents. The majority; 59(69%) knew the importance and nutritious effects of first thick milk. The majority; 74(86%) agreed that a balanced diet was important in preventing malnutrition. The majority; 80(93%) indicated that they did not have enough time to attend to their children. majority 42% of the caretakers initiated their babies on breast milk within 1 hour after delivery.

Conclusion:

The study showed that despite the caretakers knowing initiation of breastfeeding after delivery within one hour, a number of them did not adhere to the attitudes and this was affiliated to the limited resources to do so.

Recommendation:

There is a need for the caretakers to adhere to the practices and knowledge acquired to affect results concerning the improvement of the nutrition status of children. The health care providers should educate the public on other practices that reduce on malnutrition like exclusive breastfeeding, and should be advised on how and when to introduce supplementary feeds during the growth cycle of the children.

RELATIONSHIP BETWEEN REVENUE ENHANCEMENT PLANNING AND SERVICE DELIVERY IN BUTIABA SUB COUNTY; A CROSS SECTIONAL STUDY.

Esau Tolbert Mugonzebwa — 2024-03-06

Background:

This study aims to investigate the relationship between revenue enhancement planning and service delivery in Butiaba Sub County.

Methodology:

The study adopted a cross-sectional design complemented with a qualitative and quantitative approach. The study population was 176 and 124 were formed the sample size was selected using purposive and simple random sampling was elicited using a questionnaire, interview, and documentary review checklist.

Results:

The majority 82% (59) fell below 40 years of age and 18% (13) respondents were above 41 years of age. The results suggest the age representativeness of Butiaba Sub County staff and the local community who engaged in the study. A response rate of 63% was obtained. Key findings suggested a positive significant relationship between revenue enhancement planning (.530) on service delivery.

Conclusion:

The study concluded that untimely revenue enhancement planning and fewer local revenue sources negatively affect revenue management however, fair tax assessment and timely deployment of tax enforcement teams improve revenue collection.

Recommendation:

The following were recommendations made namely; conduct more on-the-job training, provide logistical support to the revenue assessment team, budget and identify untapped revenue sources, conduct more community dialogue meetings, and the need for a more autonomous hiring process. In addition, engaging more actors in budget revenue meetings or conferences avoids late submission of reports and benchmarking.

RELATIONSHIP BETWEEN PUBLIC PARTICIPATION IN PROJECT PLANNING AND SUSTAINABILITY OF FOREIGN FUNDED WATER SUPPLY PROJECTS IN JUBA CITY: A CROSS SECTIONAL STUDY.

Lui Alex Elisa Korsuk — 2024-03-01

Background

This study aims to assess the relationship between public participation in project planning and the sustainability of foreign-funded water supply projects in Juba City.

Methodology

The study employed both quantitative and qualitative approaches to collect data. In total, a sample of 94 respondents participated in the study. Data collection methods used were questionnaires, interviews, and documentary reviews. Quantitative data was coded and entered into SPSS and analyzed using the Pearson correlation coefficient Qualitative data was analyzed using thematic analysis based on the research objectives.

Results

Pearson’s correlation coefficient for public participation in project planning and sustainability of foreign-funded water Sources in Juba City was r = 0.539**, with a probability value (p = 0.000) that is less than 0 .05 level of significance showing a strong relationship between participation in planning and sustainability of foreign-funded Water Sources

Conclusion

It was concluded that public participation in project planning has a strong positive relationship with the sustainability of foreign-funded water Sources. This conclusion was based on the Pearson correlation coefficient which is at 539** with a significance level of 0.000. Therefore, if public members are involved in the planning stage such as needs identification, work plan development, and technology selection, there will be improved sustainability of foreign-funded water Sources.

Recommendations

The study recommends that public members should be involved in drafting work plans to follow while carrying out foreign-funded water Source activities. This will promote community involvement and participation which will enhance ownership and sustainability of foreign-funded water Sources.

THE RELATIONSHIP BETWEEN COMPETITIVE TENDERING METHODS AND QUALITY OF SERVICE DELIVERY IN WAKISO DISTRICT: A CORRELATIONAL STUDY.

Mariam Nakulima — 2024-03-01

Background:

The study aims to assess the relationship between competitive tendering methods and the quality of service delivery in Wakiso District.

Methodology:

This study was guided by a cross-sectional correlational research design. Triangulation of research methods was adopted in this study. 68 participants formed the sampling framework and 65 of them were determined as the sample. The sample was reached using simple random sampling techniques and purposive sampling techniques. With the quantitative data, analysis was done using frequencies, percentages, means, and Pearson correlation matrix. On the side of qualitative data, was analyzed using Content analysis.

Result:

Most of the participants were males (54%), between the ages of 40-49 years (58.8%), with an educational level of a Bachelor’s degree (58.8%), and having worked in Wakiso district user departments for 4-6years (44.1%). It was established that competitive tendering was significantly related to the quality of service delivery in Wakiso District. This is based on the Pearson value which was established at r=0.700 which was significant P=0.019. This was measured at less than 0.05 (level of significance). This meant that the higher the practice of competitive tendering, the higher the improvement in the quality of service delivery in Wakiso District.

Conclusion:

Quality of service delivery is highly determined by the proper application of competitive tendering methods in Wakiso District.

Recommendation:

National suppliers or service providers must be given a chance to undertake procurement opportunities. This can be done by ensuring that local companies that have acquired some expertise are considered without being compared to international companies.

TITLE - BITE MARKS – A VITAL INVESTIGATION IN THE FIELD OF FORENSIC MEDICINE AND FORENSIC ODONTOLOGY – SYSTEMATIC REVIEW.

KARTHIK SHUNMUGAVELU — 2024-03-01

Background

The application of dental knowledge, which is common among dental healthcare providers, to the fields of law enforcement and death investigations is known as forensic odontology.

Material and Methods

Major databases such as Medline were explored detailed literature search resulting in a systematic review of bite marks.

Results

Four original research scientific articles dated between 2020 – 2024 about bite marks were highlighted.

Conclusions

Forensic dentists are important in a variety of situations, even though postmortem dental identification is a well-known practice in cases when a deceased person cannot be recognized by traditional methods like fingerprints, scars, markings, tattoos, medical implants, and DNA. Detailed information regarding bite marks and their vital role in the field of forensic medicine and forensic odontology is discussed in this systematic review.

EXAMINING PLACENTA ACCRETA, PERCRETA, AND INCRETA IN PERIPARTUM HYSTERECTOMIES: A RETROSPECTIVE CROSS-SECTIONAL STUDY.

Seeba Hussain — 2024-03-31

Background

Abnormal placentation, encompassing placenta accreta, increta, and percreta, poses significant risks to maternal health, necessitating prompt diagnosis and management. With increasing cesarean delivery rates contributing to rising incidences of these conditions, understanding their clinical characteristics, management approaches, and outcomes in peripartum hysterectomies is crucial. The study seeks to investigate the incidence, clinical characteristics, association, and outcomes of placenta accreta, percreta, and increta in peripartum hysterectomies.

Methods

A retrospective cross-sectional study was conducted in which 40 participants meeting inclusion criteria, such as antenatal diagnoses of abnormal placentation or relevant obstetric histories, were included. Clinical data were collected from histology requisition forms, with statistical analysis achieved using SPSS version 21.0.

Results

The study revealed a notable incidence of abnormal placentation, with placenta accreta being the most common (62.5%). Clinical presentations varied, with antepartum hemorrhage predominating (70%). Peripartum hysterectomy emerged as the primary management strategy, yielding favorable maternal outcomes overall. Statistical analysis identified associations between previous cesarean sections and abnormal placentation incidence, highlighting the importance of risk mitigation strategies (p < 0.05).

Conclusion

Abnormal placentation remains a significant concern in peripartum care, necessitating a multidisciplinary approach for optimal management. Early diagnosis, prompt intervention, and ongoing research are essential to improve maternal outcomes and minimize complications associated with these conditions.

Recommendations

Healthcare providers should prioritize early and accurate diagnosis, adopt a multidisciplinary approach to management, and focus on mitigating risk factors such as previous cesarean sections. Continued research and education are essential for refining treatment strategies and improving outcomes for women affected by abnormal placentation.

AN INVESTIGATION INTO KRUKENBERG'S TUMOUR AT A TERTIARY REFERRAL CENTRE.

Samarina Kamal — 2024-03-30

Objectives:

This study aims to the evaluate histopathological, clinical, biochemical, and radiological attributes of women diagnosed with Krukenberg cancer to distinguish it from ovarian tumors.

Methods:

This retrospective study, conducted at MGM Medical College, Jharkhand, India over 1 year, aimed to assess patients with histologically confirmed Krukenberg tumors and grade 3 or 4 ovarian tumors. For this purpose, 107 patients with Krukenberg cancer as well as ovarian tumors were chosen from hospital records. The radiological studies were carried out by means of pre-operative abdominal/pelvic CT scans. The radiology results after evaluation by a diagnostic radiologist provided details on the size of the tumor, its metastases, the involvement of lymph nodes, and ascites extracted. Additionally, CT images were processed and standardized for analysis, including tumor segmentation and image resizing.

Results:

The study included 107 patients diagnosed with Krukenberg tumors or ovarian tumors, with 72.5% diagnosed at stage IV, highlighting advanced disease. Surgical resection was performed in 73.3% of patients, emphasizing its importance in management. Metachronous tumors occurred in 54.2% of patients, indicating metastasis of the ovarian tumor post-primary tumor diagnosis. Treatment responses varied, with 38.5% responding to systemic therapy, while 70.7 % experienced disease progression. Additionally, age and elevated CA125 levels showed significant associations with Krukenberg tumors in multivariable analysis.

Conclusion:

The study underscores the significance of surgical resection and highlights the diagnostic value of CA125 levels in managing Krukenberg tumors.

Recommendation:

The study recommends further investigation into the utility of CA125 levels as a diagnostic marker and emphasizes the importance of timely surgical intervention in the management of Krukenberg tumors.

A Cross-Sectional Study on Factors Associated with Cervical Cancer Screening Practices in Reproductive-Age Women

Bullu Priya Oraon — 2024-03-31

Background: Cervical cancer is still a major worldwide public health problem. Early identification can result in prompt interventions and lower death rates. The objective of the study was to find out what factors affect women of reproductive age's cervical cancer screening (CCS) habits.

Methods: The study included 260 volunteers in all, ages 15 to 49. A pre-tested structured questionnaire covering sociodemographic traits, knowledge, attitudes, invitations from healthcare providers, aspects of sexual and reproductive health, and CCS practices was used to gather data. To evaluate relationships between variables, descriptive statistics, adjusted odds ratios, and bivariable logistic regression analysis were performed.

Results: The study showed that 72.5% of participants had heard of cervical cancer, with 58.1% correctly identifying its association with HPV. However, only 41.2% were aware of cervical cancer screening methods, though 76.9% expressed willingness to undergo screening if recommended. Approximately 54.6% received healthcare provider invitations for screening, among whom 68.3% underwent screening. Nearly half (48.5%) reported a history of STIs, with only 22.3% having undergone previous CCS. Barriers to screening included lack of awareness (38.1%) and fear of the procedure (29.5%).

Conclusion: Factors influencing CCS practices among reproductive-age women include awareness, healthcare provider invitation, and history of STIs. Healthcare provider invitation significantly influenced screening uptake, highlighting the importance of provider engagement in promoting screening services.

Recommendations: Targeted interventions should focus on enhancing awareness, addressing barriers, and increasing healthcare provider engagement to improve CCS uptake among reproductive-age women.

A Retrospective Study on Peripartum cardiomyopathy, Recent Trends and disease profile, study at tertiary centre of Bihar

Aman Sinha — 2024-03-31

Background: Peripartum Cardiomyopathy (PPCM) is a rare but serious cardiovascular condition that affects women in the peripartum period. The aim of this study is to comprehensively investigate the recent trends and disease profile of PPCM among patients at a tertiary center in Bihar.

Methods: A retrospective study was conducted which included 50 female participants who met specific inclusion criteria, such as being aged 18 years or older, having a confirmed PPCM diagnosis, and having complete medical records available for analysis. Data collection encompassed demographic information, clinical presentation, diagnostic criteria, echocardiographic findings, laboratory results, and treatment modalities employed. Statistical analysis involved descriptive statistics, categorical and continuous variable presentations, and the use of SPSS ver. 18 for data analysis.

Results: The mean age at PPCM diagnosis was 32.5 years, with 60% being parous and 40% nulliparous. Clinical symptoms included dyspnea (84%), fatigue (76%), and edema (70%). Echocardiographic findings revealed compromised cardiac function, with a mean LVEF of 35%. Laboratory results demonstrated elevated BNP and troponin levels. Treatment approaches were diverse, including medications, interventions, and lifestyle modifications. Complications included arrhythmias (20%), thromboembolic events (10%), and cardiogenic shock (14%). The overall survival rate was 84%, with a mortality rate of 16%.

Conclusion: The study provides valuable insights into the clinical profile, diagnosis, treatment, and outcomes of PPCM in a retrospective cohort. The findings highlight the complex nature of PPCM and the importance of early recognition and comprehensive management strategies in improving patient outcomes. Further research and awareness efforts are needed to enhance the understanding and management of this challenging condition.

Recommendations: Medical practitioners should be educated about PPCM to aid early diagnosis. Obstetricians, cardiologists, and other professionals collaborate for multidisciplinary treatment. Frequent cardiac monitoring for high-risk pregnant and postpartum women. More research on risk factors and innovative PPCM treatments.

KNOWLEDGE, ATTITUDE AND PRACTICES REGARDING HUMAN PAPILLOMAVIRUS (HPV) VACCINATION AMONG ADOLESCENT GIRLS IN BIHAR AND EVALUATE THE FACTORS INFLUENCING IT- A CROSS SECTIONAL STUDY AT A TERTIARY CARE HOSPITAL.

Amrita — 2024-03-31

Background

Human Papillomavirus (HPV) is the causal factor for the development of carcinoma cervix in almost all cases. HPV vaccine is 100% effective against high-grade cervical lesions. Despite the availability of the HPV vaccine in India, the incidence of carcinoma cervix is likely to increase because of a lack of awareness of the HPV vaccine and less acceptability of the vaccine.

Aim

To assess the knowledge, attitude, and practices regarding HPV vaccination among adolescent girls in Bihar and evaluate the factors influencing it

Material and methods

A questionnaire-based cross-sectional study was done among 456 adolescent girls coming to the Outpatient Department. Questions related to knowledge about HPV infection and HPV vaccine were asked. Vaccination status and willingness to get vaccinated were also inquired of.

Results

The majority of patients (61.85%) were from rural areas, with the highest age group being 17-19 years (mean age 17.2 ± 2.7 years). Most participants were educated up to 12th grade, belonging to socioeconomic classes I and II. 7.68% hadn't experienced menarche, 7.9% had a family history of malignancy, and 2.41% had sexual exposure. Awareness of cervical cancer was at 12.94%, with only 2.63% aware of the HPV vaccine. Healthcare workers were the primary source of information about the HPV vaccine. Only one participant had received the HPV vaccine. The majority (74.34%) were willing to get vaccinated if the vaccine was free, while uncertainty prevailed regarding parental willingness to pay (69.07% uncertain).

Conclusion

The awareness about HPV infection and vaccination is very low among adolescent girls in Bihar. The vaccine uptake is almost zero.

Recommendation

There is a need for increased sensitization among adolescent girls to improve HPV vaccine coverage.

A retrospective study on acute renal damage during pregnancy and puberty

Samarina Kamal — 2024-03-31

Background: Acute kidney injury is uncommon in young women while pregnant and post-delivery care, but it is linked via higher deaths and morbidity.

Objective: This research aims to examine the prevalence, outcomes, and characteristics of AKI while pregnant and the post-delivery period in an Indian populace.

Methods: The present research examined pregnant women who were discharged from the hospital between 2022 to 2023. In expectant mothers who don't have a history of chronic kidney disease (CKD), AKI is described as serum creatinine levels exceeding 70.72umol/l. Acute-on-CKD is defined as a fifty percent rise in creatinine levels in the serum over baseline for individuals with pre-existing CKD.

Results: We found a high (0.81%) prevalence of AKI during pregnancy and post-delivery care. There were 172 patients of AKI during pregnancy and post-delivery care, including 10 cases of severe AKI and 11 cases of acute CKD. During pregnancy and the post-delivery period, the primary causes of acute kidney injury were hemorrhage after delivery and toxemia. Approximately 17% of women with toxemia and 60% with HELLP syndrome have complications with AKI. The outcome was favorable, except in cases of blockage in amniotic fluid, while the pregnancy outcome was generally poor. Four out of the seven fatal cases received replacement therapy for their kidneys. Pregnant women with AKI were most likely to die from amniotic fluid blockage or hemorrhage following delivery.

Conclusion: Acute renal damage a pregnant women and post-delivery care is more common than we previously thought. Toxemia is the most prevalent cause of severe kidney disease during pregnancy and post-delivery care. However, the outcome is favorable. Blockage of amniotic fluid and bleeding after delivery are the most prevalent causes of maternal death. Major Acute kidney injury may indicate an inadequate result.

A NARRATIVE REVIEW ON ANALYSIS OF CHROMOSOMAL ANOMALIES FREQUENCY AND VARIETIES IN PHENOTYPICALLY FEMALE PATIENTS EXPERIENCING AMENORRHEA.

Seeba Hussain — 2024-03-31

Amenorrhea, characterized by the absence of menstrual periods, affects a significant portion of the female population, signaling potential underlying genetic, anatomical, or hormonal disorders. Chromosomal abnormalities are pivotal in understanding the etiology of amenorrhea, especially in phenotypically female patients experiencing primary or secondary forms of the condition. The review aims to analyze and synthesize research findings on the frequency and types of chromosomal abnormalities in phenotypic females with amenorrhea, highlighting the correlation between specific chromosomal anomalies and the manifestation of amenorrhea. Studies across India have underscored the importance of cytogenetic analysis in diagnosing and managing amenorrhea, revealing a diverse range of chromosomal abnormalities contributing to this condition. Key findings include the necessity of cytogenetic analysis for accurate diagnosis and management, the clinical utility of karyotyping in primary amenorrhea cases, and the broad spectrum of genetic variations contributing to amenorrhea. The review suggests directions for future research, emphasizing the need for improved diagnostic approaches and therapeutic strategies. Understanding the genetic underpinnings of amenorrhea is crucial for developing personalized medicine approaches, optimizing hormone replacement therapy, and employing assisted reproductive technologies based on the patient's genetic and hormonal profile. The findings advocate for the integration of cytogenetic analysis into the standard diagnostic workflow for amenorrhea, enhancing patient care through precise identification of chromosomal abnormalities and informed management strategies.

THE PREVALENCE OF ANAEMIA AMONG PREGNANT WOMEN ATTENDING ANTENATAL CARE SERVICES AT KIYUMBA HEALTH CENTRE IV IN MASAKA DISTRICT. A CROSS-SECTIONAL STUDY.

LOVE MUGABE — 2024-03-03

Background

The study was to improve the health being of pregnant women and reduce conditions associated with anemia, maternal transfusion, premature delivery, and high mortality rate among others.

Methodology

A cross-sectional study design was used and this is because it was cheap and the study was to take relatively a short period. It was conducted among 186 respondents at Kiyumba Health Centre IV between June and July 2023. A simple random sampling technique was used to select the participants and the selected participants signed consent forms and thereafter questionnaires to fill those who were unable to read and write and were interviewed.

Results

The results showed that out of the 186 respondents, 35 pregnant women were found to be anemic 32(91.43%) had mild anemia, (5.71%) had severe anemia, and only (2.86%) had moderate anemia. During the study, malaria and area of residence were found to be the risk factors and determinants of anemia among pregnant women where the majority,(17.20%) had suffered from malaria and as regards to the area of residence, (91.4%) were urban dwellers and (8.60%) were rural dwellers. Finally, the participants had suffered from different signs and symptoms during the pregnancy for example headache, dizziness, fatigue, and depression.

Conclusion

The study found that the magnitude and severity of anemia among pregnant women are high in the third and second trimesters respectively. The study found that marital status, area of residence, and infections like malaria are the main risk factors and determinants of anemia among pregnant women..

Recommendations

Health workers to make sure all pregnant mothers are tested for hemoglobin levels at every antenatal visit to determine their anemic states.

INVESTIGATING INFECTION'S ROLE AS A CONTRIBUTING FACTOR IN THE GENETIC AND EPIGENETIC MECHANISMS OF ENDOMETRIOSIS: A NARRATIVE REVIEW.

Archana Jha — 2024-04-11

Endometriosis is a chronic gynecological condition, characterized by the presence of endometrial-like tissue outside the uterus. It is associated with symptoms such as pelvic pain, dysmenorrhea, and infertility, significantly impacting women's quality of life. Despite its prevalence, the pathophysiology of endometriosis is not fully understood, with genetic, epigenetic, environmental, immunological, and hormonal factors all playing roles in its development. This review aims to systematically examine the evidence linking infections to the genetic and epigenetic mechanisms of endometriosis, highlighting how these interactions may contribute to the disease's development and progression. Recent research has identified a connection between genetic predispositions to endometriosis and an enhanced immune response to infections. Specific genetic markers associated with an increased risk of endometriosis have also been linked to heightened immune reactions to infectious agents, suggesting a complex interplay between endometriosis and infections. Variations in genes regulating the immune system and inflammatory processes, such as the Toll-like receptor 4 (TLR4), have been implicated in both endometriosis and the body's response to infections. Furthermore, infections can induce epigenetic changes that may influence the development and severity of endometriosis by altering gene expression related to inflammation, immune surveillance, and tissue repair. Understanding the relationship between infections, genetic predispositions, and epigenetic modifications in endometriosis opens new avenues for research into targeted therapies. Addressing the underlying genetic and immunological factors contributing to endometriosis could lead to more effective treatment strategies, potentially improving the quality of life for those affected by the condition. Clinicians should consider the potential role of infections in the exacerbation of endometriosis symptoms and the importance of comprehensive patient evaluations to identify and treat any concurrent infections. Future therapeutic strategies should also explore anti-inflammatory therapies and preventive measures against pathogens known to influence endometriosis progression.

ULTRASOUND EXAMINATION IMPACT ON PREGNANCY OUTCOME AMID THREATENED ABORTION: AN OBSERVATIONAL STUDY.

Soumya — 2024-03-30

Background:

Ultrasound examination plays a crucial role in the management of threatened abortion, aiding in the assessment of fetal viability and the identification of potential complications. Despite its significance, the impact of ultrasonography on pregnancy outcomes in cases of threatened abortion remains to be fully elucidated. In cases where an abortion is threatened, the study aims to evaluate the impact of ultrasonography on pregnancy outcomes.

Methods:

A cohort of 50 pregnant women presenting with symptoms indicative of threatened miscarriage was enrolled. Participants were divided into 3 groups based on pregnancy outcomes: Group I (threatened abortion resulting in pregnancy loss), Group II (threatened abortion with completed pregnancy), and Group III (normal pregnancies serving as the control). Patient demographics, pregnancy outcomes, ultrasound markers, maternal and neonatal outcomes, and the diagnostic performance of sonographic parameters were assessed. Data analysis involved the use SPSS 20 software.

Results:

The study revealed no significant variations in maternal age, BMI, or parity distribution among the groups. Group I exhibited a 35% pregnancy loss rate, while all participants in Group II completed successful pregnancies. Ultrasound assessments indicated normal parameters in Groups II and III, whereas abnormal sonographic markers were observed in 15% of cases in Group I. Maternal and neonatal outcomes were favourable in Groups II and III, with no notable complications. Abnormal sonographic parameters were associated with late pregnancy complications, and their predictive value for pregnancy loss was notable.

Conclusion:

Ultrasonography significantly influences the management and prediction of pregnancy outcomes in cases of threatened abortion. Early detection of abnormal sonographic markers facilitates risk stratification and guides clinical decision-making, ultimately improving maternal and neonatal outcomes.

Recommendations:

Routine ultrasound examination should be considered in cases of threatened abortion to enhance pregnancy monitoring and improve outcomes.

An investigation of effects of maternal BMI on course and result of labour in primigravidae patients

Samarina Kamal — 2024-03-31

Background: The purpose of this research is to determine how higher BMI affects labor outcomes in primigravida pregnant women.
Methods: 200 fully developed single primigravida pregnant women who arrived at the labor unit during the active stage of labor participated in a cross-sectional investigation. The patients were separated into three equal categories according to their BMI: those with an average body mass index (group I), those who were overweight (group II), and those who had class I obesity (group III).
Results: A considerable higher risk of C-section (C.S.) was discovered to be linked with elevated BMI (13% in group I, 18% in group II, and 40% in group III). Higher BMI women who gave birth vaginally experienced much longer 1st and 2nd stages of labor, which raised the demand for oxytocin boost and dosage. Significantly higher chances of postoperative sepsis, perineal rips, wound infection, significantly higher birth weights, and longer stays in the neonatal unit (NNU) are associated with these mother and fetal results.
Conclusion: Maternal obese primigravida women were more likely to get worse than ideal results. In addition, there has been a rise in the incidence of C.S. and protracted first and second phases of labor.

Prospective Observational Study on Ultrasonography's Role in Predicting Pregnancy Outcomes during Threatened Abortion

Richa Bharadwaj — 2024-03-31

Background: Threatened abortion, characterized by vaginal bleeding in early pregnancy with a closed cervix, presents a common challenge in obstetrics. Ultrasonography has emerged as a pivotal tool for assessing this condition, offering valuable insights into pregnancy outcomes. Understanding its predictive value is crucial for clinical decision-making and patient support. The study aimed to assess the effectiveness of ultrasonography in predicting pregnancy outcomes among women presenting with symptoms of threatened abortion.

Methods: A total of 160 pregnant women aged 18 years and above, with gestational ages between 6 to 12 weeks, were included in the study. Clinical data, obstetric history, and ultrasonography findings were recorded. Participants were followed up to determine pregnancy outcomes. Statistical analysis, including logistic regression, was performed to assess the association between ultrasound findings and pregnancy outcomes.

Results: Among the participants, 92.5% had ultrasound-confirmed viable pregnancies, while 7.5% had non-viable pregnancies. The absence of fetal heartbeat on ultrasound was significantly associated with a higher risk of miscarriage (p < 0.001). Notably, no cases of ectopic pregnancy were observed. The majority of pregnancies (87.5%) resulted in live births.

Conclusion: Ultrasonography plays a pivotal role in predicting pregnancy outcomes in cases of threatened abortion. The absence of fetal heartbeat on ultrasound is a strong predictor of miscarriage, aiding clinical decision-making. These findings underscore the importance of early and accurate ultrasound assessment in managing and reassuring women facing threatened abortion.

Recommendations: Further research is warranted to refine risk assessment models and explore additional factors influencing pregnancy outcomes in threatened abortion cases.

A CLINICAL STUDY ON FETAL CONSEQUENCES OF JAUNDICE DURING PREGNANCY: INSIGHTS FROM A TERTIARY CENTRE IN BIHAR.

Gunjan Gunjan — 2024-04-01

Background:

Jaundice during pregnancy poses significant risks to both maternal and fetal health, with potential complications including fetal jaundice, kernicterus, and stillbirth. Early detection and appropriate management are crucial to mitigate these risks. The study investigates the impact of jaundice during pregnancy on fetal outcomes within a tertiary centre setting in Bihar, aiming to enhance understanding and inform clinical management strategies.

Methods:

A clinical study involving 200 pregnant patients with jaundice or deranged liver function tests during pregnancy was conducted. Demographic data, clinical features, obstetric complications, maternal and fetal outcomes, and maternal complications were assessed. Statistical analyses were performed to elucidate the relationship between jaundice during pregnancy and fetal outcomes.

Results:

The study population had an average age of 28 years (± 4.5), with the majority being multiparous (65%). Common symptoms included yellowish discoloration of the skin and sclera (100%), pruritus (80%), dark urine (70%), and abdominal discomfort (60%). Obstetric complications such as intrauterine growth restriction (IUGR), hepatomegaly, and ascites were observed in varying proportions. Abnormal liver function tests were prevalent, with elevated bilirubin levels (>2.5 mg/dL) in 95% of cases. Statistical analysis revealed a significant association between prolonged jaundice duration and adverse fetal outcomes (p < 0.05), with multiparity identified as a risk factor for maternal complications (p < 0.01).

Conclusion:

Jaundice during pregnancy significantly impacts maternal and fetal health, necessitating vigilant monitoring and early intervention. The findings underscore the importance of timely management strategies to mitigate adverse outcomes, emphasizing the need for multidisciplinary collaboration in the care of pregnant patients with jaundice.

Recommendations:

Recommendations include implementing standardized protocols for the management of jaundice during pregnancy, enhancing awareness among healthcare providers regarding the potential risks and complications, and fostering interdisciplinary teamwork to optimize maternal and fetal outcomes.

THE PREVALENCE AND FACTORS ASSOCIATED WITH INDUCED ABORTION AMONG PATIENTS ATTENDING THE MATERNITY DEPARTMENT AT KITEBI HEALTH CENTRE III IN KAMPALA DISTRICT.A CROSS-SECTIONAL STUDY.

DUNGU KATO — 2024-03-01

Purpose of the study

Was to determine the prevalence and factors associated with induced abortion among patients attending the maternity department at Kitebi Health Centre III in Kampala district.

Objectives

The specific objectives were to identify the prevalence, identify the predisposing factors for induced abortion, and determine health service-related factors leading to abortion among patients attending the maternity department at Kitebi Health Centre III.

Methodology

The study employed a cross-sectional study design. Data was collected by questionnaire method using an interviewer-administered questionnaire. Respondents were sampled by a convenient sampling technique. Data was analyzed manually and presented in tables and pie charts.

Results

The prevalence of induced abortions was found to be 9.4%. predisposing factors that were associated with abortions included; the age of 18-25 (55.6%), having children more than 5 (44.4%), being married (44.4%), alcohol consumption (55.6%), higher level of education (44.4%). Health service-related factors included; not including contraceptive methods in health education (55.6%), not counseling on reproductive health services (55.6%%), abortions done in places outside the health facilities (77.0%), and access to abortion services (77.8%)

Conclusions

The study established that the prevalence of induced abortion was high. The predisposing factors were age 18-25, being married, alcohol consumption, many live births, and having tertiary/university education. Health service-related factors were lack of counseling in reproductive health and contraceptives and access to surgical and nonsurgical abortion services.

Recommendations

There is a need to provide counseling on contraceptive methods, provisions of contraceptives with regular supplies, and training of health workers on contraceptives so that they enrich their knowledge of various contraceptive methods.

A CROSS-SECTIONAL STUDY ABOUT FACTORS ASSOCIATED WITH TEENAGE PREGNANCY AMONG TEENAGE GIRLS AT KAYUNGA HOSPITAL KAYUNGA DISTRICT.

Phionah Namutebi — 2024-03-01

Background

The purpose of the study was to determine the factors associated with teenage pregnancy among teenage girls at Kayunga Hospital Kayunga district. Specific objectives were to determine the knowledge of teenage girls toward teenage pregnancy and the socio-economic factors associated with teenage pregnancy among teenage girls.

Methods

A descriptive cross-sectional study was conducted among 100 teenagers in Kayunga Hospital Kayunga district. Data were collected using a structured questionnaire, entered, and analyzed appropriately.

Results

The majority of the respondent 69(69%) had not heard of teenage pregnancy whereas 31(31%) had heard. Most of the respondents 10(33.3%) sourced information about teenage pregnancy from school whereas 5(16.7%) from parents. The majority of the respondents 68(68%) stated that the father of the child is an elderly man whereas 32(32%) stated young man is the father. Peer pressure was the most cited reason for indulgence in sexual activities 45(45%), and culture accounted for 8(8%).

Conclusion

The results have presented a lack of knowledge among the teenagers as the majority have not heard of teenage pregnancy. The socio-economic factor predisposed most of the respondents to sexual activities.

Recommendation

Community sensitization, comprehensive sexuality education, and ensuring girls enroll and stay in schools could reduce adolescent pregnancy rates. Also, the provision of adolescent-friendly health services in schools and healthcare centers and the initiation of adolescent empowerment programs could have a positive impact.

FACTORS AFFECTING THE UPTAKE OF CERVICAL CANCER SCREENING SERVICES AMONG WOMEN AGED 15-49 YEARS ATTENDING KIBOGA HOSPITAL IN KIBOGA DISTRICT. A CROSS-SECTIONAL STUDY.

VICTOR SSENTONGO — 2024-03-01

Background:

The objectives are to find out the knowledge about cervical cancer screening services, sociodemographic factors affecting the uptake of cervical cancer screening services, and the attitude of women aged 15-49 years towards cervical cancer screening services attending Kiboga Hospital in Kiboga district.

Methodology:

The study employed the cross-sectional study design. This study was conducted at Kiboga Hospital in Kiboga District in the Outpatient Department from 5^thJuly 2023 to 5^th August 2023.

Results:

The results of the study were that the majority of the respondents, 55 (55%), did not know about cervical screening services, and 64% knew that cervical cancer screening should be done at least once. The majority, 58 (58%), said that cervical cancer screening was important because it ensures early diagnosis and treatment. The majority, 74 (74%) believed that cervical cancer screening is important. The majority, 62 (62%), believed that religious belief cannot protect them from cervical cancer. The majority of respondents, 57 (57%) aged 15-32 years were willing to participate in cervical cancer screening. The majority, 89 (89%) had never screened.

Conclusion:

The respondents had little knowledge about cervical cancer screening services and established that the sociodemographic factors affecting cervical cancer screening were the age of the respondent, employment, and level of education. It also found that the respondents had a good attitude towards cervical cancer screening.

Recommendation:

The Ministry of Health should do more health education for women about the existence of cervical cancer screening services, the government should ensure the empowerment of women in education and the government should empower women in employment through affirmative action. Also, the government should encourage women to cervical cancer screening. Health workers should continuously encourage women to participate in cervical cancer screening.

UTILISATION OF POSTNATAL SERVICES: A DESCRIPTIVE CROSS-SECTIONAL STUDY CONDUCTED AMONG MOTHERS AT DR. RONALD BATTA MEMORIAL HOSPITAL.

Elizabeth Karungi — 2024-03-01

Background

Utilization of Post Natal Care (PNC) services has been associated with huge benefits to both the mother and the baby. This care which is given from immediately after birth up to six weeks after delivery is a recommended package in the continuum of maternal care aimed at reducing maternal and neonatal mortality. Timely PNC enables health workers to detect, follow, and quickly manage complications of both the mother and newborn. Despite the benefits, there’s still underutilization of the services in some health facilities in low-income countries. Therefore, the study aimed at assessing factors that were influencing utilization of post-natal care services among mothers at Dr. Ronald Batta Memorial Hospital, Wakiso district.

Methodology

This was a descriptive cross-sectional study conducted among 36 post-natal mothers, who were selected using simple random sampling at DR. Ronald Batta Memorial Hospital. Self-administered questionnaires were used for data collection and data was analyzed using Microsoft Excel 2021.

Results

Utilization of PNC was 69.4 % (25/36). Those who did not utilize the PNC did not know its benefits 7(63.6%), rural residents 7(63.6%) and long waiting hours 10(90.9%) were among the factors that influenced the utilization of postnatal services. The study established that the lack of awareness, rural residence, long waiting hours, and non-friendly health workers influenced the utilization of post-Natal services.

Conclusions

The study established that the Poor attitude towards the utilization of PNC services, age, non-supportive Cultures towards utilization of PNC services, rural residence, long waiting hours, and unfriendly Health workers influenced the utilization of PNC among mothers.

Recommendations

MoH should support health facilities to increase awareness about the benefits of attending PNC clinics. Health facilities should provide follow-up services and training to increase awareness. More funds should be allocated to PNC services awareness programs. Health workers can also start providing door-to-door PNC services.

PUERPERAL SEPSIS AND ITS ASSOCIATED FACTORS AMONG POSTNATAL MOTHERS AT MUKONO GENERAL HOSPITAL, MUKONO DISTRICT. A CROSS-SECTIONAL STUDY.

Molly Kasasa — 2024-03-01

Introduction:

This study was on factors associated with puerperal sepsis among postnatal mothers at Mukono General Hospital, Mukono District. It was guided by two specific objectives: assess the prevalence, individual-related factors, and health facility-related factors associated with puerperal sepsis among postnatal mothers at Mukono General Hospital, Mukono District.

Methodology:

This study used a descriptive cross-sectional study design and employed quantitative and qualitative data collection approaches. The study was carried out at Mukono General Hospital, Mukono District. The study population for this study comprised postpartum mothers with puerperal sepsis at Mukono General Hospital, Mukono District. The sample size of 30 postpartum mothers with puerperal sepsis who participated in this study was sampled using a simple random sampling procedure. The questionnaire was used for data collection and analyzed using Microsoft Excel 2019.

Results:

The study established that the socio-demographic characteristics that were associated with puerperal sepsis were age between 18 – 25 years (57%), rural residence (63%), low levels of education (50%); Furthermore individual related factors included utilization of herbal medicine (63%), tears during delivery (53%), resumption of sexual intercourse before 7 days of peuperium (53%); Finally health facility related factors included lack of follow up services during peuperium (60%), negative attitude of health workers (63%).

Conclusion:

The study established that the socio-demographic characteristics that were associated with puerperal sepsis were age between 18 – 25 years, rural residence, and low levels of education; furthermore, individual-related factors included utilization of herbal medicine, tears during delivery, resumption of sexual intercourse before 7 days of puerperium; Finally, health facility related factors included lack of follow up services during puerperium, negative attitude of health workers.

Recommendation:

Health workers should provide follow-up services to postnatal mothers after delivery.

Health facilities should conduct training to improve the attitude of health workers to postnatal mothers.

KNOWLEDGE, ATTITUDE, AND PRACTICES ABOUT YOUTH-FRIENDLY REPRODUCTIVE HEALTH SERVICES AMONG STUDENTS AT MEDICARE HEALTH PROFESSIONALS COLLEGE, MENGO. A CROSS-SECTIONAL STUDY.

JOSEPHINE CLAIRE NAMBEJJA — 2024-03-01

Background

The term Youth Friendly Reproductive Health Service (YFRHS) refers to those services that are accessible, acceptable, and appropriate for youths such as contraceptive methods; quality obstetric and Antenatal care for all pregnant women and girls and prevention and management of sexually transmitted infections including HIV.

Methodology

The study employed a cross-sectional study design where 116 respondents were conveniently sampled and comprised young adults both male and female aged between 18-24 years admitted at Medicare Health Professionals’ College, Mengo. Data analysis was presented in tables and figures.

Results

The majority 113(97.4%) of the respondents had heard about YFRH services, 44(37.9%) of the respondents heard about HIV counseling and testing, while only 6(5.2%) knew of post-abortion care. 69(59.5%) of the respondents did not agree that discussion about contraceptives promotes immorality. 46(39.7%) felt embarrassed to buy condoms from the shop/ health facility. 61(52.6%) of the respondents did not agree that contraceptives are linked to sterility. The highest number 72(62.1%) had ever visited a health facility for YFRH services in the last 12 months. The majority 39(54.1%) of the respondents had used family planning services, only 1(1.4%) had gone for antenatal care while none had post-abortion care.

Conclusion

The majority of the respondents were knowledgeable about YFRH services, most heard services were family planning and HIV counseling and testing while the least known were antenatal and post about care services. The majority did not agree that discussion about contraceptives with young people promotes immorality. Most respondents had ever visited a health facility for YFRH services with the majority having used family planning services.

Recommendations

The Ministry of Health should create more awareness regarding youth services such as STI screening and treatment, antenatal care, and post-abortion care to address the high number of unplanned pregnancies and unsafe abortions present.

KNOWLEDGE, ATTITUDE, AND PRACTICES TOWARDS INSECTICIDE-TREATED MOSQUITO NET UTILIZATION AMONG PREGNANT WOMEN ATTENDING ANTENATAL CARE AT MASAKA REGIONAL REFERAL HOSPITAL, MASAKA DISTRICT: A CROSS-SECTIONAL SURVEY.

CAROLINE NAKAWOZA — 2024-03-01

Background

In Uganda, the Masaka district Health sector platform statistics from the Ministry of Health show malaria as the highest disease burden with 22.2%. Hence, as a result, ITNs have been well recognized there as part of the important components of Global and National malaria control policies.

Objective

To determine the knowledge, attitudes, and practices towards ITN utilization among pregnant women attending ANC at Masaka Regional Referral Hospital, Masaka District.

Method

A cross-section descriptive survey design was employed; 59 respondents were selected using a simple random sampling technique. Data was collected using a questionnaire and analyzed using frequency and percentages descriptive statistics.

Results

Study findings indicate majority 36(61%) knew their importance during pregnancy, 42(71.2%) knew what is correctly done before the first usage of an ITN, and some 16(27%) knew at least one of the two types of ITNs. A generally poor attitude towards ITN utilization among pregnant women was shown as up to 39(66%) didn’t like to sleep in it, 36(61%) felt bad while sleeping under it, and 41(69.5%) believed that sleeping in it is not the only way to prevent malaria. Good practices towards ITN utilization were observed as a large number of 44(74.5%) slept under it, 30(50.8%) started sleeping in it during the first trimester, and 44(75%) hung their ITNs above the bed.

Conclusion

In summary, there was a high level of knowledge, poor attitude, and generally good practices about the utilization of ITNs among respondents.

Recommendation

The government needs to ensure the motivation of pregnant women to create a culture and enhance their understanding of ITNs. Direct health education through various mediums of communication should be carried out by the health workers. Health authorities should enhance the training of volunteers and local leaders towards proper utilization of ITNs through various directed programs by experts.

FACTORS ASSOCIATED WITH LOW UTILIZATION OF CONTRACEPTIVES AMONG WOMEN AGED 15-49 YEARS AT RWAMWANJA HCIII, KAMWENGE DISTRICT. A CROSS-SECTIONAL STUDY.

ANNITAH TUSASIRWE — 2024-03-01

Introduction:

Contraception refers to |the practice of utilizing contraceptive methods intended to prevent or space future pregnancy. Contraceptive use is reported as the actual utilization or intake of contraception in the last year.

Objectives: The broad objective was to determine factors associated with low utilization of contraceptives while specific objectives were to determine the knowledge of women aged 15-49 about contraceptives and facility-based factors affecting utilization of contraceptives by women aged 15-49 at Rwamwanja HC III.

Methodology:

This was a descriptive cross-sectional study that employed a random sampling method and each participant was assessed using a pre-designed questionnaire.

Results:

According to study100% were knowledgeable at least of one family planning method used by women in the reproductive age, pills (35.1%) were the most known method, followed by injections (25.9%), implants (19.5%), condoms (13%) and IUCD (6.5%) respectively. Distance, stockouts, health workers’ attitudes, and fear of side effects were the health-based factors that affected the utilization of contraceptives by women of reproductive age.

Conclusion:

The respondents were highly knowledgeable about family planning methods with pills as the most known and IUCD being the least known. The majority of the respondents reported long distance as their main hindrance to the utilization of FP services as it limited their access to the health facility while the least reported lack of privacy.

Recommendation:

The government through the MoH extends the family planning services up to the village level to increase accessibility to all communities for example through awareness campaigns with help from community-based Resource Person and VHTs as well as enhancing the integration of lessons about family planning services into schools.

UNDERSTANDING KEY DRIVERS OF UNDER NUTRITION AMONG ADULTS LIVING WITH HIV AND AIDS ATTENDING ART CLINIC AT KYENJOJO GENERAL HOSPITAL, WESTERN UGANDA. A CROSS-SECTIONAL STUDY.

Jacqueline Karungi — 2024-03-13

Background:

The study aimed to assess the nutritional status along with the clinical and socio-economic factors associated with under nutrition among those attending the anti-retroviral clinic at Kyenjojo General Hospital.

Methodology:

A cross-sectional and descriptive study was conducted with both qualitative and quantitative research approaches. Using purposive sampling, we recruited key informants to introduce the study to the target population. By simple random sampling, the study assessed respondents 334 subjects considering a 5 % degree of precision at a 95 % confidence interval. Data on treatment patterns and socio-demographics were collected using structured questionnaires while anthropometric data was collected using anthropometric tools. Anthropometric data was used to compute the BMI. All data was entered in MS Excel and transferred to SPSS version 23. Descriptive statistics such as the frequencies, means, and standard deviations were expressed. The degree of relationship among variables was statistically evaluated using chi-square analyses. Statistical significance was reported at the p > 0.05 level.

Results:

The nutritional status of 51.1% of the respondents was normal, 16.2% were underweight, 18.3% were overweight and 14.4% were obese. Under nutrition was more prevalent in males (19.1%) than in females (14.0%). In addition, under nutrition was significantly associated with age (P=0.009), marital status (P<0.001), the highest level of education (P=0.008), estimated monthly income (P=0.002), alcohol use (P=0.031), treatment regimen (P=0.002), opportunistic infections (P=0.014), and clinical staging of disease (P=0.022).

Conclusion:

Under nutrition is a major challenge among people attending the anti-retroviral treatment at Kyenjojo General Hospital. Major changes in extension service provision, by including adults in affected Kyenjojo would help alleviate the problem at hand.

Recommendation

Health care providers including nutritionists and dieticians should create awareness on the role of nutrition in HIV/AIDS and anti-retroviral treatment.

COVERAGE AND FACTORS ASSOCIATED WITH HEALTH INSURANCE UTILIZATION AMONG REPRODUCTIVE WOMEN: INSIGHTS FROM TANZANIA DEMOGRAPHIC HEALTH SURVEY 2022. A QUANTITATIVE STUDY.

Emmanuel Asher Ikwara — 2024-03-19

Background:

Universal Health Coverage aims to alleviate poverty caused by out-of-pocket health expenses, affecting 150 million annually, particularly in low- and middle-income countries. Health Insurance plays a crucial role, yet faces challenges like low coverage rates and equity issues. This study aimed to assess the extent of coverage and identify factors influencing the utilization of health insurance among reproductive women in Tanzania, utilizing data from the 2022 Demographic Health Survey.

Methods:

The study quantitatively examined data from the 2022 Tanzania Demographic and Health Survey, involving 15,254 women of reproductive age. The analysis included univariate, bivariable, and multivariable techniques utilizing chi-square and multilevel logistic regression. Findings reported as adjusted odds ratios (AOR), determined statistical significance at p<0.05.

Results:

The overall coverage of Health Insurance (HI) stood at a mere 5.7%. Individuals aged 35-49 years were 1.6 times more inclined to utilize insurance compared to those aged 15-24 years (AOR=1.633, 95%CI: 1.326-2.010). Residents in rural areas exhibited a 1.3 times higher likelihood of using HI compared to their urban counterparts (AOR=1.300, 95%CI: 1.086-1.556). Moreover, individuals with a higher level of education were 8 times more inclined to use HI compared to those with no education (AOR=8.113, 95%CI: 5.009-13.141), indicating a correlation between increased educational attainment and HI utilization. Additionally, participants owning a television were 1.4 times more likely to use HI than those without (AOR=1.419, 95%CI: 1.135-1.774). Those who held an account in a bank or financial institution were 3.9 times more likely to utilize insurance compared to those without an account (AOR=3.999, 95%CI=3.302-4.843).

Conclusions:

The extent of Health Insurance (HI) coverage in Tanzania continues to fall short, impeding advancements toward universal health coverage.

Recommendation:

The study recommends bolstering public awareness initiatives to underscore the benefits of HI services and striving to enhance their affordability.

FACTORS INFLUENCING ORAL CONTRACEPTIVE UTILIZATION AMONG WOMEN ATTENDING FAMILY PLANNING SERVICES AT NAKASEKE HOSPITAL IN NAKASEKE DISTRICT. A CROSS-SECTIONAL STUDY.

Daniel Niima — 2024-03-01

Introduction:

Oral contraceptives are pills taken orally by women after having unprotected sex to prevent pregnancies. Oral contraception pills consist of the hormones progestin and estrogen, or only progestin.

Purpose:

To determine factors influencing oral contraceptive utilization among women attending family planning services at Nakaseke Hospital in Nakaseke district.

Study Objectives:

The objectives of the study were; to identify the socio-demographic factors, knowledge, and the effects of oral contraceptive utilization among women attending family planning services at Nakaseke Hospital in Nakaseke district.

Study methodology:

This study employed a quantitative descriptive cross-sectional study design with a sample size of 87, descriptive statistics like percentages, and frequencies, were used to analyze data and presented in frequency tables, pie charts, and graphs.

Results:

The majority 53(60.9%) of respondents reside in urban areas where the majority attained secondary education at 15(46.9%) for which the husband's decision in a home significantly influenced his wife's family planning method at 32(36.8%). The majority 84(96.6%) had ever heard about OC use in their lifetime where the source of information is hospitals through health professionals at 60(68%). The majority (98%) had ever experienced side effects of OC use for which the majority 36 ( 41.4%) of them agreed that OC use can cause specific side effects.

Conclusion:

18(34%) were using OC with the majority residing in urban areas at 53(60.9%), the majority attained secondary education at 15(38.5%) with husbands influencing decision-making on the family type at home at 19(59. 4%). 96.6% knew OC use and had obtained information from hospitals at 60(68%) with the majority ever experiencing side effects of OC use at (97.7%)

Recommendation:

More campaigns on the importance of OC use to women should be done through sexual health education, seminars, carrying out counseling, and psychological support to women who fear the side effects of OC use.

DETERMINANTS OF PREGNANCY AMONG YOUNG FEMALES IN UGANDA AGED 15-29 YEARS, A CROSS-SECTIONAL ANALYSIS.

Gabriel Wasswa — 2024-03-01

Background

Uganda grapples with a significant global total fertility rate of 5.4, marked by a growing youth demographic aged 15 to 29 and elevated pregnancy rates. This poses a pivotal challenge to Uganda's Vision 2040. This study aims to scrutinize the determinants of youth pregnancy in Uganda.

Methods

Utilizing data from the 2016 Uganda Demographic and Health Survey, this study focuses on a sample comprising 10,900 women aged 15-29 years. A multiple logistic regression with the binary outcome variable "ever got pregnant" is estimated, using dummy variables as predictors. The model assesses the odds of pregnancy among young females, contrasting those who have ever been pregnant with those who have not. Model specification is validated through the Hosmer-Lemeshow goodness-of-fit test, with acceptance of the null hypothesis indicating a well-fitted model based on the F-statistic and p-value.

Results

This study unveils a substantial prevalence of pregnancy among young females (62.4%). Those who completed secondary or higher education exhibit a lower likelihood of ever getting pregnant (OR=0.26, 95% CI 0.14-0.50; OR=0.18, 95% CI 0.11-0.29) compared to their uneducated counterparts. Literacy levels reduce the odds of pregnancy, while ownership of a mobile phone or listening to the radio increases them. Additionally, higher wealth quintiles correlate with reduced odds of ever getting pregnant (poorer OR=0.78, 95% CI 0.65-0.94; middle OR=0.53, 95% CI 0.42-0.65; richer OR=0.44, 95% CI 0.35-0.56; richest OR=0.37, 95% CI 0.28-0.48). Notably, the likelihood of pregnancy increases among contraceptive users (OR=3.48, 95% CI 2.84-4.26) and with age progression (20-24 years: OR=13.44, 95% CI 11.46-15.77; 25-29 years: OR=74.91, 95% CI 57.87-96.96).

Conclusion

Pregnancy odds decline with higher education, wealth quintile, and literacy rate but rise with contraceptive use, radio listening, age, and mobile phone ownership.

Recommendation

Ensure Comprehensive education, sexual reproductive health campaigns, and initiatives empowering the youth.

Comparative Evaluation of Oral Aprepitant vs. Injection Palonosetron for Preventing Post-operative Nausea and Vomiting in Laparoscopic Cholecystectomy Patients under General Anaesthesia: A Randomized Trial

Puja Kumari — 2024-03-31

Background: Post-operative nausea and vomiting (PONV) are common and distressing complications in individuals undergoing surgical procedures, particularly laparoscopic cholecystectomy. Effective management of PONV is crucial for patient comfort, quicker recovery, and reduced healthcare costs. This study focused to compare the efficacy of oral aprepitant and injection palonosetron in preventing PONV in such surgical settings.

Methods: A randomized controlled trial was conducted, involving 120 participants undergoing laparoscopic cholecystectomy. Individuals were divided into three groups: Group A (oral aprepitant), Group P (injection palonosetron), and Group C (placebo). The occurrence of nausea and vomiting was monitored at various intervals post-surgery, and statistical analysis was performed to estimate the efficacy of the treatments.

Results: While all groups demonstrated some effectiveness in preventing nausea, with no significant statistical differences, Group A (Aprepitant) showed a significantly higher efficacy in preventing vomiting compared to Groups P and C. Aprepitant was notably more effective, suggesting its superiority as an antiemetic in this surgical context.

Conclusion: Aprepitant emerges as a potentially more effective antiemetic agent for preventing vomiting in patients undergoing laparoscopic cholecystectomy, compared to palonosetron and placebo.

Recommendations: Future research should focus on optimizing antiemetic regimens tailored to individual patient needs and specific surgical procedures. Further studies are also recommended to explore the long-term effects and cost-effectiveness of using aprepitant in perioperative care.

An Evaluation of Unilateral Spinal Anaesthesia for Inguinal Hernia Repair: A Prospective Randomised Comparative Study

Nazia Tarannum — 2024-03-31

Introduction: Around the world, repair of inguinal hernia is frequently utilized in the Lichtenstein mesh repair process. While hernioplasty performed under local anesthesia undoubtedly offers significant advantages, it has yet to be established as a routine practice. The purpose of this study is to provide additional information about this situation and the findings of a comparison between Lichtenstein hernioplasties carried out under local anesthesia and spinal anesthesia.

Methods: By calculating the sample size, 60 patients were chosen for this non-randomized clinical investigation. Thirty patients underwent local anesthesia during their operations, while thirty more underwent spinal anesthesia.

Results: Compared to spinal anesthesia, the average operating time under local anesthesia was slightly greater, at 62.5 minutes (SD=17.8) instead of 51.1 minutes (SD=21.5). At six, twelve, and twenty-four hours after surgery, the pain was significantly less in the local anesthetic group than in the spinal anesthesia group (p=0.04, p=0.042, and p=0.041, respectively). Following spinal anesthesia, headaches, urinary retention, and hypotension were more common postoperative sequelae than those following local anesthetic. The local anesthesia group's hospital stay lasted 24.5 hours (SD=12.8), a considerable reduction from the spinal group's 57.1 hours (SD=16.7).

Conclusion: Compared to spinal anesthesia, postoperative problems such as headache, hypotension, and urine retention were less noticeable in the group under local anesthesia. There was also a substantial decrease in postoperative pain. Therefore, the study finds that the use of local anesthetics for Lichtenstein hernioplasty procedures in place of spinal anesthesia, is the standard method of anesthesia.

Recommendation: Avoiding physically demanding tasks that can cause a hernia is advised.

Electrocautery versus harmonic dissection of the gallbladder from the hepatic bed

Neha Gupta — 2024-03-31

Objective: This study aims to assess the effectiveness and safety of the Harmonic scalpel compared to electrocautery for dissecting and controlling bleeding in the gallbladder during laparoscopic cholecystectomy.

Methods: 300 patients underwent laparoscopic cholecystectomy, following strict selection criteria. These criteria included having chronic cholecystitis, no complaints at the time of operation, being between the ages of 18 to 70 years, having a normal body weight, an American Score of Anesthesia (ASA) classification of 1 or 2, no prior upper abdominal surgeries, and a gall bladder wall thickness of less than 6 mm as determined by preoperative ultrasonography.

Results: The study encompassed a total of 300 patients, with 155 patients assigned to the first group receiving electrocautery and 145 patients assigned to the second group receiving harmonic treatment. Intraoperative hemorrhage was observed in a total of 32 cases within the initial group, while the subsequent group exhibited 15 cases of intraoperative hemorrhage. A total of 24 patients in the electrocautery group exhibited gallbladder perforation, whereas slipped stone incidents were recorded in 10 patients. In comparison, within the harmonic group, 11 patients experienced gallbladder perforation and 2 patients encountered slipped stone incidents.

Conclusion: The harmonic scalpel has demonstrated notable safety and efficacy as a surgical instrument to dissect the gall bladder and achieve hemostasis during laparoscopic cholecystectomy. If the harmonic scalpel is accessible within the operation theatre, it can serve as a suitable alternative to electrocautery for these specific procedures.

Recommendation: The choice between the Harmonic scalpel and electrocautery should be made on a case-by-case basis, taking into consideration the surgeon's experience, patient factors, and specific clinical requirements.

A Prospective Study of Intestinal obstruction due to Tuberculosis

Amit Kumar Gupta — 2024-03-31

Introduction

It has been shown that intestinal tuberculosis-related bowel obstruction is more common in underdeveloped nations. The purpose of this study was to identify the patients' reasons for receiving worse-than-ideal outcomes and describe the surgical treatment, clinicopathological characteristics, and prognosis of tuberculous intestinal obstruction in the community.

Methods

A prospective study was conducted over 15 months at MGMMC & LSK, Kishanganj, involving 123 patients who underwent surgery for tuberculous intestinal blockage. The necessary authorities granted ethical approval for the study. SPSS version 17.0 was used to analyze statistical data.

Results

The study included 123 patients with intestinal blockage caused by tuberculosis. The ratio of men to women was 1.8 to 1. The age distribution of the median was 11–67 years old. The most common age range was 21 to 30 years old. HIV-positive individuals had a median CD4+ count of 225 cells/μl, and 26.3% also had concomitant pulmonary tuberculosis. In 72.9% of cases, minor intestinal restrictions were the most prevalent surgical findings. The ileo-caecal region afflicted patients the most frequently (57.6%).

The most prevalent surgical procedure for 55.9% of the patients involved a right hemicolectomy plus an ileo-transverse anastomosis. All of the patients were given antituberculous medications for a year following surgery. In 42.8% of cases, surgical site infection (SSI) accounted for 37.3% of postoperative complications and was the most frequent occurrence. Low CD4+ count and HIV-positive status were the two strongest predictors of SSI (p<0.001).

Recommendation

When you come into contact with someone who has tuberculosis, we advise you to frequently check yourself, be informed of the risks, and take preventative measures.

Conclusion

Our environment still has a high prevalence of tuberculous intestinal obstruction, which greatly raises morbidity and mortality rates. When the illness gets more complicated, most patients don't show up until later.

BRAIN NATRIURETIC PEPTIDE VERSUS THE SIMPLIFIED ACUTE PHYSIOLOGY SCORE 3 FOR PREDICTING MORTALITY IN A SOUTH AFRICAN GENERAL INTENSIVE CARE UNIT.

Thembekile Pam — 2024-03-26

Background:

The biomarker brain natriuretic peptide (BNP) may be more useful for risk stratification in general intensive care unit (ICU) patients when compared with more complex scores, such as the Simplified Acute Physiology Score 3 (SAPS 3). This study sought to investigate the prognostic relevance of BNP levels and SAPS 3 for ICU mortality at a South African quaternary hospital.

Methods:

This was a retrospective chart review of adult patients admitted to the general ICU of the Inkosi Albert Luthuli Central Hospital in Durban, South Africa in 2018 and 2019. Patient characteristics, BNP levels, and SAPS 3 totals were collected for each patient. The study outcome was ICU mortality following admission to the ICU. The prognostic relevance of BNP levels and SAPS 3 was investigated using receiver-operator characteristic curve statistics and area under the curve (AUC).

Results:

The sample size was 376 patients (medical: 133; surgical: 243). ICU inpatient mortality was 29%. SAPS 3 demonstrated superior prognostic accuracy when compared with BNP (AUC = 0.815 vs. 0.657). However, when BNP levels were compared between patients stratified as high- and low-risk for mortality based on SAPS 3, the BNP levels were significantly higher in low-risk patients who died vs. low-risk patients who survived (median: 306.0 ng/L vs. 92.0 ng/L, p<0.001).

Conclusion:

Overall, SAPS 3 was superior to BNP at predicting ICU inpatient mortality. However, BNP might potentially have some prognostic utility in patients stratified as low risk according to SAPS 3.

Recommendation:

Future research, specifically larger multicentre studies, should be conducted in the African continent to validate the results of the present study.

Research Comparing Peritumoral Injection of Methylene Blue Dye with Peri Areolar Injection as a Single Approach for the Identification of Sentinel Lymph Nodes in Individuals with Clinically Non-Palpable Breast Cancer

Kaushalendra Kumar — 2024-03-31

Background: Selecting the optimal place for injecting the blue dye in breast cancer is one of the most hotly contested questions in the SLN detection procedure. The injection techniques for peri areolar and peritumoral MBD have been compared in several studies. None, nevertheless, have evaluated the two in conjunction as opposed to using just one method.

Objective: In contrast to combining peri areolar and peritumoral injection techniques, the study's objective is to assess the SLN's detection rate utilizing peri areolar injection technique. This type of research will be helpful in standardizing the SLN approach in a tertiary care setting using MBD, hence avoiding axillary dissection in cases of early breast cancer.

Methods: This is a prospective comparative investigation with a sample size of 60 patients. Female individuals with early-stage breast cancer who were medically non-palpable and had histopathological confirmation were included. Essential workup was done which included basic routinely done OT investigations which are blood investigations, electrocardiogram and chest Xray. All patients provided informed written permission, after which they were split into two groups at random for injection of methylene blue dye for sentinel lymph node biopsy.

Results: Comparison of age in the study population is statistically significant (p value = 0.8245) and comparison of tumor site among population, upper quadrant is maximum in group A (46.67%) and B (60%) both. Comparison of histological types of carcinoma breast is not statistically significant.

Conclusion: The study found that using a 1% Methylene Blue Dye (MBD) solution is sufficient for Sentinel Node Biopsy (SNB) in breast cancer cases, even in clinical settings with limited access. .

Preoperative Surgical Site Hair Removal for Elective Abdominal Surgery: Does It Have Impact on Surgical Site Infection?

Aftab Ahmed — 2024-03-31

Background: Surgical site infection due to hair follicles on the site of incision is an avoidable postoperative complication. Removal of the hair from the surgical site has been practised to avoid such occurrences. Hairs are often considered to be unhygienic and therefore removal of the hair is a ritual before the surgery. However, the literature shows that it does not correlate with the occurrence of the infection.

Method: This study was conducted prospectively at the surgery department of the Sheikh Bhikhari Medical College, Hazaribag. The abdominal surgeries conducted in a year were included in this study. Two groups were formed. The first group underwent removal of hair whereas the other group did not undergo the hair removal process. The occurrence of infection was thoroughly evaluated and the data obtained from both the groups were compared. The patients were evaluated during the 7th day, 14th day, and a month of the surgery

Results: In all 200 patients participated in this study including both the groups out of which 21 got surgical site infection. Surgeries for less than 2 hours and the surgeries in the clean contaminated category only had significant statistical differences in the occurrence of surgical site infection in both groups.

Conclusion: From this study, it is found that when the duration of the surgery is less than 2 hours and the surgery of the clean contaminated category then there is a statistically significant difference in the shaved and unshaved group considering the number of SSI. Otherwise shaving does not cause any alteration in the number of SSIs.

Recommendation: Shaving should be considered preoperatively if its potential benefits outweigh the occurrence of surgical site infection. Also in case of clean contaminated open surgeries a rigorous prophylaxis of antibiotics should be given.

AN INVESTIGATION INTO THE USE OF ISOBARIC LEVOBUPIVACAINE AND ROPIVACAINE FOR SPINAL ANAESTHESIA DURING ELECTIVE LOWER LIMB ORTHOPAEDIC PROCEDURES.

Mrituanjay Kumar — 2024-04-01

Objectives:

The investigation aimed to contrast the anaesthetic activity of isobaric ropivacaine and levobupivacaine in lower limb orthopaedic surgeries, examining their respective onset, duration of loss of motor and sensory functioning, as well as overall safety profile.

Methods:

A randomized, double-blind investigation spanning for over a year was conducted at Shahid Nirmal Mahato Medical College in Dhanbad, Jharkhand, India to contrast the effectiveness of ropivacaine and levobupivacaine in orthopaedic surgeries of lower extremities among 120 ASA Class I and II adult patients. Employing a shuffled sealed envelope method, participants were categorized into two cohorts (Group R and Group L), and various parameters, such as sensory blockade, motor blockade, changes in the hemodynamic profile, in addition to safety, were assessed.

Results:

The investigation, involving 120 patients, categorized into Group R (Ropivacaine) and Group L (Levobupivacaine) revealed no statistically significant variations in the average time taken for surgery (81.23 min vs. 73.48 min). A similar observation was noted with the average time of commencement of sensory analgesic effect after 10 minutes (6.89 min vs. 9.24 min). The analysis of the loss of sensory and motor functioning, particularly in context with the average duration needed for maximum level of blocking sensory functioning (12.45 min vs. 16.39 min) were comparable in both cohorts. Furthermore, both groups exhibited stable hemodynamics, and neither reported common complications, emphasizing the safety profile of ropivacaine and levobupivacaine in surgical procedures of the lower extremity.

Conclusion:

The study demonstrates comparable efficacy and safety profiles between isobaric ropivacaine and levobupivacaine in lower limb orthopaedic surgeries, highlighting their interchangeability for anaesthesia management in such procedures.

Recommendation:

The study recommends further research exploring specific patient populations or surgical contexts to refine anaesthetic choices for enhanced clinical outcomes.

A RETROSPECTIVE COHORT STUDY ON REDUCED PRE-INCISION ANTIBIOTIC INFUSION TIME: EFFECTS ON SURGICAL SITE INFECTION RATES.

Surabhi Tomar — 2024-03-31

Background:

One important factor contributing to postoperative morbidity and mortality is surgical site infections (SSIs). It has been demonstrated that promptly administering preoperative antibiotics lowers the risk of SSIs. The aim of this study was to look at how SSI rates among patients taking cefazolin or vancomycin for pre-operative SSI prophylaxis were affected by a shorter pre-incision antibiotic infusion period.

Methods:

Data on pre-operative antibiotic administration, surgical services, operation schedule, and post-operative infection were gathered from 98 patients who were enrolled in a retrospective cohort analysis. Based on when the antibiotics were infused in relation to the surgery, the patients were categorized into groups. To evaluate the relationship between pre-incision antibiotic infusion time and SSI rates, statistical analysis was done.

Results:

Of the patients, 60% were male, with a mean age of 52 years. Most of the patients (70%) received cefazolin, while 30% received vancomycin. Analysis revealed that patients with antibiotic infusion started within 0 to 60 minutes before incision had a lower SSI rate compared to those with infusion started within 60 to 120 minutes before incision (p = 0.04). Multivariate analysis confirmed that earlier infusion time was related with a lower risk of SSIs (OR = 0.48, 95% CI [0.25, 0.92], p = 0.027).

Conclusion:

Early pre-incision antibiotic administration, particularly within 0 to 60 minutes before incision, significantly reduces the risk of SSIs among surgical patients. These findings emphasize the importance of adherence to timing guidelines for preoperative antibiotic prophylaxis to improve patient outcomes and reduce healthcare-associated infections.

Recommendations:

Healthcare providers should prioritize timely administration of preoperative antibiotics, aiming to initiate infusion within the hour preceding incision, to minimize the risk of SSIs in surgical patients.

A COMPARATIVE STUDY BETWEEN PREEMPTIVE MAGNESIUM SULPHATE AND GABAPENTIN IN THE MANAGEMENT OF POSTOPERATIVE PAIN IN ADULTS.

Anup Kumar Harichandan — 2024-03-02

Introduction:

Control of perioperative pain is an important aspect of anesthesia. Though several methods have been tried, pre-emptive analgesia is a debatable concept. Magnesium, an NMDA antagonist, and gabapentin, an alpha2 delta subunit of the calcium channel blocker were used as adjuvants to control perioperative pain. The objective of the present study was to compare the postoperative analgesic effect of Oral Gabapentin 10mg/kg with IV Magnesium Sulphate 50mg/kg in patients undergoing surgery under Regional Anaesthesia.

Materials and methods:

Sixty patients were divided into two groups where group A received 10mg/kg of gabapentin and group B received 50mg/kg of magnesium sulphate before spinal anesthesia. Intraoperative HR, NIBP, ECG, SPO2, urine output, and deep tendon reflexes were monitored. The sedation status of patients was assessed by the Ramsay Sedation Score. The degree of pain in the Postoperative period was assessed by VAS score at intervals of 4hrs up to the first 24hrs and with a VAS score of more than 3, Inj Diclofenac 75mg was given intramuscularly as the rescue analgesic.

Observation:

The patients in the gabapentin group achieved sensory and motor block in 6.2 and 6.3 minutes respectively while patients in the magnesium sulphate group took longer time for the same i.e. 8.1 and 8.4 minutes respectively which was statistically significant (p-value < 0.001). The pain score was significantly lower in the gabapentin group compared to the magnesium group (p-value < 0.05). The requirement for rescue analgesia was higher in the magnesium sulfate group but was not statistically significant.

Conclusion:

Pain score was significantly lower among the patients in the gabapentin group compared to the magnesium sulfate group at different time intervals. Hypotension was observed in a few patients in the magnesium sulfate group.

Recommendation:

Magnesium sulfate as pre-emptive analgesia should be considered to reduce the postoperative requirement of analgesics.

DEXMEDETOMIDINE DOSAGE'S EFFECT ON SHORT-TERM COGNITIVE FUNCTION IN ELDERLY PATIENTS RECEIVING HEAD AND NECK CANCER SURGERY.

Shashank Dhiraj — 2024-03-30

Objectives:

This study aimed to investigate the comparative effects of low-dose and high-dose dexmedetomidine infusion on postoperative cognitive function in geriatric patients undergoing cardiac surgery, with a focus on assessing cognitive outcomes and perioperative complications.

Methods:

This prospective study conducted at IGIMS Patna, India, from May 2023 to February 2024 included geriatric patients (aged 65 and above) undergoing cardiac surgery who received dexmedetomidine (DEX) infusion. Patients were grouped into two cohorts based on DEX infusion rates: Group L (0.1–0.5 µg/kg/h) and Group H (0.5–0.9 µg/kg/h). Data on demographics, medical history, surgical details, and cognitive outcomes were collected and analyzed. The primary outcome was the MMSE score on postoperative Day 2, while secondary outcomes included perioperative complications and hospital stay duration.

Results:

There were no appreciable variations in the primary outcomes, such as MMSE scores and POD incidence, between the two DEX infusion rate groups (Group L and Group H) in this trial of ninety elderly patients receiving head and neck cancer procedures. Nonetheless, bradycardia and intraoperative hypotension were more common in Group H. There were no instances of myocardial infarction, stroke, or hospital death in either group. Group H showed similar reductions (T1 vs. T0, p < 0.001) with stabilization in cognitive recovery beyond the early postoperative period, while Group L's MMSE scores considerably dropped postoperatively (T1 vs. T0, p < 0.001) and then partially recovered (T2 vs. T1, p < 0.001).

Conclusion:

The study underscores the significance lower DEX infusion rates may offer better cognitive protection postoperatively, while high doses increase the risk of intraoperative hypotension and bradycardia in elderly patients undergoing head and neck cancer surgeries.

Recommendation:

The study recommends careful consideration of DEX infusion rates to balance cognitive protection with cardiovascular risks in elderly patients undergoing head and neck cancer surgeries.

CLINICAL STUDY OF INTRA-ABDOMINAL PRESSURE IN PATIENTS WITH ACUTE ABDOMINAL CONDITIONS: A PROSPECTIVE STUDY.

Shubham Kumar — 2024-03-19

Background:

Objectives: This study explores the connection between elevated pressure within the abdominal cavity and the onset of acute abdomen, aiming to understand its prevalence, its effect on the functioning of organs, and the efficacy of early interventions for improved patient outcomes.

Methods:

The study, conducted in the Department of General Surgery of Indira Gandhi Institute of Medical Sciences (IGIMS) in Patna, Bihar, India, between January 2022 to December 2023 enrolled 150 participants diagnosed with acute abdomen based on specific criteria. Following WSACS guidelines, intra-abdominal pressure (IAP) measurements categorized patients into normal and elevated IAP groups, further unveiling distinct intra-abdominal hypertension (IAH) subgroups. Utilizing IBM SPSS and Statistica, the statistical analysis explored correlations, group differences, and regression, offering valuable insights into the impact of IAH on patient outcomes.

Results:

The study consisted of 150 acute abdomen patients, in which those with intra-abdominal hypertension (IAH) (n=90) showed a significant mortality rate of 40%, compared to 22.5% in the normal pressure group (n=60). Stratifying IAH patients by IAP levels revealed distinct mortality rates: 29%, 35%, 50%, and 80% in the four groups respectively. Statistical analyses revealed prominent correlations between mean IAP and key clinical parameters, including an extremely strong positive correlation between APP and FG. The trends depicted a gradual increase in SOFA score and CVP values with rising IAP levels, peaking in the fourth group.

Conclusion:

The study highlights the significant effect of IAH on organ perfusion and patient outcomes in acute abdomen. These findings underscore the importance of early recognition and targeted interventions to improve prognosis and reduce mortality.

Recommendation:

The study recommends implementing proactive measures for early detection and management of IAH in the acute abdomen to enhance patient outcomes.

Implementing a Clinical Practice Guideline for the Treatment of Suspected Appendicitis Could Impact the Use of Computed Tomography

Dr. Amit Kumar Gupta — 2024-03-31

Background: The Royal Adelaide Hospital implemented a clinical practice guideline for the treatment of patients with suspected appendicitis. This recommendation suggests using CT scanning sparingly until more research is done. This study compared the CT usage rate for these patients during the pre- and post-guideline implementation periods.

Methods: The study included patients who came to the emergency room with symptoms and physical results that suggested they might have appendicitis. During the period following the implementation of the guidelines, these individuals were also prospectively identified if they were referred to the on-call surgical registrar. They were identified via hospital and emergency department databases.

Results: A total of 119 individuals were included in the study, 88 of them had undergone appendicectomies due to appendicitis. Analysis was contrasted among four patient cohorts. There was a 31% decrease in CT usage following the implementation of the guidelines. The outcome was statistically significant in two of the groups. The guideline's implementation resulted in a 24 percent decrease in needless procedures; nonetheless, the analysis's statistical power was inadequate.

Conclusion: According to this study, hospitals with high rates of CT use for suspected appendicitis should lower these rates to match the national norm. Clinical practice standards or protocols may help with this effort.

Evaluation on Factors Influencing Leakage in Primary Intestinal Anastomosis Within a Tertiary Care Hospital

Utkrisht Kant — 2024-03-31

Background: Intestinal anastomosis is a procedure carried out widely for various pathological conditions such as benign tumours, malignant tumours, and inflammatory conditions of a certain part of the intestine. The removal of such a part of the intestine requires the joining of the two other parts of the intestine. Postoperatively the occurrence of a leak in this joint can lead to sepsis and increase the occurrence of mortality and morbidity.

Method: The anastomosis cases of the patients at Sheikh Bhikhari Medical College, Hazaribag are studied retrospectively, and were conducted over two years. 110 cases were reviewed. Clinical and radiological examinations were recorded. The data was statistically analysed and it was correlated with the occurrence of leakage.

Results: Among the 110 patients participating in the study it was observed that 10 patients had anastomosis leakage. 50% of the patients with leakage had diabetes. more than 70% of them had undergone either emergency surgery, with a duration of more than 2 hours, and required blood transfusion. 30% of the patients with leakage had colo-colic site surgery.

Conclusion: In the present study it was found that patients who had undergone anastomosis with associated comorbidity, of the colo-colic region, with more than 2 hours of surgery, emergency surgeries, and the required blood transfusion during the surgery had higher chances of development of the anastomosis leakage.

Recommendation: Surgeons should critically analyze the occurrence of anastomosis leakage considering the predisposing risk factors, intraoperative conditions and site of the surgery.

TA SYSTEMATIC EVALUATION AND ECONOMIC ASSESSMENT OF SUGAMMADEX IN GENERAL ANAESTHESIA FOR MUSCLE RELAXATION REVERSAL.

Piyush Kumar Sengar — 2024-04-01

Introduction:

An ambulatory treatment that is frequently used on patients who have high co-morbidity is operative laryngoscopy. Utilizing the surgical exposure best anaesthetics and returning to baseline as soon as possible after surgery improves postoperative patient safety.

Aim:

To find out if sugammadex speeds up healing in patients who are having operational laryngoscopy while under general anaesthesia and have paralysis from rocuronium.

Methods:

The total of 168 participants were randomly assigned to the two groups. Both groups were given inhaled anaesthetics consisting of remifentanil, sevoflurane, and rocuronium at 0.6 to 1.2 mg/kilogram doses for intubation and preventing nausea. Neostigmine (0.04 mg per kilogram) and glycopyrrolate (0.01 mg/kg) were administered as a reversal to Group 1. Group 2 was given sugammadex (4 mg/kg) as a reversal. In both groups, vital markers were kept at a baseline of 20%. The duration required for extubation after the operations was the primary outcome measure.

Results:

There were 168 people, and the age, sex, and weight distributions in the groups were comparable. The time needed to fulfil the discharge conditions was the only difference between the two groups' primary and secondary outcomes. 35% of the group assisted neostigmine, and 65% administered sugammadex on reaching the post-anaesthesia unit, with the latter group meeting the Aldrete criteria of 18 or above.

Conclusion:

Enhancing the anaesthetic regimen, maintaining steady intraoperative hemodynamics, and using sugammadex for reversal all contribute to patients who are more prepared for discharge following surgical laryngoscopy.

Recommendation:

We recommend determining if there is any prior complication or side-effect related to administer sugammadex or neostigmine in patients to rule out any further complication.

A PROSPECTIVE STUDY ON AXILLARY CONTRACTURE FOLLOWING BURNS AT PATNA MEDICAL COLLEGE AND HOSPITAL, BIHAR, INDIA.

Sanjay Kumar Gupta — 2024-03-01

Background and Aim:

Post-burn contracture (PBC) of the axilla, stemming from burn injuries affecting the armpit region, poses a significant challenge in terms of both function and aesthetics. This study delves into the etiology, pathophysiology, clinical manifestations, and management strategies for this debilitating condition, aiming to comprehensively address the challenges faced by patients and healthcare professionals.

Methodology:

A prospective study was conducted at the Department of Plastic Surgery at Patna Medical College and Hospital in Patna, Bihar, India involving 40 patients experiencing PBC of the axilla. Inclusion criteria comprised patients who expressed a willingness to undergo surgical management, while exclusion criteria ruled out individuals with axillary contractures occurring within 12 months of their burns.

Results:

The study cohort, ranging from 8 to 47 years, revealed a predominance of flame burns (65%), with the right axilla being more commonly affected (45%). Clinical manifestations included a restricted range of motion and deformities, emphasizing the multifaceted impact of contractures. Surgical interventions varied, with 50% undergoing contracture release and split-thickness skin grafting. The preoperative range of shoulder abduction varied between 30° and 100°, with an average of 96°.

Conclusion:

Reconstructive surgery faces an intricate challenge when dealing with PBC of the axilla, requiring tailored approaches for each case. As research progresses, individualized patient care and targeted preventive measures will play pivotal roles in enhancing outcomes and mitigating the impact of this debilitating condition arising from burn injuries.

Recommendation:

To properly treat axillary burn contracture, multicenter studies should be carried out for improved generalizability; sample sizes should be increased for increased statistical power; prospective data collection should be used to reduce recall bias; and long-term follow-ups should be carried out to thoroughly evaluate the sustainability and possible complications of surgical interventions.

SUCCESSFUL SURGICAL TREATMENT FOR RUPTURE OF AN EXTERNAL ILIAC ARTERY PSEUDO ANEURYSM INTO A URETER: A CASE REPORT.

Kumar Bhartendu — 2024-03-01

Background:

Gross hematuria can indicate various urological conditions, including nephrolithiasis, malignancies, infections, and trauma. While most cases are manageable and not life-threatening, certain rare conditions like pseudo-uretero-iliac artery fistula (UIAF) are emergent and potentially fatal, requiring prompt multidisciplinary intervention for diagnosis and treatment.

Case:

This paper presents a unique case of a ruptured pseudo-iliac aneurysm in the ureter. The patient's clinical presentation, diagnostic process, and treatment approach, encompassing angiography, cystoscopy, CT imaging, and possibly surgical exploration, are discussed to highlight the complexity and urgency of managing such cases.

Conclusion:

Pseudo-UIAF represents a critical emergency with varied clinical manifestations from asymptomatic to severe shock. The successful management of this case underscores the importance of a comprehensive diagnostic strategy and a multidisciplinary approach to treatment. Further discussion on the causes, risk factors, and pathophysiology of pseudo-UIAF, along with a review of diagnosis and treatment modalities, enriches our understanding and management of such rare but lethal emergencies.

A CROSS-SECTIONAL STUDY ON WORK RELATED OCULAR INJURIES FROM A TERTIARY CARE TEACHING HOSPITAL OF CENTRAL INDIA.

Divya Verma — 2024-03-31

Background

Work-related eye injuries are more common and severe in developing nations such as India due to the lack of emphasis on occupational health and workplace safety. Literature has revealed that work-related eye injuries make up 22% of all ocular trauma cases in their study on ocular trauma. Therefore this investigation was conducted to study epidemiological aspects of work-related eye injuries.

Method

The hospital-based observational study was conducted on 362 individuals seeking treatment for work-related ocular injuries at the ophthalmology department of a tertiary care teaching hospital in Shahdol town, Madhya Pradesh. All the patients received a thorough clinical assessment at the ophthalmology department after capturing the relevant baseline information.

Results

Of the total 362 subjects, the gender-wise majority (n=331, 91.4%) were males. Most (n=224, 61.8%) of ocular injuries were observed in the younger age group (20 to 30 years). A history of previous ocular injury was noted in 7.7% (n=28). Most (n=188, 51.9%) were reported from welding work followed by grinding work (n=54, 14.9%) as the second most common. Corneal foreign bodies were noted among 47 (13%) study subjects. Just removing protective gear with no reason (n=18, 38.3%), removing protective gear due to sweating (n=12, 25.5%) & protective gear being uncomfortable (n=10, 21.3%) were the three most common reasons cited for not using protective gears for eyes.

Conclusion

The study offers an understanding of the epidemiological features of work-related ocular injuries in central India. Many of these injuries can be avoided by using suitable eye protection and receiving safety training.

Recommendations

An individualized intervention program for workers with eye injuries should be implemented due to their high susceptibility to recurring injuries.

A QUESTIONNAIRE BASED STUDY: DIGITAL EYE STRAIN AMONG UNDERGRADUATE MEDICAL STUDENTS IN A MEDICAL COLLEGE ”

Harshika malik — 2024-03-31

Aim: To ascertain the prevalence of digital eye strain (DES) among undergraduate medical students in a tertiary eye care centre located in eastern Bihar. Additionally, it seeks to identify the practices of undergraduate medical students with respect to the prevention and prevalence of digital eye strain

Materials & methods : After receiving ethical approval from the institutional ethics committee, a cross-sectional questionnaire-based study on undergraduate medical students was conducted at Katihar Medical College over the course of one month. The completed questionnaire was collected, and data was tabulated and analyzed.

Result: Out of the 465 patients in our study, 293 had symptomatic DES. 56.99% of the affected were female. The most frequent symptom reported was headache (57.20%), which was followed by tearing and burning sensation. Of the 317 people who used their digital devices for more than four hours a day, 251 had symptomatic DES, as did 159 (70.04%) of the 227 participants who held their device at a distance of less than 33 cm. Of the 37 seldom users of spectacles, 28 showed DES symptoms. Of the 259 people who wore spectacles, 165 had antiglare devices, and only 26 of them showed DES symptoms. Every one of the seven regular contact lens wearers showed DES symptoms.

In conclusion, women are more likely to experience DES, and the risk of DES increases with the amount of time spent using digital devices. It is therefore advised to have a higher contrast and a longer viewing distance as these factors lower the risk of acquiring DES. Regular use of antiglare with habitual refractive correction is advised; however, extended contact lens wear, particularly in air-conditioned environments, should be avoided

RED REFLEX-SIMPLE YET EFFECTIVE SCREENING TOOL IN NEWBORN.

Rutayani Dash — 2024-03-30

Background:

Red reflex is practically easy to execute, non-intrusive, needs a minimum instrument, and identifies various optical disorders, cataracts, and retinal disorders. Red reflex examination in the infant is advised for the early diagnosis and management of ocular abnormalities. The prime goal of this research is to examine the outcome of the red reflex test in infants.

Materials and Methods:

This retrospective research was carried out in ABC, XYZ in which 100 newborn babies were included for one year. All the detailed history of the patients was recorded. The test was carried out in a darkened room with the new baby on the lap of the parent. The dilation of the optics was done with 0.8% tropicamide, in addition to 2.5% phenylephrine.

Results:

56 newborn babies were male and 44 newborn babies were female. 68 patients had normal vaginal delivery and 32 patients had C-sections. 24 children had red reflex, 14 children had O. red reflex, 52 children had orange reflex, 8 children had grayish white reflex and 2 children had black shadow reflex.

Conclusion:

In the present research it was concluded that the red reflex test has great precision and, therefore helps in diagnosing optical disorders in newborn babies. It is observed that the red reflex is the less time-consuming and economical procedure for detecting ocular defects. The red reflex test is an easy-to-perform and secure method for the examination of the eyes.

Recommendation:

Every newborn baby should undergo a red reflex test for the optics carried out by doctors before discharging from the medical center. The outcome of the test should be termed normal if the color, intensity, and transparency of both the eyes are same. Newborn babies with abnormalities in reflex tests should be referred to a child specialist.

OBSERVATIONAL STUDY OF CLINICAL PREVALENCE OF RETINOPATHY OF PREMATURITY IN PRETERM INFANTS AT A HOSPITAL IN ODISHA.

Bijoy Kumar Mali — 2024-03-30

Background:

Retinopathy of prematurity (ROP), the scar tissue behind the neonate lens associated with retinal detachment, have been responsible for two largest ‘epidemics’ of blindness in neonates in modern times. There is rise in such cases reported around the world. However, ROP is preventable with advanced techniques. this study is carried out to determine the epidemiological profile of ROP.

Method:

This was an observational study carried out at Department of Ophthalmology and Neonatal Intensive CareUnit Veer Surendra Sai Institute of Medical Sciences and Research Centre, Burla, Sambalpur, Odisha for the period of two. infants with lesser birth weight and preterm were considered for the study. The demography of the infants, along with oxygen therapy and the other required treatments were recorded. The eye of the infants were examined with RetCam. Retinopathy was graded into Zone and Stages as per ICROP classification. Those infants with retinopathy were further examined and those with proper vascularization were not examined.

Results:

Overall 268 infants were included in this study. The occurrence of ROP was 45.9%. The infants with less than 1000 grams, gestational age between 26-30 weeks, had sepsis, had RDS, were IVH, had anemia, and received supplemental oxygen were prone to ROP. The zone II was the most affected zone and the ROP was at stage I and II IN most of the infants.

Conclusion:

The risk factors associated with occurrence of ROP includes gestational age, birth weight, RDS, anemia, sepsis, IVH, RDS, and supplemental oxygen. Proper screening is required for diagnosis of occurrence ROP.

Recommendation:

The risk factors discussed in the study should be considered for preterm babies and necessary screening should be done. Early diagnosis can prevent blindness in infants.

AN ASSESSMENT OF THE EFFICACY OF SELECTIVE LASER TRABECULOPLASTY (SLT) IN OPEN-ANGLE GLAUCOMA PATIENTS: A CLINICAL STUDY.

Manish Kumar Karn — 2024-03-01

Introduction:

Objectives: The present study aims to assess the efficacy of selective laser trabeculoplasty (SLT) in reducing intraocular pressure (IOP) when used as the first-line or supplementary therapy for primary open-angle glaucoma (POAG) patients.

Methods:

In this study conducted over one year, 1820 patients visited the Regional Institute of Ophthalmology (RIO), IGIMS, Patna, Bihar, India for SLT, averaging about 35 patients per week. The sample was bifurcated into two groups: Group A (944 patients, 1888 eyes) received SLT in addition to their existing anti-glaucomatous medications (AGM), while Group B (876 patients, 1752 eyes) comprised newly diagnosed POAG patients, for whom SLT served as the primary treatment.

Results:

In this study, the overall cohort displayed an average baseline intraocular pressure of 21.3 ± 4.8 mm of Hg, which decreased to 15.5 ± 2.6 mm Hg post-SLT. The pressure reduction was 33.5 % in Group A and 41.5 % in Group B. In some cases, when treatment with SLT alone could not give the desired intraocular pressure, both groups turned to initiating or increasing AGM. Notably, 51.3% belonging to the first group and 64.3% belonging to the second group achieved target intraocular pressure with SLT alone, and after SLT, 71.5% of first group patients and 65.3% of second group patients no longer required glaucoma medication at the last visit.

Conclusion:

SLT proves effective as both a primary and additional therapy for open-angle glaucoma, significantly reducing medicine usage. The IOP reduction remains consistent in both primary and adjunctive treatment groups during a year of follow-up.

Recommendation:

Based on the results, it is recommended to integrate SLT into glaucoma treatment protocols, exploring its potential to reduce medication reliance, and promoting extended research for a more comprehensive assessment of SLT's long-term benefits.

A CLINICAL-EPIDEMIOLOGICAL STUDY ON BLUNT OCULAR TRAUMA AND ITS VISUAL OUTCOME IN A TERTIARY CARE HOSPITAL OF EASTERN INDIA.

Shrutakirty Parida — 2024-03-01

Background:

Injury in the ocular region accidental or intended leads to ocular morbidity that accounts for poor visual prognosis and loss of quality of life, if not diagnosed and managed at the earliest. The study aims to observe clinical-epidemiological aspects of blunt ocular trauma and to determine the visual capacity.

Methodology:

An observational study was conducted. Patients with blunt ocular trauma at tertiary care hospitals were undertaken for the study. Relevant history with demographic data was noted. A detailed clinical and thorough ocular examination was done. Patients were managed with medical or surgical methods and follow-up was taken for the next six months.

Results:

Blunt ocular trauma, found in 0.24% of cases, primarily affected males aged 21 to 30 years, often laborers, agricultural workers, or rural residents. Sticks and fists were the main causes, with the right eye and anterior segment frequently affected. Traumatic glaucoma and hypotony occurred in 66% and 34% of cases, respectively, with most managed medically (67%). Refractive errors affected 36 patients, predominantly myopic (75%). Initially, best-corrected visual acuity (BCVA) was commonly 6/60-6/18 (33.2%), improving at 6 months to 6/18-6/6 (49.5%). Common B-scan findings included vitreous hemorrhage (32%), traumatic cataract (19%), lens subluxation (13%), posterior vitreous detachment (9%), retinal detachment (8%), and lens dislocation (7%).

Conclusion:

Ocular injuries lead to multiple complications; they cannot be examined accurately by routine methods. B-scan ultrasonography is recommended while investigating these injuries this aids in the preparation of the surgery with an accurate understanding of the injury.

Recommendation:

Educating people, and creating awareness to adopt protective measures in the workplace can prevent the occurrence of blunt ocular trauma, and at the same time rapid diagnosis, early referral, accurate investigations, and appropriate management can prevent complications following trauma.

ACUTE PANCREATITIS ASSESSED WITH CT USING A MODIFIED CT SEVERITY SCORE.

Manisha Kumari — 2024-03-31

Introduction:

The analysis of the seriousness of acute pancreatitis has a noteworthy part in treatment. Moderate pancreatitis can be managed by medicines, but severe pancreatitis needs thorough observation and specific treatment. The present research aims to evaluate the relation with patient result changeability of a modified CT severity score for the examination of subjects with acute pancreatitis with the present CT severity index.

Materials and Methods:

This is retrospective research carried out in Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India, in which 100 patients were included for 1 year. All the detailed history of the patients was recorded. Scans were performed utilizing GE bright speed 16-slice computed tomography. The bolus tracking technique was utilized for a distinctive scan by placing the tracker in the aorta.

Results:

58 subjects were males, and 42 subjects were females. The major cause of acute pancreatitis is alcohol intake. Acute pancreatitis in 65 patients was caused by the intake of alcohol. 25 had acute pancreatitis caused by bile stones. 7 patients with acute pancreatitis had idiopathic causes. 3 patients had other causes. In 23 patients’ cardiovascular system is involved. In 29 patients, the respiratory system was involved and in 48 cases the renal system was involved.

Conclusion:

A modified tomography scan is a great method for the examination of acute pancreatitis. It aids in the detection of pancreatic necrosis and localized complications. In the current analysis, no remarkable interconnection was seen with the requirement of operative procedure

Recommendation:

Modified computed tomography can be used in the evaluation of the severity of acute pancreatitis. It even helps in the detection of the requirement of surgical intervention.

A Prognostic Study: Comparison of Optic Nerve Sheath Diameter to Eyeball Transverse Diameter Ratio (ONSD/ETD) With CT Rotterdam and GOS

B V S Raman — 2024-03-31

Objectives: This study aims to examine the correlation between optic nerve diameter, global transverse diameter, and correlation with CT Rotterdam score and GOS.

Methods: A retrospective study of head injury patients who underwent craniotomy was carried out to assess the optic nerve diameter, global transverse diameter, as well as the ratio of pre-and post-operative values. In addition to this, the study also noted the GOS and CT Rotterdam score of each patient, and the correlation between the measure parameters and the GOS and CT Rotterdam score using Pearson's correlation coefficient.

Results: The study revealed a strong positive correlation between the ratio of pre-and post-operative values and the CT Rotterdam score, as well as a strong positive correlation between the optic nerve diameter, global transverse diameter, and the CT Rotterdam score. Additionally, a moderate negative correlation between the optic nerve diameter, global transverse diameter, and the GOS score was also noted.

Conclusion: The comparison of ONSD/ETD ratios in pre and post-operative TBI patients showed a significant reduction in the ratio following surgical intervention, indicating a decrease in elevated ICP. The preoperative ONSD/ETD ratio demonstrated a positive correlation with Rotterdam CT scoring, suggesting its potential as a marker of intracranial pathology. However, its utility in predicting functional outcomes as measured by GOS was not significant.

Recommendation: The study recommends further research to validate the clinical utility of optic nerve sheath diameter measurements in assessing brain injury severity and predicting outcomes.

CHARACTERIZATION OF DIFFERENT OVARIAN MASSES USING IOTA ULTRASOUND RULES.

Sumity Singh — 2024-03-31

Background:

An adnexal lump in a woman is a common clinical condition. Accurately defining ovarian cancers is essential because it facilitates the identification of benign ovarian masses, which can then be treated conservatively to lower morbidity. 2008 saw the IOTA group suggest basic.

Aim:

The purpose of the investigation was to determine the diagnostic value of IOTA ultrasonography rules, as well as to assess and evaluate the guidelines' sensitivity and specificity in relation to histological diagnosis and their suitability for use as a tool at our tertiary care center for the early detection of ovarian cancer.

Methods:

This prospective cross-sectional investigation was carried out in the Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India, between 2022 to 2023. The study included women who had been recruited with at least one adnexal mass. When two adnexal masses were present, the analysis took into account the mass with the more intricate ultrasonography morphology. The masses were characterized by evaluating the sonographic morphology of the masses and doing a color Doppler examination. A link between sonography and histopathology was found using suitable statistical techniques.

Results:

Using these guidelines, 158 individuals underwent USG; of these, 98 had benign, 48 had cancer, and 10 had unclear results. 47 of the 49 masses on the final HPE report that the simple rules had predicted to be benign turned out to be benign based on histology. Histology revealed that 21 of the 24 masses that the basic rules predicted to be cancer were in fact malignant.

Conclusion:

The study evaluates the effectiveness of simple rules in distinguishing between benign and malignant adnexal masses. Despite yielding inconclusive results in about 6.4% of cases, the diagnostic performance improves with extensive training provided to resident doctors. Overall, the IOTA simple rules offer a user-friendly method for classification.

THE RELATIONSHIP BETWEEN THE DISCIPLINARY POLICIES AND ACADEMIC PERFORMANCE OF PRIMARY PUPILS IN KAJJANSI TOWN COUNCIL. A CROSS-SECTIONAL STUDY.

David Lule — 2024-03-13

Background:

This study aimed to assess the relationship between school management policies and the academic performance of primary pupils in Kajjansi Town Council, Wakiso District.

Methodology:

A descriptive correlational and cross-sectional survey design was used. A total of 134 respondents were selected as the study respondents.

Results:

According to the findings, there was a fairly good positive significant correlation (r=0.673, sig=0.000) between disciplinary policy and the educational performance of the primary pupils.

Conclusion:

There was a fairly good positive significant correlation (r=0.673, sig=0.000) between disciplinary policies and the academic performance of primary pupils in Kajjansi Town Council hence a positive relationship between disciplinary policies and academic performance of pupils in primary schools. Therefore, disciplinary policies have a significant relationship with the academic performance of pupils in selected primary schools in the Kajjansi Town Council

Recommendations:

The results of the study also suggest the use of corporal punishment as a tool for discipline in public secondary schools in Kampala City, Uganda. The findings suggest that there is a strong belief that consistent enforcement of disciplinary policies creates a safe and disciplined learning environment, promotes character development, and fosters positive relationships among stakeholders.

PRIMARY DYSMENORRHEA AMONG STUDENTS AT LIRA UNIVERSITY IN NORTHERN UGANDA: SYMPTOMS PRESENTATION AND MANAGEMENT - A QUANTITATIVE STUDY.

Emmanuel Asher Ikwara — 2024-03-02

Background:

Primary dysmenorrhea (PD) is menstrual pain not associated with any pelvic pathology. It is one of the most common gynecologic complaints in young women. In Uganda, literature is scarce on the PD-associated symptoms and management strategies used by women of reproductive age. This study aimed to describe primary dysmenorrhea-associated symptoms and management strategies used by undergraduate students in northern Uganda.

Methods:

A non-experimental cross-sectional study design was used using descriptive methods of data analysis. The study was conducted among female undergraduate students of a University in Lira, northern Uganda. Systematic sampling was used to select study participants who met the inclusion criteria until 232 study participants were recruited. The data was collected using a self-administered questionnaire. Data analysis was aided by Statistical Package for Social Sciences (SPSS) (version 23) and descriptive statistics were used.

Results:

The prevalence of PD was 90.9%. The most commonly experienced dysmenorrhea-associated symptoms were change in appetite (36.0%), breast engorgement (39.8%), and depressed mood (51.4%). Pain relievers were the most commonly used management strategy (77%) with Paracetamol being the most commonly used pain reliever (29.8%). The most commonly used non-pharmacological management strategies were; exercise (47.6%), resting (44.5 %), and relaxation (44.1%).

Conclusion:

The prevalence of PD was high among the study participants. The most common symptoms experienced by those with PD were; depressed mood, breast engorgement, and change in appetite. The most commonly used management strategies for PD were pain relievers, exercise, rest, and relaxation. University management should prioritize menstrual health and design programs to educate female students on the management of dysmenorrhea-associated symptoms using both pharmacological and non-pharmacological strategies.

Recommendation:

We recommend the university prioritize education, conduct awareness campaigns, ensure access to resources and counseling, collaborate with healthcare, develop policies, and continue research.

VERBAL ABUSE AND CHILDREN’S DEVELOPMENT IN LYAMUTUNDWE VILLAGE, WAKISO DISTRICT-UGANDA: AN EXPLORATORY STUDY.

Mary Sunday Kusemererwa — 2024-03-18

Background

The community of Lyamutundwe village in Wakiso District, Uganda, engages in constant interactions between adults and children. There are abusive practices by child caretakers that go unreported and those include the use of child verbal abuse. Considering the education status of many residents of Lyamutundwe, one would assume that matters of safeguarding children from the effects of verbal abuse would be abated by highlighting their existence and addressing them. This, however, is not the case. This observation engendered a study that aimed at investigating the beliefs of caregivers about verbal abuse and how it affects children’s growth and development. The main questions were: What beliefs do caregivers hold as they interact with children? What caused adults to use abusive words to children? What could be done to abate the effects of child verbal abuse?

Methodology

The dominantly qualitative study, which was of exploratory study design, used the open-ended methods: oral interviews, participatory observations, and focus group discussions. These elicited data from the respondents that highlighted the beliefs about abusive words and perceptions of their impact on children’s self-esteem and development.

Discussion

The study discovered that depending on their beliefs about the impact of verbal abuse on children, caregivers behave differently. Those respondents who considered verbal abuse useful maintained its use while disciplining children; those who considered it destructive, because it humiliated and demoralized children, reported that they avoided it. Overall, it was observed that discouraging, blaming children, and making jokes about them were expressions of verbal abuse that negatively impacted children’s development. The study recommended that young parents in Lyamutundwe be inducted into parental roles and made aware of the dangers of child verbal abuse. The findings and recommendations could be generalized to young families in Wakiso District, and largely to Uganda and globally world over.

THE RELATIONSHIP BETWEEN OPEN ENROLMENT AND ACADEMIC PERFORMANCE OF PUPILS IN GOVERNMENT-AIDED PRIMARY SCHOOLS IN MAKINDYE SSABAGABO MUNICIPAL COUNCIL. A CROSS-SECTIONAL STUDY.

Robert Lwanga — 2024-03-02

Background:

The study aimed to examine the relationship between open enrolment and the academic performance of pupils in Government-aided primary schools in Makindye Ssabagabo Municipal Council.

Methodology:

A cross-sectional survey design was employed among 16 UPE Schools of Ndejje, Masajja, and Bunamwaya Division, Makindye Ssabagabo Municipal Council, Wakiso district. Both probability and non-probability sampling techniques were used to select primary seven pupils to participate in the study. The method was used to give every primary seven pupils a chance to participate in the study and eliminate bias. The total sample size of 142 comprised of primary seven pupils, teachers, and head teachers. Purposive sampling was used to select teachers and head teachers as respondents to provide in-depth information on enrollment criteria in the 5 selected primary schools and the academic performance of pupils in these government-aided schools in Makindye Ssabagabo Municipal Council

Results

The findings showed that schools have a relatively open enrollment policy, with a lack of strict criteria and a tendency to enroll pupils without emphasizing their previous academic performance. The class sizes are large due to open enrollment. The findings also indicate that the schools don’t have stringent measures such as interviews or probation for pupils with low academic performance.

Conclusion:

School enrollment has a significant relationship with the academic performance of pupils in government-aided primary schools in Makindye Municipality, Wakiso District.

Recommendation:

Schools should develop targeted interventions or support programs to improve academic performance in specific exams.

PLANNING AS A MANAGEMENT FUNCTION AND THE IMPLEMENTATION OF THEMATIC CURRICULUM (ITC) IN PRIMARY SCHOOLS IN DABANI SUB-COUNTY IN BUSIA DISTRICT. A CROSS-SECTIONAL STUDY.

Mohammad Sendagi — 2024-03-01

Background:

The study investigated how planning as a management function affects the implementation of the Thematic

Curriculum (ITC) in P/S in Dabani Sub-County, Busia District.

Methodology:

The study randomly sampled a population of one hundred and eighty (180) people to form a sample size of one hundred and twenty-three (123) respondents.

Results:

89 (74.2%) of the respondents were male and 31 (25.8%) were female which implies that there were more male teachers than female. There is a strong positive correlation between planning (providing more learning materials) and implementation of a Thematic Curriculum (doing exercises on a blackboard). This can be seen clearly from the correlation significance at 0.01 levels of 0.34 (r=0.34, p<0.01) This means that planning affected the implementation of a thematic curriculum, especially in the provision of teaching and learning materials.

Conclusion:

The major conclusion of the study was that planning as a management function affected ITC.

Recommendation:

The recommendations were that the Ministry of Education and Sports in collaboration with District Education Officials should carry out more studies on; the recruitment and deployment of teachers in schools, the teachers' preparations, the teaching and learning process, and then factors that affect the setting of the minimum performance standard and making corrections from deviations in the ITC.

INFLUENCE OF TEACHER FACTORS ON ACADEMIC PERFORMANCE IN UCE UNDER USE SCHOOLS IN YUMBE TOWN COUNCIL, YUMBE DISTRICT; A CROSS-SECTIONAL STUDY.

Khamis Abdallah Zubair — 2024-03-01

Background:

This study aims to find out the influence of Teacher factors on academic performance in UCE under USE schools in Yumbe town council, Yumbe District.

Methodology:

A cross-sectional survey design based on qualitative and quantitative approaches was used to get the findings. The target population comprised of 121, head teachers, teachers, students, student leaders, district education officers, Board of governor members, and community leaders were randomly and purposively sampled. The methods of data collection included: a questionnaire survey, interview, observation, and documentary review. Descriptive and inferential statistical analyses were used and the data was presented using frequency tables and correlation matrices.

Results:

The major findings were that: the majority (82%) of the teachers were well-trained and qualified, and most (62%) teachers were not well motivated by their stakeholders. Most (76%) teachers gave students ample time to practice/exercise and kept good records of their progress as shown by the 92% response rate. The teacher-student relationship was fairly good and most (54%) teachers were always present at school. Most (74% and 62%) teachers had positive attitudes towards their work and were adequately prepared before teaching.

Conclusion:

The findings made the researcher conclude that teacher factors are very important in influencing academic performance in secondary schools in Yumbe town council, Yumbe district.

However, the teachers needed to be fully motivated more by the stakeholders in the form of good pay, improving working conditions, and their welfare among others if better academic performance was to be achieved in the USE schools in Yumbe town council, Yumbe district.

Recommendations:

The Government of Uganda and school administrators should improve on the welfare of teachers in terms of pay, and decent accommodation if they are to be motivated to work hard towards better academic performance.

KNOWLEDGE, ATTITUDE, AND PRACTICE REGARDING OVER-THE-COUNTER MEDICINE AND SELF-MEDICATION AMONG STUDENTS AT MEDICARE HEALTH PROFESSIONALS COLLEGE. A CROSS-SECTIONAL STUDY.

MOUREEN INGABIRE — 2024-03-01

Study objectives:

The general objective of this study was to assess the Knowledge, Attitude, and Practice of self-medication and over-the-counter medicine use while the specific objectives were to assess the knowledge, attitude, and practice self-medication and use of over-the-counter medications among students of Medicare health Professionals College.

Methodology:

A descriptive cross-sectional study was conducted with data collected from 115 respondents selected by simple random sampling using printed self-administered questionnaires. The data was then analyzed using Microsoft Excel version 2010 and presented in tables, pie charts, and graphs.

Results:

Out of 115 respondents, 99(86%) knew that the use of medicines with unknown substances was dangerous to people with liver and kidney diseases, and 58(50%) of them got information from the internet and social media. About 113(98%) thought that self-medication was part of self-care, 82(71%) thought self-medication was acceptable, 94(82%) had practiced self-medication only once in the past 3 months, 40(35%) practiced self-medication because they had a headache, 10(45%) adjusted the dose because of not getting better.

Conclusion:

The majority of the students had considerable knowledge concerning self-medication and the majority had self-treated themselves for mild health conditions. The internet and social media were the most used sources of information among the students. However, their attitude about the safety and effectiveness of self-medication and over-the-counter medicines is not satisfactory.

Recommendations:

The government and other concerned stakeholders should have a more intense sensitization of the general population about mindset change and advice on how to safely practice self-medication. Health promotion and sensitization campaigns should also be channeled to the internet and social media since is the audience mostly used by youths in the country.

FACTORS ASSOCIATED WITH THE PREVALENCE OF HELICOBACTER PYLORI INFECTIONS AMONG PATIENTS AGED 10-25 YEARS ATTENDING MAKONGE HEALTH CENTRE III, BUIKWE DISTRICT. A CROSS-SECTIONAL STUDY.

JOHN MAGUDO — 2024-03-01

Background.

H.pylori is a flagellated gram-negative, microaerophilic, helical bacterium about 3.5 μm long, its infections are most often contracted in childhood and are known to cause Peptic ulcer. To determine the prevalence, Socio-demographic factors, and knowledge about Helicobacter Pylori infection among patients aged 10-25 years attending Makonge Health Centre III, Buikwe district.

Methodology

A cross-sectional study with a simple random sampling technique was used and data was collected using a standard semi-structured questionnaire analyzed using descriptive frequencies, and percentages using Microsoft Excel and Microsoft Word and presented in tables and pie charts.

Results

From the results, majority, 64(67%) of the respondents tested negative, the majority of the respondents were both 10-17 years and 18-25years were 29(78%) and 35(59%) H.pylori negative respectively, and the majority of both males and females tested H.pylori negative with 33(70%) and 31(53%) respectively and majority 78(81%) of the respondents had ever heard about H.pylori with low knowledge on causes, prevention, signs, and symptoms

Conclusions

From the results, majority of respondents tested negative and the minority tested positive hence low prevalence, the ages 10 to 17 and ages 18 to 25 tested negative and the majority were female, married, and urban residents and had at least attained primary school education and the majority were not taking alcohol. Therefore, higher socio-demographic status was a high predictor of H. pylori infection. In the study to assess levels of knowledge among the respondents, the majority had ever heard and the minority had never heard about H.pylori infection and the majority did not know the cause, preventive measures, signs, and symptoms.

Recommendations.

MOH should sensitize the community to test for H.pylori whenever they get signs of ulcers and conduct mass screening by the facility and health workers health educate the community about causes, Signs, symptoms, and preventive measures of H.pylori infection.

EFFECT OF MONITORING AND EVALUATION IMPLEMENTATION ON THE PERFORMANCE OF UNIVERSAL SECONDARY EDUCATION SCHOOLS IN KINYAMASEKE TOWN COUNCIL, KASESE DISTRICT. A CROSS-SECTIONAL STUDY.

SULAIT MASEREKA — 2024-03-01

Background:

The study investigated the effect of Monitoring and Evaluation implementation on the performance of Universal Secondary Education schools in Kinyamaseke Town Council, Kasese District

Methodology:

The study employed a descriptive research design and the main data collection instruments were questionnaires and interviews. The study findings were aimed at answering the study objectives whose details have been presented concerning 64 respondents. SPSS (Statistical Package for Social Scientists) was used as well.

Results:

The majority of the respondents were male 67% (43) as compared to female respondents33% (21) and most of them were within the age group 45% (31-50). Findings revealed a significant moderate positive correlation (rho= .495) between M&E implementation and performance of USE schools whereby better M&E implementation was related to better performance of USE schools and poor M&E implementation was related to poor performance of USE schools. M&E implementation accounted for a 24.5% variance in the performance of USE schools. Both M&E information gathering and M&E accountability had a significant effect on the performance of USE schools. However, M&E information gathering had a greater effect on the performance of USE schools compared to that of M&E accountability.

Conclusion:

The study demonstrates the importance of M&E implementation in the performance of schools. The positive relationship between M&E implementation in organizational performance emphasizes that school activities should be performed well for the schools to run well.

Recommendation:

Ministry of Education and Sports should put in place a mechanism to keep stakeholders informed of USE M&E activities, periodically publish its USE M&E annual financial report, and have clear informative USE M&E reports.

COMPARATIVE MEDICINE REVIEW OF IMMUNE-MEDIATED NEPHROTIC SYNDROME DUE TO BABESIA INFECTION.

Nicola Wannenburg — 2024-03-30

Awareness regarding the need for One Health is steadily increasing. This is largely due to the zoonotic element of many diseases. The past two decades have also shown increased support for translational and comparative medicine where animals with naturally occurring non-communicable diseases as well as zoonotic diseases that are also observed in humans are studied to advance both veterinary and human medicine. Understanding renal disease progression and possible means of diagnosis as well as treatment to prevent end-stage renal failure is critical to both human and veterinary medicine. Nephrotic syndrome is of particular interest due to its challenging progression and associated proteinuria/albuminuria, which if left untreated may rapidly lead to end-stage kidney failure or death by related physical complications. Nephrotic syndrome may be caused by an immune cascade from parasitic infections such as Babesia infection. Babesia is progressively becoming a global zoonotic concern for humans, including associated immune-mediated renal disease. Due to the large number of companion and feral animals infected with Babesia, the disease process and associated complications, such as nephrotic syndrome and acute liver failure are more fully understood in these species. This review aims to explore immune-mediated nephrotic syndrome due to Babesia infection in companion animals and developments in diagnosis and treatment as well as the applicability to human medicine. Advancement in urine analysis for glomerular and tubule injury biomarkers as well as the detection of immunoglobulins in urine shows promise as a less invasive means of diagnosis than renal biopsy in small and very ill patients. Further research on felines with immune-mediated nephrotic syndrome may deliver valuable information for both veterinary and human medicine and may also provide transferable insights to large human and feline populations with immunodeficiency.

FACTORS ASSOCIATED WITH ADHERENCE TO DOLUTEGRAVIR-BASED REGIMEN AMONG ADULT HIV/AIDS PATIENTS ATTENDING ANTI RETRO VIRAL THERAPY CLINIC AT MILDMAY UGANDA HOSPITAL. A CROSS-SECTIONAL STUDY.

Griffin Amutuhaire — 2024-03-01

Background:

The purpose of the study was to determine the adherence and factors associated with adult HIV patients on DTG regimens attending the ART clinic at Mildmay Uganda Hospital.

Methodology:

This was a cross-sectional study design that used quantitative methods of data collection methods. Systematic sampling techniques were used to enroll every 2^nd patient on DTG daily into the study. Data was analyzed using Microsoft Excel 2013 and presented using tables, pie charts, and graphs.

Of the 30 respondents, non-adherence was 30% and this was common among participants aged 21-30 years (67%), those who had attained secondary school education level (67%), those taking alcohol (56%) and those not taking medication in time (56%).

Results:

Most of the study participants 15(50%) were aged 21-30 years. The prevalence of non-adherence was high (30%) and was common among youthful adults (21-30 years), with poor social behaviors like taking alcohol, low socio-economic status and not taking medication on time. Study findings showed that the majority (33%) of the non-adhering respondents were peasant farmers and this is where they earn their living.

Conclusion:

The prevalence of non-adherence was at 30% and was characterized by many factors. These were respondents aged between 21 and 30 years of age, young adults without partnership support, low education level, poor social behaviors like taking alcohol, low economic status, and those poor timing for taking drugs.

Recommendations:

The Ministry of Health should strengthen sensitization programs on DTG adherence through HIV treatment programs like community outreaches and community drug refills where HIV patients can be followed up and given drug refills from their homes.

PREVALENCE AND FACTORS ASSOCIATED WITH HYPERTENSION AMONG ADULTS AGED 18-50 YEARS ATTENDING HIV CLINIC AT ENTEBBE REGIONAL HOSPITAL IN WAKISO DISTRICT. A CROSS–SECTIONAL STUDY.

ALICE TUMUSIIME — 2024-03-01

Background:

In Uganda, about 18% of HIV-infected adults are suffering from hypertension. The comorbidity of hypertension doubles the morbidity and mortality among hypertensive patients thereby hindering the attainment of the third sustainable development goal. The purpose of this study was to determine the prevalence and factors associated with hypertension among adults aged 18-50 years attending the HIV clinic at Entebbe Regional Referral Hospital in Wakiso district.

Methodology:

A descriptive cross–sectional study design that enrolled 75 respondents who were selected using a systematic sampling method was conducted. Data was collected using self – administered questionnaires and results were analyzed using STATA version 15 and results were presented in tables and pie charts.

Results:

The study revealed that social-demographic factors like male gender (58.8%), age category 41 – 50 years (64.7%), having attained tertiary education (35.3%), being married (70.6%), body weight of above 75 kilograms (47.1%) and formal employment (47.1%) were associated with hypertension. Clinical characteristics associated with hypertension were CD4 counts of 200 – 500 cells/mm³, viral load of over 200 copies/ml, and other chronic illnesses (64.7%). Alcoholic consumption (52.9%) and not engaging in physical exercises (64.7%) were some of the behavioral and lifestyle characteristics that influenced hypertension.

Conclusion:

The prevalence of hypertension among adult HIV patients aged 18 – 50 years was high (22.7%) mainly associated with older age, male gender, high body weight, sedentary lifestyle, and presence of comorbidities.

Recommendation:

The Ministry of Health should incorporate comprehensive hypertension care into HIV care to increase accessibility since there is a higher prevalence among this population

KNOWLEDGE AND SKILLS ON PROPER SOLID WASTE MANAGEMENT TO THE COMMUNITY MEMBERS OF KATANGA SLUM; A CROSS-SECTIONAL STUDY.

Hellen Nansiiro — 2024-03-02

Aim

This study aims to avail the knowledge and skills on proper solid waste management to the community members of the Katanga slum.

Methods

A qualitative participatory methodological approach was adopted for their study following the recognized steps of community entry. Initial data for problem identification was obtained using focus group discussions; transect walks, and key informant interviews.

Results

The researchers gathered data from the entire community of Katanga slum with all the primary, secondary, and tertiary stakeholders involved. The biggest percentage of respondents was from the residents of the Katanga Slum who contributed to 60% of the researchers’ study population, the local leaders of the slum who contributed to 30% of the study population, and then the tertiary stakeholders who contributed 10% of the study population.

Conclusion

The community identified and prioritized solid waste management. Lobbying was done to supplement the identified solutions using the resources available such as providing rubbish sacks, rakes, gloves, and compound brooms to enable community members to practice proper waste management. Monitoring and Evaluation of the activities was done during and after the implementation process.

The community of Katanga slum was able to gain sufficient knowledge which led to appropriate waste collection, segregation, transportation, and disposal. The research team and participants from the community were able to learn from each other and develop problem-solving and leadership skills.

Recommendation

In the process of the implementation of the recommendation another rubbish skip was provided by KCCA and rubbish sacks were placed at every household for collection of rubbish. As part of the exit strategy, a sustainability plan was set to ensure that activities go on, even after the researchers’ exit from the community, and key people in conjunction with the community health committee will take the lead in further implementation of the activities.

KNOWLEDGE ,ATTITUDES AND PRACTICES OF HEALTH WORKERS ABOUT HEPATITIS B VACCINATION AT KASANGATI HEALTH CENTER IV WAKISO DISTRICT. A CROSS-SECTIONAL STUDY.

Anna Nyambura — 2024-03-13

Introduction

Purpose

The purpose of the study was to assess the Knowledge, Practice, and attitude of health workers about Hepatitis B Vaccination.

Objective

The study had three specific objectives; to determine the Knowledge of Hepatitis B vaccination among Health workers in Kasangati Health Center IV, To determine the Attitude towards Hepatitis B vaccination among Health workers in Kasangati Health Center IV, and to determine the Practice towards Hepatitis B vaccination among Health workers in Kasangati Health Center IV.

Methodology

The research was a cross-sectional study in which both qualitative and quantitative data were collected from a sample of 59 respondents who were obtained using a random sampling technique; the data collection method was a face-to-face interview using a questionnaire.

Results

The study findings showed that 86.6% of respondents had ever heard about Hepatitis B Vaccination. However, while some health workers demonstrated a good understanding of hepatitis B, there were gaps in knowledge among others. Furthermore, the study indicated that the majority (80%) of the study respondents were willing to receive Hepatitis B Vaccination. The study also revealed that 62% of the study respondents had received Hepatitis B Vaccination, 33% of the respondents.

Conclusion

The vaccination coverage among health workers was not optimal, with a significant proportion remaining unvaccinated. This gap in practice may be attributed to various factors, including the perceived risks of vaccination and potential side effects, as well as logistical challenges in accessing vaccination services within the healthcare facility.

Recommendations

Health workers should receive regular and comprehensive training on hepatitis B, its transmission, prevention, and the safety and efficacy of the vaccine.

KNOWLEDGE, ATTITUDE, AND PRACTICES OF MOTHERS/CAREGIVERS ON HOME MANAGEMENT OF DIARRHEA IN CHILDREN UNDER FIVE YEARS RECEIVING CARE AT ENTEBBE HOSPITAL: A CROSS-SECTIONAL STUDY.

Otile Samuel — 2024-03-01

Background

Diarrhea is the leading killer worldwide accounting for approximately 8% of all death among under-five children despite the availability of simple effective treatment. A study in this regard was conducted to assess the knowledge, attitude, and practices of mothers/caregivers on home management of Diarrhea in children under five years. Specifically, the study sought to examine the knowledge of mothers/caregivers on home management of Diarrhea in children under five years, to assess the attitudes of mothers/caregivers on home management of Diarrhea in children under five years, and to finally determine the practices of mothers/caregivers in home management of Diarrhea in children under five years.

Methods

The study targeted a sample of 106 respondents (mothers/caretakers) of age group 16-50 years with children less than five years of both sexes experiencing diarrhea symptoms attending any service at Entebbe Hospital.

Findings

In terms of the knowledge of mothers/caregivers on home management of Diarrhea in children under five years, results from the findings indicated that of most of the respondents, 50.0% indicated unclean water as the main cause of diarrhea in children with the least indicating excessive cold. About attitudes of mothers/caretakers on home management of diarrhea in children under five years, most of the mothers (86.8%) believed that diarrhea was preventable, 12.3% of the respondents did not believe that diarrhea was preventable while 0.9% of the respondents did not know. Turning to practices of mothers/caretakers on home management of diarrhea in children under five years, most of the respondents, 44.3% indicated that they would go to a health facility when their children have diarrhea with the least, 1.9% of the respondents opting to go to a traditional herbalist.

Recommendation

It is therefore recommended that the government should support community sensitization programs on the diarrhea infection and their management.

FACTORS CONTRIBUTING TO THE PREVALENCE OF WASTING AMONG CHILDREN BELOW FIVE YEARS RECEIVING HEALTHCARE SERVICES AT KAYUNGA REGIONAL HOSPITAL, KAYUNGA DISTRICT. A CROSS-SECTIONAL STUDY.

IBRAHIM SSEBATA — 2024-03-01

Objectives of the study

The main purpose of this study was to determine the factors contributing to the prevalence of wasting among children below five years receiving health care services at Kayunga Regional Referral Hospital; the study focused on three objectives that are to determine the prevalence of wasting as well as to assess the childhood factors and maternal factors contributing to wasting.

Method

A hospital-based descriptive cross-sectional study was conducted between June 2023 and July 2023 at Kayunga Regional Referral Hospital in Kayunga District. Data was collected using questionnaires & simple random sampling technique was employed to select 100 study participants. Data was analyzed using Microsoft Excel version 2016 and a scientific calculator.

Results

Data analysis and interpretation showed that 9% of the children below five years who received health care services at Kayunga Regional Referral Hospital during the time of data collection were wasted. The findings of this study further showed that 77.8% of the study participants who were wasted had severe wasting while 22.2% of them were moderately wasted. The study results reflected that 41.7% of the study participants who had a birth weight < 2.5kg were wasted while 6% of those who had a birth weight of 2.5-4.0kg were wasted. The study findings indicated that 11.8% of the children who had early initiation of complementary feeding were wasted as compared to the 7.7% and 7.1% who had timely as well as late initiation of complementary feeding respectively.

Conclusion

Wasting is still a national, medical, and public health concern among children below five years old in several districts of the country including Kayunga District.

Recommendations

The study recommends combined efforts from different stakeholders like the government, Ministry of Health, health practitioners, Village Health Teams, and local leaders to curb malnutrition, particularly wasting in the country.

KNOWLEDGE, ATTITUDE, AND PRACTICES ABOUT BIOMEDICAL WASTE SEGREGATION AND MANAGEMENT AMONG HEALTH WORKERS AT KAJJANSI HEALTH CENTRE IV, WAKISO DISTRICT UGANDA: A CROSS SECTIONAL STUDY.

Shamim Akanduhura — 2024-03-01

Background

This study aims to assess health workers’ knowledge, attitudes, and practices towards biomedical waste segregation at Kajjansi Health Centre IV.

Methodology

This research study was carried out at Kajjansi Health Centre IV. The hospital is located in Kajjansi Town, Busiiro South, Wakiso district Uganda. The hospital segregates waste in color-coded waste bins. Data was collected using a self-administered questionnaire. Data was then analyzed manually through tallying and then entered into a computer.

The data gathered was then analyzed using SPSS (Statistical Package for Social Sciences) and results were presented using appropriate tables and graphs.

Results

The majority of the health workers at Kajjansi Health Centre IV were interns being a population of 29 (47%), doctors being 2 (03%), and lab technicians having the least numbers at 4 technicians from the study. It was also found that most of the health workers collected general and biomedical wastes differently that is 42 of the respondents practiced it and 8 did not carry out the practice. 40 of the respondents picked up waste with rubber gloves when on the ground, while 20 only wore gloves at times and 2 never used gloves at all.

When it came to cleaning spills of liquid of biomedical wastes with proper procedure, 40 respondents sometimes practiced the procedure and 20 carried out the proper procedure while 2 did not carry out the procedure.

Conclusion

Education level, health workers in their specialty played and correlated with the knowledge about health waste disposal and segregation, here medical doctors appeared to have the highest knowledge.

Recommendations

Health management committees should impose tough measures where all health workers attend training and workshops on biomedical waste management and segregation.

FACTORS INFLUENCING THE PREVALENCE OF MALARIA AMONG CHILDREN BELOW 10 YEARS AT NYIMBWA HEALTH CENTER IV, LUWEERO DISTRICT. A CROSS-SECTIONAL STUDY.

SAMUEL KATENDE — 2024-03-01

Background:

Broad objective: To assess the factors influencing the prevalence of malaria among children below 10 years at Nyimbwa Health Center IV, Luweero district.

Specific objectives: To determine, evaluate, and assess the demographic, economic, and environmental factors that influenced the prevalence of malaria among children below 10 years at Nyimbwa Health Center IV, Luweero district.

Methodology:

A cross-sectional study in which both qualitative and quantitative data were collected from a sample of 81 respondents who were obtained using a simple random sampling technique, The data collection method was a face-to-face interview using a questionnaire.

Results:

Malaria cases were children aged between 9 and 10 years( 33%),60% lived in villages, 52% of cases were males and 48% females, 42% were Baganda, (46%) from families earning between UGX 110,000 to 300,000 monthly, 79% from houses constructed with cement, 89% used latrines,52% got water from boreholes,72% lived in homes with nearby stagnant water (72%).85% lived in houses with no holes, 79% reared some animals and 57% disposed of wastes in rubbish pits.

Conclusions:

The study established that factors like the age and sex of the children, the economic status of the family, presence of stagnant water greatly influenced the prevalence of malaria. Other factors included education levels of guardians, religions, places of residence, source of water for domestic purposes, method of excreta, and waste disposal.

Recommendations:

Guardians should make sure children sleep under treated mosquito nets, exclusive breastfeeding for at least the first six months and a balanced diet for older children, clearing bushes and draining stagnant water near homes to keep away from breeding mosquitoes. Health workers should create awareness of malaria prevention and effective treatment of positive cases. The government should equip health facilities with adequate staff, drugs, and necessary equipment, and timely delivery of free mosquito nets to the population.

A CROSS-SECTIONAL STUDY ON THE PERSPECTIVE OF MEDICAL STUDENTS ON ONLINE TEACHING DURING THE CORONAVIRUS (COVID-19) PANDEMIC, HIMACHAL PRADESH, INDIA.

Rachna Mehandiratta — 2024-03-01

Background:

The COVID-19 crisis has propelled the educational sector into uncharted territories, necessitating the abrupt transition to online learning. Utilizing electronic technology for teaching and learning offers a promising avenue for continuous education, facilitating interactions between teachers and students. Despite its benefits, this shift has unveiled numerous challenges, impacting the efficacy of digital education.

Methods:

To explore these challenges, an online survey was conducted using Google Forms, aimed at gathering the experiences and opinions of students. The survey targeted 120 first-year MBBS students at DYSPGMC, Nahan, who had participated in online teaching. Out of these, 75 students responded and were willing to provide feedback on their online learning experience.

Results:

The survey revealed critical issues affecting online learning, including poor internet connectivity exacerbated by high traffic, and concerns about audio and video quality during live-streamed classes. Despite these challenges, online classes were generally well-received, with most students finding them acceptable and beneficial for their professional growth, given the extensive curriculum and time constraints.

Conclusion:

The study highlights significant obstacles in the implementation of online learning, such as connectivity issues and the quality of live-streamed classes. Nonetheless, the acceptance of online classes among students indicates a positive shift towards e-learning, emphasizing its potential role in facilitating continuous professional development.

Recommendations:

It is recommended to integrate e-learning into the existing curriculum, considering the positive feedback and suggestions from students. Efforts should also be made to address the identified challenges, particularly improving internet infrastructure and the quality of online delivery, to enhance the effectiveness of online learning in future educational settings.

KNOWLEDGE, ATTITUDE AND PRACTICES OF MALARIA PREVENTION AMONG PREGNANT WOMEN ATTENDING ANTENATAL CLINIC AT GOMA HEALTH CENTER III, MUKONO DISTRICT: A CROSS SECTIONAL STUDY.

Hope Pauline Mutesi — 2024-03-01

Objectives

To determine the level of knowledge, attitude and practices about malaria prevention among the pregnant women attending antenatal clinic at Goma Health center III. Methodology: The study was a descriptive cross-sectional study that involved the use of quantitative approach of data collection and analysis. Consent from 145 pregnant women attending antenatal clinic at Goma Health center III was sought before participation into the study, they answered questions in the questionnaires in line with the study objectives and the results data was stored in Microsoft excel and analysed using stara version 14.0.

Results

Out of the 145 pregnant women who participated, 87 of them (60%) were aged between 21-40 years, and only a few were aged 45 years and above. All of them had heard about malaria in pregnancy whereby most of them (98, 67.58%) had heard about it from health facilities. They all believed that mosquitoes were the Vectors that spread malaria, but a few were ignorant about its transmission where 6 (4.13%) believed it was transmitted by coming into contact with a malaria patient, other 6 (4.13%) by eating contaminated food, some 2 (1.37%) believed in transmission by eating so many mangoes.

Conclusion

The participants ‘basic knowledge about malaria in pregnancy was good because all of them (100%) had heard about it and most of them knew its correct transmission, signs and symptoms, and prevention measures. Their attitudes towards malaria prevention were not so good because most of them strongly agreed that the disease is serious and life-threatening, their practices towards malaria prevention were good.

Recommendations

The researcher therefore recommends that more health education should be done about malaria transmission to ensure excellent knowledge, self-medication should be strongly condemned because most Africans believe in it but it is risky to pregnant women.

PREVALENCE AND FACTORS INFLUENCING TUBERCULOSIS AMONG PEOPLE LIVING WITH HIV SEEKING HEALTH CARE AT THE ART CLINIC IN KAWAALA HEALTH CENTRE IV- KAMPALA DISTRICT. A CROSS-SECTIONAL STUDY.

PATRICK BAGUMA — 2024-03-01

Background

This study specifically assessed the prevalence of Tuberculosis among PLWHIV, the social and cultural factors, and the socio-economic factors contributing to the prevalence of Tuberculosis in HIV/AIDS in patients seeking health care in Kawaala Health Center IV in Kampala district.

Methodology

The study adopted a cross-sectional research design with a quantitative approach to data collection where 96 respondents were conveniently sampled and data was gathered from them using questionnaires and self-administration questionnaire method of data collection.

Results

The study established that out of 96 respondents, 10 (10.4%) had TB while 86 (89.6%) of the HIV patients studied did not have TB. Among the 10 who had TB, 07 (70%) were male and females were 03 (30%). The study further indicated that out of 96 respondents, 51 (53.1%) did not have a family history of TB however, 56 (58.3%) were active smokers and 63 (66%) did not drink alcohol but 50 (52.1%) of those who drank did so from the joints with their friends and 80 (83%) did not have any TB patient that they were closed to. The study also established that out of 96 respondents, 60 (62.5%) were unemployed of which 58 (60.4%) had an income level of below 200,000 shillings with 67 (70%) being rural residents.

Conclusion

The study therefore concluded that the prevalence of TB among HIV patients was high, most especially among male patients with the prominent socioeconomic factors being unemployment, income level of below 200,000 shillings, rural residency, and overcrowding while active smoking and drinking from the joints with friends were the prominent socio-cultural factors.

Recommendation

The study recommends the government establish collaboration between TB and HIV programs which should be strengthened by creating a coordinating body to ensure very close collaborative activities to avoid leakages in the referral system for both programs.

PREVALENCE OF HELICOBACTER PYLORI INFECTION AMONG YOUTH AGED 15 -30 YEARS SEEKING HEALTH CARE. A PROSPECTIVE CROSS-SECTIONAL STUDY. AT C-CARE INTERNATIONAL HOSPITAL KAMPALA.

Shaban Ssewankambo — 2024-03-01

Background

The study was conducted to determine the prevalence of H. pylori infections among youth aged 15-30 years seeking health care services at C- CARE IHK. The specific objectives were to determine the prevalence, and infection patterns among various age groups and genders and also find out the risk factors influencing the prevalence of H. pylori infections among youth aged 15-30 years attending C- CARE IHK.

Methodology

A prospective cross-sectional study design using both quantitative and qualitative methods was conducted. A questionnaire was used to collect qualitative data from patients' age, gender, and other relevant data that gathered data to meet and answer the objectives of the study. Prevalence was determined by collecting and testing stool samples using stool H. pylori antigen kits and then results were entered into a result sheet. A convenient way of sampling was used to select eligible participants and a sample size of 88 was obtained.

Results

Out of the 88 samples analyzed, 47% were positive for H. pylori infection while 53% were negative. The most affected were males at 53.7%, the age group was (25-30) years at 63.4% and the least affected age group was (15-19) years at 12.2%. people living in town (75.6%), people of no level of education (51.2%), alcoholism, and smoking (73.2%,34.1%) were the factors associated with the prevalence of H. pylori infection.

Conclusion

The prevalence of H. pylori was relatively high, towns and unhygienic conditions predisposed the majority of the patients while the age of 25-30 was affected mostly.

Recommendations

The Ministry of Health should advocate for the testing of youth for H. pylori infection to put more emphasis on sensitizing youth about how it’s acquired, spread, and prevented and the complications of H. pylori.

EFFECTS OF RESULTS BASED FINANCING ON PERFORMANCE OF THE INCENTIVIZED INDICATORS. A QUASI-EXPERIMENTAL STUDY DESIGN.

Doreen Musiime — 2024-03-01

Background

Despite the nationwide roll-out of RBF, the National performance of several key incentivized indicators showed a decline in performance in the year 2019/2020 compared to the previous year.

Method

The study took on a quasi-experimental study design. Data from HFs that were part of phase one of the RBF rollout (exposed group) was analyzed and compared to data from HFs in phase three of RBF implementation (Nonexposed group) a time before the rollout of RBF phase three in Uganda. All data analysis was done in Stata using version 16.

Results:

The study results show that in the exposed group of health facilities, Incentivised indicators changed significantly after the project implementation as regards the average number (mean) of clients served by the health facilities; p< 0.01, p<0.05, or p<0.1 for the difference coefficients Similar, though relatively slower effects were observable in the same indicators for an unexposed group of health facilities. IPT2 coverage declined by 6%, health facility deliveries were 59% achieved (89% national target) and declined by 3%, and under-five Vitamin A coverage declined by 9% to 21.4% far below the target of 66%. Essential drug stock declined by 7%, to 46% below the national target of 75% maternal deaths increased by 7.6%, reporting timeliness declined by 12.5% from 97.5% public health facility staffing declined by 3% to 73% against the targeted 80%.

Conclusion

RBF contributes to improved health service utilization as evidenced by the improved performance of incentivized indicators and improved data quality over time.

Recommendation

There is a need to continuously review which indicators are incentivized to achieve quality of care in all health services if it is to be mainstreamed.

OVERWEIGHT AND JUNK SNACKING AMONG THE FEMALE STUDENTS IN HIGHER INSTITUTIONS OF LEARNING. A CASE STUDY AT MILDMAY INSTITUTE OF HEALTH SCIENCES.

Emmanuel Lukwata — 2024-03-01

Background

This study aims to investigate overweight and junk snacking among female students in higher institutes of learning.

Methodology

A case study research design was used because the findings of one case can be generalized to other related phenomena. The researcher therefore used both qualitative and quantitative research methods for collecting and analyzing data to describe and interpret it into information. The target population of the study was thirty (114) respondents from which a study sample is selected. The study population consisted of both staff and female students at Mildmay institute of Health Sciences.

Results

62% of the respondents were female and 38% were male, thereby indicating that the respondents who were approached females were more than males since they were most category who depend on junk foods.

The study findings revealed that they have never had any competitive game in their lives this was supported by 65% of the respondents, 31% reported that they have ever had a competitive game and finally 4% reported that the do not remember whether they had a competitive game or not. This implies that most of them did not have competitive games and they should engage in physical exercises to cover come overweight.

Conclusion

Physical exercises in form of games have helped many students to improve on health because it makes them to avoid of the diseases related to overweight. Playing of games enable students and other categories of people to avoid overweight related challenges like obesity.

Recommendations

The study recommends that providing Healthy Food Options has to be done: Service providers should ensure that healthy food options are readily available in school cafeterias, vending machines, and snack bars. Increase the availability of fresh fruits, vegetables, whole grains, and lean protein sources.

KNOWLEDGE, ATTITUDE AND PRACTICES TOWARDS EXCLUSIVE BREASTFEEDING AMONG PRIMIPARA MOTHERS AT LUGASA HEALTH CENTER III KAYUNGA DISTRICT; A DESCRIPTIVE CROSS SECTIONAL STUDY.

BUSHIRAH KABWIRE — 2024-03-01

Introduction:

The main purpose of this study was to determine the knowledge, attitude, and practices towards exclusive breastfeeding among primiPara mothers at Lugasa Health Center iii, Kayunga district; the study focused mainly on three objectives that are to determine the knowledge, to determine the attitude and to assess the practices towards EBF among primiPara mothers.

Method:

A hospital-based descriptive cross-sectional study was conducted between March 2023 and April, 2023 at Lugasa health center iii in Kayunga District. Data was collected using questionnaires and a simple random sampling technique was employed to select 130 study participants. Data was analyzed using Microsoft Excel and a scientific calculator.

Results:

Data analysis and interpretation showed that 61.5% of the respondents defined EFB as feeding babies on breast milk only, 91.5%, knew breast milk as the cheapest and recommended food for the newly born baby, 48.5% knew that babies should be breastfed on breast milk only for the first six months of life 60% of respondents knew that a baby should be breastfed eight times and more in a day and 76% knew that EFB decreases childhood diseases and death. The study results reflected that 68.5% of the study respondents perceived the act of EBF as an easy process, and 49% reported the act of breastfeeding in public also to be okay.

Conclusion:

The majority of the study respondents had satisfactory knowledge, favorable attitudes, and good practices towards EBF. However, the practice of EBF in the study area is still lower than the set national target of the prevalence of EBF and the WHO set global prevalence of EBF.

Recommendations:

The study recommends combined efforts from different stakeholders like the government, Ministry of Health, District Health Teams, and health workers to promote appropriate Infant and young child Feeding Practices like EBF in the country.

KNOWLEDGE, ATTITUDE, AND PRACTICES ABOUT EXCLUSIVE BREASTFEEDING AMONG MOTHERS AGED 18-49 YEARS ATTENDING SEKANYONYI HEALTH CENTRE IV IN MITYANA DISTRICT. ACROSS-SECTIOAL STUDY.

Patricia Nannono — 2024-03-01

Background: Exclusive breastfeeding is the situation in which an infant receives only breast milk from his/her mother or a wet nurse for the first six months and no other solids or liquids with the exception of drops or syrups consisting of vitamins, minerals, supplements or medicines.

Method: A descriptive crossectional study with quantitative approaches was used, 96 respondents were selected using simple random sampling technique, data was collected using a questionnaire and was analyzed using descriptive statistics of frequencies and percentages.

Results: Study findings indicated that the respondents had good knowledge about exclusive breastfeeding since majority 90 (94%) had ever had about exclusive breastfeeding, majority 80 (83%) were aware of the duration of exclusive breastfeeding, and 50 (52%) knew that breast milk reduces the risk of some non-communicable diseases. A generally fair attitude towards EBF among mothers was achieved as 94 (97.9%) agreed that giving breast milk to a new borne within an hour of birth is important 95 (98.9%) agreed that breastfed babies are healthier than non-breastfed babies and only 16 (16.7%) agreed that EBF reduces the weight gained during pregnancy. Regarding the practice of exclusive breastfeeding, it was fairly good with majority 90 (93.8%) giving their babies the colostrum, 84 (87.5%) initiated breastfeeding within an hour of birth and 48 (50%) were still breastfeeding at the time of the study.

Conclusion: it was therefore concluded that there was a high level of knowledge, fair attitude and a fairly good practice of EBF.

Recommendation: The health workers of Sekanyonyi Health Centre IV as well as the Ministry of Health in Uganda should ensure continuous sensitization of the community about the relevance of EBF and the dangers of not doing so.

FACTORS INFLUENCING INSECTICIDE-TREATED MOSQUITO NET UTILISATION AMONG PREGNANT WOMEN ATTENDING ANTE NATALCARE AT KAPCHORWA GENERAL HOSPITAL IN KAPCHORWA DISTRICT. A CROSS-SECTIONAL STUDY.

PAUL CHEMUTAI — 2024-03-01

Background

The factors influencing utilization of insecticide-treated mosquito nets among pregnant women attending ANC at Kapchorwa General Hospital.

Methodology

A cross-sectional study of 100 respondents was used for the study. A simple random sampling technique was used and data collected using survey and interviewing methods was presented and analyzed using descriptive frequencies and percentages using Microsoft Excel and Microsoft Word.

Results

From the results, the majority 92(92%) of respondents said they knew about ITNs, the majority 58(58%) of respondents heard about ITNs from ANCs a majority 67(67%) said ITNs prevent malaria, a majority 89(89%) of respondents were willing to use ITNs, a majority 82(82%) were willing to recommend others to use ITNs, a majority 85(85%) said that sleeping under ITNs does not cause suffocation, a majority of married 92(92%) and high-income earners 65(74%), and mothers aged between 15 – 30 Years, 72(92%) were all utilizing ITNs.

Conclusion

From the results, the majority of respondents said that they knew about ITNs the majority of respondents heard about ITNs from ANC, and from the radio, the majority of respondents were willing to use ITNs, and a majority were willing to recommend others to use ITNs, majority of b married women were sleeping under ITNs, a majority of the individuals earning high income were sleeping under ITNs, and the majority of the mothers aged between 15 – 30 Years, were sleeping under ITNs.

Recommendation

Health workers and VHTs should encourage mothers to go to their nearest health facilities for antenatal visits, Health workers should health educate the mothers about the benefits of sleeping under ITNs to improve their attitude, Government should provide free ITNs to pregnant mothers to increase the utilization of ITNs.

PREVALENCE AND FACTORS ASSOCIATED WITH MALNUTRITION AMONG CHILDREN AGED 6-59 MONTHS RECEIVING CARE AT TORORO GENERAL HOSPITAL, TORORO DISTRICT. A DESCRIPTIVE CROSS-SECTIONAL STUDY.

Michael Oboth — 2024-03-02

Background

Globally, 149.2 million children under the age of 5 years of age were stunted,

45.4 million Wasted, and 38.9 million overweight. In Uganda, an estimated 250,000 children are suffering from severe acute malnutrition which affects their gross well-being and life span.

The purpose of the study was to establish the prevalence and factors associated with malnutrition of children aged 6-59 months receiving care at Tororo General Hospital, Tororo district.

Methodology

The study used a descriptive cross-sectional study design that used quantitative data collection methods. A stratified sampling method was used to select 30 respondents who responded to semi-structured questionnaires. Data was analyzed and presented using Microsoft Excel 2013 that presented it in the form of frequency tables, pie charts, and graphs.

Results

The prevalence of malnutrition was 30% and was associated with being female children, birth weights of less than 2500grams (55.6%), 2nd – 5th birth order (66.7%), mothers aged 18 – 24 years (44.5%), their mothers having no formal education (44.5%), weaning children before 6 months (88.9%), being more than 5 households residents (44.5%), having one meal per day (55.6%), mother not receiving husband’s support (66.7%), not having latrine at home (55.6%), poor solid waste management (66.7% ) and child having had severe sickness in the past one year (77.8%).

Conclusion

The prevalence of malnutrition among children was high at 30% and it was associated with a variety of factors such as low birth weight, young maternal age, childhood illness, low maternal education, poor breastfeeding practices, and poor hygiene.

Recommendation

Therefore, strategies should be put into practice to empower communities and mothers on how to improve the feeding behaviors of children as well as sanitation to aid in preventing these occurrences.

FOOD CHAIN SYSTEM AND NUTRITIONAL STATUS OF INMATES IN UGANDA: A CASE STUDY OF OLIA GOVERNMENT PRISON, ADJUMANI DISTRICT. A CROSS-SECTIONAL STUDY.

Edward Dramwi — 2024-03-01

Background:

This study analyzed the effectiveness and efficiency of the prison food chain system, determined the nutritional adequacy of the prison food, and the nutritional status of the inmates in Olia government, Adjumani district, Uganda.

Method:

A cross-sectional study design was used in an average 200-bed capacity of Olia government prison. Multiple methods were used to assess food available at the group and individual levels, including verification of food portion size through food plate measurements, and quality. Food portion size measurement was done for all the 199 eligible prisoners, 179 measurements were conducted for weight and height, 2 key informant interviews were conducted, and 1 FGD with the prisoners was conducted.

Result:

Planned prison food ration to be nutritionally adequate in terms of energy (Kcal), but low in quality. The micronutrient content of the ration was low in minerals and vitamins, especially minerals like calcium and iron, and vitamin A, vitamin B5, vitamin C, vitamin D, vitamin E, and deficient in vitamin B12. The ICRC dietary targets for inmates were not achieved. The prevalence of malnutrition (overweight and underweight) among the inmates was at a serious level, 10.6%. No cases of severe wasting and obesity were identified.

Conclusion:

The inmate population is at a greater risk of developing a triple burden of malnutrition due to the presence of overweight, underweight, and micronutrient deficiencies cases in the prison. Food intake to be nutritionally adequate in terms of caloric requirement but of inadequate quality. The food chain system works well, with energy change from one from preparation to distribution phase along the food chain being below the acceptable limit of 5% from the day’s ration.

Recommendations:

More efforts are needed to improve the food storage and preparation facility, local production of fruits, vegetables, small ruminants, and documentation of food stocks.

PREVALENCE AND ASSOCIATED FACTORS OF MALNUTRITION AMONG ELDERLY AGED 60 YEARS AND ABOVE AT OPD KIBOGA GENERAL HOSPITAL IN KIBOGA DISTRICT. A CROSS-SECTIONAL STUDY.

ENOCK SSEBAMBULIDDE — 2024-03-01

Background

Malnutrition refers to a state of either undernutrition or overnutrition. Undernutrition occurs when the diet a person consumes does not meet their body's requirements for growth and development while overnutrition occurs when they consume too many calories. Undernutrition may manifest as low body weight for age.

Methodology

A cross-sectional study was used to investigate factors influencing the nutritional status of the elderly aged 60 years and above in Kiboga General Hospital, Kiboga district. The researcher used this study design to collect both quantitative and qualitative data within a short period to explain the relationship between factors influencing the nutritional status of elderly patients, functional ability, and consequences of malnutrition in the elderly.

Results

The prevalence of undernourished was 47.9% based on mid-upper arm circumference (MUAC). There was a significant difference between the prevalence of malnutrition by sex; 71.9% of women were undernourished (average MUAC=20.0cm) compared to 28.1% of men. Those who had adequate knowledge regarding malnutrition had a higher education level. 80.7% of the malnourished elderly had a low-income level (poor) thus they were unable to have 3 meals or more meals each day or to buy food supplements.

Conclusion

This study found out that almost half of the elderly participants were malnourished, with females being highly malnourished than men, majority of the elderly had adequate knowledge about malnutrition due to continuous health education given in the hospital. Furthermore, the study revealed that most of the elderly were poor this in turn affected the frequency, quantity, and quality of food they fed on.

Recommendations

The elderly need to be incorporated into health programs and policies based at local government levels as is the case with pregnant and under five (5) children.

FACTORS ASSOCIATED WITH MALNUTRITION AMONG CHILDREN AGED BELOW 5 YEARS AT KINONI HEALTH CENTRE IV, RWAMPARA DISTRICT. A CROSS-SECTIONAL SURVEY .

JONAN BYAMUKAMA — 2024-03-01

Background.

Malnutrition refers to deficiencies excesses or imbalances in a person’s intake of energy and low nutrients.

Study objective

The specific objectives were to assess the knowledge of caretakers on malnutrition among children, to examine the social demographic factors, and to determine the economic factors associated with malnutrition among children below 5 years at Kinoni Health Center IV, Rwampara district.

Methodology

A cross-sectional study of 62 respondents was used for the study. The questionnaires were used to collect data and were analyzed using a tally, the data collected was also analyzed using tables and pie charts.

Results

The majority of respondents were females, residing in rural areas by 72%. Most of them believed that malnutrition was common between the ages of 4 and 5 years. Moreover, they knew that deworming prevents malnutrition. 34.5% had poor knowledge of when to breastfeed the child and 19.4% on the importance of colostrum to the newborn. Only a few 10% stated that they started their supplementary feeds for children before 6 months, while most claimed that nutrients in breast milk alone are no longer adequate for proper child growth. 48.4% replied that poverty leads to inadequate dietary intake, infections, poor hygienic habits, and low education. Many believe that unnecessary high food prices as the highest risk of malnutrition

Conclusions.

Many of the respondents’ children had good knowledge about malnutrition. The majority were agriculturalists living in rural areas. Most were from poor families where men made decisions on family income expenditure.

Recommendations

Therefore, the study recommends that health workers continuously health educate the caretakers on how to prevent malnutrition, the requirements to make therapeutic food, how to treat malnutrition in children, and how to feed children under five when they get malnutrition.

FACTORS INFLUENCING THE NUTRITION STATUS OF CHILDREN UNDER 5 YEARS AT THE NUTRITION AND PEADIATRIC WARD IN IGANGA HOSPITAL.

EMMANUEL ORUMI — 2024-03-01

Introduction:

Objectives of the study:to assess the factors influencing nutrition status among children under 5 years at the nutrition and paediatric wards in Iganga General Hospital.

The specific objectives were to assess the level of knowledge of caregivers of children, to assess the practices of caregivers of children and to find out the maternal factors; influencing nutrition status among children under 5 years at the nutrition and paediatric wards in Iganga General Hospital.

Methodology: A cross sectional descriptive study design was used, using both qualitative and quantitative approaches at the nutrition and paediatric wards in Iganga General Hospital. The researcher conveniently sampled on 100 respondents from 6^th January 2023 to 25^th January 2023. Data collection was by using self-administered questionnaires which were filled and later analyzed using tables, graphs and pie charts.

Results: Out of the 100 respondents. Majority; 89(89%) knew the importance of exclusive breastfeeding to the children for at least 6 months. Majority; 79(79%) practiced appropriate complimentary feeding while 21(21%) did not. Majority; maternal factors like age and education levels had some effect on the factors that influence on the nutrition status of the under 5years children in Iganga general hospital.

Conclusion: The study showed that despite the caretakers having knowledge of exclusive breastfeeding and complementary feeding of the children, a number of them adhere not to the practices and application of the knowledge and this was affiliated to the limited resources to do so. The study further identified that maternal age, marital status, education level and occupation had a significant influence on the nutrition status of the children under 5 years.

Recommendation: There is need for the caretakers to adhere to the practices and knowledge acquired in order to effect results concerning the improvement of the nutrition status of children

SPECIFIC CORRELATED FACTORS TO UNDERNUTRITION AMONG CHILDREN 0-59 MONTHS IN MUBENDE DISTRICT: A CASE STUDY OF MUBENDE REGIONAL REFERRAL HOSPITAL, CENTRAL UGANDA.

Emmanuel Ahimbisibwe — 2024-03-01

Background:

Malnutrition is one of the major causes of mortality and morbidity among children 0-59 months of age not only in Uganda but worldwide. To understand the causes of malnutrition among children who are 0-59 months of age, a study was conducted in Mubende Regional Referral Hospital, Mubende district in the south-central region of Uganda to find out the specific correlated factors responsible for undernutrition children of this age category.

Methodology:

The data was collected from MMRH by use of a structured questionnaire that involved Child anthropometry, Child-related factors, maternal-related factors, and male involvement. Univariate, bivariate, and multivariate analysis of data was done in MS Excel, Epi Info program-nutrition module, and Stata statistical software.

Results:

It was found out that caretaker (P=0.03, 0.01, 0.00), age at which the mother got first born (P=0.00, 0.00, 0.02), maternal occupation (P=0.02, 0.00, 0.01), and maternal education level (P=0.03, 0.02, 0.01) were the major factors influencing on undernutrition (wasting, stunting and underweight) respectively. The study also noted that male involvement in activities to address childhood undernutrition was mainly in purchasing food while other activities were not paid much attention to.

Conclusion:

The study identifies that caretaker, age at which the mother got first born, maternal occupation, and maternal education level were the major factors influencing undernutrition in children 0-59 months of age in Mubende Regional Referral Hospital, Mubende district.

Recommendation:

The study recommends the government strengthen its poverty alleviation programs to improve household incomes, as a basis for food security. Further studies have also been recommended to be carried out with male partners themselves to understand their perspective.

IS CLIMATE CHANGE A BLESSING OR CURSE? THE CHANGING CLIMATE INFLUENCE ON PLANT DISEASES AND PESTS DEVELOPMENT: A NARRATIVE STUDY.

Benson Turyasingura — 2024-03-18

The study investigates the impact of climate change on the development of plant diseases and the emergence of novel plant diseases, the conditions for disease development, mitigation strategies, and adaptation strategies for pest control. Climate change and variability may have indirect effects on animal diseases that are more significant than direct consequences. However, there has been little focus on the impact of climate change on agriculture, particularly concerning insect pests; because rising temperatures hasten insect life cycles, migration, and nutrition. It is concluded that it is necessary to construct and reinforce barriers that stop the arrival of exotic infections, develop tools for quick diagnosis of novel diseases, and train technical personnel to use these techniques once they are in place.

PREVALENCE OF HP INFECTION AMONG ADULTS ATTENDING MEDICAL SERVICES AT OUR LADY OF CONSOLANTA KISUBI HOSPITAL. A CROSS SECTIONAL STUDY.

Anthony Ssekitoleko — 2024-03-14

Objectives;

The study’s specific objectives were to determine the prevalence of Hp infection among adult female and male patients who attended medical services at Our Lady of Consolanta Kisubi Hospital from March to April 2018 and to as well establish the relationship between gender and Hp infection among adults.

Methodology;

It was a cross-sectional study and data was collected from 100 samples collected from clients aged 18 years and above. The samples were selected using consecutive Sampling techniques and analyzed using H.pylori qualitative antibody rapid test kits. The data and results of the analysis were then collected from the laboratory request forms and reported on the checklist. This was then analyzed using simple Excel data sheet analysis and graphically presented in the form of tables and pie charts

Findings;

The study showed that the prevalence of prevalence of Hp infection among female patients that attended Our Lady of Consolanta Kisubi Hospital was found to be 21.6% and that for male adults was found to be 30.6%. The study has further established that there is no clear relationship between gender and Hp infection since prevalence in males was seen to be 9% higher than that in females which can be easily related to poor feeding time management among men.

Conclusion;

The study showed that the prevalence of Hp infections among adult patients tat attended Our Lady of Consolanta Kisubi Hospital was found to be 26.0%.

Recommendations;

I therefore recommend that Our Lady of Consolanta Kisubi Hospital works with the Ministry of Health to scale up sensitization of the public and healthcare workers about Hp infection and the risks associated with the infection. Also, I recommend that a broader study be carried out on Hp infection to have a broader picture concerning the infection and its management.

ASSESSMENT OF THE QUALITY OF ROOF HARVESTED RAINWATER: A CASE STUDY OF KYENGERA TOWN COUNCIL, AKISO DISTRICT.A CROSS-SECTIONAL STUDY.

KAFEERO HUSSEIN MUKASA — 2024-03-01

Introduction

To assess the knowledge about the quality of roof-harvested rainwater for domestic use and determine the prevalence of coliforms and E. coli in roof-harvested rainwater in Kyengera Town Council, Wakiso district.

Methods

Across cross-sectional survey was conducted in Kyengera town council on the homesteads that performed roof rainwater harvesting between December 2022 and January 2023 on a sample of 196 homesteads.. Quantitative data was analyzed by using SPSS version 26.0 and presented in a tabular form using frequencies and percentages for easy interpretation. Bar graphs, box and whisker plots, and pi-charts were used to represent the data.

Results

The participants were mainly male (52.9%), aged 46-60 years (55.1%), with education level above secondary (55.1%) and non-formal employment. The majority of them (55.1%) had harvested rainwater for over 10 years.

Most of the samples were collected from inhabitants of Kitemu and Kyengera with 17.3% each. The results have shown that 94 (48.0%) of the samples were suspected to contain total coliforms with colon-forming units ranging from 2 to 250x105/ml. The prevalence of E. coli was 7.14%. Finally, 96.9% of the participants were aware of the influence of RHRW quality on its use as well as the potential contaminants of RHRW but needed to be reminded about tank cleaning.

Conclusion

The contamination of the roof-harvested rainwater collected within Kyengera town council with E. coli and other coliforms was high and is exacerbated by poor water tank hygiene.

Recommendation

Treatment of roof-harvested rainwater should be done before consumption of the water due to the associated contamination with coliforms and E. coli. This will reduce the prevalence of total coliforms and E. coli in roof-harvested rainwater which would cause waterborne diarrheas.

FACTORS INFLUENCING THE MANAGEMENT AND PREVENTION OF FUNGAL SKIN INFECTIONS AMONG CHILDREN UNDER THE AGE OF 5 SEEKING HEALTH CARE AT KAJANSI HEALTH CENTRE IV. A CROSS-SECTIONAL STUDY.

Andrew Cohen Bbaale — 2024-03-01

Purpose

This study assessed factors influencing the management and prevention of fungal skin infections in children under 5 years seeking care at Kajansi Health Centre IV in Uganda.

Objectives

The objectives were to examine caregiver knowledge, attitudes, and practices; health system-related factors; and social demographic factors impacting fungal infection prevention and management.

Methods

A cross-sectional study design was utilized. Data was collected through interviews with 100 caregivers of children under 5 with fungal skin infections at Kajansi Health Centre IV. A systematic random sampling technique was used to select participants from health center records. Structured questionnaires covering caregiver experiences, health system factors, and demographic details were administered.

Results

The Highest proportion (40) of the respondents were caretakers of children in a range of 1-2 years with the lowest observed among 5 years. Knowledge gaps among caregivers regarding causes, transmission, severity, and prevention. Variable attitudes were found, with concerns about stigma but also misconceptions of mildness. Health system weaknesses existed in workforce capacity, medication supply, and prioritization of fungal infections. Poverty, rural residence, and young age emerged as demographic factors increasing infection risk and care access barriers. Long waiting times, medication stock-outs, and financial limitations were commonly cited health system barriers.

Conclusions

Targeted education, health system strengthening, and tailored interventions for high-risk groups are necessary to address identified knowledge, attitudinal, and health system limitations negatively impacting fungal infection prevention and management.

Recommendations

Recommendations include developing national guidelines designating fungal infections as a priority issue; integrating caregiver education into outreach; ensuring consistent medication availability; improving rural access through outreach; establishing community initiatives to address financial barriers; and strengthening health workforce capacity.

DETERMINANTS OF UPTAKE OF COVID-19 VACCINATION AMONG TEACHERS IN UGANDA, A CROSS SECTIONAL STUDY USING BARRIER ANALYSIS APPROACH.

ALEX MUKEMBO — 2024-03-31

Background

The COVID-19 pandemic continues to adversely affect the population with over 233 million infections and over 4 million deaths. COVID-19 resulted in the closure of schools and education institutes in countries including Uganda. Several COVID-19 vaccines have been developed, however uptake and hesitancy remain big challenges. With the reopening of schools and education institutes tagged to total vaccination of teachers, understanding key determinants for uptake of COVID-19 uptake in teachers may help to develop strategies for improving vaccination programs. This study assessed determinants of COVID-19 vaccine uptake among teachers in Uganda.

Methods

A cross-sectional study was conducted using a barrier analysis approach targeting teachers from both the private and public sectors in 5 districts across the regions of the country. 448 teachers (224 vaccinated and 224 non-vaccinated) were sampled using a multistage approach. Each sampled vaccinated teacher was matched with a non-vaccinated teacher from the same community using a snowball approach. Sampled teachers were interviewed by trained research assistants using structured electronic questionnaires from May –June2021. Collected data was downloaded into Excel then cleaned before being exported to stata version 15 for analysis. At bivariate level, factors were considered significant at p<0.05

Results

Factors that were positively associated with uptake of covid-19 vaccine were older age, easy access to vaccination site, perceived increased risk of contracting COVID-19, belief that COVID-19 vaccine can protect against COVID-19 and trust in the vaccine. Factors that were negatively associated with uptake of COVID-19 vaccines were, lack of vaccines , long distances from vaccination site, perceived severity of side effects and perception that few people contracted COVID-19 in the community.

Conclusion

Increasing access to vaccines through the creation of more vaccination sites, sensitization of safety of Covid vaccines, and risk of contracting Covid by teachers are critical to increasing COVID-19 vaccination rates among teachers.

FACTORS INFLUENCING COMPLETION OF IMMUNISATION SCHEDULE AMONG CHILDREN UNDER FIVE YEARS; A CASE OF KOMAMBOGA HEALTH CENTER III; A CROSS-SECTIONAL STUDY.

Denis Ndyamuhaki — 2024-03-16

Background

The purpose of this study was to examine factors influencing the completion of immunization schedules among children under five years old at Case Komamboga Health Center III. The objectives of the study were; to determine the child-related factors, parent/caretaker, and health facility-related factors influencing the completion of immunization schedule among children below 5 years at Komamboga Health Center III.

Methodology

The study used a cross-sectional design. Data was collected using a questionnaire method and a questionnaire as a tool. Simple random sampling was used to collect data from the 71 mothers/caretakers. Data was sorted and entered into Microsoft Excel and later presented into pie charts and tables

Results

The majority (78%) of the respondents had their children immunized however only 56.4% had completed the immunization schedules. The majority of the children that were fully immunized were 12-23 years old (45.1%), were firstborn (32.3%), and were female children (54.8%). Most of the fully immunized children were from the parents/caretakers who were 25-34 years old (61.8%), had secondary education (35.4%), and earned about 100,000-250,000 shillings (41.1%). The majority of the fully immunized children were residing less than 5 kilometers from the health facility (91.7%), and their parents/caretakers stated that the healthcare providers were not friendly (54.8%) and that vaccines were always available (93.5%).

Conclusions

Generally, child, mother/caretaker, and hospital-related factors influence the completion of immunization schedules among children under five years.

Recommendations

The study recommends that policies designed to promote child immunization should incorporate age, birth order, distance to health facility, and sex into their policies to have policies impactful.

HUMAN PAPILLOMAVIRUS VACCINATION AND ITS ASSOCIATED FACTORS AMONG FEMALE ADOLESCENTS (AGED 9-14 YEARS) ATTENDING KAJJANSI HEALTH CENTER IV IN WAKISO DISTRICT: A CROSS-SECTIONAL STUDY.

Shibbah Ankunda — 2024-03-01

The background of the study

Uganda is overflowing with many women of reproductive age at risk of developing cervical cancer. Getting immunized with the HPV vaccine could be the only hope to avert this risk. WHO greatly recommends HPV vaccination to combat the spread of the HPV vaccine. However, despite availing the HPV vaccine in health facilities, its uptake remains stunted.

The objective of the study

The objective of the study was to determine the factors associated with the uptake of Human Papillomavirus vaccination among female adolescents attending Kajjansi Health Center IV in Wakiso district.

Study methods

The study was of a cross-sectional descriptive design that utilized quantitative methods of data collection. This enabled the researcher to collect data from a large number of respondents (100 respondents) within a short period.

Results

A total of 100 questionnaires were collected. The score rates of knowledge were 63%, and those of attitude towards its effectiveness were 46% and uptake rates were 54%. The main factors influencing knowledge were age, attitude towards its effectiveness, and the source of information. Altitude was affected by socioeconomic status, and the uptake was mainly affected by the side effects experienced.

Conclusions

It was evident that most participants had information about HPV vaccination, although it was insufficient for them to complete the series. The side effects of the vaccine, inadequate health worker recommendation, inadequate knowledge about the safety of the vaccine, and absence of school-based vaccination programs were observed to influence its uptake.

Recommendations

Mass sensitization of the public should go on to enhance a complete understanding of the need to start and complete the series of HPV vaccinations. Any program aimed at creating mass awareness about HPV vaccination at any level should be boosted by the people in charge.

KNOWLEDGE, ATTITUDE AND PRACTICES TOWARDS CHILD IMMUNIZATION AMONG MOTHERS ATTENDING TO KISIITA HEALTH CENTER III, IN KAKUMIRO DISTRICT

JIBRIL KAZIBWE — 2024-03-01

Introduction

The burden of un-immunized children in Uganda is 48% of children under the age of five years who are not immunized at all or partially immunized meaning some of them start immunization but do not complete the immunization schedule.

Methodology

The study was based on a purposive sampling method in which 117 mothers were enrolled in the study; the study employed a structured questionnaire which was administered by the researcher and the research assistants to collect data.

Results

Majority of the mothers; we're in the 21- 30 age group 60(51.3%), 84(71.8%) were married, 50(42.7%) were banyankore by tribe, majority 63(53.8%) were farmers, 40(34.1%) were Catholics, those who attained secondary education level were 63(53.8%). Of those who had heard about child immunization 73%, majority 44(37.6%) heard about it from radio, majority 60(51.3%) mentioned fever as the side effect they know following immunization, 57(48.7%) mentioned 3 and more child immunizable diseases, and majority mentioned others about the importance of child immunization, 34(29.1%) mentioned that immunization promotes child health, 20(17.1%) it protects from serious diseases, 19(16.2%) reduces risk of child death rates. The majority, 71% of the respondents said yes in support of child immunization services being carried out, 68% agreed that they would encourage others to bring their children for immunization, and 70% said yes the support of immunization programs to continue. The majority 71% had ever taken their children for immunization.

Conclusions

Majority of the mothers knew child immunization, its importance towards their children’s health, and the VPDs. Recommendations

Government should come up with programs creating awareness concerning the importance of child immunization as well as providing health education to parents about the Vaccine Preventable Diseases.

ADVANCEMENTS IN MARBURG VIRUS VACCINE DEVELOPMENT: UNRAVELLING RECENT FINDINGS. A NARRATIVE REVIEW.

Amna Zaheer — 2024-03-01

Marburg Virus Disease (MVD) is a lethal single-stranded RNA virus transmitted by Egyptian rousette bats, causing 12 surges in Sub-Saharan Africa, including a recent outbreak in Tanzania in 2023. With a fatality rate of approximately 90%, no approved vaccines currently exist. Ongoing research explores potential candidates, such as a recombinant vesicular stomatitis virus (VSV)-based vaccine and MVA-BN-Filo, aiming to combat this deadly infection. The objective of this review is to comprehensively examine Marburg virus vaccines, exploring various candidates and their development stages, efficacy in non-human primates and human studies, and challenges faced in the development process. Various vaccines are under development, including Ad26, Ad5, viral vector, and DNA vaccines. Promising candidates like Ad26.Filo and ChAd3-MARV have emerged. Additionally, VLP-based, DNA plasmid and rVSV-based vaccines are discussed, highlighting their effectiveness and challenges in development, such as limited information, gene expression issues, and outbreak control measures. The implications for future research and clinical practice/policy development are significant. Marburg virus vaccine development shows promise in mitigating the threat posed by this deadly pathogen. Despite complex challenges, advancements in vaccine candidates offer hope. Continued research and development may lead to the successful prevention of major Marburg virus outbreaks. Ongoing clinical trials indicate potential breakthroughs in a short period, contributing to public health protection.

KNOWLEDGE, ATTITUDE, AND PRACTICES OF MOTHERS TOWARDS CHILD IMMUNISATION AT GOMBE DISTRICT HOSPITAL, BUTAMBALA DISTRICT. ACROSS-SECTIONAL STUDY.

Resty Namutebi — 2024-03-01

Introduction

Immunization is the process whereby a person is made immune or resistant to an infectious disease, typically by administering a vaccine. These vaccines help to stimulate the body’s immune system to protect the person against subsequent infection or disease.

Methodology

This was a cross-sectional study that employed a random sampling method and each participant was assessed using a pre-designed questionnaire. Data was analyzed by use of paper, pens, and tallying and presented in tables and pie-charts for easy interpretation

Results

majority 63.2% had heard about immunization before, 50% knew that the importance of immunization was to strengthen their children’s ability to fight against childhood immunizable diseases, attitude of mothers towards immunization majority 90% agreed that immunization was of importance towards a child’s health, most of the mothers (79%) say they would encourage other mothers to bring their children for immunization majority of the mothers (64.2%) believe it’s safe to vaccinate their children. Regarding practices of mothers towards immunization; the majority (77.9%) fully immunize their children and the minority (22.1%) did not fully immunize their children because of the fear of the post-vaccination side effects.

Conclusion

majority of the mothers know child immunization, its importance towards their children’s health, and when a child needs to be vaccinated, the vids and the recommended sites for different vaccines, mothers generally had good attitude towards immunization of children since all had ever brought their children for immunization and mothers had good practices for immunization of their children which was portrayed by most of the children being fully immunized.

Recommendation

Government should come up with programs creating awareness concerning the importance of child immunization and delivery of immunization services at all health facilities among various communities as this is associated with a higher likelihood of child immunization.

POSITIVE CORRELATION OF CRP, FOLIC ACID AND D-DIMER WITH PROGRESSION OF CKD STAGING.

Afsha Mohi Ud din — 2024-03-31

Background:

Chronic kidney disease (CKD) is characterized by kidney damage or a decline in glomerular filtration rate (GFR) over a period of three months, often leading to various complications and stages of severity. Biomarkers such as C-reactive protein (CRP), D-dimer, and folic acid have been implicated in CKD progression, yet their correlation across different CKD stages remains to be fully elucidated. The study aims to do a comparative study of D-dimer, CRP, and Folic acid in different stages of chronic kidney disease.

Methods:

The study employed a cross-sectional design. Serum samples from 150 CKD patients were collected and analyzed for CRP, D-dimer, and folic acid levels using standard laboratory procedures. Statistical analysis was performed using SPSS software and Microsoft Excel to assess the significance of biomarker variations across CKD stages.

Results:

Analysis revealed significant differences in serum CRP, D-dimer, and folic acid levels among different CKD stages. Serum CRP and D-dimer levels were notably elevated in advanced CKD stages, while folic acid levels exhibited a contrasting pattern, with higher levels observed in earlier CKD stages.

Conclusion:

The study underscores the importance of monitoring biomarker levels in CKD progression, with CRP and D-dimer serving as potential indicators of disease severity. Additionally, the observed inverse relationship between folic acid levels and CKD staging warrants further investigation into its potential protective role against CKD progression.

Recommendations:

Clinicians should consider incorporating regular assessment of CRP, D-dimer, and folic acid levels into CKD management protocols to better understand disease progression and tailor treatment strategies accordingly.

Prognostic Value of biomarkers hsCRP and NT-proBNP in patients with myocardial infarction

Sanjeev Kumar — 2024-03-31

Background: To evaluate whether serum interleukin-6 (IL-6) and highly sensitive c reactive protein is associated with preferred predictor for risk factor associated to Myocardial Infarction.

Aim: The aim of this study was to investigate the Interleukin 6 and high sensitivity C-reactive protein (hsCRP) levels in patients with Myocardial Infarction.

Materials and methods: Total numbers of 50 subjects Myocardial Infarction patients were included. hsCRP by immunoturbidimetry method, Interleukin 6 estimation was carried out by sandwich ELISA Method, The inclusion of age group was between 25 to 74 years. Statistical analysis was done by using SPSS, version 21.0. p values were calculated by Quartile ratio, ANOVA unpaired t-test and Kaplan-Meier Curve Method. The p<0.05 was considered statistically significant. All participants had completed questionnaire, physical examination, Present/Past Medical History, and laboratory assessment.

Results: The cross-sectional study, Demographic and baseline characteristic of Quartile group of IL-6 and hsCRP are significant (p value= ˂0.001). Lipid profile correlated with quartile ratio association between IL-6 and hsCRP are significant (p value= ˂0.001). IL-6 and hsCRP were each associated participants observed via Kaplan-Meier method with significantly of Quartile 25% vs 40% and Overall comparison of biomarkers (Log rank) chi square test (IL-6= 12.80 p-value= 0.005 vs hsCRP= 7.24 p- value= 0.064).

Conclusion: Our study shows that high levels of hsCRP and IL-6 may be used as diagnostic information that provided by the predictable Acute Myocardial Infarction.

EVALUATION OF SERUM TROPONIN I LEVEL IN SEVERE ACUTE RESPIRATORY SYNDROME CORONA VIRUS 2 (SARS COV2) INFECTED PATIENTS ADMITTED IN CORONA VIRUS (COVID) WARD AND INTENSIVE CARE UNIT IN SILCHAR MEDICAL COLLEGE AND HOSPITAL, ASSAM: A RETROSPECTIVE STUDY.

Biswadeep Choudhury — 2024-03-01

Background:

The pandemic of COVID-19 led to the mortality of a large number of people worldwide. In several studies carried out in different parts of the world, it was seen that cardiac troponin I is a prognosticating biochemical marker of SARS-CoV2-infected patients. This present study aimed to evaluate the serum troponin I level in severe acute respiratory syndrome coronavirus 2 infected patients admitted to covid ward and COVID ICU and to find out any relationship between cardiac Troponin I and disease prognosis. This will aid in early diagnosis.

Methodology:

102 patients participated in this study. Among the 102 patients of SARS COV 2 infection, 49 patients were taken from the Covid ward suffering from mild or moderate form of the disease. The remaining 53 patients were taken from the ICU who were critically ill. Serum cardiac Troponin I value was collected from the Laboratory Information System of the hospital and all the data was analyzed statistically.

Results:

Cardiac Troponin I level is higher in covid positive critically ill patients admitted to ICU with COVID-19. The median (IQR) value of serum cardiac Troponin I is significantly higher (0.0190 ng/ml) in COVID-19 ICU patients than in the COVID patients of the General ward (0.0120 ng/ml). The difference was found to be significant with a p-value of 0.00. A p-value of <0.05 was considered statistically significant.

Conclusion:

Serum Troponin I can be used as a prognosticating marker in COVID-19 infection and a marker of ICU admission in COVID-19-positive patients.

Recommendation:

More studies will be required with a large number of study samples to establish the findings of the present study.

ANTEPARTUM HEMORRHAGE A THREAT TO MATERNAL AND CHILDBIRTH OUTCOMES: COMMENTARY.

Francis Ogwang — 2024-03-01

NARRATIVE REVIEW AND ERIKSONIAN-SYNTHESIS OF LESSONS FROM ANIMALS: MUTUALITY OF RECOGNITION IN THE AGE OF THE PSEUDO SPECIES.

Nicola Wannenburg — 2024-03-29

Violence in society has become more pervasive in all facets of life and is often rationalized by the formation of ‘unique identities’. Homes, communities, and places of education have all been implicated. On-going violence and destruction also lead to issues surrounding the sustainability of the environment and the potential long-term impact on humans and animals. Despite technological advancement making the world a smaller place, it has not necessarily brought people together. Increased alienation from the self as well as other people and nature has been associated with decreased stability and increased psychological distress. Post the Covid-19 pandemic there has been a call for greater focus on One Health, which views the health of humans, animals, and nature as interlinked. Animals as aids for healing is ever increasing in medical and therapeutic settings. Increased focus on retaining the healing aspects of nature and relationships with animals in an ever-changing society and technological world may assist a move to a holistic approach to living, education, and ethical treatment of others and the environment. Further research is needed on children's and adults’ understanding of affective empathy and ethical action. Research as well as guidance on the ethical treatment of others may inform school curriculums and may encourage an ethical stance to policy development as well as implementation. An Eriksonian synthesis on lessons from animals regarding mutuality of recognition in an ecologically bound universe is offered as one lesson and philosophy that may facilitate ethical thinking and action.

THE INFLUENCE OF AFRICAN ORAL ART FORMS IN RAISING CLIMATE CHANGE AWARENESS IN OLIVER MTUKUDZI’S ‘PINDIRAI’.

Witness Roya — 2024-03-01

Background:

The need for different stakeholders, particularly in developing nations, to promote climate change awareness has been emphasized by scholars and environmental activists. Yet, musicians appear to be overlooked in these calls despite their influence in society. The article presents an analysis of “Pindirai”, a song that was composed and sung by the legendary Zimbabwean musician, Oliver Mtukudzi, to show how it presents the effects of anthropogenic climate change through traditional African oral art forms.

Methods:

Afrocentricity served as a theoretical lens through which we examined ‘Pindirai’ because it rejected the claim that Europe is the origin of knowledge which was perpetuated by Europe’s global dominance for many years. In addition, critical discourse analysis (CDA), a qualitative means of gathering data, was used to examine words’ frequency, usage, and implications in the song under study. CDA enabled the study to infer meanings and motivation behind the way messages are encoded which facilitated interpretations based on the context.

Results:

It was observed that, through thought-provoking rhetorical devices such as invocation, rhetorical figures, proverbs, and symbolism among others, Mtukudzi departs from the victimhood narrative by giving agency to Africans whom the singer calls on to revert to their traditions which serve as a manual for life.

Conclusions:

Mtukudzi is successful in urging Africans, using their language, to own up for their part in causing climate change by preserving natural resources. Much as scientists have flagged human activities in Western countries as the main cause of climate change, Mtukudzi is commended for urging Africans to act responsibly.

Recommendations:

African governments need to provide resources to communicate climate-related initiatives and facilitate the participation of indigenous people in endeavors that seek to sustain livelihoods in the face of adverse effects of climate change.

KNOWLEDGE, ATTITUDE AND PRACTICES ON NOSOCOMIAL INFECTION PREVENTION AND CONTROL AMONGST HEALTH WORKERS IN MUBENDE REGIONAL REFERRALHOSPITAL, MUBENDE DISTRICT. A CROSS-SECTIONAL STUDY.

MAZZI JULIET BAYIYANA — 2024-03-01

Background
Nosocomial infection rates are still high and have rather steadily increased during the recent decade, this can be due to the carelessness of health workers, failure to observe and adopt standard operating procedures, and poor waste segregation and disposal. This study aims to assess the knowledge attitude and practices on nosocomial infection prevention and control among health workers in Mubende Regional Referral Hospital, Mubende district
Methodology
A descriptive cross-section study employing a quantitative method was used, where 50 participants were selected using a simple random sampling method, data was collected using semi-structured questionnaires, and results were entered into the computer data program and Microsoft Excel for frequency tables
Results
60% mentioned that blood-borne infections are the most commonly occurring born infections, and 78% of the respondents said patients were the most common sources of hospital-acquired infections to health workers. 80% of respondents thought working in a hospital exposes you to infection with 60% thinking that his /her family members may get infected through him because some infections can be obtained from contacts and 78% of respondents felt that using PPE is essential and it can prevent the occurrence of nosocomial infections 40% were washing hands before aseptic procedures, and the majority 80% after touching the patient environment, 60% of the respondents disposed of their medical wastes and biohazards wastes after segregation and 80% discarded there sharps in the safety box, and the least 4%in bins.
Conclusion
Health workers in this study had sufficient knowledge of infection prevention prevention, but their attitudes and implementations of safe practices were substandard. The healthcare healthcare workers' practices were unsatisfactory.
Recommendation
Health workers should be trained through continuous medical education, going for further training to improve their knowledge of nosocomial infection control in health facilities

FACTORS AFFECTING DATA QUALITY IN PRIVATE FACILITIES IN KALUNGU DISTRICT.THE CASE OF ST. JOSEPH OF GOOD SHEPHERD KYAMULIBWA H/C IV. A CROSS-SECTIONAL STUDY.

Peter Wabwire — 2024-03-01

Background:

To find out how external and internal factors affect data quality in Private facilities in Kalungu district.

Methodology:

The study used a cross-sectional research design on a population that involved the staff of St Joseph of Good Shepherd Kyamulibwa H/ C IV. A total of 32 respondents were selected for the study. Both random and non-random sampling techniques were used in selecting the samples. The study was guided by a quantitative model. Data from the questionnaires was analyzed quantitatively using Statistical Package for Social Scientists (SPSS) Data from questionnaires was presented in the form of frequency tables and bar graphs.

Results:

Females were 18(56%) and 14 (44%) were males whose age was between 18 and above years. In regards to internal factors that affect data quality (69%) strongly agreed that the Compilation of inaccurate data by departments automatically distorts data quality in the long run, while 4(12%) disagreed that most departments don’t have consistent data models that would ensure the integrity and quality of the data. 1(3%) strongly disagreed that the Completeness of information entered into the facility record is not dependable. In regards to the external factors, 13(41%) strongly agreed that monitoring and keeping track of data over time and reporting variations in the data affects the quality of data. While 1(3%) strongly disagreed that data compiled by departments is not relevant to what user’s health needs requirements.

Conclusion:

The study findings confirmed that internal and external factors negatively affect data quality in private facilities.

Recommendation:

Private facilities should invest in formal training for all staff in data management, M&E topics included in the facilities’ Continuous Medical Education (CME) sessions to translate into the culture of data demand and information use (DDIU), Mentorships, and forming Quality improvement projects (QI) to promote sustainability in private facilities.

ASSESSMENT OF THE EFFECT OF THE MEDICAL STORAGE AND RETRIEVAL SYSTEMS ON SERVICE DELIVERY: A CASE OF KISWA HEALTH CENTRE IV. A CROSS-SECTIONAL STUDY.

Adrine Mpirirwe — 2024-03-01

Background:

This study aimed at assessing the effect of the Medical Storage and Retrieval Systems on Service Delivery.

Methodology:

This study adopted an analytical and cross-sectional research design that aimed at data collection for two or more variables examined at a single point in time to detect variable patterns of association. The study targeted a sample of 156 respondents and the sample respondents were drawn from the top management and middle-level staff as well as the outgoing patients from Kiswa Health Centre IV. 150 questionnaires were effectively filled in for analysis translating to a 96.2% response rate. Data analysis was conducted using SPSS on the information gathered to generate descriptive statistics. The presentation of results was done in tables and figures.

Results:

In terms of the impact of medical retrieval systems used for patient records on Service Delivery, the results indicated that medical retrieval systems positively impact Service Delivery at Kiswa Health Centre IV, this is indicated by a correlation coefficient, r =.878 whose p-value is less than 0.01. In line with the effect of the medical storage systems used on the Service Delivery, the results of the study established that there was a positive and significant relationship between the Medical Storage System and Service Delivery of Kiswa Health Centre (r =.743, p-value<0.01).

Conclusion:

The major challenges faced with the storage and retrieval of patient records at Kiswa Health Centre IV were the inefficient retrieval process, the breakdown with the integration of electronic health records, data loss or corruption challenges, training and adoption of the system challenges, data migration challenges, inadequate staff to operate the systems and finally the disorganization in record management.

Recommendation:

There is a need to recruit more medical personnel to improve the service delivery at Kiswa Health Centre IV given the challenge of inadequate resources.

MEDICAL RECORDS MANAGEMENT SYSTEM IN THE MANAGEMENT OF TUBERCULOSIS PATIENTS IN ST. FRANCIS NSAMBYA HOSPITAL: A CROSS-SECTIONAL STUDY.

Gift Nebyeye — 2024-03-01

Background

The study aimed to assess the Medical Records Management System (MRMS) in the Management of Tuberculosis Patients at St. Francis Nsambya Hospital.

Methodology

A cross-sectional design was used to assess the current state of the MRMS, including its structure, utilization, and functionality at a single point in time. The study targets the staff in the TB clinic who use the existing medical records management systems to manage TB patients. Participants were sampled using a non-probability method, specifically purposive sampling. The study encompassed qualitative data collection from home care section, where the TB clinic is found, including a target study population, face-to-face interviews, document review guide, and observation guides.

Result

The study had a total of 12 participants but only 9 responded. The majority of which were record program administrators (75%) & had 2-2.9 years of experience in using the medical records. Pertaining to the status of TB records many (83.3%) said that TB records were in an active state, while the rest reported they were in both active and semiactive states. All respondents (100%) confirmed the use of a centralized system. Identified challenges in filing and storage of TB records were: Misfiling and misplacement of records (100%), Delayed retrieval of records (100%), Overcrowding of files on shelves (66.7%), Lack of sufficient staff with expertise in records filing and storage (50%) and inadequate storage equipment (50%).

Conclusion

The back-to-front filing method used in the hospital, ensured the strategic placement of new documents on top of preceding ones, simplifying document retrieval. The findings highlighted the hospital's commitment to systematic filing practices, furthermore the hospital's dedication to maintaining accessible records for current healthcare activities. Moreover, the need for targeted interventions to enhance records management practices.

Recommendations

Methods towards filing and storage need to be improved, challenges addressed, and enhancement in record management

COMPARISON OF STOOL ANTIGEN TEST OVER UREA BREATH TEST IN DETECTION OF HELICOBACTER PYLORI INFECTION AMONG PATIENTS ATTENDING NSAMBYA HOSPITAL IN KAMPALA DISTRICT.A CROSS-SECTIONAL STUDY.

JANE NANYUNJA — 2024-03-01

Background

H. pylori infection rates are higher in resource-poor settings and developing -countries such as Uganda. Even though most health facilities in Uganda including government health facilities have put in place several measures including diagnostic methods for H. pylori, there is still a rise in the prevalence of H. pylori infection.

Aim

The study aimed to compare stool antigen test over urea breath test in detecting helicobacter pylori infection among patients attending Nsambya Hospital in Kampala district.

Methods

The study employed a cross-sectional design and a questionnaire guide to gather information from 375 individuals at the Outpatient department at Nsambya Hospital in Kampala district. These were selected using simple random sampling.

Results

The study results indicate that the prevalence of H. pylori was 48.0% by UBT and that of SAT was 46.9%, with most of the positive cases being in females 30.4% for UBT and 29.6% for SAT. On comparing SAT with UBT, SAT had a sensitivity of 97.8% and a specificity of 99.5%.

Conclusion

In this study, UBT performance showed a slightly higher prevalence of detecting H. pylori infection compared to SAT thus UBT remains the gold standard method in diagnosing H. pylori infection. In addition, UBT also detects H. pylori bacteria in low parasitemia.

Recommendations

The SAT, which detects present but not previous infection of H. pylori would be applicable in mass survey.UBT should be done for every patient suspected of having H. pylori infection with negative SAT in order not to miss out on people with the disease as it remains the gold standard for H. P diagnosis. The Health authorities and other stakeholders should encourage using UBT on all patients suspected of having H. pylori infection.