Determinants of Intraocular Pressure (IOP) of Glaucoma Patients at Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia

Background. Glaucoma is a leading cause of irreversible blindness in the world associated with characteristic damage to the optic nerve and patterns of visual field loss due to retinal ganglion cell degeneration. The main objective of this study was to investigate determinants for the variation of intraocular pressure of glaucoma patients under treatment at Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia. Methods. A retrospective cohort study design was conducted on 328 randomly selected glaucoma patients in the ophthalmology clinic at the hospital under the follow-up period from January 2014 to December 2018. Glaucoma patients who have two and more than two visits in the study period were included in the study, but patients who are attending medications less than two visits were excluded from the study. A linear mixed-effects model for intraocular pressure change was used for data analysis. Result. The estimated coefficient of fixed effect intercept was 25.1829, which indicates that the average IOP of the patients was 25.1829 mmHg at baseline time by excluding all covariates in the model ( p value <0.0001), age ( β =0.07, 95%CI 0.03, 0.11), urban residence ( β = −1.60, 95%CI −2.84, −0.36), family history of glaucoma ( β = 4.90, 95%CI 3.38–6.43), timolol and pilocarpine medication ( β = −2.02, 95%CI −4.01, −0.03), cup-disk ratio >0.7 ( β = 2.60, 95% CI 1.24–3.96), and follow-up time ( β = −0.34, 95%CI −0.47, −0.21) were significantly associated with intraocular pressure of glaucoma patients. Conclusion. The predictor age, residence, family history of glaucoma, type of medication, cup-disk ratio, and follow-up time were significantly associated with the intraocular pressure of glaucoma patients. Therefore, healthcare providers give more attention and prioritize those identified factors and give frequent counseling about reducing intraocular pressure of glaucoma patients.

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Incidence of Diabetic Foot Ulcer and Its Predictors Among Diabetes Mellitus Patients at Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia: A Retrospective Follow-Up Study

Diabetes Metabolic Syndrome and Obesity Targets and Therapy ◽

10.2147/dmso.s280152 ◽

2020 ◽

Vol Volume 13 ◽

pp. 3703-3711

Author(s):

Ali Mekonen Adem ◽

Asrat Atsedeweyn Andargie ◽

Achamyeleh Birhanu Teshale ◽

Haileab Fekadu Wolde

Keyword(s):

Diabetes Mellitus ◽

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Northwest Ethiopia ◽

Referral Hospital ◽

Bahir Dar ◽

Follow Up Study ◽

Felege Hiwot Referral Hospital

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Prevalence of pre-eclampsia and associated factors among women attending antenatal care services in Felege-Hiwot referral hospital, Bahir Dar city, Northwest Ethiopia

10.21203/rs.2.11607/v1 ◽

2019 ◽

Author(s):

Agumas Fentahun Ayalew ◽

Getasew Mulat Bantie ◽

Tigabu Birhan Kassa ◽

Ashenafi Abate Woya

Keyword(s):

Diabetes Mellitus ◽

Family History ◽

Gestational Diabetes ◽

Antenatal Care ◽

Associated Factors ◽

Referral Hospital ◽

Hypertensive Disorder ◽

Bahir Dar ◽

Family History Of Diabetes ◽

History Of

Abstract Introduction Preeclampsia, also called pregnancy-induced hypertension is a pregnancy-specific hypertensive disorder usually occurs after 20 weeks of gestation and affects both the mother and the fetus. preeclampsia is one of the driving causes of maternal and perinatal horribleness and mortality. Objective To assess the prevalence of preeclampsia and associated factors among women attending antenatal care service at Felge Hiwot Referral Hospital, Bahir Dar, Ethiopia, 2017. Methods Institution based cross-sectional study was conducted from March 1st up to 30th 2017. Study participants was recruited by using systematic random sampling technique. A pre-tested questionnaire was used for data collection. The data were checked for its completeness and consistency each day and the collected data was coded and entered into Epi Data version 3.1 and analyzed by using Statistical package for social science version 23. The logistic regression assumption was checked and fitted at P >0.05. Result The prevalence of preeclampsia was found to be 13.0% (95%CI: 8.3,17.6). Factors that had a statistically significant association with preeclampsia were women having a family history of hypertension [AOR=4.61(1.06, 20.07)], Gestational diabetes mellitus [AOR=11.41(1.40, 92.83)], using traditional medicine during pregnancy [AOR= 26.29(3.68, 187.84)]. Conclusion the result indicated that the prevalence of preeclampsia in this hospital was higher than similar studies conducted in Ethiopia. Preventable and risk factors Having a family history of Diabetes Mellitus, Gestational Diabetes Miletus and taking traditional medicines during pregnancy were statistically associated with preeclampsia.

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Determinants of Intraocular Pressure and Time to Blindness for Glaucoma Patients at Felege Hiwot Referral Hospital, Bahir Bar, Ethiopia: A Comparison of Separate and Joint Models

Cancer Informatics ◽

10.1177/11769351211045975 ◽

2021 ◽

Vol 20 ◽

pp. 117693512110459

Author(s):

Mitiku Wale Muluneh ◽

Awoke Seyoum Tegegne

Keyword(s):

Intraocular Pressure ◽

Survival Time ◽

Joint Model ◽

Referral Hospital ◽

Public Health Issue ◽

P Value ◽

Ratio Test ◽

Number Of Patients ◽

Felege Hiwot Referral Hospital

Background: Due to the substantial increase in the number of glaucoma cases within the next several decades, glaucoma is a significant public health issue. The main objective of this study was to investigate the determinant factors of intraocular pressure and time to blindness of glaucoma patients under treatment at Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia. Methods: A retrospective study design was conducted on 328 randomly selected glaucoma patients using simple random sampling based on the identification number of patients in an ophthalmology clinic at the hospital under the follow-up period from January 2014 to December 2018. A linear mixed effects model for intraocular pressure data, a semi-parametric survival model for the time-to-blindness data and joint modeling of the 2 responses were used for data analysis. However, the primary outcome was survival time of glaucoma patients. Results: The comparison of joint and separate models revealed that joint model was more adequate and efficient inferences because of its smaller standard errors in parameter estimations. This was also approved using AIC, BIC, and based on a significant likelihood ratio test as well. The estimated association parameter (α) in the joint model was .0160 and statistically significant ( P-value = .0349). This indicated that there was strong evidence for positive association between the effects of intraocular pressure and the risk of blindness. The result indicated that the higher value of intraocular pressure was associated with the higher risk of blindness. Age, hypertension, type of medication, cup-disk ratio significantly affects both average intraocular pressure and survival time of glaucoma patients ( P-value < .05). Conclusion: The predictors; age, hypertension, type of medication, and cup-disk ratio were significantly associated with the 2 responses of glaucoma patients. Health professionals give more attention to patients who have blood pressure and cup-disk ratio greater than 0.7 during the follow-up time to reduce the risk of blindness of glaucoma patients.

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Determinants of Intraocular Pressure and time to blindness for Glaucoma patients at Felege Hiwot Referral Hospital, Bahir Bar, Ethiopia; A Comparison of Separate and Joint Models

10.21203/rs.3.rs-59436/v1 ◽

2020 ◽

Author(s):

Mitiku Wale Muluneh ◽

Awoke Seyoum Tegegne

Keyword(s):

Blood Pressure ◽

Intraocular Pressure ◽

Joint Modeling ◽

Joint Model ◽

Referral Hospital ◽

Public Health Issue ◽

P Value ◽

Ratio Test ◽

Felege Hiwot Referral Hospital

Abstract Background Due to the substantial increase in the number of glaucoma cases within the next several decades, glaucoma is a significant public health issue. The main objective of this study was to investigate determinants for the variation of intraocular pressure and time to blindness of glaucoma patients under treatment at Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia. Materials and Method A retrospective cohort study design was conducted on 328 randomly selected glaucoma patients in ophthalmology clinic at the hospital under the follow-up period from January 2014 up to December 2018. A linear mixed effects model for intraocular data, a semi-parametric survival model for the time-to-blindness data and joint modeling of the two responses were used for data analysis. Result The comparison of joint and separate models revealed that joint model was more adequate and efficient inferences because of its smaller standard errors in parameter estimations. This was also approved using AIC, BIC and based on a significant likelihood ratio test as well. The estimated association parameter (α) in the joint model was 0.0160 and statistically significant (p - value = 0.0349). This indicated that there was strong evidence for positive association between the effects of intraocular pressure and the risk of blindness. The result indicated that the higher value of intraocular pressure was associated with the higher risk of blindness. As age increased by one year, the average IOP of the patients was also increased by 0.0726 mmHg (p-value < 0.0001) keeping all variables constant. Conclusion The predictors; age, blood pressure, type of medication and cup-disk ratio were significantly associated with the two responses of glaucoma patients. Health professionals should give more attention for patients who have blood pressure and cup-disk ratio greater than 0.7 during the follow-up time to reduce the risk of blindness of glaucoma patients.

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Determinants of Pulse Rate change and Time-To Default from Treatment among Congestive Heart Failure Patients in Felege- Hiwot Referral Hospital, Bahir Dar, Ethiopia; comparison of separate and joint models

10.21203/rs.3.rs-228538/v1 ◽

2021 ◽

Author(s):

Yikeber Abebaw Moyehodie ◽

Kasim Mohammed Yesuf ◽

Adem Aragaw Sied ◽

Bezanesh Melese Masresha

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Pulse Rate ◽

Nyha Class ◽

Referral Hospital ◽

Bahir Dar ◽

Joint Models ◽

Heart Failure Patients ◽

Felege Hiwot Referral Hospital

Abstract Background: Globally, heart failure is a rapidly growing public health issue with an estimated prevalence of >37.7 million individuals. It is a shared chronic phase of cardiac functional impairment secondary to many etiologies. The main purpose of this study was to identify factors that affect the longitudinal changes of pulse rate and survival endpoints, time-to default among Congestive Heart Failure Patients in Felege- Hiwot Referral Hospital, Bahir Dar, Ethiopia.Methods: Hospital based retrospective studies were conducted among 302 congestive heart failure patients who were 15 years old or older and who were on treatment follow-up from the first February 2016 to thirty-one December 2018 in Felege-Hiwot Referral Hospital, Bahir Dar, Ethiopia. First, data were analyzed using linear mixed model and survival models separately, and then the joint models of both sub-models were analyzed by linked their shared unobserved random effects using a shared parameter model. Results: Out of the total 302 CHF treatment followers, 103 (34.1%) of the patients were defaulting from treatment. The mean pulse rate of female and male patients was 87.25 and 90.20, respectively. Averagely 51.12 % of blood in the left ventricle is pushed out with each heartbeat. The results for separate and joint models were quite similar to each other but not identical. However, the estimated association parameter (α) in the joint model is (HR=1.0311, 95%CI: 1.0033,1.0597, P=0.0278), providing there is evidence of a positive association between the survival and the longitudinal sub-models. Thus, defaulting is more likely to occur in patients with higher pulse rates. Patients, being male, hypertensive, CKD, pneumonic, and NYHA class IV patients were associated with a higher risk of defaulting. Age, LVIF, follow-up time in a month had a negative significant effect and NYHA class, and male gender had a positive significant effect on average evaluation of pulse rate of patients. Conclusions: The patient who are male, NYHA class IV, had low LVIF and comorbid with hypertensive, CKD, pneumonia were risk factors of pulse rate change and defaulting from treatment of CHF patients. The joint model was preferred for simultaneous analyses of repeated measurement and survival data.

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Vitamin D status and risk of type 2 diabetes in the Norwegian HUNT cohort study: does family history or genetic predisposition modify the association?

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001948 ◽

2021 ◽

Vol 9 (1) ◽

pp. e001948

Author(s):

Marion Denos ◽

Xiao-Mei Mai ◽

Bjørn Olav Åsvold ◽

Elin Pettersen Sørgjerd ◽

Yue Chen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Family History ◽

Genetic Predisposition ◽

Effect Modification ◽

P Value ◽

Family History Of Diabetes ◽

Increased Risk ◽

History Of

IntroductionWe sought to investigate the relationship between serum 25-hydroxyvitamin D (25(OH)D) level and the risk of type 2 diabetes mellitus (T2DM) in adults who participated in the Trøndelag Health Study (HUNT), and the possible effect modification by family history and genetic predisposition.Research design and methodsThis prospective study included 3574 diabetes-free adults at baseline who participated in the HUNT2 (1995–1997) and HUNT3 (2006–2008) surveys. Serum 25(OH)D levels were determined at baseline and classified as <50 and ≥50 nmol/L. Family history of diabetes was defined as self-reported diabetes among parents and siblings. A Polygenic Risk Score (PRS) for T2DM based on 166 single-nucleotide polymorphisms was generated. Incident T2DM was defined by self-report and/or non-fasting glucose levels greater than 11 mmol/L and serum glutamic acid decarboxylase antibody level of <0.08 antibody index at the follow-up. Multivariable logistic regression models were applied to calculate adjusted ORs with 95% CIs. Effect modification by family history or PRS was assessed by likelihood ratio test (LRT).ResultsOver 11 years of follow-up, 92 (2.6%) participants developed T2DM. A higher risk of incident T2DM was observed in participants with serum 25(OH)D level of<50 nmol/L compared with those of ≥50 nmol/L (OR 1.72, 95% CI 1.03 to 2.86). Level of 25(OH)D<50 nmol/L was associated with an increased risk of T2DM in adults without family history of diabetes (OR 3.87, 95% CI 1.62 to 9.24) but not in those with a family history (OR 0.72, 95% CI 0.32 to 1.62, p value for LRT=0.003). There was no effect modification by PRS (p value for LRT>0.23).ConclusionSerum 25(OH)D<50 nmol/L was associated with an increased risk of T2DM in Norwegian adults. The inverse association was modified by family history of diabetes but not by genetic predisposition to T2DM.

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Eculizumab discontinuation in atypical hemolytic uremic syndrome: TMA recurrence risk and renal outcomes

Clinical Kidney Journal ◽

10.1093/ckj/sfab005 ◽

2021 ◽

Author(s):

Gema Ariceta ◽

Fadi Fakhouri ◽

Lisa Sartz ◽

Benjamin Miller ◽

Vasilis Nikolaou ◽

...

Keyword(s):

Family History ◽

Hemolytic Uremic Syndrome ◽

Univariate Analysis ◽

Atypical Hemolytic Uremic Syndrome ◽

Renal Response ◽

Pathogenic Variants ◽

Increased Risk ◽

History Of ◽

Uremic Syndrome

ABSTRACT Background Eculizumab modifies the course of disease in patients with atypical hemolytic uremic syndrome (aHUS), but data evaluating whether eculizumab discontinuation is safe are limited. Methods Patients enrolled in the Global aHUS Registry who received ≥1 month of eculizumab before discontinuing, demonstrated hematologic or renal response prior to discontinuation and had ≥6 months of follow-up were analyzed. The primary endpoint was the proportion of patients suffering thrombotic microangiopathy (TMA) recurrence after eculizumab discontinuation. Additional endpoints included: eGFR changes following eculizumab discontinuation to last available follow-up; number of TMA recurrences; time to TMA recurrence; proportion of patients restarting eculizumab; and changes in renal function. Results We analyzed 151 patients with clinically diagnosed aHUS who had evidence of hematologic or renal response to eculizumab, before discontinuing. Thirty-three (22%) experienced a TMA recurrence. Univariate analysis revealed that patients with an increased risk of TMA recurrence after discontinuing eculizumab were those with a history of extrarenal manifestations prior to initiating eculizumab, pathogenic variants, or a family history of aHUS. Multivariate analysis showed an increased risk of TMA recurrence in patients with pathogenic variants and a family history of aHUS. Twelve (8%) patients progressed to end-stage renal disease after eculizumab discontinuation; 7 (5%) patients eventually received a kidney transplant. Forty (27%) patients experienced an extrarenal manifestation of aHUS after eculizumab discontinuation. Conclusions Eculizumab discontinuation in patients with aHUS is not without risk, potentially leading to TMA recurrence and renal failure. A thorough assessment of risk factors prior to the decision to discontinue eculizumab is essential.

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Ab interno 180-degree trabeculectomy with a dual blade in a patient with refractory primary congenital glaucoma

European Journal of Ophthalmology ◽

10.1177/11206721211010402 ◽

2021 ◽

pp. 112067212110104

Author(s):

Mehmet Talay Koylu ◽

Fatih Mehmet Mutlu ◽

Alper Can Yilmaz

Keyword(s):

Intraocular Pressure ◽

Female Patient ◽

Congenital Glaucoma ◽

Safe Procedure ◽

Primary Congenital Glaucoma ◽

History Of ◽

Kahook Dual Blade ◽

The Right ◽

Ab Interno

A 13-year-old female patient with refractory primary congenital glaucoma (PCG) in the right eye who had a history of multiple glaucoma operations underwent ab interno 180-degree trabeculectomy with the Kahook Dual Blade (KDB) targeting the nasal and inferior angles. On postoperative day 1, the intraocular pressure (IOP) of the right eye reduced from 43 to 15 mmHg while on medical therapy. The patient maintained this IOP level throughout the 6-month follow-up. Ab interno KDB trabeculectomy targeting both nasal and inferior angles may be an effective and safe procedure for the treatment of PCG even in eyes with a history of previously failed glaucoma procedures.

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