scholarly journals Hospitalization and Predictors of Inpatient Mortality among HIV-Infected Patients in Jimma University Specialized Hospital, Jimma, Ethiopia: Prospective Observational Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Kirubel Minsamo Mishore ◽  
Nezif Hussein ◽  
Solomon Assefa Huluka
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Multiple Logistic Regression Analysis ◽  
Significant Proportion ◽  
People Living With Hiv ◽  
Inpatient Mortality ◽  
Cell Counts ◽  
Specialized Hospital ◽  
Number Of Patients ◽  
Jimma University

Despite the number of patients enrolled in ART is increased, HIV/AIDS continues to constitute a significant proportion of medical admissions and risk of mortality in low- and middle-income countries. As one of these countries, the case in Ethiopia is not different. The aim of this study was thus to assess reasons for hospitalization, discharge outcomes, and predictors of inpatient mortality among people living with HIV (PLWH) in Jimma University Specialized Hospital (JUSH), Jimma, Southwest Ethiopia. Prospective observational study was conducted in medical wards of JUSH from February 17th to August 17th, 2017. In this study, 101 PLWH admitted during the study period were included. To identify the predictors of mortality, multiple logistic regression analysis was employed. Of the 101 hospitalized PLWH, 62 (61.4%) of them were females and most of them (52.5%) were between 25 and 34 years of age. A majority (79.2%) of the study participants were known HIV patients, before their admission. Tuberculosis (24.8%), infections of the nervous system (18.8%), and pneumonia (9.9%) comprised more than half of the reasons for hospitalization. Moreover, drug-related toxicity was a reason for hospitalization of 6 (5.9%) patients. Outcomes of hospitalization indicated that the overall inpatient mortality was 18 (17.8%). The median CD4 cell counts for survivors and deceased patients were 202 cells/μL (IQR, 121–295 cells/μL) and 70 cells/μL (IQR, 42–100 cells/μL), respectively. Neurologic complications (AOR = 13.97; 95% CI: 2.32–84.17, P=0.004), CD4 count ≤ 100 cells/μl (AOR = 16.40; 95% CI: 2.88–93.42, P=0.002), and short hospital stay (AOR = 12.98, 95% CI: 2.13–78.97, P=0.005) were found to be significant predictors of inpatient mortality. In conclusion, opportunistic infections are the main reason of hospitalization in PLWH.

scholarly journals Current Practice and Barriers to an Early Antimicrobial Conversion from Intravenous to Oral among Hospitalized Patients at Jimma University Specialized Hospital: Prospective Observational Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Alemseged Beyene Berha ◽  
Gizat Molla Kassie
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Current Practice ◽  
Significant Proportion ◽  
Severe Infection ◽  
Hospitalized Patients ◽  
P Values ◽  
Specialized Hospital ◽  
Jimma University ◽  
Clinical Stability

Objective. The aim of the present study was to explore the current practice and its barriers to an early antimicrobial conversion from intravenous (IV) to oral (PO) therapy among hospitalized patients.Method. Hospital based prospective observational study was conducted to assess the practice of an early antimicrobial IV to PO conversion and its barriers using medical chart and case-specific physicians’ interviews, respectively, from February to September, 2014. Patient charts and medication records were reviewed for appropriateness of IV to PO conversion program every 24hrs using a pretested data collection abstraction format. Independent samplest-test was used to compare the duration of therapy and time to clinical stability between converted and nonconverted patients. Two-tailed P values of < 0.05 were regarded as statistically significant.Results. One hundred forty-two patients were included in the study, of whom two-thirds (67.6%) of the patients were eligible for IV to PO antimicrobial conversion. However, only 20.9% of patients’ timely conversion was made. A shorter duration of IV therapy was recorded for converted (2.80±1.87) versus nonconverted patients (8.50±6.32), (P=0.009). The most important barriers of not converting IV to PO in clinically stable patients were presence of comorbidity; clinicians perceived that the patient should always complete IV course of antimicrobials as a standard practice.Conclusion. Conversion from IV to PO antimicrobials was found to be unnecessarily delayed in a significant proportion of patients hospitalized with moderate to severe infection due to a range of different barriers. Addressing these issues has the potential to reduce inappropriate antimicrobial use and resistance.

scholarly journals Usefulness of the prostate health index in predicting the presence and aggressiveness of prostate cancer among Korean men: a prospective observational study

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jae Yoon Kim ◽  
Ji Hyeong Yu ◽  
Luck Hee Sung ◽  
Dae Yeon Cho ◽  
Hyun-Jung Kim ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Specific Antigen ◽  
Significant Proportion ◽  
Health Index ◽  
Free Psa ◽  
Prostate Health Index ◽  
Total Psa ◽  
Prostate Health

Abstract Background We aimed to evaluate the usefulness of the Beckman Coulter prostate health index (PHI) and to compare it with total prostate-specific antigen (PSA) levels and related derivatives in predicting the presence and aggressiveness of prostate cancer (PCa) in the Korean population. Methods A total of 140 men who underwent their first prostate biopsy for suspected PCa were included in this prospective observational study. The diagnostic performance of total PSA, free PSA, %free PSA, [–2] proPSA (p2PSA), %p2PSA, and PHI in detecting and predicting the aggressiveness of PCa was estimated using the receiver operating characteristic curve (ROC) and logistic multivariate regression analyses. Results Of 140 patients, PCa was detected in 63 (45%) of participants, and 48 (76.2%) of them had significant cancer with a Gleason score (GS) ≥ 7. In the whole group, the area under the curve (AUC) for ROC analysis of tPSA, free PSA, %fPSA, p2PSA, %p2PSA, and PHI were 0.63, 0.57, 0.69, 0.69, 0.72, and 0.76, respectively, and the AUC was significantly greater in the PHI group than in the tPSA group (p = 0.005). For PCa with GS ≥ 7, the AUCs for tPSA, free PSA, %fPSA, p2PSA, %p2PSA, and PHI were 0.62, 0.58, 0.41, 0.79, 0.86, and 0.87, respectively, and the AUC was significantly greater in the PHI group than in the tPSA group (p < 0.001). In the subgroup with tPSA 4–10 ng/mL, both %p2PSA and PHI were strong independent predictors for PCa (p = 0.007, p = 0.006) and significantly improved the predictive accuracy of a base multivariable model, including age, tPSA, fPSA and %fPSA, using multivariate logistic regression analysis. (p = 0.054, p = 0.048). Additionally, at a cutoff PHI value > 33.4, 22.9% (32/140) of biopsies could be avoided without missing any cases of aggressive cancer. Conclusions This study shows that %p2PSA and PHI are superior to total PSA and %fPSA in predicting the presence and aggressiveness (GS ≥ 7) of PCa among Korean men. Using PHI, a significant proportion of unnecessary biopsies can be avoided.

scholarly journals Prospective observational study to evaluate the efficacy of labetalol versus nifedipine in the management of preeclampsia

2020 ◽  
Vol 9 (4) ◽  
pp. 1448
Author(s):  
Sarulatha D. ◽  
Menaga M.
Keyword(s):  
Blood Pressure ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Age Distribution ◽  
Unknown Etiology ◽  
P Value ◽  
Maternal Risk ◽  
Medical Disorders ◽  
Number Of Patients

Background: Hypertensive disorders of pregnancy are the common medical disorders in pregnancy. It has effects both on expectant mother and fetus. Pre-eclampsia is a pregnancy specific multisystem disorder of unknown etiology, and accounts for 12-18% of maternal mortality. There is general consensus that maternal risk is decreased by antihypertensive treatment that lowers very high blood pressure. Objective of this study was to study the efficacy of oral labetalol versus oral Nifedipine in the management of preeclampsia in the antepartum and intrapartum period.Methods: The present study was conducted in a tertiary care centre, Chennai from October 2013 to September 2014. It was a prospective observational study done in antenatal ward and labor ward. All antenatal women diagnosed to have pre-eclampsia, irrespective of gestation are included in this study.Results: Age distribution of PIH patients and the maximum number of patients were 20-25 years of age. maximum patients of severe preeclampsia were primigravida. Both systolic and diastolic BP in the two groups (oral labetalol and oral Nifedipine groups) were not statistically significant as the p value is >0.005.Conclusions: From this study, authors found that both oral labetalol and oral nifedipine are effective and well tolerated when used for rapid control of blood pressure in severe hypertension of pregnancy.

scholarly journals Gestational Diabetes and Intraoperative Tubal Sterilization are Risk Factors for Pain After Cesarean Delivery: A Prospective Observational Study.

2020 ◽  
Author(s):  
Patchareya Nivatpumin ◽  
Pawinee Pangthipampai ◽  
Sukanya Dej-Arkom ◽  
Somkiat Aroonpruksakul ◽  
Tripop Lertbunnaphong ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Observational Study ◽  
Pain Score ◽  
Cesarean Delivery ◽  
Severe Pain ◽  
Prospective Observational Study ◽  
Rating Scale ◽  
Tubal Sterilization ◽  
Number Of Patients ◽  
Median Pain

Abstract Background: Postcesarean delivery pain leads to several adverse maternal outcomes. The primary objective of this study was to determine the incidence of moderate-to-severe pain after the use of spinal morphine for cesarean delivery. The secondary aim was to identify the factors influencing the moderate-to-severe pain.Methods: This prospective observational study was conducted at a single university hospital. The inclusion criteria were a patient age of ≥ 18 years, and undergoing elective cesarean delivery under spinal anesthesia with intrathecal morphine (200 mcg). Moderate-to-severe pain was defined as a numerical-rating-scale score of more than 3 within 24 hours postoperatively. Patients’ demographic characteristics, preoperative obstetric data, and intraoperative and postoperative data were collected and analyzed.Results: In all, 660 patients were enrolled. As 16 were subsequently removed because they met the study withdrawal criteria, data relating to 644 patients were analyzed. The incidence of moderate-to-severe pain during the first postoperative day was 451/644 patients (70.03%; 95% confidence interval [CI], 66.38%–73.44%). The median pain score (interquartile range [IQR]) was 5 (3–6), with 176/644 (27.33%) of patients requiring a rescue analgesic. A multivariate analysis revealed that two factors were associated with moderate-to-severe pain on the first postoperative day: gestational diabetes (adjusted OR [AOR], 1.849; 95% CI, 1.068–3.203; p-value = 0.028), and intraoperative tubal sterilization (AOR, 1.533; 95% CI, 1.060–2.218; p = 0.023). A significantly higher number of patients experienced moderate-to-severe pain on postoperative Day 1 (451/644 [70.03%]) than Day 2 (348/644 [54.19%]; p < 0.001). The median pain score (IQR) on postoperative Day 2 was 4 (3–5), which was less than that for Day 1 (p < 0.001).Conclusions: A high incidence of moderate-to-severe postoperative pain was found after a single dose of spinal morphine for cesarean delivery. Gestational diabetes and intraoperative tubal sterilization were the independent factors correlated with the pain.Trial registration: Clinicaltrial.gov registration number NCT03205813

scholarly journals Drug-related problems and its determinant among hospitalized neonates with sepsis at Jimma University Medical Center, Ethiopia: a prospective observational study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mengist Awoke ◽  
Tsegaye Melaku ◽  
Mohammed Beshir
Keyword(s):  
Drug Therapy ◽  
Observational Study ◽  
Neonatal Intensive Care ◽  
Prospective Observational Study ◽  
Medical Center ◽  
Clinical Pharmacy Service ◽  
Drug Related Problems ◽  
Combined Use ◽  
Jimma University ◽  
Neonatal Population

Abstract Background Neonatal populations are quite susceptible to drug-related problems (DRPs) because of clinical heterogeneity and clinical practice trends. However, studies reporting DRPs in the neonatal population are quite limited. Objective This study aimed to assess the magnitude and types of DRPs and determinant factors among neonates admitted with neonatal sepsis at the Neonatal Intensive Care Unit (NICU) of the Jimma University Medical Center (JUMC), Ethiopia. Methods A hospital-based prospective observational study was conducted involving 201 neonates with sepsis admitted to the NICU from May to August 30, 2018. DRPs were classified using Cipolle’s classification method. Statistical Package for Social Science Version 22 was employed for data analysis. Logistical regression was carried out to determine the determinants of DRPs. A p-value < 0.05 was considered to be statistically significant. Results Of 201 neonates with sepsis included in this study, 125 (62.2%) were males and the median age of the neonate was 5 days. The mean (±standard deviation) number of medications taking during their hospital stay was 2.6 ± 0.7. DRPs were identified in 98 neonates, at a rate of 48.8% (95% CI, 41.7–55.9). Dose too high (42, 35.8%) and need additional drug therapy (40, 34.1%) were the commonly identified DRPs. Taking antibiotics plus other medications (Adjusted Odds Ratio (AOR) =5.2, 95%CI [1.2–22.0], p = 0.02) was a determinant factor for the occurrence of DRPs. Conclusion The burdens of DRPs occurrence were high in hospitalized neonates with sepsis. The most common DRPs identified were dose too high and need additional drug therapy. Combined use of other medicines with antibiotics was a predictor of DRP occurrence. The innovative way to tackle the occurrence of DRPs, such as the incorporation of clinical pharmacy service provider into the neonatal care team, which will prevent, detect and/or minimize the occurrence of DRPs, is highly recommended.

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