scholarly journals Non-Proteinuric Preeclampsia: Prevalence, Factors Associated and End-Organ Dysfunction at Mbarara Regional Referral Hospital in Southwestern Uganda  

2021 ◽  
Author(s):  
Asiphas Owaraganise ◽  
Wasswa GM Ssalongo ◽  
Leevan Tibaijuka ◽  
Musa Kayondo ◽  
Godfrey Twesigomwe ◽  
...  
Keyword(s):  
Organ Dysfunction ◽  
Complete Blood Count ◽  
Referral Hospital ◽  
Chronic Hypertension ◽  
Care Providers ◽  
Cross Sectional ◽  
Regional Referral Hospital ◽  
Pregnancy Hypertension ◽  
Factors Associated ◽  
Significant Difference

Abstract Background: Formerly, preeclampsia was only diagnosed if high blood pressure and proteinuria were present in a gravid woman at or past 20 gestation weeks. Although it is possible to have preeclampsia yet never have proteinuria, the literature on how common and factors associated with non-proteinuric preeclampsia as well as whether the frequency of end-organ dysfunction among women with non-proteinuric differs from those with proteinuric pre-eclampsia is scant.Objectives: To determine the prevalence of, factors associated with non-proteinuric preeclampsia, and compare the frequency of end-organ dysfunction between women with non-proteinuric and proteinuric preeclampsia.Methods: Between November 2019 and May 2020, women with pre-eclampsia were consecutively enrolled in a cross-sectional study at Mbarara Regional Referral Hospital. We interviewed all pregnant women ≥20 gestation weeks presenting with hypertension ≥140/90mmHg and recorded their socio-demographic, medical, and obstetric characteristics. We excluded women with chronic hypertension and pregnancy hypertension. We measured bedside proteinuria on clean-catch urine, complete blood count, and renal function and liver enzyme tests. Pre-eclampsia was defined as hypertension plus any feature of severity including <100,000 platelets/ul, creatinine >1.1g/dl, and liver transaminases ≥ twice upper normal limit with or without proteinuria. We computed the proportion of total participants with non-proteinuric pre-eclampsia at ≤+2 urine dipstick cut-off, determined the factors associated with non-proteinuric preeclampsia using logistic regression; and used Chi-square test to compare the frequency of end-organ dysfunction between non-proteinuric preeclampsia and proteinuric groups.Results: We enrolled 134 of the screened 136 participants. Their mean age was 26.9 (SD±7.1) years and 51.5% were primigravid. The prevalence of non-proteinuric preeclampsia was 24.6% (95% CI: 17.9-32.7). Primigravidity (aOR 2.70 95%CI:1.09-6.72, p=0.032) was the factor independently associated with non-proteinuric pre-eclampsia. There was a non-significant difference in the frequency of end-organ dysfunction in women with non-proteinuric and proteinuric pre-eclampsia, p=0.309.Conclusion: Non-proteinuric preeclampsia is common, especially among primigravidae. End-organ dysfunction occurs similarly in women with non-proteinuric and proteinuric preeclampsia. Obstetrics care providers should emphasize laboratory testing, beyond proteinuria, among all women with hypertensive disorders of pregnancy to optimally diagnose and manage non-proteinuric preeclampsia.

scholarly journals Nonproteinuric Preeclampsia among Women with Hypertensive Disorders of Pregnancy at a Referral Hospital in Southwestern Uganda

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Asiphas Owaraganise ◽  
Richard Migisha ◽  
Wasswa G. M. Ssalongo ◽  
Leevan Tibaijuka ◽  
Musa Kayondo ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Chronic Hypertension ◽  
Care Providers ◽  
Hypertensive Disorders Of Pregnancy ◽  
Cross Sectional ◽  
Hypertensive Disorders ◽  
Liver Transaminases ◽  
Southwestern Uganda

Background. Preeclampsia is a priority obstetric emergency requiring urgent diagnosis and treatment to avert poor pregnancy outcomes. Nonproteinuric preeclampsia poses even greater diagnostic challenges due to contested diagnostic criteria by the clinical practice guidelines and variable clinical presentation. Previously, preeclampsia was only diagnosed if high blood pressure and proteinuria were present. This study determined the prevalence of nonproteinuric preeclampsia and associated factors among women admitted with hypertensive disorders of pregnancy at a referral hospital in southwestern Uganda. Methods. Women with hypertensive disorders of pregnancy were consecutively enrolled in a cross-sectional study at Mbarara Regional Referral Hospital between November 2019 and May 2020. We interviewed all pregnant women ≥20 gestation weeks presenting with hypertension and obtained their sociodemographic, medical, and obstetric characteristics. We excluded women with chronic hypertension. We measured bedside dipstick proteinuria in clean-catch urine. Preeclampsia was defined as hypertension plus any feature of severity including <100,000 platelets/ul, creatinine >1.1 g/dl, and liver transaminases ≥twice upper normal limit with or without proteinuria. We defined nonproteinuric preeclampsia in participants with <+2 urine dipstick cut-off and determined the factors associated with nonproteinuric preeclampsia using logistic regression. Results. We enrolled 134 participants. The mean age was 26.9 (SD ± 7.1) years and 51.5% were primigravid. The prevalence of nonproteinuric preeclampsia was 24.6% (95% CI: 17.9–32.7). Primigravidity (aOR 2.70 95% CI: 1.09–6.72, p  = 0.032) was the factor independently associated with nonproteinuric preeclampsia. Conclusion. Nonproteinuric preeclampsia was common, especially among primigravidae. We recommend increased surveillance for nonproteinuric preeclampsia, especially among first-time pregnant women, who may not be detected by the traditional criteria. Obstetrics care providers should emphasize laboratory testing beyond proteinuria, among all women with hypertensive disorders of pregnancy to optimally diagnose and manage nonproteinuric preeclampsia.

scholarly journals Factors associated with physical inactivity among female and male rural adolescents in Borneo – a cross-sectional study

2014 ◽  
Vol 26 (3) ◽  
pp. 447-453 ◽  
Author(s):  
Whye Lian Cheah ◽  
Hazmi Helmy ◽  
Ching Thon Chang
Keyword(s):  
Self Efficacy ◽  
Physical Inactivity ◽  
Cross Sectional Study ◽  
Perceived Barriers ◽  
Anthropometric Measurement ◽  
Rural Adolescents ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Significant Difference

Abstract Rural communities have shown marked increase in metabolic syndrome among young people, with physical inactivity as one of the main contributing factors. This study aimed to determine factors associated with physical inactivity among male and female rural adolescents in a sample of schools in Malaysia. A cross-sectional study was conducted among 145 students aged 13–15 years. Data on socio-demographic, health-related, and psychosocial factors (perceived barriers, self-efficacy, social influences) were collected using a self-administered questionnaire. Anthropometric measurement was taken to generate body mass index (BMI)-for-age, while physical activity (PA) level was assessed using pedometers. The mean steps per day was 6251.37 (SD=3085.31) with males reported as being more active. About 27% of the respondents were either overweight or obese, with more females in this group. There was no significant difference in steps among males and females (p=0.212), and nutritional status (BMI-for-age) (p=0.439). Females consistently scored higher in most items under perceived barriers, but had significantly lower scores in self-efficacy’s items. Males were more influenced by peers in terms of PA (p<0.001) and were more satisfied with their body parts (p=0.047). A significantly higher body size discrepancy score was found among females (p=0.034, CI –0.639, –0.026). PA level was low and almost one-third of the respondents were overweight and obese. Female students faced more barriers and had lower self-efficacy with regards PA. Based on the findings, it is recommended that interventions focus on reducing barriers while increasing support for PA. This is particularly important in improving the health status of the youth, especially among the females.

scholarly journals Acceptance of smoking cessation support and quitting behaviours of women attending Aboriginal Maternal and Infant Health Services for antenatal care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Justine B. Daly ◽  
Sarah Dowe ◽  
Belinda Tully ◽  
Flora Tzelepis ◽  
Christophe Lecathelinais ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Antenatal Care ◽  
Treatment Guidelines ◽  
Local Health ◽  
List Type ◽  
Care Providers ◽  
Cross Sectional ◽  
Factors Associated ◽  
Aboriginal Women ◽  
Quitting Smoking

Abstract Background Acceptance of smoking cessation support during antenatal care and associated quitting behaviours of pregnant Aboriginal women or women having an Aboriginal baby has not been investigated. This study aimed to determine, among pregnant women who smoke and attended AMIHS for their antenatal care: The acceptance of smoking cessation support, factors associated with acceptance and barriers to acceptance; The prevalence of quitting behaviours and factors associated with quitting behaviours. Methods A cross-sectional telephone survey of women who attended 11 AMIHSs for their antenatal care during a 12 month period in the Hunter New England Local Health District of New South Wales. Results One hundred women contacted consented to complete the survey (76%). Of those offered cessation support, 68% accepted NRT, 56% accepted follow-up support and 35% accepted a Quitline referral. Participants accepting NRT had greater odds of quitting smoking at least twice during the antenatal period [OR = 6.90 (CI: 1.59–29.7)] and those reporting using NRT for greater than eight weeks had six times the odds of quitting smoking for one day or more [OR = 6.07 (CI: 1.14–32.4)]. Conclusions Aboriginal women or women having an Aboriginal baby who smoke make multiple attempts to quit during pregnancy and most women accept smoking cessation support when offered by their antenatal care providers. Acceptance of care and quitting success may be improved with increased focus on culturally appropriate care and enhanced training of antenatal care providers to increase skills in treating nicotine addiction and supporting women to use NRT as recommended by treatment guidelines.

MO785CAUSES OF THE DELAY IN CREATING PERMANENT VASCULAR ACCESS IN HEMODIALYSIS PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Abdulla Al-Sayyari
Keyword(s):  
Vascular Access ◽  
Venous Catheter ◽  
Cross Sectional ◽  
Factors Associated ◽  
Practical Concern ◽  
Significant Difference ◽  
Patient Noncompliance ◽  
Hospital Factors ◽  
Patient Factor ◽  
Main Factor

Abstract Background and Aims Many patients start HD with central venous catheter (CVC) which has multiple complications This study aims at identifying the physicians’ perspectives regarding the reasons of delayed AVF creation Method This is a cross-sectional questionnaires-based survey designed at discovering the physicians' opinions and perception about the reasons for the delay in the creation of permanent vascular access and patient’s factors, physicians factors, and hospital factors leading to this delay, Results There was a total of 212 participants, of whom 131 (61.8%) were of consultant level. The three most important factors associated with delay in AVF creation were “denial of kidney disease or the need of AVF” (76.4%), “dialysis fears and practical concern” (75.9%) and “the patient refusing to undergo AVF surgery” (73.1%). Significantly fewer consultants (42.7%) than below consultants (45.7%) pointed out that “patient noncompliance with nephrology appointments” was a significant factor (p=0.046). The most important physicians & hospital factors was “insufficient conduction of pre-dialysis care and education about AVF initiation to the patient (63.7%) The respondents were asked to choose one of four possible factors that they felt was the main factor in delaying AVF creation. Over two thirds (68.4%) chose the patient factor as the main factor There was no significant difference in this response whether the respondents were consultants or below consultants (p=0.8)) Conclusion The most agreed on factors associated with AVF creation delay are the denial of the need for dialysis, fear of dialysis and practical concern, insufficient conduction of pre-dialysis care and education about AVF initiation to the patient, and late referral to a nephrologist. a validated approach to patients' selection and referral to vascular access creation that could be applied on different types of patient in different regions is required .

scholarly journals ANALYSIS OF PLATELET COUNT ON FIBROSIS DEGREE IN CHRONIC HEPATITIS B PATIENTS

2018 ◽  
Vol 24 (2) ◽  
pp. 165
Author(s):  
Hairul Anwar ◽  
Mutmainnah Mutmainnah ◽  
Ibrahim Abdul Samad
Keyword(s):  
Chronic Hepatitis ◽  
Platelet Count ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Complete Blood Count ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
B Virus ◽  
Spearman Correlation Test

Chronic hepatitis B is an infectious liver disease caused by hepatitis B virus that persist for more than 6 months. Fibrosis is a result of fibrogenesis which is the formation of connective tissue (scarring) caused by liver tissue damage. Liver damage will affect the production of thrombopoetin causing disturbances in the balance between destruction and production of platelet resulting in decreased platelet counts. This study was a retrospective cross-sectional study by taking the data from medical records of chronic hepatitis B patients who were tested for complete blood count and fibroScan at the Dr.Wahidin Sudirohusodo Hospital Makassar from January 2014 to July 2016. The result showed a total of 323 chronic B hepatitis patients, 99 with severe fibrosis, 84 with moderate fibrosis and 140 with mild fibrosis. The Spearman correlation test showed a significant correlation between the platelet count and the degree of fibrosis (p <0.001) and showed a positive correlation between both of them with a very strong correlation (r = 0.802). The Kruskal-Wallis test showed a significant difference between platelet count and the degree of fibrosis (p<0.001). The conclusion is that a decreased platelet count is a sign of an increase in the degree of fibrosis in chronic hepatitis B patients. It is suggested to perform another study with larger samples based on the degree of fibrosis. 

scholarly journals The Relationship between Mental Health with the Level of Empathy Among Medical Students in Southern Thailand: A University-Based Cross- Sectional Study

2021 ◽  
Vol 73 (12) ◽  
pp. 832-840
Author(s):  
Katti Sathaporn ◽  
Jarurin Pitanupong
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Protective Factor ◽  
Cross Sectional Study ◽  
Clinical Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Significant Difference ◽  
High Level

Objective: To determine the level of and factors associated with empathy among medical students.Materials and Methods: This cross-sectional study surveyed all first- to sixth-year medical students at the Facultyof Medicines, Prince of Songkla University, at the end of the 2020 academic year. The questionnaires consisted of:1) The personal and demographic information questionnaire, 2) The Toronto Empathy Questionnaire, and 3) ThaiMental Health Indicator-15. Data were analyzed using descriptive statistics, and factors associated with empathylevel were assessed via chi-square and logistic regression analyses.Results: There were 1010 participants with response rate of 94%. Most of them were female (59%). More than half(54.9%) reported a high level of empathy. There was a statistically significant difference in empathy levels betweenpre-clinical and clinical medical students; in regards to empathy subgroups (P-value < 0.001). The assessment ofemotional states in others by demonstrating appropriate sensitivity behavior, altruism, and empathic respondingscores among the pre-clinical group were higher than those of the clinical group. Multivariate analysis indicatedthat female gender, pre-clinical training level, and minor specialty preference were factors associated with empathylevel. The protective factor that significantly improved the level of empathy was having fair to good mental health.Conclusion: More than half of the surveyed medical students reported a high level of empathy. The protective factorthat improved the level of empathy was good mental health. However, future qualitative methods, longitudinalsurveillance, or long-term follow-up designs are required to ensure the trustworthiness of these findings.

scholarly journals Factors Associated With Herbal Medicine Use in Pregnancy Among Postnatal Mothers in Mbarara Regional Referral Hospital in Western Uganda

2021 ◽  
Author(s):  
Laban Muteebwa ◽  
Ali Ssetaala ◽  
Dan Muramuzi ◽  
Annet Nanvubya ◽  
Yunia Mayanja
Keyword(s):  
Herbal Medicine ◽  
Pregnant Women ◽  
Herbal Medicines ◽  
Referral Hospital ◽  
Sub Saharan Africa ◽  
Medicine Use ◽  
Regional Referral Hospital ◽  
Factors Associated ◽  
Western Uganda ◽  
In Pregnancy

Abstract BackgroundThere is widespread use of herbal medicines among populations in sub-Saharan Africa. However, pregnant women should be conscious about medication taken during pregnancy including herbal medicines because their safety profiles are not known and some of them might affect the mother, fetus and pregnancy outcomes. Knowledge about use and safety of herbs in pregnant women is limited. This study aimed to assess the extent of use and the factors associated with use of herbal medicine in pregnancy.MethodsA cross-sectional study involving 385 women 6 weeks post-partum and below, receiving post-natal services at Mbarara Regional Referral Hospital in Western Uganda was conducted during May to August 2016. Simple random sampling was used to select participants. A structured pretested questionnaire was administered after written informed consent. Data was analyzed using logistic regression (STATA- 14).ResultsOf 385 respondents, 70.4% reported to have used herbal medicine during their most recent pregnancy. Associated factors were perception that herbal medicines are safe (aOR 9.8, 95% CI (4.2-23.0), perception that herbal medicines are important (aOR 12.4, 95% CI (5.2-29.5), staying more than 10KM from the heath facility (aOR 3.1, 95%CI (1.4-6.9), being a first time mother (aOR 2.6, 95%CI (1.1-6.2) and dissatisfaction with ANC services at health facility (aOR 2.6, 95%CI (1.1-6.3)ConclusionHerbal medicine use in pregnancy is common in the study area. Community Sensitization drives about the dangers of herbal medicine use in pregnancy is recommended. Healthcare workers should routinely screen for herbal medicine use during antenatal care visits and labor.

scholarly journals Early Malaria Diagnosis and Treatment Seeking Behavior Among Clients Attending Outpatient Department Sekou-Toure Regional Referral Hospital in Mwanza, Tanzania; A Cross-Sectional Study

2021 ◽  
Author(s):  
Samson Mvandal ◽  
Godfrida Marandu
Keyword(s):  
Health Facility ◽  
Early Treatment ◽  
Malaria Diagnosis ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Treatment Seeking ◽  
Sectional Study ◽  
Cross Sectional ◽  
Regional Referral Hospital ◽  
Seeking Behavior

Early diagnosis of malaria and treatment seeking behavior play key role in controlling and preventing further complication related to malaria disease. Aim of this study was to determine the responses on early malaria diagnosis and treatment seeking behavior among outpatient clients attending at Sekou toure regional referral hospital in Mwanza, Tanzania. Methods: A cross-sectional study was conducted among outpatient client at Sekou-Tour&eacute; regional referral hospital, convenient simple random sampling used and self-administered questionnaire were used to collect data and data was entered into Microsoft excel and then exported to SPSS version 25.0 for further analysis and presented on the percentages and table. The analysis of strength of relationships between categorical variables was conducted using the Chi-square test. A p-value of &le; 0.05 was considered to be statistically significant. Results: A total of 192 respondents completed the study with a response rate of 97.6%. The study revealed that Most of the respondents about 90.6% stated they would seek treatment from health facility when symptoms appear. However, only 6.3% seek treatment within 24 hours of onset of illness (p= 0.017). Half of respondents (50.5%) experienced malaria symptoms in the past six months and only 30% seek for treatment at health facility. Preference of health facility, (51%) respondents were going direct to pharmacy to buy medicine for self-treatment. Overall, cost of service, time consumed and distance of health facility especially health center shows significant with such delay. Conclusion: A low proportion of malaria-suspected patients sought treatment within 24 h of fever onset compared to the national target. Distance from the health facility, cost of service and time consumed were found to be predictors of early treatment-seeking behavior for malaria. Strengthening strategies tailored to increasing awareness for communities about malaria, importance of going hospital and early treatment-seeking behavior is essential.

scholarly journals Antimicrobial Resistance of Neisseria gonorrhoeae Isolated from Out Patients Presenting with Urethral and Vaginal Discharges at Mbarara Regional Referral Hospital

2019 ◽  
pp. 1-7
Author(s):  
Judith Owokuhaisa ◽  
Joel Bazira
Keyword(s):  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Test Organism ◽  
Referral Hospital ◽  
Cross Sectional ◽  
Regional Referral Hospital ◽  
Sexually Transmitted ◽  
Peptone Water ◽  
Phenotypic Methods ◽  
Micro Organisms

Background: Gonococcus is one of the most common sexually transmitted diseases in developing countries and it has become a global health burden, hence a need for effective treatment. However, there is growing trend of antimicrobial resistant strains, in many parts of the world, to the previously effective antimicrobials thus creating serious health concerns. Setting: Mbarara Regional Referral Hospital -South-Western Uganda. Objectives: 1) To determine the prevalence of gonococcus among out patients presenting with urethral and vaginal discharges at MRRH. 2) To determine the level of antimicrobial resistance of gonococcus based on phenotypic methods at MRRH. Design: The study was cross sectional and enrolled 189 participants presenting with urethral and vaginal discharges. The urethral and endo cervical swab samples collected were cultured on Chocolate media supplemented with 5%-10% carbondioxide in candle jar (inoculated plates were placed in a jar and a burning candle placed in the same jar, then closed, by the time the candle went off, that 5%-10% carbondioxide atmosphere would have been created). Isolates obtained were identified according to the laboratory standard operating procedures. Drug Sensitivity Test (DST) on confirmed Neisseria gonorrheae isolates was performed using the Kirby Bauer technique. The colonies of the test organism were emulsified in peptone water and then inoculated on prepared sterile chocolate agar and the following discs were applied to it (Ceftriaxone discs (30µg), Erythromycin (15ug), Ciprofloxacin (10ug) and Penicillin (10IU). The plates were incubated at 37°C for 24- 48 hours under 5% carbon dioxide atmospheres. The Zone of inhibition was seen around an antibiotic disc to which the organism was sensitive. Results: Out of the 189 participants whose urethral swabs and Endo cervical swabs were cultured, 89 were positive cultures (47%), out of which 25 (28%) were found to have gonococcal infection, 64 (72%) patients had other micro-organisms. The prevalence of Neisseria Gonorrhoeae was 13%. In total, 4% of the isolates were resistant to Ceftriaxone, 28% to Ciprofloxacin, 68% to Erythromycin and 80% to Penicillin. A high percentage of resistance was observed against Penicillin (80%) and Erythromycin (68%). Conclusion: Adults aged 18 years and above who present at Mbarara Regional Referral Hospital with urethral or vaginal discharges are more likely to have a Neisseria gonorrhoeae which is resistant to Penicillin and Erythromycin.

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