Evaluation of the Effect of Pharmaceutical Care Interventions on the Mean Daily Dose of Oral Antidiabetes Drugs in a Nigerian Tertiary Hospital

Introduction Screening and early detection reduce morbidity and mortality in colorectal cancer. Our aim is to study the effect of income disparities on the clinical characteristics of patients with colorectal cancer in Massachusetts. Methods Patients were extracted from a database containing all surgically treated colorectal cancers between 2004 and 2015 at a tertiary hospital in Massachusetts. We split patients into 2 groups: “above-median income” and “below-median income” according to the median income of Massachusetts ($74,167). Results The analysis included 817 patients. The above-median income group consisted of 528 patients (65%) and the below-median income group consisted of 289 patients (35%). The mean age of presentation was 64 ± 15 years for the above-median income group and 67 ± 15 years for the below-median income group ( P = .04). Patients with below-median income were screened less often ( P < .001) and presented more frequently with metastatic disease ( P = .02). Patients with above-median income survived an estimated 15 months longer than those with below-median income ( P < .001). The survival distribution was statistically significantly different between the groups for stage III disease ( P = .004), but not stages I, II, or IV ( P = 1, 1, and .2, respectively). For stage III disease, a lower proportion of below-median income patients received chemotherapy (61% vs. 79%, P = .002) and a higher proportion underwent nonelective surgery (5% vs. 2%, P = .007). Conclusions In Massachusetts, patients with colorectal cancer residing in lower income areas are screened less, received adjuvant chemotherapy less, and have worse outcomes, especially when analyzing those who present with stage III disease.

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Late endoscopic evaluation of the ostium size after external dacryocystorhinostomy

European Journal of Ophthalmology ◽

10.1177/1120672120976044 ◽

2020 ◽

pp. 112067212097604

Author(s):

Reem R Al Huthail ◽

Yasser H Al-Faky

Keyword(s):

Chart Review ◽

Retrospective Chart Review ◽

Tertiary Hospital ◽

Nasal Endoscope ◽

Long Term Follow Up ◽

Mean Size ◽

External Dacryocystorhinostomy ◽

The Mean

Objective: To evaluate the effect of chronicity on the size of the ostium after external dacryocystorhinostomy (DCR) with intubation. Methods: Design: A retrospective chart review of patients who underwent external DCR with intubation over 10 years from January 2003 at a tertiary hospital. All patients were recruited and examined with rigid nasal endoscope. Results: A total number of 66 (85 eyes) patients were included. The mean age at the time of evaluation was 53.1 years with gender distribution of 54 females (81.8 %). The mean duration ±SD between the date of surgery and the date of evaluation was 33.2 ± 33.6 (6–118 months). Our study showed an overall anatomical and functional success of 98.8% and 95.3%, respectively. The mean size of the ostium (±SD) was 23.0 (±15.7) mm2 (ranging from 1 to 80.4 mm2). The size of the ostium was not a significant factor for failure ( p = 0.907). No statistically significant correlation was found between the long-term duration after surgery and the size of the ostium ( R: 0.025, p = 0.157). Conclusions: Nasal endoscopy after DCR is valuable in evaluating the ostium with no observed potential correlation between the long-term follow-up after surgery and the size of the ostium.

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High Dose of Lamivudine and Resistance in Patients with Chronic Hepatitis B

Hepatitis Research and Treatment ◽

10.1155/2014/615621 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Hamid Ullah Wani ◽

Saad Al Kaabi ◽

Manik Sharma ◽

Rajvir Singh ◽

Anil John ◽

...

Keyword(s):

Chronic Hepatitis ◽

Retrospective Study ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Standard Dose ◽

High Dose ◽

Lamivudine Therapy ◽

Daily Dose ◽

The Mean ◽

Emergence Of Resistance

Background. Lamivudine is the most affordable drug used for chronic hepatitis B and has a high safety profile. With the daily dose of 100 mg there is progressive appearance of resistance to lamivudine therapy. In our study we used 150 mg of lamivudine daily as a standard dose which warrants further exploration for the efficacy of the drug. Aims of the Study. To assess the efficacy of lamivudine 150 mg daily on resistance in patients with chronic hepatitis B. Methods. This retrospective study consists of 53 patients with chronic hepatitis B treated with 150 mg of lamivudine daily. The biochemical and virological response to the treatment were recorded at a 1-year and 2-, 3-, 4-, and 5-year period and time of emergence of resistance to the treatment was noted. Results. The mean age of the patients was 54 years with 80% being males. The resistance to lamivudine 150 mg daily at 1 year and 2, 3, and 5 years was 12.5%, 22.5%, 37.5%, and 60%, respectively, which is much less compared to the standard dose of 100 mg of lamivudine. Conclusions. Lamivudine is safe and a higher dose of 150 mg daily delays the resistance in patients with chronic hepatitis B.

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Pseudotumor cerebri in childhood and adolescence: data from a specialized service

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20180131 ◽

2018 ◽

Vol 76 (11) ◽

pp. 751-755 ◽

Cited By ~ 1

Author(s):

Gabriela G. M. Balbi ◽

Sandro L. Matas ◽

Claudio A. Len ◽

Melissa M. Fraga ◽

Iggor O. Sousa ◽

...

Keyword(s):

Rheumatic Disease ◽

Disease Onset ◽

Pseudotumor Cerebri ◽

Tertiary Hospital ◽

Outpatient Clinics ◽

Childhood And Adolescence ◽

Common Symptom ◽

Medical Reports ◽

Specialized Service ◽

The Mean

ABSTRACT Objective: To report cases of children and adolescents diagnosed with pseudotumor cerebri associated or not with rheumatic disease. Methods: This was a retrospective study based on medical reports of 29 patients, up to 18 years of age and diagnosed with pseudotumor cerebri, followed up in the Pediatric Rheumatology and Neurology outpatient clinics of a tertiary hospital, until December 2016. Results: Among the 29 patients diagnosed with pseudotumor cerebri, 51.7% were girls and the mean age at the disease onset was 12.3 years. In 18 patients (62%) where an etiology was found, four were associated with a rheumatic disease. The most common symptom was headache (69%) and acetazolamide was the most used medication (69%). Two patients developed blindness and 10 are still being followed up. Conclusion: Although rare, pseudotumor cerebri should be considered in children with headaches, especially in patients with rheumatic disease.

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Treatment of hyperthyroidism with a small single daily dose of methimazole

Acta Endocrinologica ◽

10.1530/acta.0.1190139 ◽

1988 ◽

Vol 119 (1) ◽

pp. 139-144 ◽

Cited By ~ 22

Author(s):

Yasuo Mashio ◽

Mutsuo Beniko ◽

Akemi Ikota ◽

Hiroaki Mizumoto ◽

Haruhiko Kunita

Keyword(s):

Divided Dose ◽

Dose Regimen ◽

Single Daily Dose ◽

Once Daily ◽

Daily Dose ◽

The Mean ◽

Time Required ◽

Daily Dose Regimen ◽

Mean Time ◽

Immunoglobulin Levels

Abstract. A prospective randomized trial with the conventional divided doses (10 mg 3 times daily, N = 29) and a small single daily dose (15 mg once daily, N = 25) of methimazole for the treatment of Graves' hyperthyroidism was performed. Within 8 weeks, almost 80% of the patients in both groups became euthyroid. The mean time required to achieve the euthyroid state was 6.0 ± 2.8 and 6.0 ± 3.8 weeks, respectively. TSH binding inhibitor immunoglobulin was found in about 90% of the patients in both groups before methimazole treatment. However, a gradual fall of its levels was observed in nearly all patients after treatment. There was no difference in the mean levels of TSH binding inhibitor immunoglobulin between the two groups during therapy. We conclude that the single daily dose regimen of 15 mg of methimazole will control Graves' hyperthyroidism in most patients, and TSH binding inhibitor immunoglobulin levels decrease in this regimen in the same way as with the conventional divided dose regimen (10 mg 3 times daily).

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Systemic disorders and the prognosis of stroke in Congolese patients: a cross-sectional study

Ghana Medical Journal ◽

10.4314/gmj.v54i4.4 ◽

2020 ◽

Vol 54 (4) ◽

pp. 225-230

Author(s):

Marc Tshilanda ◽

Ulrick S. Kanmounye ◽

Remy Kapongo ◽

Michel Tshiasuma

Keyword(s):

Stroke Patient ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Arterial Hypotension ◽

Sectional Study ◽

Stroke Event ◽

Chi Square ◽

Cross Sectional ◽

Chi Square Test ◽

The Mean

Objectives: Stroke is one of the leading causes of death, disability, and dementia in developing countries. Our study aimed to evaluate the systemic disorders associated with mortality in patients admitted within 72 hours of the initial stroke event. Setting: The study took place at a tertiary hospital in Kinshasa. Participants: Patients admitted within 72 hours of the initial stroke event. Interventions: This cross-sectional study consisted of a retrospective review of stroke patient records from January 2016 to December 2018. The Pearson-Chi square test and odds ratios were calculated with a threshold of significance of 0.05. Main outcome measures: Mortality Results: We recruited 114 cases. The mean age was 61.8 ± 2.4 years, and the sex ratio was 1.78 in favor of men. Hypertension (76.3%), dyslipidemia (71.1%), and diabetes mellitus (58.8%) were the most frequent comorbidities. Most patients had hypoxia (85.9%), hypertension (82.4%), hyperglycemia (57.8%), and fever (28.1%). We registered thirty-two deaths (28.1%): 20 (62.5%) from the ischemic strokes, and 12 (37.5%) from hemorrhagic strokes. Systemic disorders with the worst prognosis during were arterial hypotension (OR=3.87, p >0.001), and fever (OR = 1.56, p = 0.047). Conclusion: Arterial hypotension and fever adversely affect stroke patient outcomes, and strokes are responsible for high mortality in Congo

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Assessment of patients waiting and service times in the ophthalmology clinic of a public tertiary hospital in Nigeria

Ghana Medical Journal ◽

10.4314/gmj.v54i4.5 ◽

2020 ◽

Vol 54 (4) ◽

pp. 231-237

Author(s):

Lateefat B. Olokoba ◽

Kabir A. Durowade ◽

Feyi G. Adepoju ◽

Abdulfatai B. Olokoba

Keyword(s):

Waiting Time ◽

Waiting Times ◽

Sampling Technique ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Ethical Review ◽

Cross Sectional ◽

Arrival Times ◽

The Mean ◽

Service Times

Introduction: Long waiting time in the out-patient clinic is a major cause of dissatisfaction in Eye care services. This study aimed to assess patients’ waiting and service times in the out-patient Ophthalmology clinic of UITH. Methods: This was a descriptive cross-sectional study conducted in March and April 2019. A multi-staged sampling technique was used. A timing chart was used to record the time in and out of each service station. An experience based exit survey form was used to assess patients’ experience at the clinic. The frequency and mean of variables were generated. Student t-test and Pearson’s correlation were used to establish the association and relationship between the total clinic, service, waiting, and clinic arrival times. Ethical approval was granted by the Ethical Review Board of the UITH. Result: Two hundred and twenty-six patients were sampled. The mean total waiting time was 180.3± 84.3 minutes, while the mean total service time was 63.3±52.0 minutes. Patient’s average total clinic time was 243.7±93.6 minutes. Patients’ total clinic time was determined by the patients’ clinic status and clinic arrival time. Majority of the patients (46.5%) described the time spent in the clinic as long but more than half (53.0%) expressed satisfaction at the total time spent at the clinic. Conclusion: Patients’ clinic and waiting times were long, however, patients expressed satisfaction with the clinic times.

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Acute Testicular Torsion in Children: A Tertiary Hospital Experience in a Developing Country

Journal of Clinical Surgery and Research ◽

10.31579/2768-2757/024 ◽

2021 ◽

Vol 2 (4) ◽

pp. 01-03

Author(s):

Chukwubuike Kevin Emeka

Keyword(s):

Pediatric Surgery ◽

Testicular Torsion ◽

Undescended Testis ◽

Tertiary Hospital ◽

Prior History ◽

Testicular Pain ◽

History Of ◽

The Mean ◽

Urological Emergency ◽

The Right

Background: Testicular torsion is a urological emergency in which there is a race against time to salvage the testis. The aim of this study was to evaluate our experience in the management of children who presented with acute testicular torsion. Materials and Methods: This was a retrospective study of children aged 15 years and below who had surgery for acute testicular torsion between January 2013 and December 2017 at the pediatric surgery unit of a teaching hospital in Enugu, Nigeria. Results: Sixty-four children were managed during the study period. The ages of the patients ranged from 2 months to 14 years with a median of 6 years. The right testis was mostly affected and the mean duration from the onset of symptom to presentation was 4 hours. All the patients presented with testicular pain and half of the patients had a prior history of intermittent testicular pain. Four (6.3%) patients had a history of trauma precipitating the testicular torsion and 3 (4.7%) patients had undescended testis. Detorsion and Orchidopexy was the most performed surgical procedure and wound infection was the most common post-operative complication. There was no mortality. Conclusion: Testicular torsion is not uncommon in children and may be associated with testicular loss. The right testis is mostly involved in children. Prior history of intermittent testicular pain, trauma and undescended testis are important considerations. Prompt detorsion and orchidopexy remains the cornerstone of treatment.

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Willingness of Family Caregivers to Consent to Relative’s Postmortem Examination that Die Suddenly in a Nigerian Tertiary Hospital

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v30i3.9 ◽

2020 ◽

Vol 30 (3) ◽

Author(s):

Samuel Anu Olowookere ◽

Adegboyega Adeleke Abiodun ◽

Joseph Gbenga Omole ◽

Akinwumi Oluwole Komolafe ◽

Akintunde Julius Olowookere ◽

...

Keyword(s):

Sudden Death ◽

Family Caregivers ◽

Tertiary Education ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Postmortem Examination ◽

Skilled Worker ◽

Cross Sectional ◽

Adequate Knowledge ◽

The Mean

BACKGROUND: Postmortem examination is necessary to diagnose the cause of sudden death, and family caregivers are expected to consent to this examination. This study assessed knowledge, attitude, practices and willingness of family caregivers to consent to postmortem examination of their relative if they die suddenly in a Nigerian tertiary hospital.METHODS: Descriptive cross-sectional study of family caregivers of our patients that completed an interviewer administered semistructured questionnaire assessing their knowledge, attitude, practices and willingness to consent to postmortem examination of their relative if they die suddenly. Data were analyzed using descriptive and inferential statistics.RESULTS: A total of 224 caregivers were interviewed. The mean age (SD) was 34.95 (11.74), ranging 22-75 years. They were parents (32.6%), siblings (37.9%), spouses (11.2%) and other relatives (18.3%). Only 17% had adequate knowledge, 44.6% positive attitude and 11.2% good practices to postmortem examination of sudden death. The majority (75.9%) would consent to postmortem examination of their relatives if they die suddenly. Sociodemographic variables associated with willingness to consent to postmortem examination after relative’s sudden death include being male (AOR 3.61; 95%CI 3.09-8.92; p=0.001), having tertiary education (AOR 4.83; 95%CI 1.01-8.29; p=0.034), Christianity (AOR 2.59; 95%CI 1.25-5.35; p=0.010) and skilled worker (AOR 1.43; 95%CI 1.33-3.80; p=0.020).CONCLUSION: Some family caregivers would not consent to postmortem examination of their relatives when they die suddenly. Sensitization programs targeting family caregivers are necessary to increase knowledge and enhance prevention of sudden death as well as improve willingness to consent to postmortem examination when their relatives die suddenly.

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Clinical and histopathological pattern of colorectal malignancies, the experience in a tertiary hospital in south-western region, Saudi Arabia

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20184556 ◽

2018 ◽

Vol 5 (11) ◽

pp. 4684

Author(s):

Majed Saleh M. Aldayhum ◽

Anas Abdullah R. Alshehri ◽

Dlaim H. AlQahtani ◽

Eman Yahia Alfussaily ◽

Suha Abdulrahman S. Althibait ◽

...

Keyword(s):

Saudi Arabia ◽

Clinical Presentation ◽

Early Stage ◽

Tertiary Hospital ◽

Central Hospital ◽

Early Stage Disease ◽

Common Cancer ◽

Stage Disease ◽

Common Grade ◽

The Mean

Background: Colorectal cancer is the third most common cancer all over the world and the second leading cause of the cancer death in both sexes. CRC is the second most common cancer in Kingdom Saudi Arabia. However, this aspect was not recently studied.Methods: This is a retrospectively cohort based study. We collected and analyzed the records of the patients with CRC diagnosed at Aseer Central Hospital, Abha, Saudi Arabia from January 2008 to June 2016. A pre-specified data sheet was used to collect information regarding socio-demographics, age, Altitude, site of tumor, clinical presentation, outcome and prognosis as well as histopathological pattern of cancer and the stages of disease. Descriptive statistics was performed using SPSS.Results: A total of 291 cases of CRC were registered in the Aseer Central Hospital. 171 cases 58.87% were males while 120 cases 41.2% were females. The mean age of patients (SD) at the time of diagnosis was 59.38 years. At the time of diagnosis, 219 patients 84.6% presented with early stage disease and 40 15.4% had distant metastasis advanced stage. The most frequent CRC located in sigmoid 26.5%, rectal 23.7%and 14% in ascending. The moderately differentiate adenocarcinoma grade of tumor is being the most common grade among all variants 75.6%.Conclusions: In this study, we have nearly similar results found in previously published study by Alshehri et al. Males considered most affected, most of the patients were more than 50 years, 84.6% of the patients came with early stage disease. Left side colon were the most common site of CRC.

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