scholarly journals A simulated client exploration of nonprescription availability of antibiotics at drugstores for childhood acute diarrhea and upper respiratory infection in Lahore, Pakistan

2020 ◽  
Author(s):  
Usman Rashid Malik ◽  
Jie Chang ◽  
Furqan Hashmi ◽  
Naveel Atif ◽  
Hareem Basir ◽  
...  
Keyword(s):  
Respiratory Infection ◽  
Acute Diarrhea ◽  
Viral Infections ◽  
Cross Sectional Study ◽  
Easy Access ◽  
Categorical Variables ◽  
P Value ◽  
Cross Sectional ◽  
Upper Respiratory Infection ◽  
Upper Respiratory

Abstract Background The excessive consumption of antibiotics is a major contributor to antimicrobial resistance, especially in children. Children are often being advised antibiotics for viral infections. In developing countries, the drugstores are a prime source of easy access to nonprescription antibiotics. Also, in Pakistan, their irrational use is an “everyday routine”. The study, therefore, aimed to evaluate the dispensing of nonprescription antibiotics for children at drugstores of Lahore, Pakistan.Methods Using the pediatric acute diarrhea and acute upper respiratory infection as disease scenarios, a simulated client, cross-sectional study was conducted in Lahore, Pakistan to explore the antibiotics’ ease of availability at both categories of drugstores (pharmacies and medical stores) from November 1st, 2019 to January 31st, 2020. Chi-square (x2) test was used to compare the differences in practices of different categorical variables. Multivariable logistic regression was applied to analyze the association of various factors with antibiotics dispensing.Results Antibiotics were dispensed without prescription in 456 (59%) of 773 simulated visits out of which 425 (93.2%) were dispensed on the advice of the drugstore staff. The qualified pharmacist was available in only 164 (21.2%) cases. Of 386 visits for acute diarrhea and 387 for acute upper respiratory infection, nonprescription antibiotic dispensing occurred in 259 (67.1%) and 197 (50.9%) visits respectively. The considerable differences (p-value < 0.05) were observed between the practices of the towns, disease scenario presented, categories of drugstores, and pharmacist-supervised drugstores. Conclusions The inappropriate dispensing practices were prevalent to a large extent at the drugstores and antibiotics were effortlessly obtainable without prescriptions. The quality of the services provided, especially by the non-pharmacist staff, was also not satisfactory. Therefore, the Drug Regulating Authority of Pakistan must enforce strict implementation of drug laws at the drugstores without delays especially in major cities to help curb the felonious use of antibiotics.

Phototherapy Induced Hypocalcemia in Neonates with Unconjugated Hyperbilirubinemia

2021 ◽  
Vol 11 (1) ◽  
pp. 4-8
Author(s):  
Amna Khan ◽  
Anila Farhat ◽  
Hamayun Anwar ◽  
Sajid Shamim ◽  
Mujeeb Ur Rehman ◽  
...  
Keyword(s):  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
P Value ◽  
Cross Sectional ◽  
Unconjugated Hyperbilirubinemia ◽  
Before And After

Objective: To determine the frequency of hypocalcemia in neonates with unconjugated hyperbilirubinemia receivingphototherapy.Study design and setting: Cross sectional study conducted at neonatal intensive care unit, King Abdullah Teaching Hospital,Mansehra for one year from December 2017 to November 2018.Methodology: Total 213 full term stable neonates of either gender with jaundice were studied in this study. Out of which,143 with unconjugated hyperbilirubinemia were exposed to phototherapy while 70 neonates with exaggerated physiologicalhyperbilirubinemia taken as control were not exposed to phototherapy. Serum calcium level was determined through bloodtest before and after 24 hours of phototherapy. SPSS version 22 was used to analyze the data. Frequency and percentageswere used to describe categorical variables like gender and hypocalcemia. Hypocalcemia was stratified by age and genderto see effect modifiers. Post stratified chi-square test was applied in which p value = 0.05 was considered as significancevalue.Results: In study group, 143 neonates who received phototherapy had mean age of 7 days ± 2.62 SD. Total 65% neonateswere male and 35% neonates were female. Mean serum calcium level of neonates before and after provision of phototherapywas 9.28 mg/dl ± 0.23 and 8.54 mg/dl ± 0.68 respectively, which is statistically significant. The frequency of hypocalcemiawas 40% in neonates with unconjugated hyperbilirubinemia after 24 hours of phototherapy.Conclusion: Hypocalcemia is an important complication in neonates with unconjugated hyperbilirubinemia after continuousphototherapy. Hypocalcemia has clinical impact and adds to morbidity, and if left untreated, can lead to mortality.

scholarly journals Leptospira spp. seroprevalence in humans involved in a cross-sectional study in Garissa and Tana River Counties, Kenya

2020 ◽  
Author(s):  
Arithi Mutembei ◽  
Festus K. Mutai ◽  
Damaris Mwololo ◽  
John Muriuki ◽  
Mark Obonyo ◽  
...  
Keyword(s):  
Case Fatality ◽  
Cross Sectional Study ◽  
Wilcoxon Test ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Sectional Study ◽  
Test Statistic ◽  
Cross Sectional ◽  
Tana River

AbstractIntroductionLeptospirosis is a neglected bacterial zoonotic infection caused by spirochetes of Leptospira genus. Humans get infected through direct or indirect contact with urine of infected animals or environment. It accounts for more than 300,000 severe cases annually worldwide with case fatality rates of over 30%. Costs of diagnosis and treatment for human and animals, disruption of international trade of animals and products, reduced productivity and reproductivity in animals constitute economic importance. In Kenya, leptospirosis burden is significant but under-diagnosis and under-reporting affects the awareness of the disease. This study aimed to determine and compare the sero-prevalence and factors associated with Leptospira spp. in the two counties.MethodsWe conducted a cross-sectional study that involved apparently healthy people of at least 5 years of age in randomly selected households in Garissa and Tana River Counties. Blood samples were collected and tested for Leptospira spp antibodies using IgM ELISA. Standardized structured questionnaires were administered to collect socio-demographic and exposure information. We calculated frequencies and proportions for categorical variables and odds ratios (OR) and 95% confidence interval (CI) to evaluate association between sero-positivity and exposure factors. We used Wilcoxon test to evaluate statistical difference in sero-positivity for continuous variables and calculated test statistic (H) and p-value.ResultsA total of 952 subjects were recruited into the study – these included 482 persons from Garissa and 470 from Tana River. The overall sero-prevalence was 26% [(244/952); (CI: 23% to 29%)]. Garissa County had significantly higher Leptospira spp. seroprevalence (31%, n = 147; CI: 27% to 35%) compared to Tana River County (21 %, n = 97; CI: 17% to 25%). Being a female (OR=1.6, CI: 1.2-2.2) and engaging in pastoralism (OR=2.7, CI: 1.8-3.9) were significantly associated with higher odds of Leptospira spp. seropositivity compared to being a male or working in irrigated areas. The mean altitude of residence of sero-positive patients was 73m ± 21 SD (standard deviation) above sea level and that for sero-negative was 80m ± 22 SD (H=35, p-value = 0.00).ConclusionThis study determined the seroprevalence and risk factors for Leptospira spp. exposure in Garissa and Tana River Counties, Kenya. Females in pastoral communities experience high burden of the disease. Enhanced surveillance in humans and animals and further research is required to understand the complex and multifactorial drivers of leptospirosis transmission in the two Counties.

scholarly journals Faktor Eksternal Yang Berhubungan Dengan Minat Ibu Melakukan Kunjungan Ke Posyandu

2021 ◽  
Vol 11 (1) ◽  
pp. 63-72
Author(s):  
Juli Widiyanto ◽  
Supryati Zebua
Keyword(s):  
Data Collection ◽  
Family Support ◽  
Cross Sectional Study ◽  
External Factors ◽  
Easy Access ◽  
P Value ◽  
Cross Sectional ◽  
Study Approach ◽  
Data Collection Technique ◽  
The Village

Posyandu is useful for empowering the community and providing easy access to basic health services. The purpose of this study was to determine external factors related to maternal interest in visiting posyandu (a study in the village of Labuh Baru timur). This type of research is an observational analytic study with a cross-sectional study approach design, namely data collection and results are carried out at one time, the data collection technique is carried out using stratified random sampling where the sample of this study is some of the mothers who have children under five in the village area. Labuh Baru Timur. The instruments used in data collection were questionnaires and analysis used univariate and bivariate with the help of the SPSS Version 16.0 program. The results of research conducted by researchers from March to April 2020 with the title of external factors related to maternal interest in visiting posyandu show that there is no relationship between distance to posyandu, family support, and posyandu service services with maternal interest in visiting posyandu which is proven by p-value> 0.05, which is arranged in sequence 0.931 and OR 1, 046; 0.945 and OR 0.959; 0.768 and OR 0.842. Based on the results of this study, it can be concluded that there is no relationship between distance to posyandu, family support, and posyandu services with mothers' interest in visiting posyandu. It is hoped that mothers in East Labuh Baru Village can further increase visits to posyandu in order to improve the health and development of toddlers.

scholarly journals Risk factors associated with Acute Respiratory Infection (ARI) among children under 10-years in Rohingya refugee camp

2020 ◽  
pp. 32-35
Author(s):  
Shafiqua Nawrin Oishi ◽  
Nazmul Alam
Keyword(s):  
Risk Factors ◽  
Respiratory Infection ◽  
Acute Respiratory Infection ◽  
Viral Infections ◽  
Respiratory Infections ◽  
Cross Sectional Study ◽  
Nasal Discharge ◽  
Cross Sectional ◽  
Factors Associated ◽  
Aged People

Acute respiratory infections are cause by bacterial, fungal or viral infections of the respiratory tract. Very young and older aged people are most vulnerable of these infections lead to difficulties from fever, cough, nasal discharge, sputum production, fatigue, wheezing, pain on swallowing, at times ear infections and meningitis. With huge number of Rohingya influx in Bangladesh, camps are overly crowded allowing many infectious diseases to transmit easily. Although there are researches that have been conducted in this area, there remains a huge gap of research in these camps where children being vulnerable are mostly suffering from respiratory disease such as Acute Respiratory Infection (ARI). This cross-sectional study investigated the risk factors associated with ARI among children less than 10 years in Rohingya refugee camps. After collecting information based on their demographic, anthropometric, history of respiratory problem, accommodation and nutritional status, it was found that about 21.6% of 259 children under this study had symptoms of ARI. Living in congested housing and with lack of nutritious food children were found negatively associated with ARI.

scholarly journals PREGNANCY INDUCED HYPERTENSION;

2018 ◽  
Vol 25 (08) ◽  
pp. 1168-1172
Author(s):  
Uzma Jamil ◽  
Anam Mukhtar ◽  
Shaista Hussain ◽  
Farida Munawar
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Late Pregnancy ◽  
Fetal Distress ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
P Value ◽  
Age Difference ◽  
Continuous Variables ◽  
Cross Sectional

Objectives: To investigate serum uric as an indicator of fetomaternal complicationsin women with late pregnancy. Study Design: Cross sectional study. Setting: Shalamar Medicaland Dental College Lahore ethical committee. Period: One year from October 2016 to October2017. Methodology: Continuous variables were presented as mean and standard deviationlike age and Serum malonaladehyde concentration; categorical variables were presented asnumbers and percentages like intra uterine growth restriction, Mild to moderate and sever preeclampsia and fetal distress. One way ANOVA, independent sample t test and chi square testwere applied to check significance of results, p value less than or equal to 0.05 was consideredas significant. Results: Overall, 100% (n=400) patients were included in this study. The meanage of the patients was 25.81±4.33 years. The age difference was not statistically significant,in groups (p=0.383). The mean serum uric acid levels of the patients for maturity (weeks)36, 37, 38, 39 and 40 was 247.96±2.52 (nmol/l), 253.95±2.04 (nmol/l), 261.19±3.15 (nmol/l),263.95±2.75 (nmol/l) and 296.19±2.55 (nmol/l) respectively. The differences were statisticallysignificant (p=0.000). Fetal distress, number with rising levels were (n=23) 71.8%, number withno change in levels were (n=3) 9.4% and number with falling levels were (n=6) 18.8%. Thedifferences were statistically significant. (p=0.000). Conclusion: The observations of our studyconcluded that serial increase of serum uric acid from 36th week to 40th week was observedin pregnancy induced hypertion patients, and raised serum level of uric acid had significantrelation with fetomaternal complications. like Fetal distress, preeclampsia, and intrauterinegrowth retardation. So serum uric acid can be used an indicator for fetometernal complicationsin late pregnancy.

scholarly journals TNF-α inhibitors can increase the risk of respiratory infection when used in rheumatism: a meta-analysis and systematic review

2020 ◽  
Author(s):  
Wenwen Luo ◽  
Luo Wenwen ◽  
Zhu Jialian ◽  
Cheng Xuan ◽  
Li Yun ◽  
...  
Keyword(s):  
Respiratory Infection ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
P Value ◽  
Upper Respiratory Infection ◽  
Serious Infection ◽  
Tnf Α ◽  
Serious Infections ◽  
Upper Respiratory

Abstract Background The risk of tumor necrosis factor-α(TNF-α) inhibitors (infliximab, etanercept, adalimumab) for the treatment of rheumatic diseases leading to infection events has not yet been established. This meta-analysis aims to assess the risk of developing serious infections of three TNF-α inhibitors for rheumatic diseases.Methods A systematic literature search of Pubmed, Embase and Cochrane Library was conducted through December 2018. Selecting the RCTs which subjects were diagnosed as rheumatoid diseases according to ACR criteria or other authoritative diagnostic criteria and over 18-year-old. Finally, RCTs with Jadad score greater than or equal to 4 were included in this meta-analysis. The Odds Ratio (OR), Confidence Interval (CI) and p value were calculated to assess the risk of serious infections. Results 34 RCTs involving 14166 subjects were included, including 11 RCTs for infliximab, 7 RCTs for etanercept, and 16 for adalimumab. Meta-analysis demonstrated that, with the pooled OR of 1.29 (95%CI 1.04 to 1.60), the TNF-α inhibitors group had a higher risk of serious infection than control group. In the subgroup analysis, infliximab and adalimumab had a higher risk of serious infection than control group, and the pooled ORs were 1.48 (p=0.03) and 1.47 (p=0.03), respectively. For other infections including pneumonia, upper respiratory infection, and nasopharyngitis, the risks of these adverse events were higher in experimental group than control group, while the risk of tuberculosis were not, with the pooled OR of 2.31 (p=0.08）.Conclusions TNF-α inhibitors, especially infliximab and adalimumab, can increase the risk of infections. Among the infections, pneumonia, upper respiratory infection and nasopharyngitis have higher risks in TNF-α inhibitors group than control group. As a result, we summarized that TNF-α inhibitors can increase the risks of respiratory infection when used in rheumatic disease. It is suggested that clinicians should pay attention to the prevention of respiratory infections when using TNF-α inhibitors, so as to achieve a better prognosis for patients with rheumatism.

scholarly journals SYPHILIS;

2019 ◽  
Vol 26 (04) ◽  
Author(s):  
Ahsan Ashfaq ◽  
KAUSAR ABBAS SALDERA ◽  
AYESHA EJAZ ◽  
NOOR-UN NISA MEMON ◽  
HINA RASHID ◽  
...  
Keyword(s):  
Blood Donors ◽  
Viral Infections ◽  
Local Population ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Serum Neopterin ◽  
Neopterin Level

Objectives: To assess serum Neopterin levels in blood donors of local population and to study its relationship with transfusion transmitted infections (TTIs) including syphilis. Study Design: Descriptive cross-sectional study. Place and Duration of Study: This study was carried out in the Department of Physiology LNMC in collaboration with Basic Medical Sciences Institute, (BMSI), and Jinnah Post Graduate Medical Centre (J.P.M.C.) Karachi, from Jan to July 2015.”Methods: Total 174 blood donors were included in the study through random sampling technique. They were screen through the standard procedures used for screening at the JPMC blood bank for WHO recommended diseases. Neopterin was estimated using ELISA. Data analysis was performed using SPSS version 21. Chi square and ANOVA were applied at a confidence level of 95%.”Results: Neopterin level in the sera of syphilis positive blood donors was 5.86 ± 0.78 nmol/l which was within normal range below the cutoff value of 10 nmol/l. Neopterin content in the serum of blood donors who were negative for transfusion transmitted infections was 6.23± 2.19 nmol/l as compared to blood donors testing positive for transfusion transmitted viral infections showing high Neopterin level of 15.10 ± 4.93 nmol/l. (P value 0.001).”Conclusion: Neopterin levels were found to be within normal limits in blood donors testing positive for syphilis However in  blood donors with transfusion transmitted viral infections  serum neopterin levels were elevated.

scholarly journals Sleep quality among students in Ibn Sina National College

2021 ◽  
Vol 8 (3) ◽  
pp. 1110
Author(s):  
Murad A. Yasawy ◽  
Rehab A. Mohammed ◽  
Mahmood A. Yasawy ◽  
Nada Mohammed Hafiz ◽  
Haneen A. Turkistani
Keyword(s):  
Medical Students ◽  
Sleep Quality ◽  
Cross Sectional Study ◽  
Statistical Correlation ◽  
Categorical Variables ◽  
P Value ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Cross Sectional ◽  
Ibn Sina

Background: Aim of the study was to assess the sleep quality among medical students and explore its relation to many variables as BMI, smoking and chronic diseases.Methods: A descriptive cross-sectional study, conducted among medical students at Ibn Sina national college, Jeddah, KSA. This study was approved by Research Center. A total of 408 participants; Participants are who admitted to hospital for last two days, pregnant and who under 18 years were excluded. We consider p value=0.05 as significant statistically and our confidant interval (CI) is 95%. We used bivariate and univariant variables, for categorical variables we used Chi-square and Fisher exact test.Results: The participants’ mean age was 22.6±2.7 (87.9%) of them were females. Most of our participants were Single (89.8%). A total of 85.9% of the students had poor sleep quality. Those who had less than 6 Hours of sleeping per day had poor sleep quality by 92.2% and statistically affecting their sleep quality p value =0.000. There was no statistically significant relation between sleep quality and academic year or with Gender (p=0.139, p=0.263) respectively. There was no statistical correlation between Sleep quality and Nightmares or Snoring (p value =0.063, 0.055) respectively.Conclusions: Poor sleep quality was prevalent in all class years of the undergraduate medical course and more common between females. This study revealed high prevalence of poor sleep quality. Sleep educational programs, stress management courses and lifestyles modifications are required.

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