Evaluation of Iatrogenic Hypocortisolemia Following Trilostane Therapy in 48 Dogs with Pituitary-Dependent Hyperadrenocorticism

Author(s):  
Elizabeth Appleman ◽  
Abigail Schrage ◽  
Kenneth E. Lamb ◽  
Cathy Langston

ABSTRACT This study aimed to retrospectively describe the clinical progression following diagnosis of iatrogenic hypocortisolemia (iHC) in 48 dogs receiving trilostane for pituitary-dependent hyperadrenocorticism. Cortisol concentrations were ≥1.5 μg/dL within 6 mo following diagnosis of iHC in 76.3% of dogs (95% confidence interval [CI] 59.8–88.6%). At the time of study completion, 25% of dogs (95% CI 13.6–39.6%) were receiving either glucocorticoids or mineralocorticoids or both; 42% of dogs (95% CI 27.6–56.8%) were on no adrenal-related medications; and the remaining 33% of dogs (95% CI 20.4–48.4%) were receiving trilostane. No patient-, clinicopathologic-, or trilostane-associated factors were identified to influence adrenal recovery following diagnosis of iHC, and it remains difficult to predict the clinical progression in this population of dogs.

2020 ◽  
Vol 8 ◽  
pp. 205031212098245
Author(s):  
Assefa Tola Gemeda ◽  
Lemma Demissie Regassa ◽  
Adisu Birhanu Weldesenbet ◽  
Bedasa Taye Merga ◽  
Nanti Legesse ◽  
...  

The foundation of controlling hypertension is adherence to antihypertensive medication adherence. This systematic review and meta-analysis aimed to assess the magnitude and associated factors of adherence to antihypertensive medication among adult hypertensive patients in Ethiopia. A comprehensible bibliographic searching was conducted from PubMed, EMBASE, Scopus, and Web of Science core collection. All published and unpublished studies that had been accessible before 31 May 2020, and written in English were eligible. Joanna Briggs Institute assessment tool was used to evaluate the quality of the findings of the included studies. Stata software 16.0 was used to analyze the data. Study-specific estimates were pooled to determine the overall prevalence estimate across studies using a random-effects meta-analysis model. Publication bias and heterogeneity were checked. Fourteen studies with a total of 4938 hypertensive patients were included in the final systematic review and meta-analysis. The pooled prevalence of medication adherence among hypertensive patients in Ethiopia was 65.41% (95% confidence interval: 58.91–71.91). Sub-group analysis shown that the pooled prevalence of medication adherence was the highest (69.07%, 95% confidence interval: 57.83–80.31, I2 = 93.51) among studies using questionnaire technique whereas the lowest in Morisky Medication Adherence Scale eight-items (60.66%, 95% confidence interval: 48.92–72.40, I2 = 97.16). Moreover, medication adherence was associated with the presence of comorbidities (pooled odds ratio = 0.23, 95% confidence interval: 0.07–0.38, p = 0.030, I2 = 54.9%) and knowledge about the disease and its management (pooled odds ratio = 2.98, 95% confidence interval: 1.72–4.24, p = 0.04, I2 = 55.55%) but not with place of residence (pooled odds ratio = 1.22, 95% confidence interval: 0.51–1.93, p = 0.00, I2 = 76.9%). Despite a lack of uniformity among included studies, adherence to antihypertensive medication among the hypertensive population in Ethiopia was moderate. The presence of comorbidities and/or complications reduced the odds of adherence whereas having good knowledge about the disease increased chance of medication adherence among hypertensive patients.


2019 ◽  
Author(s):  
Mulugeta Woldu Abrha ◽  
Kiros Demoz Ghebremedhin ◽  
Tesfay Teklemariam Weldeslasie

Abstract Background Religious institutions found at the community, not only uphold belief and cultural values but also as a force for positive change and development. Improved sanitation and hygiene is crucial in these institutions to decrease preventable infections due to unsanitary conditions. However, there are no studies among religious institution on availability of latrine. So this study was conducted to assess the latrine availability and associated factors among religious institution in Tigray Region, Ethiopia.Method Institution based cross – sectional study design was conducted in Tigray Region, Northern Ethiopia. Multi-stage sampling was used to sample 385 religious institutions. Data was collected using pre tested, structured questionnaire and observation checklist. Logistic regression was fitted and odds ratio with 95% confidence interval (CI) with p-value less than 0.05 was used to determine the predictors of latrine availability. Analysis was carried out using SPSS 20 TM - software package.Results In this study latrine availability was 32.8%. And was significantly affected by currently saved money towards having a latrine (Adjusted Odds ratio (AOR): 0.32, 95% confidence interval (CI) [0.25, 0.42]), any messages seen, heard or received on sanitation and hygiene (AOR: 0.43, 95% CI [0.38, 0.51]) and place where messages seen, heard, received (AOR: 2.95, 95% CI [1.11, 5.55]).Conclusion Availability of latrine was very low when compared to the national target of 100% among the religious institution and was affected by the currently saved money towards having a latrine, any messages seen, heard or received on sanitation and hygiene and place where the messages receive. Information regarding latrine availability should be provided to the community visiting religious institutions through available channels and practical models promotion.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lingxia Guan ◽  
Jing Guo ◽  
Jinghao Ban ◽  
Gang Li ◽  
Juan Tong ◽  
...  

Abstract Background Tibet, a region where average elevation is above 3500 m and socio-economic development is relatively lower, was not included in National Oral Health Survey over decades. The cross-sectional study aimed to investigate the status of dental caries and associated factors in Tibetan adults. Methods Participants aged 35–44, 55–64 and 65–74 years were selected. Decayed, missing, and filled tooth (DMFT), decayed and filled root (DF-Root) and root canal index (RCI) were used to evaluate dental caries. Questionnaire survey on demographic information, socioeconomic status, dietary habits, and oral health knowledge and behavior was conducted. Mann-Whitney U test, logistic regression were used for the statistical analyses. Results A total of 446 participants were enrolled in the survey. Of these: 222 (49.8%) were females, 224 (50.2%) were males; 149 (33.4%), 151 (33.9%), 146 (32.7%) were aged 35–44, 55–64 and 65–74 years respectively. The mean DMFT (SD) was 7.62 (4.84), 12.46 (8.16), and 21.38 (8.93). The filling rate was very low in all age groups (1.77%, 0.98%, 0.45%). The mean DF-Root (SD) was 0.50 (1.04), 1.04 (2.02), 1.32 (2.14), respectively. Root caries index was 42.27, 44.78 and 57.60%. Older age (65–74 age group) was positively associated with crown caries (odds ratio = 31.20, 95% confidence interval: 10.70–90.96). College degree and above and brushing teeth at least once a day were negatively associated with crown caries (odds ratio = 0.28, 95% confidence interval: 0.09–0.89; odds ratio = 0.39, 95% confidence interval: 0.21–0.72, respectively). Rural area, high income level and brushing teeth at least once a day were negatively and tooth with attachment loss was positively associated with root caries. Conclusions The status of dental caries in the adults in Tibet is severe and the treatment rate is very low. The study suggests a correlation between crown caries and the variables age, level of education and frequency of tooth brushing; correlation between root caries and residence, income level, frequency of tooth brushing and exposed root surfaces. These findings could be as reference to develop community based interventions to reduce the prevalence of caries in Tibet.


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Jonathan Izudi ◽  
Pontius Apangu ◽  
Francis Bajunirwe ◽  
Edgar Mulogo ◽  
Vincent Batwala

Background. Under Option B plus, the transmission of Human Immunodeficiency Virus (HIV) along the Early Infant Diagnosis (EID) of HIV cascade remains unknown. We described HIV transmission along the EID cascade and determined associated factors at Arua Regional Referral Hospital, Northwestern Uganda. Methods. Data on 295 mother-baby pairs in EID care (January 2014 and April 2015) was extracted, cleaned, and analysed in STATA. Univariate, bivariate, and multivariate analyses were performed. Independently associated factors were stated in adjusted odds ratio (AOR), 95% confidence interval (CI), and p-values. Results. 233 (89.0%) mothers were above 30 years, 251 (85.1%) were in World Health Organization (WHO) clinical stages I/II at enrolment, 170 (57.6%) attended antenatal care (ANC) visits during recent pregnancy, and 204 (69.1%) delivered in a health facility. Meanwhile, 257 (87.1%) HIV Exposed Infants (HEIs) received Nevirapine prophylaxis from birth up to 6 weeks and 245 (83.0%) were exclusively breastfed during the first 6 months. Of 295 mother-baby pairs, 25 (8.5%) HEIs turned HIV-positive along the EID cascade. Baseline maternal CD4 count of more than 500 cells/ul compared to less than 500 cells/ul (adjusted odds ratio (AOR) = 0.29; 95% Confidence Interval (CI): 0.10–0.85; p = 0.024) and exclusive breastfeeding (EBF) in the first 6 months of delivery in contrast to not EBF in the first 6 months (AOR = 0.17; 95% CI: 0.52–0.55; p = 0.003) reduced HIV transmission. Meanwhile, ANC visits, place of delivery, time of Nevirapine initiation, and maternal antiretroviral therapy use were not significantly associated with infant HIV transmission. Conclusion. HIV transmission was high. High baseline CD4 count and exclusive breastfeeding reduced HIV transmission.


2020 ◽  
Vol 16 ◽  
pp. 174550652095200
Author(s):  
Arsema Berhe ◽  
Abayneh Alamer ◽  
Kiflom Negash ◽  
Belete Assefa

Background: Urinary incontinence is any involuntary leakage of urine. It has serious negative health impacts on quality of life in pregnant women. According to the scientific committee of the International Continence Society report, worldwide prevalence of urinary incontinence estimated ranges between 32% and 64% among pregnant women. However, there is scarcity of evidence on prevalence and associated factors of urinary incontinence in Ethiopia. Objective: The aims of this study were to assess prevalence and associated factors of urinary incontinence among pregnant women attending antenatal care in public health facilities of Mekelle city, Tigray, Ethiopia. Methodology: Institution-based cross-sectional study design was conducted. Data were collected using an interviewer-administered structured questionnaire. Physical examination was done to assess the strength of pelvic floor muscles. The data were entered to EPI Info version 7 and analyzed using SPSS version 23. Bivariate and multivariate logistic regression analyses were done to investigate the factors associated with urinary incontinence. Results: Among 317 respondents, the prevalence of urinary incontinence was 23%. The contributing factors that had statistically significant association with urinary incontinence were gestational age (adjusted odds ratio: 9.6 (1.87–49.39, 95%), parity (adjusted odds ratio: 6.32 (1.48–27.05), 95% confidence interval), prior miscarriage (adjusted odds ratio: 6.28 (2.15–18.28), 95% confidence interval), constipation (adjusted odds ratio: 8.25 (3.12–21.84), 95% confidence interval), respiratory problem (adjusted odds ratio: 6.31 (2.05–19.43), 95% confidence interval), and weak pelvic floor muscle (adjusted odds ratio: 7.55 (2.51–22.67), 95% confidence interval). Conclusion: The prevalence of urinary incontinence is moderate compared to other studies. Gestational age, parity, prior miscarriage, having constipation, having respiratory problem, and weak pelvic floor muscle had significant association with urinary incontinence. This finding will help to increase the awareness of health care professionals involved in the care of pregnant women about urinary incontinence.


2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096433
Author(s):  
Bekalu Getahun Agaje ◽  
Demoze Delelegne ◽  
Elias Abera ◽  
Kindie Desta ◽  
Mikael Girum ◽  
...  

Objective To assess the strabismus prevalence and associated factors among children aged ≤15 years. Methods This hospital-based cross-sectional study was conducted from March 2017 to October 2017 in the Department of Ophthalmology & Optometry, Hawassa University Comprehensive Specialized Hospital. Interviewer-administered questionnaires were used to collect relevant data and clinical examinations were performed for patient diagnosis. Results Overall, 582 children participated in the study (response rate, 97%). The prevalence of childhood strabismus was 17.9% [95% confidence interval: 14.6–21.1]. Additionally, 9.6%, 16.7%, and 9.6% of the children had anisometropia, amblyopia, and dense cataract, respectively. Among the 16.7% of children with amblyopia, 56.7% had strabismus; among the 22.5% of children with clinically significant refractive error, 52.7% had strabismus. Moreover, among the 9.6% of children with anisometropia, 58.9% had strabismus. The presence of amblyopia (adjusted odds ratio [95% confidence interval]: 3.9, 1.7–8.6), age <5 years (13.5 [5.0–36.1]), age 5 to 10 years (6.1 [2.3–16.3]), and clinically significant refractive error (13.3 [5.8–30.6]) were significantly associated with childhood strabismus. Conclusions The prevalence of strabismus was relatively high among patients in this study. Early screening for childhood strabismus is essential. A well-controlled community-based study is needed to confirm strabismus prevalence and predictors.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Wondu Feyisa Balcha ◽  
Azezu Asres Nigussie ◽  
Fentahun Yenealem Beyene ◽  
Azimeraw Arega Tesfu

Background. Obstetric fistula is abnormal passageway between the vagina and bladder or rectum, and it has the most devastating effects on physical, social, and economic levels and represents a major public health issue of thousands of women, which failed to provide accessible and appropriate intrapartum care for women within a developing country, particularly in Ethiopia. Therefore, we tried to assess the awareness and its associated factors of obstetrics fistula among pregnant mothers attending antenatal care clinics. Methods. A health institutional-based cross-sectional study was employed from March 4 to 29/2019 among 413 pregnant women. Data was collected by a systematic random sampling technique and entered into a computer using Epi data 3.5, edited and analyzed using Statistical Package of Social Sciences 23.0 version. Bivariate and multivariate logistic regression analyses were employed to estimate the crude and adjusted odds ratio with a confidence interval of 95% and p value of less than 0.05 considered statically significant. Result. This study identified that 39.5% with 95% confidence interval (34.6-44.6%) of pregnant women had good awareness about obstetrics fistula. Multivariate logistic regression analysis showed that living in urban [AOR=1.98, 95% CI=1.07−3.69], attending formal education [AOR=2.11, 95% CI=1.06−4.12], having history antenatal care [AOR=3.87, 95% CI=1.60−9.68], and childbirth at health institution [AOR=7.10, 95% CI=2.52−2.02] were significantly associated with awareness of obstetrics fistula. Conclusion and recommendation. This study showed that awareness of obstetrics fistula was low. Residency, education, and occupation of the women, having history of antenatal care and childbirth at health institution was significantly associated with awareness of obstetrics fistula. Still, there is a gap on awareness of obstetrics fistula; therefore, it is good to emphasize on providing information on maternal health care issues, particularly about obstetrics fistula.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Mulugeta Woldu Abrha ◽  
Kiros Demoz Ghebremedhin ◽  
Tesfay Teklemariam Weldeslasie

Background. Religious institutions found in the community not only uphold belief and cultural values but can also act as a force for positive change and development. Improved sanitation and hygiene are crucial in these institutions to decrease preventable infections due to unsanitary conditions. However, there are no studies among religious institutions on availability of latrines. Therefore, this study was conducted to assess latrine availability and associated factors among religious institutions in the Tigray Region, Ethiopia. Method. An institution-based cross-sectional study design was conducted in the Tigray Region, Northern Ethiopia. Multistage sampling was used to sample 385 religious institutions. Data were collected using a pretested, structured questionnaire and observation checklist. Logistic regression was fitted, and an odds ratio with 95% confidence interval (CI) with p value less than 0.05 was used to determine the predictors of latrine availability. Analysis was carried out using the SPSS 20TM software package. Results. In this study, latrine availability was 32.8%. It was significantly affected by currently saved money towards having a latrine (adjusted odds ratio (AOR): 0.32, 95% confidence interval (CI) [0.25, 0.42]), any messages seen, heard, or received on sanitation and hygiene (AOR: 0.43, 95% CI [0.38, 0.51]), and the place where messages were seen, heard, or received (AOR: 2.95, 95% CI [1.11, 5.55]). Conclusion. Latrine availability was very low when compared to the national target of 100% among religious institutions and was affected by the currently saved money towards having a latrine, any messages seen, heard, or received on sanitation and hygiene, and the place where the messages were received. Information regarding latrine availability should be provided to the community visiting religious institutions through available channels and promotion of practical models.


2005 ◽  
Vol 84 (8) ◽  
pp. 715-720 ◽  
Author(s):  
S.O. Griffin ◽  
P.M. Griffin ◽  
J.L. Swann ◽  
N. Zlobin

To characterize the extent and severity of coronal caries among older US adults and document their need for prevention interventions, we systematically reviewed studies on coronal caries incidence, increment, and attack rate. We abstracted six studies and calculated summary measures using a random-effects model (95% confidence interval [95%CI]). We tested for heterogeneity and identified associated factors by examining the correlation between outcome measures and baseline population risk and study characteristics. We re-calculated summary measures after adjusting outcomes that netted out examiner reversals. Incidence and increment varied significantly by study. Adjusting studies for netting out examiner reversals reduced heterogeneity significantly. Annual attack rate among adjusted North American studies was 1.4 surfaces per 100 surfaces (95%CI = 1.0–1.9), or approximately 1 new carious surface per person per year. These rates are equal to or higher than those in children and indicate a need for caries-prevention services.


2021 ◽  
Vol 9 ◽  
pp. 205031212110328
Author(s):  
Zelalem Jabessa Wayessa ◽  
Girma Tufa Melesse ◽  
Elias Amaje Hadona ◽  
Wako Golicha Wako

Objectives: Globally, novel coronavirus disease 2019 (COVID-19) has spread rapidly since it was first identified and challenging the provision of essential services for low-resource countries. Healthcare workers involved in providing care are at high risk of developing mental health problems. The aim of this was to determine the prevalence of depressive symptoms due to COVID-19 and associated factors among healthcare workers in the West Guji zone in public health facilities, southern Ethiopia. Methods: A facility-based cross-sectional study was conducted in public health facilities found in the West Guji zone. A simple random sampling technique was employed to select 283 study subjects. This study was used to assess the prevalence of depression symptoms using Depression, Anxiety and Stress Scale-21, a depression subscale. Descriptive statistics, binary and multiple logistic regressions were used. Adjusted odds ratios (AORs) with 95% confidence interval will be estimated to assess the strength of associations and statistical significance will be declared at a p-value < 0.05. Results: Out of 283 eligible healthcare workers, 275 respondents had participated in this study with a 97.2% response rate. The prevalence of depressive symptoms was 21.5%. The independent predictors associated with depressive symptoms due to COVID-19 were age (adjusted odds ratio = 2.35, 95% confidence interval = 1.126–3.95), family size (adjusted odds ratio = 3.56, 95% confidence interval = 1.09–11.62), alcohol use (adjusted odds ratio = 4.31, 95% confidence interval = 1.76–10.55), medical illness (adjusted odds ratio = 9.56, 95% confidence interval = 3.71–24.59), having training on COVID-19 (adjusted odds ratio = 0.37, 95% confidence interval = 0.17–0.81), and lack of knowledge on COVID-19 (adjusted odds ratio = 15.34, 95% confidence interval = 6.32–37.21). Conclusion: The prevalence of depressive symptoms among healthcare workers due to COVID-19 was high. Factors associated with depressive symptoms were age, family size, alcohol use, medical illness, having training on COVID–19, and lack of knowledge on COVID-19.


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