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Subarachnoid haemorrhage in a newly diagnosed Chronic Myelogenous Leukemia patient: A diagnostic challenge 新诊断的慢性粒细胞白血病患者出现蛛网膜下腔出血:诊断难题
Q3 Medicine Pub Date : 2024-04-15 DOI: 10.4314/emj.v62i2.7
Zekewos Demissie, Brook Alemayehu, Nahom Zemedkun, Fisihatsion Tadesse
Chronic Myelogenous Leukemia (CML) is a myeloproliferative neoplasm with a prevalence of 1 to 2 cases per 100,000 adult population. In chronic myelogenous leukemia (CML), central nervous system (CNS) manifestations are reported in the advanced phase of the disease due to leukostasis, thrombosis, bleeding, infection, and CNS infiltration. However, CNS manifestations are uncommon in the chronic phase (CP) of CML, and an alternate diagnosis should be considered for symptomatic patients. We report a ruptured aneurysmal subarachnoid hemorrhage (SAH) as an initial presentation in a previously undetected CML patient.
慢性粒细胞白血病(CML)是一种骨髓增生性肿瘤,发病率为每 10 万成年人中有 1 到 2 例。据报道,在慢性粒细胞白血病(CML)的晚期,由于白细胞凝集、血栓形成、出血、感染和中枢神经系统浸润,会出现中枢神经系统(CNS)表现。然而,中枢神经系统表现在慢性骨髓增生性白血病(CML)的慢性期(CP)并不常见,有症状的患者应考虑其他诊断。我们报告了一名先前未被发现的慢性骨髓性白血病患者初次出现动脉瘤破裂性蛛网膜下腔出血(SAH)。
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引用次数: 0
Understanding the link between urban household food insecurity and contraceptive use among reproductive-age women in Lideta Sub-City, Addis Ababa, Ethiopia 了解埃塞俄比亚亚的斯亚贝巴利德塔副城城市家庭粮食不安全与育龄妇女使用避孕药具之间的联系
Q3 Medicine Pub Date : 2024-04-15 DOI: 10.4314/emj.v62i2.4
Ephrem Tadesse Goda, Terefe Degefa Boshera, Mengistu Ketema Aredo
Introduction: The enhancement of reproductive health in women can result in an improvement of children’s nutritional status resulting in improvement of reproductive health. This association is important for sustainable population growth without overusing resources. This study aims to examine the relationship between household food insecurity and contraceptive use.Method: A study was conducted on 651 reproductive-age women in three randomly selected Woredas (districts), Lideta Sub-city from February to March 2023. Six Ketenas (villages) were selected using a probability proportional to size technique from three Woredas. Data were collected through a validated survey by trained individuals, and household income and expenditure were used to measure food insecurity access. The Pearson chi-square test (c2) and logistic regression were used to examine the relationship between household food insecurity and contraceptive use, considering other covariates.Result: Modern contraception usage was at 50.5% in the study area. Women with food insecurity had only a 32.0% usage rate, while those who were food secure had the higher rate of 68.7%. Women in food-insecure households had a 76.5% lower chance of using modern contraception. Positive attitude, family planning information, partner discussion, income, and childhood mortality were associated with contraceptive use (p <0.05).Conclusion: Use of modern methods of contraception showed a negative correlation with food insecurity. Therefore,  addressing household food insecurity as a potential obstacle to the development of family planning services requires comprehensive stakeholder engagement and socio-economic policy intervention.
导言:提高妇女的生殖健康水平可以改善儿童的营养状况,从而提高生殖健康水平。这种联系对于在不过度使用资源的情况下实现人口的可持续增长非常重要。本研究旨在探讨家庭粮食不安全与避孕药具使用之间的关系:研究于 2023 年 2 月至 3 月在利德塔副城随机抽取的三个县(区)的 651 名育龄妇女进行了调查。采用概率与规模成比例的技术,从三个区选出了六个 Ketenas(村)。数据由经过培训的人员通过有效调查收集,家庭收入和支出用于衡量粮食不安全状况。在考虑其他协变量的情况下,采用皮尔逊卡方检验(c2)和逻辑回归法来研究家庭粮食不安全与避孕药具使用之间的关系:结果:在研究地区,现代避孕药具的使用率为 50.5%。粮食无保障的妇女使用率仅为 32.0%,而粮食有保障的妇女使用率更高,达到 68.7%。粮食不安全家庭的妇女使用现代避孕方法的几率要低 76.5%。积极态度、计划生育信息、伴侣讨论、收入和儿童死亡率与避孕药具的使用有关(P <0.05):结论:现代避孕方法的使用与粮食不安全呈负相关。因此,要解决作为计划生育服务发展潜在障碍的家庭粮食不安全问题,需要利益相关者的全面参与和社会经济政策干预。
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引用次数: 0
Health professionals’ intention to leave their job from public health facilities and associated factors in Ethiopia: A systematic review and meta-analysis. 埃塞俄比亚公共卫生机构卫生专业人员的离职意向及相关因素:系统回顾和荟萃分析。
Q3 Medicine Pub Date : 2024-04-15 DOI: 10.4314/emj.v62i2.10
Getachew Assefa Zenebe, Abinet Meno, T. L. Lerango
Background: Intention to leave describes an employee’s intention or plan to leave their current job and seek alternative employment opportunities. This intention serves as an early indicator of potential turnover behavior. Notably, no comprehensive national data in the country reveals the extent and underlying factors associated with this phenomenon.Objective: To examine health professionals’ intention to leave their jobs in public health facilities and its determinants in Ethiopia.Methods: Studies were searched for using databases such as PubMed, CINHAL, Science Direct, and HINARI, while Google Scholar was utilized for accessing gray literature. This review covers both published and unpublished studies containing quantitative data written in English, focusing on the intention of health professionals to leave their jobs in Ethiopia. All necessary data were extracted by two independent authors and imported into STATA version 14.0 for analysis. Heterogeneity was checked by using a χ2 and I2 tests. Publication bias was examined by performing Egger’s correlation and Begg’s regression intercept tests. A meta-analysis was conducted using a random-effects model.Results: We used a total of 25 primary studies in our review. The pooled overall health professionals’ intention to leave their job was 59.05% (95% CI; 54.35, 63.74%) with a range from 39%-83.7%. Sex (AOR: 1.69, 95%CI: 1.31 -2.18), job or work environment (AOR: 3.59, 95% CI: 2.05–6.29), payment or any benefit (AOR: 7.37, 95%CI: 2.89-18.79), supervision and evaluation (AOR: 2.99, 95% CI: 2.27–3.93), appraisal and recognition (AOR: 3.4, 95% CI: 2.62-4.41) and organizational commitment (AOR: 1.9, 95%CI: 1.04–3.48) were the significant factors.Conclusion and recommendation: The results reveal a significant intention among health professionals to leave their jobs in Ethiopia. To counter this trend, it is advised to cultivate a positive workplace environment, implement effective monitoring and evaluation systems, and offer ample career development opportunities.
背景:离职意向是指员工有意或计划离开现有工作岗位,另谋高就。这一意向是潜在离职行为的早期指标。值得注意的是,国内尚无全面的全国性数据揭示与这一现象相关的程度和潜在因素:研究埃塞俄比亚公共卫生机构卫生专业人员的离职意向及其决定因素:方法:使用 PubMed、CINHAL、Science Direct 和 HINARI 等数据库搜索相关研究,并使用 Google Scholar 查阅灰色文献。本综述涵盖已发表和未发表的研究,这些研究均以英语撰写,包含定量数据,重点关注埃塞俄比亚卫生专业人员的离职意向。所有必要数据均由两位独立作者提取,并导入 STATA 14.0 版进行分析。使用 χ2 和 I2 检验检查异质性。通过 Egger 相关性检验和 Begg 回归截距检验来检查发表偏倚。采用随机效应模型进行了荟萃分析:我们共使用了 25 项主要研究。汇总的卫生专业人员离职意向总体为 59.05% (95% CI; 54.35, 63.74%),范围在 39%-83.7% 之间。性别(AOR:1.69,95%CI:1.31 -2.18)、工作或工作环境(AOR:3.59,95%CI:2.05-6.29)、薪酬或任何福利(AOR:7.37,95%CI:2.89-18.79)、监督和评估(AOR:2.99,95%CI:2.结论和建议:研究结果表明,埃塞俄比亚的医疗卫生专业人员离职意愿强烈。为扭转这一趋势,建议营造积极的工作环境,实施有效的监测和评估系统,并提供充足的职业发展机会。
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引用次数: 0
Chondrosarcoma of the sternum: A rare and challenging entity 胸骨软骨肉瘤:一种罕见且具有挑战性的实体瘤
Q3 Medicine Pub Date : 2024-04-15 DOI: 10.4314/emj.v62i2.9
A. Guiga, Wissal ben Yahia, Atef Benabdelkader, Amel Amara, Maissa Thabet, Maissa Omrani, Ansar Mefteh, Bechir Ben Radhia, A. Atig, N. Ghannouchi
Background: Chondrosarcoma is a relatively common primary malignant bone tumor, with the sternum being an unusual location. When this tumor arises in the sternum, clinicians encounter diagnostic and therapeutic complexities. Indeed, the sternal location warrants attention due to its potential for local invasion, metastasis, and poor prognosis. Nonetheless, optimal treatment strategies remain contentious, hampered by the limited number of reported cases and a scarcity of dedicated research on sternal chondrosarcomas.Case presentation: A 82-year-old male, presented with sternal pain. CT scan, revealed loss of sternal continuity and a destructive mixed lesion involving the sternal body with extensive cortical lysis and infiltration of adjacent soft tissues. A biopsy confirmed the diagnosis of grade II chondrosarcoma without evidence of metastasis. The patient underwent surgical resection due to the absence of metastasis.Discussion: sternal chondrosarcoma is a relatively frequent primary malignant bone tumor.Imaging techniques, including X-ray, CT, MRI, and PET scans, play a crucial role in diagnosis. Management of this tumor involves surgical resection with the goal of complete tumor removal. Prognosis depends on factors such as cancer stage, histological grade, tumor size, presence of metastases, and response to treatment. High grade and larger tumors, the presence of metastases are associated with a poorer prognosis.
背景:软骨肉瘤是一种比较常见的原发性恶性骨肿瘤,而胸骨是一个不常见的部位。当这种肿瘤发生在胸骨时,临床医生会遇到复杂的诊断和治疗问题。事实上,由于胸骨位置可能发生局部侵袭、转移和预后不良,因此值得关注。然而,由于报道的病例数量有限,而且对胸骨软骨肉瘤的专门研究很少,因此最佳治疗策略仍存在争议:一名 82 岁的男性,因胸骨疼痛就诊。CT 扫描显示胸骨连续性丧失,胸骨体出现破坏性混合病变,皮质广泛溶解,邻近软组织浸润。活检确诊为二级软骨肉瘤,无转移迹象。讨论:胸骨软骨肉瘤是一种比较常见的原发性恶性骨肿瘤,包括X光、CT、MRI和PET扫描在内的影像学技术在诊断中起着至关重要的作用。该肿瘤的治疗包括手术切除,目的是彻底切除肿瘤。预后取决于癌症分期、组织学分级、肿瘤大小、有无转移以及对治疗的反应等因素。肿瘤分级高、体积大、有转移灶的预后较差。
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引用次数: 0
Healthcare professionals’ job motivation in a federal hospital in Ethiopia: A Cross-sectional study 埃塞俄比亚一家联邦医院医护人员的工作动机:横断面研究
Q3 Medicine Pub Date : 2024-04-15 DOI: 10.4314/emj.v62i2.6
Bezawit Woldaregay Wagaye, T. Leulseged, Mebratu Abera Gurara, Betelhem Tiruneh Gebremedhin, Yared Adane Minas, Yonas H Gebeyehu, Zekarias Tadele Alemneh, Thomas Tadesse Meshesha, Nathnael Tesfa Lisanu, S. W. Beza
Background: Healthcare professional motivation is crucial for delivering high-quality healthcare in any setting. However, low motivation is a significant challenge in developing countries like Ethiopia, where workforce shortages and a weak healthcare system strain to handle an increasing patient flow.This study aimed to assess the motivation levels and associated factors among healthcare professionals working at ALERT Comprehensive Specialized Hospital in Ethiopia.Methods: A cross-sectional study was conducted from May to June 2022 among 293 healthcare professionals. Participants were selected from the pool of permanent hospital employees who were actively working at the time of the study. Data were collected using a pre-tested, structured, self-administered questionnaire. Motivation level was assessed using 23 questions under 7 constructs that are measured on a five-point likert scale and finally reported as a standardized percentage of scale maximum (% SM). To identify factors associated with motivation level, a multiple linear regression analysis was run at 5% level of significance, where regression coefficient (β) with 95% confidence interval (CI) was used to interpret significant results.Results: The participants' job motivation level was 41.6% (95%CI: 39.8-43.6%). Being a doctor was associated with a significantly lower level of motivation than nurses (β=-7.94, 95%CI=-11.80, -4.07, p<0.001). On the other hand, significantly high motivation levels were associated with having a managerial role (β=3.95, 95% CI=0.74,7.15, p=0.016), availability of adequate resources for effective work performance (β=2.77, 95% CI=1.27,4.27, p<0.0001), and low practice of subjective performance appraisal system (β=2.41, 95%CI=1.02,3.79, p=0.001).Conclusion: The healthcare professionals' level of motivation was moderate. Designing interventions to minimize workload, and improve decision making power, resources availability, and performance appraisal system is crucial. Further multi-center study using a mixed-methods design is essential to gain an in-depth understanding and reach a more generalizable finding.
背景:医护人员的积极性对于在任何环境下提供高质量的医疗服务都至关重要。本研究旨在评估在埃塞俄比亚 ALERT 综合专科医院工作的医护人员的积极性水平及相关因素:2022年5月至6月,对293名医护人员进行了横断面研究。研究对象从研究时正在工作的医院正式员工中选取。数据收集采用了预先测试的结构化自填问卷。激励水平是通过 7 个结构下的 23 个问题进行评估的,这些问题采用五点李克特量表进行测量,最后以量表最大值的标准化百分比(% SM)进行报告。为了确定与工作动机水平相关的因素,我们在 5%的显著性水平上进行了多元线性回归分析,回归系数(β)和 95%的置信区间(CI)用于解释显著结果:结果:参与者的工作动机水平为 41.6%(95%CI:39.8-43.6%)。医生的工作积极性明显低于护士(β=-7.94,95%CI=-11.80,-4.07,p<0.001)。另一方面,较高的积极性水平与以下因素相关:担任管理职务(β=3.95,95%CI=0.74,7.15,p=0.016)、拥有充足的资源以实现有效的工作绩效(β=2.77,95%CI=1.27,4.27,p<0.0001)以及较少采用主观绩效考核制度(β=2.41,95%CI=1.02,3.79,p=0.001):结论:医护人员的积极性处于中等水平。设计干预措施以最大限度地减轻工作量、提高决策能力、资源可用性和绩效考核制度至关重要。为了深入了解研究结果并使其更具普遍性,采用混合方法设计进一步开展多中心研究至关重要。
{"title":"Healthcare professionals’ job motivation in a federal hospital in Ethiopia: A Cross-sectional study","authors":"Bezawit Woldaregay Wagaye, T. Leulseged, Mebratu Abera Gurara, Betelhem Tiruneh Gebremedhin, Yared Adane Minas, Yonas H Gebeyehu, Zekarias Tadele Alemneh, Thomas Tadesse Meshesha, Nathnael Tesfa Lisanu, S. W. Beza","doi":"10.4314/emj.v62i2.6","DOIUrl":"https://doi.org/10.4314/emj.v62i2.6","url":null,"abstract":"Background: Healthcare professional motivation is crucial for delivering high-quality healthcare in any setting. However, low motivation is a significant challenge in developing countries like Ethiopia, where workforce shortages and a weak healthcare system strain to handle an increasing patient flow.This study aimed to assess the motivation levels and associated factors among healthcare professionals working at ALERT Comprehensive Specialized Hospital in Ethiopia.Methods: A cross-sectional study was conducted from May to June 2022 among 293 healthcare professionals. Participants were selected from the pool of permanent hospital employees who were actively working at the time of the study. Data were collected using a pre-tested, structured, self-administered questionnaire. Motivation level was assessed using 23 questions under 7 constructs that are measured on a five-point likert scale and finally reported as a standardized percentage of scale maximum (% SM). To identify factors associated with motivation level, a multiple linear regression analysis was run at 5% level of significance, where regression coefficient (β) with 95% confidence interval (CI) was used to interpret significant results.Results: The participants' job motivation level was 41.6% (95%CI: 39.8-43.6%). Being a doctor was associated with a significantly lower level of motivation than nurses (β=-7.94, 95%CI=-11.80, -4.07, p<0.001). On the other hand, significantly high motivation levels were associated with having a managerial role (β=3.95, 95% CI=0.74,7.15, p=0.016), availability of adequate resources for effective work performance (β=2.77, 95% CI=1.27,4.27, p<0.0001), and low practice of subjective performance appraisal system (β=2.41, 95%CI=1.02,3.79, p=0.001).Conclusion: The healthcare professionals' level of motivation was moderate. Designing interventions to minimize workload, and improve decision making power, resources availability, and performance appraisal system is crucial. Further multi-center study using a mixed-methods design is essential to gain an in-depth understanding and reach a more generalizable finding.","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":"326 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140703495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dietary adequacy among pregnant women in Southern Ethiopia. A weighted food record study 埃塞俄比亚南部孕妇的膳食充足性。加权食物记录研究
Q3 Medicine Pub Date : 2024-04-15 DOI: 10.4314/emj.v62i2.5
Temesgen Muche Ewunie, Eden Ashenafi, Abriham Shiferaw, Daniel Sisay, Getachew Assefa, Robel Hussen Kabthymer, S. Desalegn
Background: Nutrient deficiencies are a public health concern among pregnant women in developing countries, including Ethiopia. This study aimed to assess the adequacy of nutrients among pregnant women in Dilla, Southern Ethiopia.Methods: A community-based cross-sectional study design was conducted in Dilla Town, Southern, Ethiopia. Data on socio-demographic and obstetric characteristics were collected using a standardized questionnaire. We employed a day-weighted food record method among 71 pregnant mothers. All the foods consumed by pregnant women were weighed using digital weight scales. Data collectors and supervisors were trained in data collection techniquesand procedures. Calibration of equipment and standardized techniques were used to minimize random anthropometric measurement errors. Data entry was done using SPSS version 25 and NutriSurvey2007 and exported to Intake, Monitoring Assessment and Planning Program (IMAPP) software to estimate the usual nutrient intake and prevalence of nutrient inadequacy.Results: The current study indicated that energy, protein, and micronutrient intakes (iron, folic acid, and calcium) among pregnant women in the study area were low as compared to the World Health Organization (WHO)/Food and Agricultural Organization (FAO) reference nutrient intake. The inadequacy of selected micronutrient intakes such as vitamin-A, vitamin-C, iron, calcium, and zinc for pregnant women by comparing usual nutrient intake with the estimated average requirement (EAR) cutoff point. Calcium, vitamin-C, and vitamin-A deficiency were prevalent in 98.47, 95.52, and 72.28 percent of the population, respectively.Conclusions: The prevalence of risk of nutrient inadequacy (calcium, vitamin-A, and vitamin-C) among pregnant mothers was high. Therefore, multiple micronutrient supplementation and provision of nutrient-dense food-based interventions need to be considered. Furthermore, multisectoral collaboration on the nutrition-sensitive and specificity intervention is also needed
背景:营养素缺乏是包括埃塞俄比亚在内的发展中国家孕妇的一个公共卫生问题。本研究旨在评估埃塞俄比亚南部迪拉镇孕妇的营养素充足程度:方法:在埃塞俄比亚南部的迪拉镇开展了一项基于社区的横断面研究。我们使用标准化问卷收集了有关社会人口学和产科特征的数据。我们对 71 名孕妇采用了按日称重的食物记录方法。我们使用数字体重秤对孕妇食用的所有食物进行了称重。数据收集员和监督员接受了数据收集技术和程序方面的培训。对设备和标准化技术进行了校准,以尽量减少随机人体测量误差。数据输入使用 SPSS 25 版和 NutriSurvey2007,并导出到摄入、监测、评估和规划程序(IMAPP)软件中,以估算通常的营养摄入量和营养不足的发生率:本次研究表明,与世界卫生组织(WHO)/联合国粮农组织(FAO)的参考营养素摄入量相比,研究地区孕妇的能量、蛋白质和微量营养素(铁、叶酸和钙)摄入量偏低。通过将孕妇通常的营养素摄入量与估计平均需要量(EAR)临界点进行比较,得出孕妇维生素 A、维生素 C、铁、钙和锌等特定微量营养素摄入量的不足情况。钙、维生素-C 和维生素-A 的缺乏率分别为 98.47%、95.52% 和 72.28%:结论:孕产妇营养素(钙、维生素-A 和维生素-C)不足的风险发生率很高。因此,需要考虑补充多种微量营养素和提供营养丰富的食物作为干预措施。此外,还需要就营养敏感性和特异性干预措施开展多部门合作。
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引用次数: 0
Identification of common bacterial etiologic agents, antimicrobial susceptibility pattern & associated risk factors of Otitis media among pediatric patients of ENT Center of Orotta National Referral Hospital 奥罗塔国家转诊医院耳鼻喉科中心儿科中耳炎患者常见细菌病原体、抗菌药敏感性模式及相关风险因素的鉴定
Q3 Medicine Pub Date : 2024-04-15 DOI: 10.4314/emj.v62i2.2
Khawaja Shakeel Ahmed, Matiwos Araya, Yordanos Kessete, Armana G/Her, Dawit Kessete, Eden A/ Mariam, Fyori Mhretab, Miriam Mogos, Zebib G/Micael
Background: Otitis media is a pervasive childhood problem posing great healthcare challenges in developing countries. The magnitude of the problem and the lack of appropriate data about the prevalence, common etiologic agents, and the risk factors responsible for otitis media among children in Eritrea have encouraged us to undertake the present study.Methods: A total of 366 ear discharge samples were collected by an Otorhinolaryngologist. All collected samples were screened by using appropriate media and conditions that favor the growth of bacteria. Antibiotic susceptibility testing was done to record the sensitivity and resistance of bacteria by the disc diffusion method. Sociodemographic and clinical data were collected using standard and structured questionnaires and the data was analyzed using SPSS version 20 software.Results: Of 400, 366 (91.5%) samples were with Otitis media and 305 showed the presence of bacteria (83.33%). The most common pathogenic bacteria was Staphylococcus aureus followed by Hemophilus influenza and Pseudomonas aeruginosa. The results showed that the infection is more common in lower-aged children, daycare attendees, and big families. All are statistically significant (P-value 0.003), (P-value 0.036) (p<0.000), respectively. H.influenza, P.aeruginosa, and S.aureus showed good sensitivity towards ciprofloxacin, which was 85.5%, 100%, and 68.1% respectively.Conclusion: Of 400, 366 (91.5%) samples were with Otitis media and 305 showed the presence of bacteria (83.33%). The most common pathogenic bacteria was Staphylococcus aureus followed by Hemophilus influenza and Pseudomonas aeruginosa. The results showed that the infection is more common in lower-aged children, daycare attendees, and big families. All are statistically significant (P-value 0.003), (P-value 0.036) (p<0.000), respectively. H.influenza, P.aeruginosa, and S.aureus showed good sensitivity towards ciprofloxacin, which was 85.5%, 100%, and 68.1% respectively.
背景:中耳炎是一个普遍存在的儿童问题,给发展中国家的医疗保健带来了巨大挑战。由于这一问题的严重性,以及缺乏有关厄立特里亚儿童中耳炎发病率、常见病因和风险因素的适当数据,促使我们开展了本研究:方法:耳鼻喉科医生共收集了 366 份耳道分泌物样本。方法:耳鼻喉科医生共收集了 366 份耳道分泌物样本,并使用适当的培养基和有利于细菌生长的条件对所有收集到的样本进行了筛查。通过抗生素敏感性测试,以碟片扩散法记录细菌的敏感性和耐药性。采用标准的结构化问卷收集社会人口学和临床数据,并使用 SPSS 20 版软件对数据进行分析:在 400 份样本中,366 份(91.5%)患有中耳炎,305 份(83.33%)显示存在细菌。最常见的致病菌是金黄色葡萄球菌,其次是流感嗜血杆菌和绿脓杆菌。结果显示,感染在低龄儿童、日托人员和大家庭中更为常见。它们分别具有统计学意义(P 值为 0.003)、(P 值为 0.036)(P<0.000)。流感嗜血杆菌、铜绿假单胞菌和金黄色葡萄球菌对环丙沙星的敏感性较好,分别为 85.5%、100% 和 68.1%:在 400 份样本中,366 份(91.5%)为中耳炎样本,305 份(83.33%)显示存在细菌。最常见的致病菌是金黄色葡萄球菌,其次是流感嗜血杆菌和绿脓杆菌。结果显示,感染在低龄儿童、日托人员和大家庭中更为常见。它们分别具有统计学意义(P 值为 0.003)、(P 值为 0.036)(P<0.000)。流感嗜血杆菌、铜绿假单胞菌和金黄色葡萄球菌对环丙沙星的敏感性分别为 85.5%、100% 和 68.1%。
{"title":"Identification of common bacterial etiologic agents, antimicrobial susceptibility pattern & associated risk factors of Otitis media among pediatric patients of ENT Center of Orotta National Referral Hospital","authors":"Khawaja Shakeel Ahmed, Matiwos Araya, Yordanos Kessete, Armana G/Her, Dawit Kessete, Eden A/ Mariam, Fyori Mhretab, Miriam Mogos, Zebib G/Micael","doi":"10.4314/emj.v62i2.2","DOIUrl":"https://doi.org/10.4314/emj.v62i2.2","url":null,"abstract":"Background: Otitis media is a pervasive childhood problem posing great healthcare challenges in developing countries. The magnitude of the problem and the lack of appropriate data about the prevalence, common etiologic agents, and the risk factors responsible for otitis media among children in Eritrea have encouraged us to undertake the present study.Methods: A total of 366 ear discharge samples were collected by an Otorhinolaryngologist. All collected samples were screened by using appropriate media and conditions that favor the growth of bacteria. Antibiotic susceptibility testing was done to record the sensitivity and resistance of bacteria by the disc diffusion method. Sociodemographic and clinical data were collected using standard and structured questionnaires and the data was analyzed using SPSS version 20 software.Results: Of 400, 366 (91.5%) samples were with Otitis media and 305 showed the presence of bacteria (83.33%). The most common pathogenic bacteria was Staphylococcus aureus followed by Hemophilus influenza and Pseudomonas aeruginosa. The results showed that the infection is more common in lower-aged children, daycare attendees, and big families. All are statistically significant (P-value 0.003), (P-value 0.036) (p<0.000), respectively. H.influenza, P.aeruginosa, and S.aureus showed good sensitivity towards ciprofloxacin, which was 85.5%, 100%, and 68.1% respectively.Conclusion: Of 400, 366 (91.5%) samples were with Otitis media and 305 showed the presence of bacteria (83.33%). The most common pathogenic bacteria was Staphylococcus aureus followed by Hemophilus influenza and Pseudomonas aeruginosa. The results showed that the infection is more common in lower-aged children, daycare attendees, and big families. All are statistically significant (P-value 0.003), (P-value 0.036) (p<0.000), respectively. H.influenza, P.aeruginosa, and S.aureus showed good sensitivity towards ciprofloxacin, which was 85.5%, 100%, and 68.1% respectively.","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":"54 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140701126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Herpes simplex virus-1 herpetic meningoencephalitis in Adults: Three cases in Casablanca, Morocco 成人单纯疱疹病毒-1疱疹性脑膜脑炎:摩洛哥卡萨布兰卡的三个病例
Q3 Medicine Pub Date : 2024-04-15 DOI: 10.4314/emj.v62i2.8
Kamena Mwana-yile Hassan, Hanane Badi, Houda Lahrichi, Ouiame El Fadel, L. Marih, Moustapha Sodqi, Abdellaoui Soussi, K. M. El Filali
Herpes simplex virus type 1 is the first cause of acute focal encephalitis with necrosis of the cerebral parenchyma in children and adults, with high morbidity. Herpes simplex virus type 2 is the main cause of herpetic meningitis in adults, with a good evolution. Herpetic meningoencephalitis is rarely caused by HSV-1. We report three observations of PCR-confirmed HSV-1 meningoencephalitis in cerebrospinal fluid in young immunocompetent adults aged 27, 53, and 58. They presented with a meningoencephalitis picture consisting of a meningeal syndrome and encephalic involvement. Lumbar puncture confirmed lymphocytic clear-fluid meningitis, with a median white blood cell count of 97, red blood cell count of 69, proteinorachia of 0.78, and glycorachia of 0.62. Cerebral magnetic resonance imaging is the gold-standard neuroimaging technique in the management of herpetic meningoencephalitis. Early initiation of acyclovir has contributed significantly to improved patient outcomes and prognosis. Herpetic meningoencephalitis is a diagnostic and therapeutic emergency, with a very poor functional prognosis, particularly in terms of complications.
单纯疱疹病毒 1 型是导致儿童和成人急性局灶性脑炎并伴有脑实质坏死的首要病因,发病率较高。单纯疱疹病毒 2 型是成人疱疹性脑膜炎的主要病因,病情发展良好。疱疹性脑膜脑炎很少由 HSV-1 引起。我们报告了在年龄分别为 27、53 和 58 岁的免疫功能健全的年轻成人中观察到的三例经 PCR 证实的 HSV-1 脑膜脑炎病例。他们的脑膜脑炎症状包括脑膜综合征和脑部受累。腰椎穿刺证实为淋巴细胞性清脑膜炎,白细胞计数中位数为 97,红细胞计数中位数为 69,蛋白尿为 0.78,糖尿为 0.62。脑磁共振成像是治疗疱疹性脑膜脑炎的金标准神经成像技术。尽早使用阿昔洛韦大大改善了患者的治疗效果和预后。疱疹性脑膜脑炎是一种诊断和治疗上的急症,其功能性预后极差,尤其是在并发症方面。
{"title":"Herpes simplex virus-1 herpetic meningoencephalitis in Adults: Three cases in Casablanca, Morocco","authors":"Kamena Mwana-yile Hassan, Hanane Badi, Houda Lahrichi, Ouiame El Fadel, L. Marih, Moustapha Sodqi, Abdellaoui Soussi, K. M. El Filali","doi":"10.4314/emj.v62i2.8","DOIUrl":"https://doi.org/10.4314/emj.v62i2.8","url":null,"abstract":"Herpes simplex virus type 1 is the first cause of acute focal encephalitis with necrosis of the cerebral parenchyma in children and adults, with high morbidity. Herpes simplex virus type 2 is the main cause of herpetic meningitis in adults, with a good evolution. Herpetic meningoencephalitis is rarely caused by HSV-1. We report three observations of PCR-confirmed HSV-1 meningoencephalitis in cerebrospinal fluid in young immunocompetent adults aged 27, 53, and 58. They presented with a meningoencephalitis picture consisting of a meningeal syndrome and encephalic involvement. Lumbar puncture confirmed lymphocytic clear-fluid meningitis, with a median white blood cell count of 97, red blood cell count of 69, proteinorachia of 0.78, and glycorachia of 0.62. Cerebral magnetic resonance imaging is the gold-standard neuroimaging technique in the management of herpetic meningoencephalitis. Early initiation of acyclovir has contributed significantly to improved patient outcomes and prognosis. Herpetic meningoencephalitis is a diagnostic and therapeutic emergency, with a very poor functional prognosis, particularly in terms of complications.","PeriodicalId":11937,"journal":{"name":"Ethiopian Medical Journal","volume":"36 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140701632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bacteriologic Profile, Antibiotics Resistance Pattern, and Outcomes of Patients Admitted to Lancet General Hospital from June 2022 to June 2023: A Retrospective Cohort Study 2022 年 6 月至 2023 年 6 月期间兰塞特综合医院住院患者的细菌学特征、抗生素耐药性模式和预后:回顾性队列研究
Q3 Medicine Pub Date : 2024-01-19 DOI: 10.4314/emj.v62i1.3
Zekewos Demissie, Serkalem Nurlegn, Nahom Zemedkun, Yidnekachew Demssis, Bethel Mekuriya, Eyob Beyene, Seifemichael Getachew, Desalew Mekonnen, Yohannes Birhanu, Brook Alemayehu, Nebiyat Sileshi, Gelila Sintayehu, D. Admasu, Kibruyisfaw Zewdie
Background: Prior studies indicated increased antimicrobial resistance in Ethiopia, with related health, economic, and environmental  costs. Knowing an institutions and population microbiologic profile allows for proper antibiotic treatment, which substantially impact  patients’ outcomes such as healthcare related costs, morbidity, and mortality. The current study assessed the bacteriologic profile,   resistance pattern, and treatment outcome in Lancet General Hospital. Method: A retrospective cohort study on the bacteriologic profile, antibiotics resistance pattern, and outcome of patients was done on  128 eligible patients who were admitted to Lancet General Hospital from June 2022 to June 2023. Data from all hospitalized patients with  culture-confirmed infection were analyzed. SPSS version 26.0 was used to analyze the data. Association between independent and  dependent variables was analyzed using binary logistic regression model. Results: Gram-negative bacteria were recovered in 77% of the  cases. Extended-spectrum beta-lactamase producing Enterobacteriaceae was found in 37.5% (54) isolates and carbapenem resistant  bacteria were identified in 27.8% of patients. In-hospital mortality from multidrug resistant bacterial infection was 14.8%. Age ≥ 65 years, presence of septic shock, and presence of carbapenem-resistant bacteria were independently associated with increased in-hospital  mortality. Conclusion: High number of resistant microorganisms was isolated, and increased mortality was documented from infections  caused by carbapenem-resistant bacteria. Multi-center studies should be done to determine the extent of resistant organisms in health  facilities throughout the country.epidemiology, and the findings should be factored into clinical decision making and program design for  disease prevention, screening, and treatment. It also calls for further prospective research to learn more about the conditions in the  context of additional relevant personal and clinical characteristics 
背景:先前的研究表明,埃塞俄比亚的抗菌药耐药性有所增加,并带来了相关的健康、经济和环境成本。了解机构和人群的微生物学概况有助于进行适当的抗生素治疗,这对患者的治疗效果(如医疗相关成本、发病率和死亡率)有重大影响。本研究评估了兰塞特综合医院的细菌学概况、耐药性模式和治疗效果。研究方法对 2022 年 6 月至 2023 年 6 月期间兰塞特综合医院收治的 128 名符合条件的患者的细菌学特征、抗生素耐药模式和治疗效果进行了回顾性队列研究。分析了所有经培养确诊感染的住院患者的数据。数据分析采用 SPSS 26.0 版。使用二元逻辑回归模型分析自变量和因变量之间的关系。结果77%的病例回收了革兰氏阴性菌。37.5%(54 例)的分离菌株中发现了产生广谱β-内酰胺酶的肠杆菌科细菌,27.8%的患者对碳青霉烯类耐药。耐多药细菌感染的院内死亡率为 14.8%。年龄≥65岁、出现脓毒性休克和耐碳青霉烯类细菌与院内死亡率升高密切相关。结论大量耐药微生物被分离出来,耐碳青霉烯类细菌引起的感染导致死亡率升高。应开展多中心研究,以确定全国各地医疗机构中耐药微生物的程度和流行病学,并将研究结果纳入临床决策和疾病预防、筛查和治疗的方案设计中。该报告还呼吁进一步开展前瞻性研究,以便结合更多相关的个人和临床特征了解更多情况。
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引用次数: 0
Complete Blood Count, C-reactive Protein, and Erythrocyte Sedimentation Rate Changes in People with Brucellosis 布鲁氏菌病患者全血细胞计数、C 反应蛋白和红细胞沉降率的变化
Q3 Medicine Pub Date : 2024-01-19 DOI: 10.4314/emj.v62i1.7
Alireza Mohammadzadeh, Mozhgan Khanderoo, A. Abbasnezhad, Mohammad Ghorbani, Sina Nasrollahian, Reyhaneh Noorizadeh, Jalal Mardaneh
Background: Brucellosis is a major health and economic problem in many parts of the world, including the Middle East. Blood disorders such as anemia, leukopenia, and thrombocytopenia can be seen in brucellosis. However, laboratory findings of this disease are different.  Therefore, this study aimed to investigate the changes in complete blood count (CBC), C-reactive protein (CRP), and erythrocyte  sedimentation rate (ESR) in people with brucellosis in Gonabad community health centers. Methods: During the 4 years from May 2016 to May 2019, a prospective study was performed on 221 patients with brucellosis. According  to the national guidelines for brucellosis, titers greater than 1/80 for Wright and more than 1/40 for 2-ME were considered positive cases  of brucellosis. Using the checklist, information related to CBC, CRP, and ESR test parameters was collected. Results: The results showed that out of 221 patients studied, 58.4% were male and 41.6% were female. The mean age was 44.9±19.8 years  for men and 49.3±17.3 years for females. High ESR was seen in 43.4% and positive CRP in 59.7% of patients. Leukopenia in 8.6%,  leukocytosis in 9%, neutropenia in 6.8%, neutrophilia in 9.5%, lymphopenia in 3.6%, lymphocytosis in 10%, anemia in 17.2% and  thrombocytopenia in 9.5% of patients were seen. Conclusion: Brucellosis in endemic areas should be considered in the differential diagnosis of patients presenting with  thrombocytopenia. Also in high Wright titers, CRP is a more valuable indicator than ESR. 
背景:布鲁氏菌病是包括中东在内的世界许多地区的主要健康和经济问题。布鲁氏菌病可导致贫血、白细胞减少和血小板减少等血液疾病。然而,这种疾病的实验室检查结果却各不相同。 因此,本研究旨在调查戈纳巴德社区医疗中心布鲁氏菌病患者的全血细胞计数(CBC)、C反应蛋白(CRP)和红细胞沉降率(ESR)的变化。研究方法在2016年5月至2019年5月的4年间,对221名布鲁氏菌病患者进行了前瞻性研究。根据布鲁氏菌病国家指南,莱特滴度大于1/80、2-ME滴度大于1/40即为布鲁氏菌病阳性病例。使用核对表收集了与全血细胞计数、CRP 和血沉测试参数相关的信息。结果显示结果显示,在研究的 221 名患者中,58.4% 为男性,41.6% 为女性。男性平均年龄(44.9±19.8)岁,女性平均年龄(49.3±17.3)岁。43.4%的患者血沉增快,59.7%的患者 CRP 呈阳性。8.6%的患者白细胞减少,9%的患者白细胞增多,6.8%的患者中性粒细胞减少,9.5%的患者中性粒细胞增多,3.6%的患者淋巴细胞减少,10%的患者淋巴细胞增多,17.2%的患者贫血,9.5%的患者血小板减少。结论出现血小板减少的患者在鉴别诊断时应考虑流行区的布鲁氏菌病。此外,在莱特滴度较高的情况下,CRP是比血沉更有价值的指标。
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引用次数: 0
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Ethiopian Medical Journal
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