scholarly journals Strategies used by Kenyan patients on maintenance haemodialysis for coping with stress related to intradialytic events

2021 ◽  
Vol 24 (1) ◽  
Author(s):  
Lydia Muthoka ◽  
Dorcas Maina ◽  
Samuel Thuo Kimani

Background: Patients on haemodialysis experience various challenges associated with their disease as well as complications related to therapy. Intradialytic events, such as cramping, hypotension and shivering, are major stressors for persons on haemodialysis. In an attempt to cope with stress associated with dialysis, most patients tend to adopt emotion-orientated coping strategies. This study aimed at evaluating the coping strategies used by patients at Kenyatta National Hospital, to deal with stress related to intradialytic events. Methods: A cross-sectional study was conducted among 96 participants undergoing maintenance haemodialysis. They were selected through convenience sampling. Data were collected using a researcher-administered questionnaire for demographic data, a visual analogue scale to assess stress, and the Jaloweic coping scale. Data were analysed using SPSS version 23. Results: The majority (62%) of the participants were male. Muscle cramps (55%), headaches (54%) and hypertension (47%) were the most commonly experienced intradialytic events. The mean level of stress on the Jaloweic scale was 5.1 ± 2.1. The commonly used coping strategies were confrontational (45%), fatalistic (46%) and supportive (48%). The level of stress explained 66% of the variance associated with the use of a coping style (P = 0.01). Conclusions: Intradialytic events were common among our participants and the majority used confrontational, fatalistic and supportive coping strategies. Tailored counselling services are recommended to reinforce effective coping.

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 508.2-509
Author(s):  
K. Maatallah ◽  
H. Boussaa ◽  
H. Riahi ◽  
H. Ferjani ◽  
M. Habechi ◽  
...  

Background:Foot disease is a common problem in rheumatoid arthritis (RA). Therapeutic decisions are often based on clinical examination (CE) alone, which can be adversely affected by factors such as deformity, obesity, and peripheral edema. Ultrasonography (US) has previously been shown to be more sensitive than CE for detecting synovitis and tenosynovitis in RA forefeet, but few data exist for the hindfoot and ankle.Objectives:The aim of this study was to compare CE and US for the detection of hindfoot and ankle synovitis and tenosynovitis in patients with established RA.Methods:We conducted a cross-sectional study including patients with RA (ACR/EULAR 2010). Demographic data and disease parameters were collected. CE was performed by a rheumatologist for the presence or absence of tenderness, swelling, and mobility restriction of both ankles. The following tendons were examined for tenosynovitis: tibialis anterior (TA) and posterior (TP), fibularis longus (FL), and brevis (FB) (assessed together). In a second time, US examination of the tibiotalar, talonavicular, and subtalar joints and the same tendons as CE was performed by a blinded radiologist experienced in musculoskeletal imaging using a Philips HD11 device with a high-frequency linear transducer. The presence or absence of synovitis and tenosynovitis was recorded, and the composite synovitis score (power doppler / grayscale ultrasound (PDUS)) was measured for each joint. The US score of each patient was defined by the sum of the composite scores of the joints studied (0-30). A p-value <0.05 was considered significant.Results:Sixty-two feet were examined in 31 RA patients (25 women and six men) with a mean age of 54.8±10.8 years old [32-70]. The mean disease duration was 8.5±7.2 years [1-37]. Rheumatoid Factor (RF) and Anti-Citrullinated Peptides Antibodies (ACPA) were positive in 61.3% and 83.8% of cases. The mean DAS28 ESR was 3.8±1.5 [0.6-7].Clinical examination of ankles revealed tenderness in 57.4% of cases, swelling in 38.8% of cases, and restriction in the range of motion in 11.1% of cases. TA tenosynovitis was noted in 14.8% of cases, TP tenosynovitis in 22.2% of cases, and FL and FB tenosynovitis in 31.5% of cases.US showed tibiotalar synovitis in 59.3% of cases, talonavicular synovitis in 64.8% of cases, and subtalar synovitis in 46.3% of cases. TA tenosynovitis was noted in 5.6% of cases, TP tenosynovitis in 22.2% of cases, and FB and FL tenosynovitis in 25% and 11.1% of cases respectively.An association was found between clinical tenderness and US synovitis of the tibiotalar joint (p=0.013) and the talonavicular joint (p=0.027). No association was noted between clinical swelling and US synovitis in these joints.No association was noted between clinical and US tenosynovitis of TA (p=0.279), TP (p=0.436), FB (p=0.495) and FL (p=0.315).Conclusion:Clinical examination of RA ankles may be challenging and needs to be coupled with US, which is more sensitive and accurate in the detection of synovitis and tenosynovitis.Disclosure of Interests:None declared


2015 ◽  
Vol 59 (6) ◽  
pp. 3240-3245 ◽  
Author(s):  
Kanokrat Rungtivasuwan ◽  
Anchalee Avihingsanon ◽  
Narukjaporn Thammajaruk ◽  
Siwaporn Mitruk ◽  
David M. Burger ◽  
...  

ABSTRACTTenofovir (TFV) is eliminated by renal excretion, which is mediated through multidrug-resistant protein 2 (MRP2) and MRP4, encoded byABCC2andABCC4, respectively. Genetic polymorphisms of these transporters may affect the plasma concentrations of tenofovir. Therefore, the aim of this study was to investigate the influence of genetic and nongenetic factors on tenofovir plasma concentrations. A cross-sectional study was performed in Thai HIV-infected patients aged ≥18 years who had been receiving tenofovir disoproxil fumarate at 300 mg once daily for at least 6 months. A middose tenofovir plasma concentration was obtained. Multivariate analysis was performed to investigate whether there was an association between tenofovir plasma concentrations and demographic data, including age, sex, body weight, estimated glomerular filtration rate (eGFR), hepatitis B virus coinfection, hepatitis C virus coinfection, duration of tenofovir treatment, concomitant use of ritonavir-boosted protease inhibitors, and polymorphisms ofABCC2andABCC4. A total of 150 Thai HIV-infected patients were included. The mean age of the patients was 43.9 ± 7.2 years. The mean tenofovir plasma concentration was 100.3 ± 52.7 ng/ml. In multivariate analysis, a low body weight, a low eGFR, the concomitant use of ritonavir-boosted protease inhibitors, and theABCC44131T → G variation (genotype TG or GG) were independently associated with higher tenofovir plasma concentrations. After adjusting for weight, eGFR, and the concomitant use of ritonavir-boosted protease inhibitors, a 30% increase in the mean tenofovir plasma concentration was observed in patients having theABCC44131 TG or GG genotype. Both genetic and nongenetic factors affect tenofovir plasma concentrations. These factors should be considered when adjusting tenofovir dosage regimens to ensure the efficacy and safety of a drug. (This study has been registered at ClinicalTrials.gov under registration no. NCT01138241.)


Author(s):  
P. Kalpana ◽  
A. Kavitha

Background: The objective was to study the determinants of anemia among pregnant women. There is a negative effect on the health of the mother and as well as that of the child due to anemia in women with pregnancy. Death rate is more in women who are pregnant and having anemia. The objective of this study was to study the determinants of anemia among pregnant women.Methods: A hospital based cross sectional study was carried out among 40 pregnant women over a period of six months. Demographic data like age, residence, occupation etc was recorded. Obstetric data like gravida, parity, previous LSCS was also recorded. The data was presented as means and student’s t test was applied.Results: The mean age was 23.43±3.4 years. Majority were young between the ages of 19-22 years. Majority belonged to urban residents i.e. 57.5%. 20% of the subjects were found to be illiterate. Majority of the mothers were housewives i.e. 82.5%. Majority were multi-gravida i.e. 60%. Majority had no history of abortions in the past i.e. 75%. Out of total 19 repeat pregnancies, majority i.e. 84.2% had lower segment cesarean section. Majority reported that they had normal menstrual history. The mean hemoglobin level was found out to be 7.94 gm/dl. It was found that the mean hemoglobin level did not differ significantly across age, residence, education, occupation, gravidity, history of abortions, type of delivery but differed significantly by abnormal menstrual cycle.Conclusions: Mean hemoglobin level was more in women with normal menstrual history compared to those women with abnormal menstrual history and this difference was found out to be statistically significant. Hence abnormal menses should be promptly treated, hemoglobin assessed.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S52-S53
Author(s):  
Jamie Sin Ying Ho ◽  
Vikram Rohra ◽  
Laura Korb ◽  
Bhathika Perera

AimsThe prevalence of cardiovascular diseases (CVD) in people with intellectual disability (ID) is around 14%, higher than the general population. However, CVD risk assessments are not consistently performed. Given the high risk of premature deaths in people with ID, it is important to identify preventable risk factors and follow evidence-based interventions. QRISK-3 is a validated risk-stratification tool, which calculates the 10-year risk of developing a heart attack or stroke (https://qrisk.org/three/index.php). There are no published studies on the use of QRISK-3 in people with ID. This project aimed to understand the use of QRISK-3 in an ID clinic and to quantify individual CVD risks to recommend appropriate management options.MethodA cross sectional study was performed on 143 patients open to an ID psychiatry clinic. Patients and carers were sent an accessible information leaflet on this study. Basic demographic data and information on psychiatric diagnoses were collected. Patients were grouped according to the presence of severe mental illness (SMI) defined as schizophrenia, bipolar disorder and other psychotic illnesses. QRISK-3 ≥ 10% was defined as elevated risk in accordance with NICE guidelines. Patients who had a high QRISK-3 score were advised to contact their GP.ResultOf 143 patients, 73 (51.0%) had a mild ID and the remaining had a moderate to severe ID. The mean age was 43.3 years, 53.1% were male. Overall, 28 (19.6%) participants had an elevated CVD risk, of whom 16 (57.1%) were not on statins, which is the recommended treatment. The mean QRISK-3 score was 6.31 (standard deviation [SD] 8.95), and the relative risk is 3.50 (SD 7.13). The proportion of QRISK-3 ≥ 10% and mean score were not significantly different in those with SMI, but those with SMI were more likely to be prescribed statins than those without (14 [31.1%] vs 10 [10.2%], p = 0.002). Statins were given to 24 (16.8%) participants, of whom 12 (50%) had elevated CVD risk. 89% had a blood pressure recording within the past 5 years, 87% had height and 88% had weight recorded. 73% had lipid serology results recorded.ConclusionElevated CVD risk was common in this ID study population, and more than half with elevated QRISK-3 were not on the medical treatment recommended by national guidelines. QRISK-3 could feasibly be implemented in the outpatient setting. Increased routine CVD risk assessment and management should be considered as another measure to reduce morbidity and mortality.


2012 ◽  
Vol 4 ◽  
pp. OED.S9204 ◽  
Author(s):  
GO Ovenseri-Ogbomo ◽  
S Ocansey ◽  
EK Abu ◽  
S Kyei ◽  
SB Boadi-Kusi

Objective The focus of this study was to evaluate the visual status of mine workers who were directly involved in mining and/or are exposed to the mining environment. Methods A hospital based cross-sectional study was conducted. Four hundred and six (406) workers were conveniently sampled for the study. Information on their socio-demographic data was also collected. In addition, all participants underwent ophthalmic examination. Results The mean age of the workers was 41.1 years. Visual impairment was found in 114 (28.1%) of the study population of which refractive error (56.8%) was the major cause. Presbyopia was also observed in 45.5% of the workers with only 30.3% of them wearing near correction. The prevalence of eye diseases were pterygium/pingueculae (25.8%), conjunctivitis (26.8%), suspected glaucoma (15.3%), and cataract (7.4%). Conclusions Visual impairment and eye diseases were found among the miners.


2016 ◽  
Vol 35 (3) ◽  
pp. 261-270 ◽  
Author(s):  
Jéssika Leão Fabbris ◽  
Ana Cláudia Mesquita ◽  
Sílvia Caldeira ◽  
Ana Maria Pimenta Carvalho ◽  
Emilia Campos de Carvalho

Purpose: To analyze the relation between anxiety and spiritual well-being in undergraduate nursing students. Design: Cross sectional, correlational, and survey design. Method: A total of 169 students from a Brazilian Nursing School completed three instruments: demographic data, Spiritual Well-Being Scale (SWBS), and Beck Anxiety Inventory (BAI). Findings: The mean score of SWBS was high, and the mean score of BAI was low. When experiencing anxiety, there was lower probability of experiencing high spiritual well-being. For those students considering religiosity very important, the score of SWBS was high. Students scoring lower in SWBS had more probability of experiencing moderate/high anxiety. Conclusions: Higher scores of SWBS and importance given to religiosity were related to lower scores of BAI. Also, the performance and score of spiritual well-being were related to anxiety scores. Further research is worthy to identify and validate which educational aspects could promote spiritual well-being and reduce anxiety as well as research to analyze the relation between spiritual well-being score and learning outcomes.


2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Shakeel Ahmad ◽  
Rashida RIaz ◽  
Muhammad Haseeb ◽  
Hafiza Ammara Rasheed ◽  
Samia Iqbal

Purpose: To compare the mean difference of visual acuity as measured by auto refraction and subjective refraction. Study Design:  Descriptive cross-sectional study. Place and Duration of Study:  Department of ophthalmology, Services hospital Lahore from November 2013 to April 2014. Material and Methods:  Using non-probability consecutive sampling 300 eyes of 300 patients fulfilling inclusion criteria were recruited through OPD registration slip. Demographic data including age and gender was recorded. Complete ophthalmic examination was performed. This included measurement of refractive error by auto-refraction as well as subjective refraction. Detailed anterior segment examination with slit lamp and dilated fundus examination with indirect ophthalmoscopy was performed. The collected data was analyzed by using software SPSS version 17. Results:  The mean age of patients was 34.71 ± 7.45 years. There were 156 (52%) males and 144 (48%) females. There were 263 (87.69%) patients who had visual acuity of 6/6 and 37 (12.33%) had 6/9. Mean spherical auto-refraction and subjective refraction was 0.0290 ± 2.58 and -0.2842 ± 2.37 D with mean difference of -0.3133 ± 1.27 D. The mean cylindrical auto and subjective refraction in this study was -.9742 ± 0.78 D and -0.7500 ± 0.81 D and mean difference was 0.2242 ± 0.74 D. The mean cylindrical axis of auto and subjective refraction was 114.88 ± 49.75 and 115.60 ± 49.70 with mean difference as 0.72 ± 3.02 D (p-value < 0.05). Conclusion:  Difference of spherical, cylindrical and cylindrical axis in auto and subjective refraction was significantly different.


2017 ◽  
Vol 2 (2) ◽  
pp. 63
Author(s):  
Amir Moghaddamahmadi ◽  
Pouria Yazdian-Anari ◽  
Siamak Kazemisufi ◽  
Alireza Vakilian ◽  
Aliasghar Ranjbartotoei ◽  
...  

Background and objectives: Multiple sclerosis is a chronic and progressive autoimmune disease of the central nervous system that causes motor and sensory impairment and physical disability in patients. This study was conducted to determine the demographic, clinical, and beyond clinical characteristics in patients with multiple sclerosis to help identify common disabilities and better understand of the specific needs of these ones.Materials and methods: This descriptive cross-sectional study was carried out on 50 MS patients in Rafsanjan, Iran. A definitive diagnosis has been done according to neurologist and McDonald criteria. The neurologist conducted examinations. The demographic data were recorded using questionnaire. MRI images were analyzed with the help of radiologist and all data were analyzed using SPSS software.Results: The mean age was 33.81±8.38 years and male/female ratio was 7/42. According to data, 66.7% of the patients were suffering from relapsing-remitting type (RR) disease, and most lesions on MRI in these patients were observed in pyramidal and JuxtaCortical areas. The mean EDSS scores of patients was 1.46. The duration of disease and the number of attacks had a significant correlation with educational level (P<0.05); age was significantly associated with pyramidal, mental and sphincter symptoms (P<0.05).Conclusion: These results suggest that the prevalence of MS in women is higher than in men, especially among housekeeper women. Relapsing and remitting disease showed higher frequency.


2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Ioanna V. Papathanasiou ◽  
Anna Rammogianni ◽  
Dimitros Papagiannis ◽  
Konstantinos Tsaras ◽  
Foteini Kaberi ◽  
...  

Introduction: Quality of Life (QoL) among elderly is an important issue that reflects the status of well-being of this vulnerable population. Aim: This study aims to assess quality of life among elderly population and to examine possible correlations with associated demographic, social and health factors. Material and Method: A cross sectional study was conducted, in which 257 elderlies from Greece were participated. For the data collection the WHOQOL-BREF (30-items Greek version) questionnaire was used as well as a questionnaire with questions about demographic data, social & health factors. Descriptive statistics such as frequencies, means, percentages and standard deviations have been utilized. Inferential statistics such as t-test and pearson r correlation have been used to determined correlations between relevant variables. Level of significance accepted is p < 0.05. Results: From the total 257 elderlies 55.6% (n=143) were women and 44.4% (n=114) were men with a mean age 75.12±8.39. The mean score of overall QoL is 14.14±2.87 and the mean of each factor of WHOQOL-BREF is 13.56±2.79 for physical health, 13.61±2.74 for mental health, 13.72±2.60 for social relationships and 13.70±1.96 for environment. Age, marital status, number of children, level of education, residence area, lifestyle, chronic diseases and serious illnesses are the factors that affects levels of QoL among Greek elderly population Conclusions: Results indicates that levels of QoL between elderly are moderate and many demographic, social and health factors are correlated with QoL status.


Author(s):  
Ghaida Aziz, Ghaida jabri, Ghaida Al-Ahmadi, Mona Ehab, Marw

Breast feeding (BF) is known to have many advantages but our Arab region has a pattern similar to western countries; where exclusive breastfeeding less than 35%. Knowledge given to women during her antenatal visits plays an important influential role in her attitude and practice of BF later on.  Objective: To explore knowledge and attitude of female medical students at Taibah University about breastfeeding.  Methods: A Cross sectional study was carried out from October to November 2012. It included female medical students. Stratified sampling allocation technique was used; with a total sample of 149 students. A specialty designed self-administrated questionnaire in Arabic form was used. It included socio-demographic data, obstetric history, data about the knowledge and attitude of female medical students towards breastfeeding value and guidelines. Mean percent knowledge score for value of BF, mean percent score for BF guidelines and mean percent score for attitude were calculated. Appropriate statistical tests for qualitative and quantitative data were used accordingly. Results: Majority (91.9%) (of the studied sample) was never married and 37.6% got their knowledge about BF via books. Regarding ever married women, 58.3% only were gravid (mean =2.2±1.94). Only 25.0% were family planning users; 66.7% of them used hormonal contraceptives. Only 20% breast fed their infants with a mean duration for exclusive BF of 3.8 ± 2.87 months and mean age of weaning of 2.3 ±0.63 months. The mean knowledge percent score for guidelines of BF was 64.7±8.45. The mean attitude percent score for concepts related to BF was 76.9±7.91. Conclusion: Media and internet have minor roles in getting knowledge about BF. The mean knowledge score about advantages of BF, guidelines of BF and attitude towards BF of all female medical students; especially academic years were unsatisfactory.


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