scholarly journals Determinants of diabetes ketoacidosis among diabetes mellitus patients at North Wollo and Waghimra zone public hospitals, Amhara region, Northern Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Addisu Getie ◽  
Adam Wondmieneh ◽  
Melaku Bimerew ◽  
Getnet Gedefaw ◽  
Asmamaw Demis
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Alcohol Drinking ◽  
Public Hospitals ◽  
Amhara Region ◽  
Determinant Factors ◽  
Diabetic Education ◽  
Study Participants ◽  
North Wollo

Abstract Background Diabetes Mellitus (DM) is a metabolic disorder associated with acute and chronic complications. Diabetic ketoacidosis (DKA) is the most serious diabetic emergency in patients with type one and type two diabetes mellitus. It is the leading cause of mortality in children and young adults. Even though the burden of DKA has increased, no research has been conducted on the determinants of Diabetes ketoacidosis in Ethiopia, particularly in the Amhara region. Thus, this study aimed to identify the determinants of diabetes Ketoacidosis among Diabetes Mellitus patients at North Wollo and Waghimra Zone public Hospitals. Methods An institution-based unmatched case-control study design was employed among 408 patients at North Wollo and Waghimra Zone Public Hospitals from March 1st to April 30th, 2020. A consecutive sampling method was used to select study participants. The data were collected using structured interviewer-administered questioners and reviewing of patient charts. The analysis was done using a binary logistic regression model. Then, P-value < 0.05 was considered statistically significant. Result The mean (±SD) age of the study participants was 46.96 (± 15.175 SD) years. Irregular follow-up in diabetes clinic (AOR:4.19, 95% CI: 2.28–7.71), not received diabetic education (AOR: 2.87, 95% CI:1.44–5.72), alcohol drinking (AOR:2.99, 95% CI: 1.46–6.12), discontinuation of medications (AOR: 4.31, 95% CI:1.92–9.68), presence of comorbidity (AOR:2.57, 95% CI: 1.37–4.84), and being type one of diabetes mellitus (AOR: 2.01, 95% CI:1.11–3.63) were determinant factors of diabetic ketoacidosis . Conclusions This study showed that the behavioral and clinical characteristics of diabetic patients were determinant factors of DKA. Follow-up in the diabetic clinic, diabetic education, discontinuation of medications, alcohol drinking, presence of comorbidities, and type of diabetes mellitus were independent determinants of diabetic ketoacidosis.

scholarly journals Sleep quality and associated factors among patients with chronic illness at South Wollo Zone Public Hospitals, Northeast Ethiopia

2021 ◽  
Vol 5 (1) ◽  
pp. 043-050
Author(s):  
Edmealem Afework ◽  
Ademe Sewunet ◽  
Andualem Atsedemariam
Keyword(s):  
Chronic Illness ◽  
Sleep Quality ◽  
Associated Factors ◽  
Public Hospitals ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Northeast Ethiopia ◽  
Ethical Approval ◽  
Study Participants

Background: Pathological and nighttime sleep deprivations have substantial adverse effects on regulation of weight, sugar and blood pressure because of endothelial dysfunction, sympathetic nervous system stimulation, regulation and activation of systemic inflammation. Thus, this study was aimed to assess quality of sleep among patients with chronic illness and its associated factors at South Wollo Zone Public Hospitals, Northeast Ethiopia. Methods and Materials: The study was conducted at South Wollo Zone Public Hospitals, Northeast Ethiopia from February 15 2019 till April 15 2019. Institutional based cross sectional study design was employed. All patients with chronic illness who are on follow up in South Wollo Zone Public Hospitals were sources of population. Sample size was calculated by using EPI info version 7 and the total sample size was 344. The study employed stratified random sampling technique and study participants were selected by systematic sampling. After taking ethical approval from College of Medicine and Health Sciences Ethical Approval Committee, permission from selected Hospitals and informed verbal consent from patients, the data were collected by a tool which has 3 parts: Sociodemographic data, Pittsburgh Sleep Quality Index and factors affecting sleep quality. Data were entered in to Epi data version 4.1 and exported to Statistical Package for Service Product 25 for analysis. Different data presentation tools and binary logistic regression were enrolled by considering 95% confidence level and p value of 0.05. Result: Among the total study participants, near to one third (31.7%) of them got sleep after 30 minutes. More than one fourth of them slept for less than 7 hours. Less than half of the study participants had habitual sleep efficiency of more than 85% however 296(86%) of them did not face day time dysfunction Conclusion and recommendations: more than one third of patients with chronic illness had poor sleep quality. One third of study participants had sleep duration of less than the recommendations(less than 7 hours). Age, educational status, residence, and perception of prognosis of disease were factors that have associations with poor sleep quality among patients with chronic illness. Health care providers who are doing in chronic illness follow up clinic should be initiated to assess and screen those patients with poor sleep quality.

scholarly journals Maternal Satisfaction with Intrapartum Nursing Care and Its Associated Factors among Mothers Who Gave Birth in Public Hospitals of North Wollo Zone, Northeast Ethiopia: Institution-Based Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Asmamaw Demis ◽  
Ribka Nigatu ◽  
Derebe Assefa ◽  
Getnet Gedefaw
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Nursing Care ◽  
Public Hospitals ◽  
Maternal Satisfaction ◽  
Care Providers ◽  
Cross Sectional ◽  
Intrapartum Nursing ◽  
Study Participants ◽  
North Wollo

Background. Now a day, satisfaction had been identified as the major index to assess the quality of health-care provision in the world including Ethiopia. Mothers judge the quality of intrapartum care received based on their satisfaction with the services provided, thus influencing their utilization of the available health facilities. Therefore, this study aimed to assess maternal satisfaction with intrapartum care and associated factors among mothers who gave birth in public hospitals in North Wollo Zone, Northeastern Ethiopia, 2019. Methods. Institutional-based cross-sectional quantitative study was conducted in public hospitals of North Wollo Zone, and a total of 398 study participants were selected by using a systematic random sampling method. Data was collected using a standardized questionnaire by direct interviewing of study participants, and data was analyzed using SPSS 24 versions to determine the frequency of variables. Logistic regression was carried out to identify factors associated with maternal satisfaction. Results. From the total of 398 study participants, about 51% of women were satisfied with the hospital-based intrapartum nursing care. Being rural in residency (AOR: 2.03; 95% CI: 1.05-3.93), time to be seen by health-care providers (AOR: 2.82; 95% CI: 1.46-5.46), having history of ANC follow-up (AOR: 3.73; 95% CI: 1.12-12.57), and getting adequate meal (AOR: 3.96; 95% CI: 1.13-13.83) had showed statistical significant association with maternal satisfaction. Conclusion. In this study, the overall maternal satisfaction with intrapartum nursing care was low. Therefore, improving ANC follow-up, early examined by health-care providers, and getting adequate meal while in labour and delivery might enhance women satisfaction with intrapartum nursing care services.

scholarly journals Self-care practice and its predictors among adults with diabetes mellitus on follow up at public hospitals of Arsi zone, southeast Ethiopia

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Rahel Nega Kassa ◽  
Ibrahim Yimer Ibrahim ◽  
Hana Abera Hailemariam ◽  
Mekdes Hailegebriel Habte
Keyword(s):  
Diabetes Mellitus ◽  
Self Care ◽  
Public Hospitals ◽  
Care Practice ◽  
Diabetic Patients ◽  
Care Providers ◽  
Family History Of Diabetes ◽  
Arsi Zone ◽  
Southeast Ethiopia

Abstract Objective Diabetes mellitus is a chronic illness that requires ongoing patient self-management and support to prevent acute complications and to reduce the risk of long- term complications. The objective of the study was to assess diabetic self-care practice and its predictors among adults with diabetes mellitus on follow up at hospitals of Arsi zone, southeast Ethiopia. Results Above half (53.3%) of diabetic patients had good self-care practice. Younger age (AOR: 8.95, 95% CI 1.89,42.48), earning a high income (AOR: 2.495, 95% CI 1.0,5.85), having a family history of diabetes (AOR: 4.5, 95% CI 1.3, 15.5), long duration since the diagnosis of diabetes (AOR: 2.14,95% CI 1.127,4.05), not having diabetic complications (AOR: 3.87, 95% CI 2, 7.48), and having glucometer (AOR: 4.08, 95% CI 1.78 l, 9.33) were significantly associated factors with good diabetic self care practice. Efforts should be made to prevent complications of diabetes mellitus, to support patients who are aged and who have no glucometer at their home to promote good self-care practice. Particularly, health care providers should give special attention to newly diagnosed patients.

scholarly journals The Troublesome Triad: Hypertriglyceridemia-Induced Acute Pancreatitis in Diabetic Ketoacidosis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A404-A404
Author(s):  
Hytham Rashid ◽  
Jessie Martin ◽  
Alan Truong ◽  
Emily Nix ◽  
Deepu Thoppil ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Acute Pancreatitis ◽  
Diabetic Ketoacidosis ◽  
Medication Compliance ◽  
Metabolic Derangement ◽  
History Of ◽  
Beta Hydroxybutyrate ◽  
Hispanic Male

Abstract Background: Diabeticketoacidosis (DKA) is an acute metabolic derangement that can triggerhypertriglyceridemia-induced acute pancreatitis (HTGAP). While DKA classicallypresents in patients with Type 1 Diabetes Mellitus (DM1), previous literaturedescribes HTGAP in DKA as the initial presentation of Type 2 Diabetes Mellitus(DM2). The following case illustrates the diagnostic complexities of thisenigmatic triangle. Clinical Case: Apreviously healthy, 28-year-old Hispanic male with a family history of DM2presented to the ED complaining of a sharp epigastric 10/10 pain radiating tothe right flank for one day that evolved into nausea with intractablenonbilious, nonbloody vomiting. He recently immigrated from Mexico City and hasnot seen a physician since childhood. He denied any tobacco, alcohol, norillicit substance use. Oninitial exam, he was afebrile and hemodynamically stable with dry mucosa,epigastric tenderness with voluntary guarding, but no evidence of jaundice,scleral icterus, nor abdominal distention. Pertinent initial labs foundglucosuria and ketonuria with a normal CBC, but his CMP was delayed as hisblood was lipaemic requiring serial dilutions that found hyperglycemia (415mg/dL, n &lt;140), decreased carbon dioxide (17 mmol/L, n:23–29), a high aniongap (18 mmol/L, n&lt;12), elevated ALT (154 u/L, n:4–36). Additional testingfound severely elevated triglycerides (4,427 mg/dL, n&lt;150 mg/dL), elevated lipase(536 u/L, n&lt;160), elevated Beta-hydroxybutyrate (5.30 mg/dL, n&lt;2.81), andan elevated HgA1C (10.1%, n&lt;5.7). These findings confirmed the diagnosis ofDKA with concerns for underlying HTGAP. CT abdomen showed hepatic steatosis andperipancreatic inflammation, confirming the diagnosis. Hewas admitted to the ICU, received aggressive IV fluid resuscitation with 5%dextrose in half normal saline while on an insulin infusion, with morphine andondansetron to control his pain and nausea. His abdominal pain resolved as histriglycerides trended down and anion gap closed. He was transitioned to an oraldiet with subcutaneous insulin prior to discharge on insulin and fenofibrate. At 1 month follow up, he reported medication compliance and denied anyrecurrence. Conclusion: While DKA rarely triggers HTGAP in &lt;4% of pancreatitis cases, HTGAP willexacerbate DKA as the pancreatic inflammation leads to acute beta celldysfunction causing insulin deficiency, propagating lipolysis. A serumtriglyceride level &gt;1000 mg/dL is required for diagnosis of HTGAP, and thedegree of elevation is associated with the severity of pancreatitis. Reference: Timilsina, S, et al. (2019). Triad of Diabetic Ketoacidosis,Hypertriglyceridemia, and Acute Pancreatitis: Severity of Acute PancreatitisMay Correlate with the Level of Hypertriglyceridemia. Cureus, 11(6), 4930–4934.

scholarly journals Health care professionals’ perspectives on screening and management of gestational diabetes mellitus in public hospitals of South India – a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Biswamitra Sahu ◽  
Giridhara R. Babu ◽  
Kaveri Siddappa Gurav ◽  
Maithili Karthik ◽  
Deepa Ravi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Gestational Diabetes ◽  
Health Care Providers ◽  
Public Hospitals ◽  
Effective Management ◽  
Care Providers

Abstract Background Women developing Gestational Diabetes Mellitus (GDM) are subsequently at a higher risk of developing Type 2 Diabetes later in life. Screening and effective management of women with GDM are essential in preventing progression to type 2 diabetes mellitus. We aimed to explore the perspectives of healthcare providers regarding the barriers from the health system context that restrict the timely screening and effective management of GDM. Methods We conducted six in-depth interviews of health care providers- four with nurses and two with obstetricians in the public hospitals in India’s major city (Bengaluru). The interviews were conducted in the preferred language of the participants (Kannada for nurses, English for the obstetricians) and audio-recorded. All Kannada interviews were transcribed and translated into English for analysis. The primary data were analyzed using the grounded theory approach by NVivo 12 plus. The findings are put into perspective using the socio-ecological model. Results Health care providers identified delayed visits to public hospitals and stress on household-level responsibilities as barriers at the individual level for GDM screening. Also, migration of pregnant women to their natal homes during first pregnancy is a cultural barrier in addition to health system barriers such as unmet nurse training needs, long waiting hours, uneven power dynamics, lack of follow-up, resource scarcity, and lack of supportive oversight. The barriers for GDM management included non-reporting women to follow - up visits, irregular self-monitoring of drug and blood sugar, trained staff shortage, ineffective tracking, and lack of standardized protocol. Conclusion There is a pressing need to develop and improve existing GDM Screening and Management services to tackle the growing burden of GDM in public hospitals of India.

scholarly journals Health Care Professionals’ Perspectives on Screening and Management of Gestational Diabetes Mellitus in Public Hospitals of South India – a Qualitative Study

2020 ◽  
Author(s):  
Biswamitra Sahu ◽  
Giridhara R Babu ◽  
Kaveri Siddappa Gurav ◽  
Maithili Karthik ◽  
R Deepa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Health System ◽  
Health Care Providers ◽  
Resource Scarcity ◽  
Public Hospitals ◽  
Care Providers

Abstract Background Women developing Gestational Diabetes Mellitus (GDM) have a higher risk of developing Type 2 Diabetes later in life. We aimed to explore the perspectives of healthcare providers regarding the barriers from the health system context that restrict the timely screening and effective management of GDM. Methods We conducted six in-depth interviews of health care providers- four with nurses and two with obstetricians in the public hospitals in India's major city (Bengaluru). The interviews were conducted in the preferred language of the participants ( Kannada for nurses, English for the obstetricians), and audio-recorded. All Kannada interviews were transcribed and translated into English for analysis. The primary data were analyzed using grounded theory approach by NVivo 12 plus. The findings are put into perspective using the socio-ecological model. Results Health care providers identified delayed visits to public hospitals and stress on household-level responsibilities as barriers at the individual level for GDM screening. Also, migration of pregnant women to natal home during first pregnancy is a cultural barrier in addition to health system barriers such as unmet nurse training needs, long waiting hours, uneven power dynamics, lack of follow-up, resource scarcity, and lack of supportive oversight. The barriers for GDM management included non-reporting women to follow - up visits, irregular self-monitoring of drug and blood sugar, trained staff shortage, ineffective tracking, and lack of standardized protocol. Conclusion There is a pressing need to develop and improve existing GDM Screening and Management services to tackle the growing burden of GDM in public hospitals of India.

scholarly journals Magnitude of overweight and associated factors among type 2 diabetes mellitus patients at Mekelle public hospitals, Tigray, Ethiopia: a cross-sectional study

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Kbrom Gemechu Kiros ◽  
Gebre Yitayih Abyu ◽  
Desta Siyoum Belay ◽  
Mekonnen Haftom Goyteom ◽  
Tensay Kahsay Welegebriel
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Dietary Intake ◽  
Associated Factors ◽  
Central Obesity ◽  
Public Hospitals ◽  
Urban Residence ◽  
Study Participants

Abstract Objective To assess magnitude of overweight and associated factors among type 2 diabetes mellitus patients at Mekelle public hospitals, Tigray, Ethiopia. Results A total of 365 participants were enrolled in this study. One hundred ninety-eight (54.2%) of the participants were males and 288 (78.9%) of the study participants were from an urban residence. In this study 161 (44.1%) and 12 (3.3%) of the study subjects were alcohol consumers and smokers respectively. Besides, 166 (45%) of the study participants had poor dietary intake and around 302 (82.7%) had low level of vigorous physical activity. The proportion of individuals who were overweight using body mass index as a measure was 149 (40.8%) and the proportion of individuals who had central obesity using waist circumference as a measure was 194 (53.2%). The magnitude of overweight among study participants from urban residence and alcohol consumers was 138 (92.6%) and 93 (62.4%) respectively. Residence area, alcohol consumption, physical activities, central obesity and dietary intake were the determinant factors for overweight among type 2 diabetes mellitus patients.

scholarly journals Incidence and predictors of diabetic ketoacidosis among children with type 1 diabetes mellitus in Western Amhara Referral Hospitals, Northwestern Ethiopia, 2018: A Retrospective Follow-Up Study

2019 ◽  
Author(s):  
Melkamu Siferih Zeleke ◽  
Getiye Dejenu Kibret ◽  
Tsige Gebre ◽  
Molla Yigzaw Birhanu ◽  
Cheru Tesema Leshargie
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Insulin Dose ◽  
P Value ◽  
Follow Up Study ◽  
Referral Hospitals

Abstract Background Diabetic ketoacidosis remains a major cause of morbidity, hospitalizations and mortality in children with established type 1 diabetes mellitus. Therefore, this study aimed to determine the incidence and predictors of diabetic ketoacidosis among children with established type 1 diabetes mellitus at Western Amhara region.Method Institution-based retrospective follow-up study was done on 393 children with established type 1 diabetes mellitus registered between September 2013 and September 2017 in Western Amhara referral hospitals. The collected data was entered into Epidata version 4.2 and further analysis were done using STATA version 14.1. Negative Binomial Poisson Regression analysis model was used.Result The cumulative incidence and incidence density rate of diabetic ketoacidosis among children with established type 1 diabetes mellitus in western Amhara referral hospitals was 63.9% and 41.5 per 100 person-years respectively. The incidence of diabetic ketoacidosis increased with age at diagnosis [ARR:2.61, p-value<0.001], siblings only care givers [ARR:1.87, p-value <0.001], fathers only [ARR:1.51, p-value=0.004],omission of insulin (ARR:1.58, p-value <0.001), lower frequency of clinical visits [ARR:2.35, p-value=0.007] and baseline insulin dose >1.2 u/kg/day [ARR:1.39, p-value=0.015], diabetic education (no) [ARR:1.52, p-value=0.011]. But the risk was decreased with baseline insulin type (Lente and regular) (ARR; 0.73, p-value =0.006), base line insulin dose <0.6u/kg/day (ARR: 0.5, p-value=0.034) and community health insurance membership (no membership) [ARR: 0.49, p-value <0.001]. In general, this study revealed that a substantial number of patients had at least one episode of diabetic ketoacidosis and a higher rate of diabetic ketoacidosis.

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