Ethiopian Journal of Health Sciences最新文献

Background: Uncontrolled hypertension is a leading modifiable risk factor for cardiovascular disease morbidity and mortality. Despite the availability of several effective blood pressure lowering drugs, hypertension control rates remain poor globally. This study aimed to define the level of blood pressure control and to determine the factors associated with poor hypertension control.

Methods: A hospital-based cross-sectional study was conducted from January to March 2019 at Tikur Anbessa Specialized Hospital among randomly selected 369 patients with hypertension. Data were collected using a pre-tested structured questionnaire. Multivariate binary logistic regression was used to identify determinants of blood pressure control.

Results: The mean (SD) age of the study participants was 55.5 (13.2) years; 188 (50.9%) were males and 28 (7.6%) were active smokers. More than half of the patients (56.0%) were overweight or obese. The most commonly identified comorbidities were diabetes mellitus (48.0%), dyslipidemia (50.9%), and chronic kidney disease (56.1%). The mean (SD) systolic blood pressure was 140.6 (22) mmHg, and diastolic blood pressure was 85.8 (14) mmHg. About two-thirds of the patients (60.2%) had uncontrolled blood pressure. The factors associated with poor blood pressure control with an AOR (95% CI) were increasing age: 1.05 (1.00-1.11), increasing household income: 1.25 (1.04-1.49), being physically inactive: 7.64 (1.14-51.13), chronic kidney disease: 5.36 (1.14-5.16), and use of home blood pressure monitoring: 0.31 (0.102-0.94).

Conclusion: The rate of blood pressure control in patients with hypertension was suboptimal. Age, household income, level of physical activity, chronic kidney disease, and use of home blood pressure monitoring were independent predictors of blood pressure control. It is important to optimize the treatment of hypertension in this high-risk group by implementing effective strategies.

Background: This review aims to determine the potential role of Merkel Cell Polyomavirus (MCPyV) in the pathogenesis of cervical squamous cell carcinomas and adenocarcinomas.

Methods: A PRISMA systematic search appraisal was conducted. The Scopus, Web of Science, PubMed, EMBASE, Google Scholar, and MEDLINE databases for publications in English were searched up to September 2022 for all relevant articles. All articles that have outlined the contributions of the MCPyV to cervical squamous cell carcinomas and adenocarcinomas were included.

Results: The six databases produced 6806 articles. Only six articles met the inclusion criteria and were included. The protocol of this review was submitted and registered with the PROSPERO (Code no. CRD42022369197). The total sample size across the articles was 1135; the age of the participants ranged between 18 and 75 years. In addition, the included articles were conducted between 2012 to 2016. All included articles have a cross-sectional design.Furthermore, different kinds of samples were collected in the reviewed articles, namely cervical tissue biopsies, cervical smears, formalin-fixed paraffin-embedded resection specimens, and cervical adenocarcinomas. Moreover, five articles showed no statistically significant association between the MCPyV and cervical squamous cell carcinomas and adenocarcinomas. In contrast, one article revealed a positive association between MCPyV and cervical squamous cell carcinomas and adenocarcinomas.

Conclusions: MCPyV could not be associated with the pathogenesis of cervical squamous cell carcinomas and adenocarcinomas. Further attention should be given to examining this association, and further studies with a large sample size are recommended to confirm these findings.

Background: There are studies on the determination of hepatic fibrosis with noninvasive markers but data about liver biopsy results and noninvasive markers in patients with chronic hepatitis B (CHB) are limited. The aim of this study is to determine the relationship between pathological findings and noninvasive markers, and to determine the marker that predicts fibrosis in patients with consistently normal serum alanine aminotransferase (ALT) levels, diagnosed with CHB and undergoing liver biopsy.

Methods: A total of 122 patients with CHB, 29 of them with HbeAg (+), aged 30 years and older, HBV DNA > 2000 IU / ml, and serum ALT levels measured four times in the last year, were consistently normal, and 93 of them with HbeAg (-) were included in the study. Demographic characteristics of patients, laboratory parameters, histological activity index (HAI) and fibrosis values obtained in liver biopsy, and noninvasive markers (AP (age-platelet) index, APRI (AST/Platelet ratio) and FIB-4 score, neutrophil/lymphocyte ratio, mean platelet volume (MPV) and erythrocyte distribution width (RDW) were recorded.

Results: The relationship between RDW value and fibrosis was statistically significant in the HbeAg (+) group (p<0.001). The relationship between AP index, APRI and FIB-4 score, neutrophil/lymphocyte ratio and MPV with fibrosis was not statistically significant (>0.05 for each).

Conclusion: It has been shown that the RDW value can be used to predict fibrosis in CHB patients with normal ALT and HbeAg (+), and the cut-off value for RDW is 12.

Background: Glaucoma is a serious eye disease that impairs eyesight and negatively impacts quality of life. If left untreated, glaucoma can lead to blindness. This study aims at assessing the quality of life among glaucoma patients in the West Bank (WB) of Palestine and main influencing the factors.

Methods: This is a cross-sectional study and included two questionnaires; the Short-Form 36 Health Survey (SF-36) and Glaucoma Quality of Life-15 (GQL-15). Data were collected from a systematically randomized 100 glaucoma patients in the WB. ANOVA test was used to compare means of continuous variables at a statistically significant P value ≤ to 0.05.

Results: The overall quality of life among glaucoma patients was relatively suboptimal. The analysis revealed that the glaucoma quality of life is worse among older patients (mean=3.55±0.64), patients who are less educated (mean=3.91±0.77), among patients who were unemployed (mean=3.44±0.86), and patients who were treated in private clinics (3.57±0.8). Patients with good health (mean=2.48±0.94), type of glaucoma (close glaucoma; mean=3.22±0.9), less than 5 years duration of glaucoma (mean=2.88±1.13), and less than 5 years duration of cryonic diseases (mean=2.48±0.73 have a better glaucoma quality of life.

Conclusions: This study revealed numerous factors that can impact the quality of life of glaucoma patients in WB. Health professionals, specialists, ophthalmologists, and health educators should be aware of how various socioeconomic and general health factors impact the quality of life of glaucoma patients in order to better diagnose, manage, guide, and educate patients for better health outcomes.

Background: Arsenic trioxide is an activist agent in the treatment of acute promyelocytic leukemia (APL), which acts alone, but has an adverse effect on patients. Moreover, deferoxamine has antiproliferative activity and induces leukopenia. In order to enhance antileukemic effectiveness and to reduce the dosage of arsenic trioxide, the combination effect of it with deferoxamine (DFO) was evaluated on the APL cell line (NB4).

Methods: In this experimental study, to investigate the cytotoxic effects of ATO/DFO in acute promyelocytic leukemia, the NB4 cell line (provided by Pasteur Institute of Iran) was treated with different doses and then at 24, 48, and 72 hrs intervals, the percentage of survival, cell count, metabolic activity and apoptosis induction were investigated respectively. Also, hTERT gene expression was analyzed by the RT-PCR method.

Results: We found that DFO alone and in combination with ATO has cytotoxic and antiproliferative effects, and reduces viability and cell metabolic activity in the NB4 cell line in a dose and time-dependent manner. In addition, this combination causes an increase in apoptosis, up-regulation of Caspase-3, and down-regulation of hTERT genes in cells.

Conclusion: Combined ATO/ DFO treatment cooperatively decreased the mRNA levels of the hTERT and increased the mRNA levels of Caspase-3 in a time-dependent manner compared to DFO alone.

Background: Using anthropometric parameters to determine the appropriate Plastibell size before circumcision ensures that cumbersome carrying of all the sizes before each procedure is eliminated and also complications reduced.

Methods: Male neonates who presented for routine circumcision by Plastibell method were recruited. Collected on a proforma were their age in days, weight in Kg, stretched penile length (SPL) in cm, penile diameter (PD) in cm and the Plastibell size used by the "circumciser". The routine circumcision was carried out for each neonate according to protocol. P value was set at <0.05.

Results: There were 231 neonates who had Plastibell circumcision. Their mean age, weight, SPL and PD were 15.6(±5.73) days, 3.7(±0.58) Kg, 3.66 (±0.58) cm and 3.79 (±0.64) cm, respectively. Plastibell size 1.3 is the most used (53.6%). There was a positive correlation between weight, SPL, PD, on one hand and Plastibell size , on the other hand with P-values of <0.001, <0.001 and <0.001 respectively. The weight was a weak determinant for Plastibell sizes 1.1 and 1.3: (OR 7.104; 95% CI 1.108 - 45.559; P = .039) and (OR 2.044; 95% CI 1.054 - 3.963; P = .034) respectively. The SPL is also a weak predictor for Plastibell sizes 1.2 and 1.5: (OR 2.176; 95% CI 1.136 -4.136; P = .019) and (OR .043; 95% CI .072 - .984; P = .047), respectively.

Conclusion: The anthropometric parameters correlate well with Plastibell sizes. However, they are not effective in predicting the appropriate sized Plastibell for neonatal circumcision.

Background: Type 2 diabetes is the most common type of diabetes, and dietary adherence is a self-care practice. This research aims to improve dietary adherence among type 2 diabetics in Zahedan using the HAPA model.

Methods: In this cross-sectional study, a total of 210 type 2 diabetics admitted to hospital clinics in Zahedan during summer 2022 were selected. The intervention group (n = 105) and the control group (n = 105) were from hospitals in Zahedan. Samples were selected by the simple random sampling method among the diabetics. After data collection using the demographic characteristics questionnaire and the Dietary Adherence Questionnaire and the HAPA model constructs questionnaire, the pre-test analysis was performed. One and three months after the educational intervention, the questionnaires on HAPA model constructs and self-care behavior were filled out by the patients. Next, data were analyzed using independent t-test, chi-square test, and the Shapiro-Wilk test in SPSS 23.

Results: The results showed that all of the HAPA model constructs had significant differences, one and three months after the educational intervention (P = 0.001), indicating the effectiveness of education in the intervention group. However, there was no significant difference in the control group (P = 0.009).

Conclusion: After the intervention using the HAPA model, the model's constructs had a significant impact on the patients' self-care of dietary adherence following the training.

Background: The effect of percussion massage on hamstring flexibility is unknown. This study aimed to investigate the acute effects of percussion massage on hamstring flexibility and to compare its effectiveness with static stretching.

Methods: Fifty-four healthy individuals aged 18-25 years with at least 15 degrees of active knee extension were included in the study. The study was conducted between February and May 2022. The participants were randomly divided into 3 groups in this cross-randomization study as percussion massage (n=18), static stretching (n=18), and control (n=18). The Active Knee Extension test and the Sit and Reach test were used as evaluation parameters, and assessments were performed pre-intervention and 30 min post-intervention (acute).

Results: In both percussion and stretching intervention groups, the range of motion (ROM) gain in the Active Knee Extension test was statistically significant (p<0.05) compared to the control group. Active knee extension angle gain was similar between percussion and stretching interventions (p>0.05). It was found that hamstring flexibility improved significantly in both percussion massage and static stretching groups (p<0.05). However, considering the last measurement and flexibility gain values, it was found that percussion massage and static stretching had similar acute effects on hamstring muscle flexibility (p>0.05).

Conclusion: Percussion massage had an acute positive effect on hamstring flexibility and ROM, and it was as effective as static stretching. Therefore, percussion massage devices are recommended as part of pre-exercise in a structured warm-up for increase in joint range of motion and flexibility.

Background: Hypertensive disorders in pregnancy (HDP) are a leading cause of maternal and fetal death, especially in a resource-constrained setting. There is no study from Liberia on the disorder. This pilot study aimed to determine the burden, sub-types, and maternal-fetal outcomes of hypertensive disorders in pregnancy at the John F. Kennedy Maternity Center (JFKMC), Liberia.

Methods: From January 1 to December 31, 2020, the medical records of 130 pregnant and post-partum patients admitted with Hypertensive disorders in pregnancy (HDP) in a census method of sampling were retrieved, while 83.1% (108) were suitable for analysis in an institutional cross-sectional retrospective study in the department of obstetrics and gynecology at the John F. Kennedy Maternity Center, Liberia. The extracted information was analyzed using SPSS version 26. Results were presented in frequencies and percentages. The statistical association between categorical variables was subjected to the Chi-square test. The level of significance was set at a P-value of < 0.05.

Results: There was an institutional prevalence of 3.0% of HDP. The maternal fatality rate was 12.3%, while the perinatal fatality rate was 14.3%. There was a significant association between HELLP syndrome and Severe pre-eclampsia with maternal death, P< 0.001. Prematurity, first minutes Apgar score <5, NICU admission, and low birth weight were associated with perinatal deaths (P <0.001).

Conclusion: HDP was an important contributor to maternal and perinatal deaths at the JFKMC, Liberia. Continuous support by the government and development partners for the provision of critical life-saving medical equipment at the JFKMC is recommended.

Background: Sexual satisfaction is directly related to marital sustainability and quality of life. This study assessed the magnitude of sexual satisfaction and associated factors among married women.

Methods: A community-based cross-sectional study was conducted from May 18 to June 8/2021 using mixed data collection methods. The sample was calculated using single population proportion formula for the quantitative part while data saturation was applied for the qualitative part. Simple random and purposive sampling techniques were used to get participants for the quantitative and the qualitative parts respectively. The quantitative data were analyzed using Statistical Package for Social Science (SPSS) version 25, and the qualitative data were analyzed manually. Ordinal logistic regression was applied to explore the model. P-value <0.05 and AOR with a 95%CI were used to identify the statistical significance of the association.

Result: About 398 married women participated in the study, making a response rate of 94.3% and 44.7% of them were moderately satisfied with their sexual life. Sexual satisfaction among the married women was significantly associated negatively with attending elementary education 99.9% [AOR=0.1, 95%CI:0.0,0.4)], positively with having social responsibility 19[AOR=19.3, 95%CI: 1.8, 28.3], and negatively with having poor sexual attitude 97%[AOR=0.1, 95%CI: 0.0, 0.3]. The qualitative finding showed that the majority of women engage in sexual intercourse for the satisfaction of their partners, without their needs.

Conclusion: Sexual satisfaction among married women was low in the study area. Comprehensive sexual and reproductive health awareness and strengthening of the prevention of harmful traditional practices are recommended.