scholarly journals Dosage individualization proposed for anti-gout medications among the patients with gout

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257082
Author(s):  
Binaya Sapkota ◽  
Suraj Chaudhary ◽  
Prakash Gurung ◽  
Anisha Humagain ◽  
Sujan Sapkota
Keyword(s):  
High Risk ◽  
Multinomial Logistic Regression ◽  
Clinical Success ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
P Value ◽  
Willingness To Participate ◽  
Cross Sectional ◽  
Dose Individualization ◽  
The Individual

Background The conventional one-size-fits-all approach has been criticized for almost all drugs used especially for chronic diseases, including gout. The present study was aimed to explore the need of individualization and optimization of the dose of anti-gout medications among gout patients. Methods Cross-sectional study was carried out among 384 randomly selected new gout patients visiting two gout treatment centers at Lalitpur Metropolitan City, Nepal and who were taking antigout medications. Patients not taking anti-gout medications and not showing willingness to participate were excluded. The eGFR was calculated with the CKD Epidemiology Collaboration (CKD-EPI) creatinine equation (2009). Doses to be individualized were decided based on the Renal Drug Handbook and verified with the BNF 80. Data were analyzed via R 4.0.3 by applying the multinomial logistic regression to analyze statistical significance of risk with various predictors, and considering a p-value <0.05 statistically significant. Comorbidities were coded as per the ICD-11 coding and medicines were coded according to the WHO Guidelines for ATC classification and DDD assignment 2020. Results The high risk of progression to CKD increased in the age range 54–63 and ≥84 years by 17.77 and 43.02 times, respectively. Also, high risk increased by 29.83 and 20.2 times for the overweight and the obese respectively. Aceclofenac 100mg was prescribed for maximum patients (30.5%). Need of dose individualization was realized in 30 patients, with maximum (7) in case of etoricoxib 90mg. Various glucocorticoids were prescribed for 36.9% patients, out of whom 3.8%required dose individualization and 15.9% patients with xanthine oxidase inhibitors, out of whom 1.3% required dose individualization. Conclusion Thirty cases required dose individualization, which was although minimal but could have meaningful impact on the clinical success of the individual patient. Based on the recommendation on dose individualization, those patients could be optimized on their therapy on future follow ups.

scholarly journals Dosage individualization proposed for anti-gout medications among the patients with gout: a bicentric study in Nepal

2020 ◽  
Author(s):  
Binaya Sapkota ◽  
Suraj Chaudhary ◽  
Prakash Gurung ◽  
Anisha Humagain ◽  
Sujan Sapkota
Keyword(s):  
High Risk ◽  
Multinomial Logistic Regression ◽  
Statistical Significance ◽  
Evidence Base ◽  
Cross Sectional Study ◽  
P Value ◽  
List Type ◽  
Sectional Study ◽  
Cross Sectional ◽  
Dose Individualization

AbstractBackgroundThe conventional one-size-fits-all approach has been criticized for almost all drugs used especially for chronic diseases, including gout. The present study was aimed to individualize and optimize the dose of anti-gout medications among gout patients.Methods and findingsBicentric cross-sectional study was carried out among 384 randomly selected new gout patients visiting two gout treatment centers at Lalitpur Metropolitan City, Nepal and taking antigout medications. Patients not taking anti-gout medications and not showing unwillingness to participate were excluded. The eGFR was calculated with the CKD Epidemiology Collaboration (CKD-EPI) creatinine equation (2009). Doses to be individualized were decided based on the Renal Drug Handbook and BNF 80. Data were analyzed via R 4.0.3. Multinomial logistic regression analysis was performed to analyze statistical significance of risk with various predictors, considering a p-value <0.05 statistically significant. Comorbidities were coded as per the ICD-11 coding and ATC classification of medicines as per the WHO Guidelines for ATC classification and DDD assignment 2020. High risk of progression to CKD increased in the age range 54-63 and ≥84 years by 17.77 and 43.02 times, respectively. High risk of gout increased by 29.83 and 20.2 times for overweight and obese patients respectively. Aceclofenac 100 mg was prescribed for maximum patients (117, 30.5%). Need of dose individualization was realized altogether in case of 30 patients (8%), with maximum (7, 1.8%) in case of etoricoxib 90 mg (i.e., avoid if possible). There were 260 (67.7%) cases without associated comorbidities, followed by 37 (9.6%) patients with hyperthyroidism. Various glucocorticoids were prescribed for 141 (36.9%) patients, out of whom 14 (3.8%) required dose individualization. Altogether 61 (15.9%) patients were prescribed with xanthine oxidase inhibitors, out of whom 5 (1.3%) required dose individualization.ConclusionsThirty (8%) cases required dose individualization, which was although minimal but could have meaningful impact on clinical success of individual patient. Based on the recommendation on dose individualization, those patients could be optimized on their therapy on future follow ups. Also, future randomized controlled trials may be based on these to derive a more conclusive evidence base for gout management.Author summaryWhy was this study done?Dosage individualization helps optimize drug selection and dosing based on pathogenesis, mechanism of action of drugs, and their dose exposure-response relationships.Very limited researches have been undertaken in Nepal to individualize medications for chronic medication users including gout patients. The present study was probably the first of its kind in Nepal aiming to individualize the dose of anti-gout medications among gout patients.What did the researchers do and find?Bicentric cross-sectional study was carried out among 384 new gout patients visiting two gout treatment centers in Nepal and taking antigout medications.Doses to be individualized were decided based on standard references of the Renal Drug Handbook and the British National Formulary 80. Dose to be individualized was later discussed with the prescribing physicians.Need of dose individualization was realized altogether in case of 30 patients (8%), with maximum (7, 1.8%) in case of etoricoxib 90 mg (i.e., avoid if possible).What do these findings mean?The present simple effort of individualization of antigout medications might help the physicians optimize the therapeutic success for the patients, once they implement it and patients adhere to it.Since the study was limited to only two gout and rheumatic diseases treatment centers, it might not represent the whole gout patients in the nation but it might provide the evidence base for future large controlled clinical trials.

Safety climate and related factors in rehabilitation nurses of hospitals in Iran

Work ◽  
2021 ◽  
pp. 1-8
Author(s):  
Javad vatani ◽  
Zahra Khanikosarkhizi ◽  
Mohammad Ali Shahabi Rabori ◽  
mohammad khandan ◽  
Mohsen aminizadeh ◽  
...  
Keyword(s):  
Safety Climate ◽  
Cross Sectional Study ◽  
P Value ◽  
Related Factors ◽  
Cross Sectional ◽  
Climate Assessment ◽  
Safety Work ◽  
Significant Difference ◽  
Training Courses ◽  
The Individual

BACKGROUND: Safety climate is a common insight of staff that indicates individuals’ attitudes toward safety and priority of safety at work. OBJECTIVES: Nursing is a risky job where paying attention to safety is crucial. The assessment of the safety climate is one of the methods to measure the safety conditions in this occupation. The aim of this study was to assess the safety climate of rehabilitation nurses working in hospitals in Tehran. METHODS: This is a cross-sectional study which was carried out on 140 rehabilitation nurses selected from all hospitals and clinics in Tehran in 2019. To collect the required data, a two-section questionnaire was used. The first section was related to demographic factors and the second part (22 statements) was to measure the safety climate using nurses’ safety climate assessment questionnaire. The collected data were analyzed by SPSS V16 using independent t-test, ANOVA, Kruskal-Wallis and Mann-Whitney U test at the 5% level. RESULTS: Findings showed that the total mean of safety climate was 3.06±0.56. According to the results, a significant difference was found between the positive and negative satisfaction of nurses with safety climates (P-value = 0.03), communication with nurses (P-value = 0.01) and supervisors’ attitude (P-value = 0.02). Furthermore, a significant difference in safety climate between the individual with the second job and the individual without second could be observed (P-value = 0.01). CONCLUSIONS: The results indicated that the safety climate was not at an acceptable level. Thus, it is essential to introduce safety training courses (e.g. safety, work-rest balance, and so on) and to improve the safety performance at work.

scholarly journals Perception on Management of Nursing Education Institutes among Bachelors Students in Selected Nursing Colleges at Kathmandu

2020 ◽  
Vol 7 (1) ◽  
pp. 23-36
Author(s):  
Bhuwan Kumari Dangol ◽  
Narbada Thapa
Keyword(s):  
Nursing Education ◽  
Nursing Students ◽  
Statistical Significance ◽  
Data Entry ◽  
Education Institution ◽  
Cross Sectional Study ◽  
Current Status ◽  
P Value ◽  
Cross Sectional ◽  
Organizational Goals

Management is a process of planning, decision making, organizing, leading, motivating and controlling, and an effective utilization of the resources to reach the organizational goals efficiently and effectively. Management has a crucial role in quality of work and production in any institutions. Although a rapid increase of Nursing Education Institutions in Nepal since last decade which had been trained thousands of nursing cadres, the management aspects of these institutions are not studied adequately. Thus current study intended to explore the current status of Nursing Education Institution Management as experienced and perceived by the bachelors nursing students. A descriptive cross-sectional study was conducted among the nursing institutions in Kathmandu valley. Of the total 28 in the valley, 14 were selected purposively. From the selected institutions, all 377 eligible students currently in final year of study were selected. Among them, 208were from BSN and 169 were from B Sc program.  The data was collected through the self administered structured questioners after taking informed consent. Data entry and analysis was done in SPSS version 16 software. The findings of the study show that 70% students were satisfied in institutional management (mean59.62, SD ± 3.66). In academic management (78%), (mean139.82, SD ± 6.22), followed by human resources 67%, (mean43.54, SD ± 2.79) and were in physical resources management 75% students were satisfied (mean45.02, SD ± 3.08). Analysis of variations between group (administrators, faculties, students) found statistical significance (p value <0.05). So it is concluded the perception of students, faculties and administrator were different on managing the nursing education.

scholarly journals Climate Change Awareness and related Tree Planting Practices in a Rural Community in North-Western Nigeria

2021 ◽  
Vol 33 (1) ◽  
pp. 41-49
Author(s):  
A.A. Gobir ◽  
A.A. Aliyu ◽  
A.A. Abubakar ◽  
C. Esekhaigbe ◽  
I.A. Joshua ◽  
...  
Keyword(s):  
Climate Change ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
Tree Planting ◽  
P Value ◽  
Community Based ◽  
Cross Sectional ◽  
Household Heads ◽  
Tree Cutting ◽  
Fire Wood

Background: Tree cutting is one of the causes of climate change and a common practice in Africa, a continent under significant threat from climate change. Therefore, climate change awareness and mitigation are vital to reducing its impacts in the region. Reforestation through planting of trees is an important carbon emission reduction strategy. This study assessed climate change awareness and related tree planting practices among household heads in a Nigerian rural community.Methods: A community-based descriptive, cross-sectional study was conducted in April 2019 among all household heads in Nasarawan Buhari community. An interviewer-administered questionnaire was used to collect data from the 104 household heads (or their representatives). Data was analyzed using SPSS (version 21.0) and statistical significance was set at p value of < 0.05.Results: The mean age of respondents was 40.6±12.6 years, and most of them (87.5%) were males. Half (50.0%) were aware of climate change, and their main source of information was radio (63.5%). Most (98.1%) used fire wood for cooking. Only a minority (27.9%) planted at least a tree in the year preceding the study. There was a statistically significant association between climate change awareness and occupation (p=0.038) but not with tree planting (p=0.827).Conclusion: The results indicated that only half of respondents were aware of climate change. There was high use of wood as cooking fuel with low tree planting. Tree planting was not associated with climate change awareness. There is therefore a need for continuous climate change education and mitigation campaign in the community.

scholarly journals Economic implications of polypharmacy in Nepal: Multicenter community-based study

2020 ◽  
Author(s):  
Binaya Sapkota ◽  
Suraj Shakya ◽  
Saroj Sah ◽  
Narendra Chaudhary ◽  
Bijendra Tamang ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Multinomial Logistic Regression ◽  
Statistical Significance ◽  
Age Groups ◽  
Pharmacoeconomic Evaluation ◽  
Secondary Outcome ◽  
P Value ◽  
Cross Sectional ◽  
Economic Implications ◽  
Total Cost

Objective:Improper management of polypharmacy in community and hospital pharmacies may lead to adverse effects and drug interactions in patients of all age groups, especially children and the elderly. This study aimed to determine the scenario of polypharmacy in multiple communities in Nepal and the costs associated with them. Design: Cross-sectional study Setting:Local communities of nine districts in Nepal Participants:Total 400 patients of all age groups, who were consuming medicines and who fulfilled inclusion criteria from May 2017 to August 2018 Primary and secondary outcome measures:A semi-structured questionnaire, based on the prescription optimization method, was used for data collection. Multinomial logistic regression was performed to analyze the statistical significance of polypharmacy with the predictor variables (e.g., age, education level, occupation, diagnosis, total cost of medicines). The p-value <0.05 was considered statistically significant at 95% confidence interval. Polypharmacy cases and their economic implications were reported. Results:Eighty-one patients (20.3%) with an age group of 22-31 years with female patients (219, 54.8%) reported more polypharmacy events. There were 216 patients (54%) with prescriptions of five medicines i.e., moderate polypharmacy. Total number of medicines consumed by all 400 patients was 2269, with a mean, SD 5.67, 1.08. Total expenditure by all 400 patients was USD 3409.54 during the study period, with a mean, SD 8.66, 6.04. Both moderate and severe polypharmacy cases were non-significantly related with age, gender and total cost of medications. They had significant relationship in almost all levels of education and occupation and showed mixed type of significance and non-significance with the diagnosis of the respondents. Conclusion: Polypharmacy cases can be minimized, considering adverse drug reactions and drug interactions. Further studies are warranted in medication utilization and avoidable polypharmacy along with detailed pharmacoeconomic evaluation.

scholarly journals Hubungan Kepuasan Kerja dengan Kinerja Perawat di Rumah Sakit

2021 ◽  
Vol 21 (3) ◽  
pp. 1135
Author(s):  
Raja Syafrizal ◽  
Yulihasri Yulihasri ◽  
Zifriyanthi Minanda Putri
Keyword(s):  
Job Satisfaction ◽  
Work Performance ◽  
Statistical Tests ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Low Performance ◽  
The Individual

The performance of nurses can be seen from several cases that occur in hospitals. The incidence of falls in patients, nosocomial infections, inadequate documentation is the result of nurses' low performance. Factors that affect the performance of nurses in hospitals are job satisfaction. So this study aims to describe the relationship between job satisfaction and nurse performance. This study used a cross-sectional study design with a sample of 85 nurses at Arosuka Hospital using proportional sampling technique. The research instrument used a job satisfaction survey questionnaire and the Individual Work Performance quasi (IWPQ) and statistical tests used frequency distribution and chi-square tests. The results showed that the majority of nurses' job satisfaction was in the satisfied category as much as 56.5% and the majority of nurses' performance in the high category was 51.8%. Then obtained a significant relationship between job satisfaction and nurse performance with a p-value of 0.000. So it is expected that hospitals can pay attention to aspects of nurse job satisfaction in making policies

Colostrum Avoidance Practice among primigavida Mothers in Urban Northwest Ethiopia. A Cross-Sectional Study

2020 ◽  
Author(s):  
Tilksew Ayalew ◽  
Eden Asmare
Keyword(s):  
Statistical Significance ◽  
Cross Sectional Study ◽  
Northwest Ethiopia ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Normal Delivery ◽  
Childhood Illnesses ◽  
Complete Form ◽  
Strength Of Association

Abstract Background: Breast milk is the ideal and complete form of nutrition for infants colostrum contains all the necessary nutrients for infants’ growth and development and antibodies that can protect from many childhood illnesses. Understanding the extent of and barriers to colostrum avoidance in Ethiopia is important for learning how to best improve optimal breastfeeding. No single study has been conducted on primigavida mothers in the country. Therefore, this study aimed to assess the rate of colostrum avoidance practice and associated factors among primigavida mothers Method: A community- based cross-sectional study was conducted from March to April 2016 among (n=398) randomly selected primigavida mothers in Bahir Dar city, northwest Ethiopia. Data were collected using a structured interviewer-administered questionnaire and analyzed using SPSS version25. Bivariate and multivariate logistic regression analyses were carried out. Odds ratio with 95% confidence interval was used to measure the strength of association. Statistical significance was declared at P-value ≤0.05.Results: Out of 398 primipara mothers, 8.8% discarded colostrum. The most common reasons for discarding colostrum were; yellow and creamy (39.2%), bad for infant (35.2%), traditional/cultural reason (17.1%) and infant unable to feed (8.5%).Married mothers (OR=4.52, p<0.05), employed mothers (OR=3.46, p<0.05), mothers underwent normal delivery (OR=5.20, p<0.05) and mothers who initiated breastfeeding within 1 hr. (OR=2.79, p=0.05) were less likely to discard colostrum.Conclusion: The current study revealed that colostrum was discarded by 8.8 % of premiparious mothers. Primipara mothers who were married, unemployed, underwent normal delivery and initiated breastfeeding within one hour were less likely to discard colostrum. These results suggest that multi-sectorial and multi-disciplinary approaches are needed to increase optimal breastfeeding among premiparious mothers.

scholarly journals Adquisición de conocimientos en cuidados paliativos mediante un plan de estudios transversal en enfermería

2020 ◽  
Vol 19 (3) ◽  
pp. 322-344
Author(s):  
Antonio Valenzuela Vidal ◽  
Ana Folch Ayora ◽  
Joan Bou Esteller ◽  
Zaira Fernández Yañez ◽  
Sebastian Eroles Tena ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Students ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
P Value ◽  
Future Health ◽  
Cross Sectional ◽  
Care Experience ◽  
Compulsory Subject ◽  
Academic Year

La implementación de los cuidados paliativos en las universidades ha sido paulatina. Su reciente implantación requiere de su evaluación para la mejora en la formación de nuestros futuros profesionales. Por tanto, el objetivo de este trabajo es valorar el conocimiento en paliativos, en estudiantes de enfermería de la Universidad Jaume I, tras la implementación de un plan de estudios de enseñanza transversal y evaluación mediante una asignatura de carácter obligatorio. Método: Estudio observacional, de corte transversal, durante el curso académico 2017/2018 mediante la escala Palliative Care Quiz for Nursing. Análisis descriptivo, comparativo de las variables cuantitativas y cualitativas global y según aciertos/errores, significación estadística p-value <0,05.Resultados: La muestra de n=155, edad 22,21±6,61 años, con predominio del sexo femenino en el 80% (n=124). La esfera con mayor número de aciertos fue la relacionada con el control de dolor y los síntomas 69,1% y la esfera con más fallos la relacionada con la filosofía y los principios 46,9%. El conocimiento en paliativos viene explicado en un 16% por el curso académico y con la experiencia previa en paliativos. Conclusiones: Mediante nuestros resultados observamos, que la educación en paliativos desarrollada de forma transversal con la culminación de una asignatura obligatoria en cuarto curso, resulta ser efectiva en estudiantes de enfermería, donde el 63% ostentó una buena tasa de aciertos en conocimientos de paliativos.   The inclusion of palliative care content in university curricula has been gradual. Due to the recent incorporation of palliative care as a subject, an evaluation is necessary in order improve the education of our future health professionals. The objective of this study was thus to assess palliative care knowledge in nursing students at Jaume I University after the transversal inclusion of palliative care content throughout the program, culminating in a subject of an obligatory nature. Method: This observational cross-sectional study was undertaken over the 2017/2018 academic year using the Palliative Care Quiz for Nursing. A descriptive and comparative analysis of the quantitative and qualitative global variables was performed with respect to correct/incorrect responses. Statistical significance was set at p <0.05.Results: The sample included 155 participants, with a mean age of 22.21±6.61 years. Females (n=124) were predominant in the sample (80%). The domain which received the highest number of correct responses was related to the control of pain and symptoms (69.1%) and the domain which received the highest number of incorrect responses was related to philosophy and principles (46.9%). Academic year and prior palliative care experience explained 16% of the variance in knowledge. Conclusions: Through our results, we observed that palliative care education, implemented in a transversal manner and with the completion of compulsory subject in the fourth year, was effective in nursing students, with 63% achieving good scores with respect to palliative care knowledge.

scholarly journals Perinatally acquired HIV-positive status disclosure and associated factors in Dire Dawa and Harar, Eastern Ethiopia: a health facility-based cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e019554 ◽  
Author(s):  
Melkamu Merid Mengesha ◽  
Yadeta Dessie ◽  
Aklilu Abrham Roba
Keyword(s):  
Health Status ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
Hiv Treatment ◽  
Hiv Positive ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Eastern Ethiopia ◽  
Dire Dawa

ObjectivesThe aim of this study was to assess the level and factors associated with caregivers’ disclosure of perinatally HIV-infected (PHIV+) children’s seropositive status.DesignWe conducted a cross-sectional study in five public health facilities providing HIV treatment and care in Dire Dawa and Harar, Eastern Ethiopia. The data were collected from 310 caregivers through face-to-face interviews and record reviews. Data analyses were done using STATA V.14.2 and statistical significance was declared at p value <0.05.ResultsThe study revealed that the level of PHIV+ diagnosis disclosure was 49.4% (95% CI 43.8 to 54.9). Mean age at disclosure was 11.2 years. Disclosure level was higher among children who frequently asked about their health status (aOR (adjusted OR) 2.04, 95% CI 1.04 to 4.03) and when caregivers knew other people who had a disclosure experience (aOR 2.49, 95% CI 1.17 to 5.32). Disclosure level was less among children of 12 years or below (aOR 0.04, 95% CI 0.02 to 0.09) and among caregivers practising deception about the children’s HIV positive status (aOR 0.38, 95% CI 0.19 to 0.74).ConclusionOnly half of the caregivers disclosed their child’s PHIV+ diagnosis. To facilitate disclosure, caregivers should be counselled about the appropriate age of disclosure and related misconceptions that hinder it. It is also apparent that caregivers need to be guided as to how to address children’s frequent questions about their health status. These interventions can be made in a one-on-one approach or through patient group counselling when they come to get healthcare services.

scholarly journals Prevalence, Pattern and Correlates of Intimate Partner Violence among Postpartum Women in Osogbo, Nigeria

2019 ◽  
pp. 1-12
Author(s):  
Adejoke Deborah ◽  
Abiodun Afolabi Benjamin ◽  
Ibigbami Olanrewaju
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
Emotional Abuse ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
Intimate Partner ◽  
Public Health Issue ◽  
P Value ◽  
Postpartum Women ◽  
Cross Sectional

Aim: Intimate partner violence (IPV) is a public health issue in both developed and developing countries. It is one of the most common forms of violence against women. It affects all ethnic groups and it is not impeded by cultural, socio-economic or religious barriers. IPV in postpartum women can increase the risk of homicide and suicide. The study aimed to assess the prevalence, pattern and correlates of IPV among postpartum women attending postnatal and infant welfare clinics of LAUTECH Teaching Hospital, Osogbo. Study Design: This was a cross-sectional study. Place and Duration of Study: This study was conducted at LTH, Osogbo Nigeria between September and November 2015. Methodology: This was study conducted among 220 consenting postpartum women using Composite Abuse Scale and socio-demographic questionnaire. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 21. The level of statistical significance was set at p-value less than 0.05. Results: Prevalence of IPV was 26.8%, patterns of IPV were physical abuse 14.5%. Emotional abuse, 26.3, severe combined abuse 9.9% and Harassment 14.5%. IPV was significantly associated with support from respondents’ partner during pregnancy (χ2= 5.470, p=0.019) and partner’s religion. (χ2= 7.746, p= 0.010) The odd ratio for those who had partner’s support was less than 1. (OR =0.337, p=0.014, CI=0.141-0.803). Conclusion: The prevalence of IPV is high among postpartum women. Increased media campaign about intimate partner violence and preventive measures is urgently needed.

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