scholarly journals 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

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.

scholarly journals 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

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.

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

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Mitiku Wale Muluneh ◽  
Shewayiref Geremew Gebremichael
Keyword(s):  
Intraocular Pressure ◽  
Family History ◽  
Visual Field Loss ◽  
Pressure Change ◽  
Referral Hospital ◽  
Bahir Dar ◽  
Cell Degeneration ◽  
Felege Hiwot Referral Hospital ◽  
History Of

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.

scholarly journals A Ten Years Retrospective Study of Hysterectomy in Goba Referral Hospital, Bale Zone, South East Ethiopia, Magnitude Indications and Outcomes

2020 ◽  
Author(s):  
Aklilu Getachew ◽  
Takele Mengistu ◽  
Yaregal Asres
Keyword(s):  
Retrospective Study ◽  
Antenatal Care ◽  
Low Income ◽  
Uterine Rupture ◽  
Female Genital Tract ◽  
Referral Hospital ◽  
Low Income Countries ◽  
Categorical Variables ◽  
P Value

Abstract Background: Hysterectomy is one of the major surgeries performed in clinical practice for commonly encountered diseases of the female genital tract worldwide. Even if Hysterectomy is widely performed surgery in both developed and low income countries little is known about is epidemiology in rural part of develop countries. Especially in developing countries like Ethiopia representative reliable statistics are rarely available on this important aspect of women’s health mainly on its prevalence, indication and outcome. So the aim of this study was to assess the magnitude indication and outcome of hysterectomy in Goba Referral Hospital from January 1, 2008 to January1, 2018. Methods: institutional based retrospective study was conducted in Goba Referral Hospital. Self-administered structured checklists were used to collect the data. The data were entered into Epi data version 3.1 and analyzed by SPSS version 20. Continuous and categorical variables were summarized by tables, graph and descriptive statistics. Logistic regression was used to determine association between predictors and Hysterectomy prevalence. P-value <0.05 was -considered as statistically significant. Results: a total of 200 hysterectomies were done for obstetrics and gynecology indications, of which the commonest, 47% (n=94), indication was uterine rupture. From the total of 116 women, who had no antenatal care follow up, 40% (n=47) had uterine rupture. This study also indicated that, most of uterine rupture cases 80% (n=76) were living far away from the hospital (> 50km from the hospital) 94.6% (n-89) were multiparous. This study has also indicated that from the total of 20 discharged dead, 90% (n=18)) were came from a distance of >100km far from the hospital and 95% (n=19) were those who didn’t attend antenatal care. Conclusions: the higher rate of uterine rupture was seen in those who were multi Para, far from Hospitals and those who have no ANC follow up. Large scale study for the identification of determinant factors for evidence based intervention will be very important.

scholarly journals Evaluation of General, Pathological, and Radiological Features of Male Breast Cancer

2020 ◽  
Vol 17 (3) ◽  
Author(s):  
Fariba Zarei ◽  
Fereshte Bagheri ◽  
Amin Dehdashtian ◽  
Majid Akrami
Keyword(s):  
Breast Cancer ◽  
Survival Time ◽  
Male Breast Cancer ◽  
Medical Records ◽  
Male Breast ◽  
Treatment Modalities ◽  
Time Interval ◽  
Number Of Patients ◽  
History Of

Background: Male breast cancer (MBC) is an infrequent disease and a scarcely researched topic. Since the incidence of male breast cancer is increasing and so far, management advices have been concluded from results of trials in female patients, there has been a growing interest in this field of research. Objectives: In this study, we aimed to evaluate the general, radiological and pathological features of MBC patients. Patients and Methods: We retrospectively reviewed the medical records of MBC patients who had been referred to breast clinic, Shahid Motahari in Shiraz, Iran, between 2005 and 2018. Data regarding general characteristics of patients such as demographic information, age, and also past history of any cancer, family history of breast cancer, mammogram and ultrasound findings, stage, size and location of tumor, histopathology of tumor, metastasis, treatment modalities and follow-up time were attained by reviewing medical records. Results: Fifty-one patients with MBC were included with the mean age of 58.4 years. Invasive ductal carcinoma was the most prevalent pathologic type. By use of the Kaplan Meier survival estimate, survival probability of patients for each time interval after diagnosis was calculated. There was a decline over time until about 85 months after diagnosis when it reached a plateau state above 50%. Age, human epidermal growth factor receptor 2 (HER2) and metastasis showed to lower the survival time by increasing the hazard ratio. Only 13 patients had mammography and 22 had an ultrasound, which are less than 50% of the total number of patients. Conclusions: This study showed that there is still unfulfilled need to evaluate MBC in order to find the best management guidelines such as screening in high risk populations, diagnosis, treatment, and follow-up. Risk factor evaluation, survival time, and diagnostic radiologic modalities have not been well assessed in MBC so far.

scholarly journals Efficacy and Safety of Argon Laser Trabeculoplasty in Lowering Intraocular Pressure as Adjunctive Treatment to Primary Open Angle Glaucoma

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Uzma Fasih, Erum Shahid Arshad Sheikh
Keyword(s):  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Argon Laser ◽  
Adjunctive Treatment ◽  
P Value ◽  
Open Angle ◽  
Argon Laser Trabeculoplasty ◽  
Laser Trabeculoplasty

Purpose: To assess efficacy and safety of argon laser trabeculoplasty (ALT) to lower intra ocular pressure (IOP) as adjunctive treatment in primary open angle glaucoma (POAG) patients. Study Design: Descriptive Cross Sectional. Place and Duration of Study: Ophthalmology Department, Abbassi Shaheed Hospital from May 2016 to August, 2017. Materials and Methods: Primary open glaucoma patients were selected from eye OPD. Patients with Inflammatory, angle closure, traumatic glaucoma were excluded. Pre laser and Post laser IOP was measured at 1st week then at 1, 3 and 6 months. Data was collected and analyzed on SPSS version 20. There were 114 patients Results: There were 69 (61%) male patients. Mean age of patients was 60.53 ± 10.71 years. Mean pre laser Intraocular pressure was 23.98 ± 10.01 mm Hg. Mean post laser IOP at one month was 15.6 ± 3.25 and at 6 months was 14.8 ± 3.28 mm Hg. Overall mean reduction of IOP was 9.18 mm Hg from baseline, with p value less than < 0.005. Pre laser 3 medications were used by 20 (18%) and 2 medications by 49 (43%). At 6 months follow-up 4 (3.5%) patients were on 3 medications and 31 (37%) were on 2 medications. It has a p value < 0.005. Drug free patients at 6 months follow-up were 37 (33%). Mild iritis was seen in 7 (6.14%) patients. Conclusion: Argon Laser Trabeculoplasty is effective and safe method to control IOP in POAG when used as an adjunct to medical therapy. It also decreases number of drugs used by patients. Key Words: Argon laser trabeculoplasty, intraocular pressure, primary open angle glaucoma.

scholarly journals Dietary non-adherence and associated factors among individuals with diabetes who are on treatment follow up at Felege-Hiwot Referral Hospital, Northwest Ethiopia

Heliyon ◽  
2020 ◽  
Vol 6 (8) ◽  
pp. e04544
Author(s):  
Mulat Tirfie ◽  
Sebsibe Tadesse ◽  
Haile Woldie ◽  
Teshager Weldegiorgis ◽  
Minyichil Birhanu ◽  
...  
Keyword(s):  
Associated Factors ◽  
Northwest Ethiopia ◽  
Referral Hospital ◽  
Felege Hiwot Referral Hospital

Doxil, Vincritine, Reduced Frequency Dexamethasone in Combination with Thalidomide (DVd-T) Is Associated with Higher Overall and Progression Free Survival as Compared to DVd in Patients with Multiple Myeloma (MM).

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2557-2557 ◽  
Author(s):  
Khaldoun Almhanna ◽  
Revathi Suppiah ◽  
Rachid Baz ◽  
Mary Ann Karam ◽  
Beth Faiman ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow Involvement ◽  
Pegylated Liposomal Doxorubicin ◽  
Progression Free Survival ◽  
Disease Stage ◽  
P Value ◽  
Free Survival ◽  
Number Of Patients

Abstract Background: Although initially responsive to chemotherapy, multiple myeloma ultimately relapses. Replacing Adriamycin with pegylated liposomal doxorubicin in the VAD regimen results in a regimen with better safety profile (less neutropenia, alopecia, fewer hospital and clinic visit). DVd resulted in normalizing the angiogenic process however this did not improve PFS or OS. Thalidomide because of its antiangiogenic, immunomodulatory effects and chemo-sensitizing activity through modulating integrins was added to the DVd regimen. Adding the thalidomide to the DVd regimen resulted in an overall response rate of 89% with a CR/NCR rate of 49 % as compared to 60% and 18 % respectively for the DVd. At this stage it is not clear if the quality of response affects outcome in multiple myeloma patients receiving conventional dose therapy. To better assess the prognostic implication of improved quality responses and to define the role of up front Thalidomide, we compared the DVd to the DVd-T regimen by retrospectively reviewing the two trial data, the follow up for both trials is mature. It is still not clear whether thalidomide is more appropriately used up front or in the management of relapse. Methods: we recruited a total of 68 patients in our DVd trial versus 105 patient in the DVd-T trial. A total of 155 patients in both groups were evaluable for follow-up and response (58 received DVd and 97 received DVd-T). Patients were matched for age, disease prognosticators, disease stage, and bone marrow involvement. The newly diagnosed patients were comparable in both groups except for the b 2 microglobulin which was higher in the DVd-T group as compared to the DVd (3.2 vs. 5.0; respectively. p0.05). In the relapsed/refractory group of patients, all variables were comparable. Results: The median follow up was 5 years for the DVd group and 2 years for the DVd-T group. Median age for the DVd was 62 years, which was similar to the DVd-T. For the DVd vs. the DVd-T group of patients achieving complete and near complete remission was 17% vs. 49.5% respectively with a p value of 0.001. Progression free survival was significantly longer for the DVd-T regimens vs. the DVd (28 vs. 13 months p= 0.0002) Figure 1., and for over all survival the median is not reached for the DVd-T vs. 28 months for he DVd (p=0.006). Conclusion: we conclude that the addition of thalidomide significantly improved the quality of response and this appears to translate in to a PFS and OS benefit. While, recently published SWOG data suggests that the overall survival is determined by the duration of the PFS and not the quality of the response, this discrepancy could be related to the small number of patients in our study or the lack of use of biologic immune modulators among SWOG patients. Figure Figure

Comparison between Latanoprost, Travoprost, and Tafluprost in reducing intraocular pressure fluctuations in patients with glaucoma

2021 ◽  
pp. 112067212199054
Author(s):  
Ahmed Essam Faseeh ◽  
Riham SHM Allam ◽  
Ahmed B Shalash ◽  
Mai Nasser Abd Elmohsen
Keyword(s):  
Intraocular Pressure ◽  
Side Effects ◽  
Open Angle Glaucoma ◽  
Pressure Fluctuations ◽  
Study Groups ◽  
P Value ◽  
Newly Diagnosed ◽  
P Values ◽  
And Gender

Purpose: To compare the efficacies of latanoprost 0.005%, travoprost 0.004%, and tafluprost 0.0015% in reducing diurnal intraocular pressure (IOP) fluctuations in patients with newly diagnosed primary open-angle glaucoma (POAG). Methods: In this prospective randomized clinical trial, 60 patients who were newly diagnosed with POAG were divided into three equal groups. Patients were examined at presentation and at second and sixth weeks. Diurnal phasing of IOP was conducted using a calibrated Goldmann applanation tonometer. IOP measurements were recorded from 8:00 am to 9:00 am, from 3:00 pm to 4:00 pm, and from 7:00 pm to 8:00 pm. Results: The study groups were distributed similarly in terms of age and gender ( p-values: 0.76) and the participants had a mean age of 52.98 ± 13.43 years. The IOP at the day of inclusion was not statistically significant among the three groups ( p-values 0.27, 0.51, and 0.64 at 8 am, 2 pm, and 8 pm, respectively). Similar nonsignificant differences were noticed on the follow-up visits. However, the tafluprost group showed a significant reduction in IOP on the follow-up visit at the second week at 8 pm (30.5% reduction, p-value: 0.03). All three drugs showed a comparable and significant reduction in IOP and IOP fluctuations. The pattern of side effects was similar in all the groups. Conclusion: Latanoprost, travoprost, and tafluprost show a similar effectiveness in reducing the mean IOP and the diurnal IOP fluctuation in POAG. Importantly, the three drugs have comparable tolerability with insignificant differences regarding the pattern of their side effects.

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