scholarly journals Time-to-recovery After Cesarean Section Delivery Among Women who Gave birth through Cesarean Section at Hawassa University Comprehensive Specialized Hospital, south Ethiopia: A Prospective Cohort Study

2021 ◽  
Author(s):  
Anteneh Fikrie ◽  
Rahel Zeleke ◽  
Henok Bekele ◽  
Wengelawit Seyoum ◽  
Dejene Hailu
Keyword(s):  
Cohort Study ◽  
Cesarean Section ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Incidence Density ◽  
Early Recovery ◽  
Cesarean Section Delivery ◽  
Specialized Hospital ◽  
Hawassa University

Abstract Background: Despite the progressive increment of caesarean section rates worldwide over the last decades; still the trend has not been accompanied by significant maternal or perinatal benefits. Moreover, information on the quality of the service, as measured by timely recovery, is scarce. This study assessed predictors of time-to-recovery after cesarean section delivery among women who gave birth through cesarean section at Hawassa University Comprehensive Specialized Hospital (HU-CSH), southern Ethiopia.Methods: Institution based prospective cohort study was conducted on 381 randomly selected women who gave birth by cesarean section in HU-CSH during the follow up period. Pre-tested structured questionnaire was used to collect the data. Data were analyzed using Kaplan Meir (KM) curve, Log rank test and Cox-Proportional hazard model. The outputs of the bivariable and multivariable Cox model are presented using Adjusted Hazard Ratio (AHR) with the respective 95% confidence intervals (CIs).Results: After a maximum of 19 days of stay, 96.2% [95%CI: 94.04-98.4%] of the women were early recovered. The overall median IQR) time of recovery was 2.00 (2, 3) days. The overall incidence density rate (IDR) of recovery in the cohort was 0.34 per Person-days or 2.38 per person-week. On the other hand the overall mean survival time was 3.07(95%CI: 2.75-3.40) days. Women who had ANC follow-up (AHR=1.49, 95%, CI: 1.05-2.10) and discharge from the wound site (AHR=0.13, 95%, CI: 0.03-0.56) were identified as significant positive and negative predictors of time-to- recovery after CS delivery respectively. Conclusion: This study showed that the rate of early recovery was high and is comparable to the global level figures. However, further improving preoperative maternal status, intraoperative follow up and post-operative care is needed to improve early recovery.

scholarly journals Pattern and Outcome of Pediatric Traumatic Brain Injury: A Prospective Cohort Study at Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia

2019 ◽  
Author(s):  
Tuji Bedry ◽  
Henok Tadele
Keyword(s):  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Intracranial Bleeding ◽  
Southern Ethiopia ◽  
Severe Tbi ◽  
Hawassa University

Abstract Background Traumatic brain injury (TBI), a major public health problem, is the most common cause of death/disability in children. Glasgow coma scale is used to assess, decide treatment and follow up of TBI. TBI causes and outcome data are scarce from sub-Saharan Africa, non-existent from Ethiopia. We aimed to document pattern and predictors of childhood TBI outcome in a teaching hospital, Southern Ethiopia. METHODS Prospective cohort study was conducted from September 2017 to September 2018 among pediatrics TBI presented to Hawassa University Hospital. Data were collected by structured questionnaires and analyzed using SPSS version 20. Logistic regression was carried out and significant associations were declared at p-value of < 0.05. RESULT During 1year period there were 4258 emergency room(ER) visits, TBI contributed to 317(7.4%) cases. The mean age of study subjects was 7.66±3.88 years. Boys, predominantly above 5years of age, comprise 218(68.8%) of study subjects with male to female ratio of 2.2:1. Pedestrian RTA 119 (37.5%) and falls 104 (32.8%) were the commonest causes of TBI. Mild, moderate, and severe TBI were documented in 231(72.9%), 61(19.2%), and 25(7.9%) of cases respectively. Most of TBI cases presented within 24hrs of injury 258(81.4%). Recovery with no neurologic deficit, 267(84.2%); focal neurologic deficit, 30(9.5%); depressed mentation, 10(3.2%) and death 10(3.2%) were documented. Presence of increased intracranial pressure(ICP) at admission [AOR: 1.415 (95% CI: 0.458-9.557)], severe TBI [AOR: 2.103 (95% CI: 0.965-4.524)], presence of hyperglycemia [AOR: 2.318 (95% CI: 0.873-7.874)] and head computed tomographic(CT) scans of contusion, diffuse axonal injury (DAI) or intracranial bleeding [AOR: 2.45 (95% CI: 0.811-7.952)] were found to be predictors of TBI outcome. CONCLUSION TBI contributed to 7.4% of pediatric ER visits. Boys above 5years of age were highly affected. Pedestrian RTA and falls, early presentation (<24hrs of injury) and mild form of TBI were the common documented patterns. Presence of increased ICP, hyperglycemia, severe TBI and CT findings of contusion, DAI/intracranial bleeding were predictors of poor outcome. Public awareness on road safety, childhood safety in preventing falls/animal injuries, closer follow-up of TBI cases for ICP and glycemic controls are recommended.

scholarly journals POS0647 EFFICACY, SAFETY AND CHARACTERISTICS OF IGURATIMOD-BASED THERAPY IN THE TREATMENT OF UA, ERA AND RA PATIENTS FOR 24 WEEKS: A PROSPECTIVE COHORT STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 561.2-562
Author(s):  
X. Liu ◽  
Z. Sun ◽  
W. Guo ◽  
F. Wang ◽  
L. Song ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Adverse Events ◽  
Disease Activity ◽  
Prospective Cohort Study ◽  
Early Rheumatoid Arthritis ◽  
Prospective Cohort ◽  
Combined Treatment ◽  
Serious Adverse Events

Background:Experts emphasize early diagnosis and treatment in RA, but the widely used diagnostic criterias fail to meet the accurate judgment of early rheumatoid arthritis. In 2012, Professor Zhanguo Li took the lead in establishing ERA “Chinese standard”, and its sensitivity and accuracy have been recognized by peers. However, the optimal first-line treatment of patients (pts) with undifferentiated arthritis (UA), early rheumatoid arthritis (ERA), and rheumatoid arthritis (RA) are yet to be established.Objectives:To evaluate the efficacy and safety of Iguratimod-based (IGU-based) Strategy in the above three types of pts, and to explore the characteristics of the effects of IGU monotherapy and combined treatment.Methods:This prospective cohort study (ClinicalTrials.gov Identifier NCT01548001) was conducted in China. In this phase 4 study pts with RA (ACR 1987 criteria[1]), ERA (not match ACR 1987 criteria[1] but match ACR/EULAR 2010 criteria[2] or 2014 ERA criteria[3]), UA (not match classification criteria for ERA and RA but imaging suggests synovitis) were recruited. We applied different treatments according to the patient’s disease activity at baseline, including IGU monotherapy and combination therapies with methotrexate, hydroxychloroquine, and prednisone. Specifically, pts with LDA and fewer poor prognostic factors were entered the IGU monotherapy group (25 mg bid), and pts with high disease activity were assigned to combination groups. A Chi-square test was applied for comparison. The primary outcomes were the proportion of pts in remission (REM)or low disease activity (LDA) that is DAS28-ESR<2.6 or 3.2 at 24 weeks, as well as the proportion of pts, achieved ACR20, Boolean remission, and good or moderate EULAR response (G+M).Results:A total of 313 pts (26 pts with UA, 59 pts with ERA, and 228 pts with RA) were included in this study. Of these, 227/313 (72.5%) pts completed the 24-week follow-up. The results showed that 115/227 (50.7%), 174/227 (76.7%), 77/227 (33.9%), 179/227 (78.9%) pts achieved DAS28-ESR defined REM and LDA, ACR20, Boolean remission, G+M response, respectively. All parameters continued to decrease in all pts after treatment (Fig 1).Compared with baseline, the three highest decline indexes of disease activity at week 24 were SW28, CDAI, and T28, with an average decline rate of 73.8%, 61.4%, 58.7%, respectively. Results were similar in three cohorts.We performed a stratified analysis of which IGU treatment should be used in different cohorts. The study found that the proportion of pts with UA and ERA who used IGU monotherapy were significantly higher than those in the RA cohort. While the proportion of triple and quadruple combined use of IGU in RA pts was significantly higher than that of ERA and UA at baseline and whole-course (Fig 2).A total of 81/313 (25.8%) pts in this study had adverse events (AE) with no serious adverse events. The main adverse events were infection(25/313, 7.99%), gastrointestinal disorders(13/313, 4.15%), liver dysfunction(12/313, 3.83%) which were lower than 259/2666 (9.71%) in the previous Japanese phase IV study[4].The most common reasons of lost follow-up were: 1) discontinued after remission 25/86 (29.1%); 2) lost 22/86 (25.6%); 3) drug ineffective 19/86 (22.1%).Conclusion:Both IGU-based monotherapy and combined therapies are tolerant and effective for treating UA, ERA, and RA, while the decline in joint symptoms was most significant. Overall, IGU combination treatments were most used in RA pts, while monotherapy was predominant in ERA and UA pts.References:[1]Levin RW, et al. Scand J Rheumatol 1996, 25(5):277-281.[2]Kay J, et al. Rheumatology 2012, 51(Suppl 6):vi5-9.[3]Zhao J, et al. Clin Exp Rheumatol 2014, 32(5):667-673.[4]Mimori T, et al. Mod Rheumatol 2019, 29(2):314-323.Disclosure of Interests:None declared

Sign in / Sign up

Export Citation Format

Share Document