Ethiopian Journal of Health Sciences最新文献

Background: The main role of nurses is not only to inform about the disease and treatment of the patient but also to establish an effective therapeutic relationship to address concerns and provide empathy, comfort, and support. This issue is very prominent in neonatal intensive care units (NICUs) and doubles the importance of empathetic communication between nurses and parents and promoting empathy skills in nurses working in neonatal intensive care units.

Aim: This study aimed to evaluate the effect of a support program on the empathy of neonatal intensive care nurses across the Iran.

Methods: This study was conducted in 2021 as a semi-experimental intervention in a group of 166 nurses working in the neonatal department all over Iran who met the inclusion criteria. Jefferson's empathy questionnaire was completed electronically by the participants before and after the online education program start. Data were analyzed using SPSS software (V 24.0).

Results: The empathy score of nurses was 60.31 ± 5.76 before and 66.47 ±6.60 after the intervention. The empathy scores of nurses after the intervention increased statistically significantly.

Conclusion: Nurses can communicate empathically with parents by training their verbal and nonverbal communication skills and gaining a common understanding of the feelings of parents of premature infants.

Background: Scoliosis is an abnormal side-to-side spinal curve of greater than or equal to 10⁰ Cobb angle. It is the most common spinal deformity in children and adolescents. Epidemiological evidence about scoliosis is scarce in Africa, including Ethiopia. This study was aimed at determining the prevalence of scoliosis among adolescents and analysing its association with age and sex using plain chest radiographs obtained for non-spinal reasons in Tikur Anbessa Specialized Hospital.

Method: All non-tilted, non-rotated, and non-poorly penetrated digital plain chest radiographs of adolescents aged 10 to 19 years obtained at Tikur Anbessa Specialized Hospital between January 1 and December 31, 2019, were measured for the coronal Cobb angle. The data were cleaned, coded, and entered into SPSS version 26 for analysis. Chi-square, and linear regression, and logistic regression analyses were also carried out to evaluate the effect of sex and age on scoliosis.

Results: The Cobb angles of 1,369 posteroanterior chest radiographs of adolescents were measured. Thirty (2.2%, 95% CI: 1.4%, 3.0%) of these were found to have scoliosis. The mean coronal Cobb angle was 2.27⁰±6.32⁰. There was no statistically significant difference between the prevalence of scoliosis in boys (2.21%) and girls (2.17%) (X²=0.003, P=0.954). Likewise, age did not show any statistically significant difference in the prevalence of scoliosis (X²=2.655, P=0.265).

Conclusion: This study revealed that incidental finding of adolescent scoliosis in plain chest radiographs is common. Further study using whole spine radiography should be carried out to determine the true general population prevalence of scoliosis in Ethiopia.

Background: Diffusion-weighted imaging (DWI) is the random Brownian motion of water molecules within a tissue voxel. The apparent diffusion coefficient (ADC) is a quantitative parameter calculated from the DWI that directly reflects the mobility of water molecules in biological tissues. The objective of this study was to establish and compare the normal reference ADC values of fetal organs and the placenta using 1.5 T and 3.0 T MRI at various gestational ages.

Methods: This was a retrospective and prospective observational study. This study included one hundred and three (103) singleton pregnancies for each magnetic field strength. Diffusion-weighted imaging was performed using single-shot spin-echo-planar imaging (EPI) in the axial plane of the fetal head-trunk with a slice thickness of 4mm and diffusion gradient values of b = 0 and b = 700-800 s/mm².

Results: The mean ADC values of cerebral WM areas were significantly higher than the deep grey areas in the brain. The white-matter regions, lung, and placenta showed a positive and significant correlation with increasing gestational age in both field strengths. A statistically weak negative correlation was observed between increasing gestational age and ADC measurements obtained in the thalamus, cerebellum, pons, and kidney.

Conclusion: This study gives the reference values for both 1.5T and 3T MRI of vital organs. The current study shows that diffusion-weighted MRI can offer a promising technique to evaluate the structural development of fetal organs and can potentially act as a biomarker for predicting the functionality of the fetal organs in abnormalities.

Background: Informed consent is a communication process of providing the patient/parents/guardians with relevant information regarding the diagnosis and the treatment so that they can make informed decisions. This study was to assess the practice of surgical informed consent in Addis Ababa.

Methods: An institution-based cross-sectional study was undertaken in Addis Ababa in 2021. A total of 312 women who underwent cesarean section were interviewed immediately after their hospital discharge. Thirteen components of SIC were used based on international recommendations, including the Royal College of Surgeons' standards of informed consent practices for surgical procedures.

Results: Almost all (100 %) of the respondents were asked to provide written consent, and 96.2 % of them signed the consent form. Most women (89.4%) received information about the indication(s). Few (18.6%) respondents were informed about the type of anesthesia to be administered while only 9 %( n= 28) of them were given an opportunity to choose the option of anesthesia. Only 44.9% of the respondents have received at least six of the 13 components of SIC suggested by the investigators. In this, the most secured data was the signature of the patient which is 96 %. The least documented element of SIC was alternative treatment.

Conclusion: A majority of women who underwent both elective and emergency cesarean section did not receive comprehensive information during the Surgical Informed Consent process in the study hospitals. There is a need that patients need to be counseled during antenatal visits, specifically when patients visit near term for antenatal checkups.

Background: Enuresis, defined as involuntary nocturnal urination without any underlying organic disorder in a child expected to control urination, poses a common problem. This study evaluated the effectiveness of Tolterodine and Oxybutynin in children presenting with primary desmopressin-resistant enuresis.

Materials and methods: A randomized clinical trial was undertaken involving 68 participants aged between 5 and 16 years, all suffering from primary enuresis. These patients were randomly assigned to one of two treatment groups for a three-month period: Group 1, treated with Oxybutynin and Desmopressin, and Group 2, treated with Tolterodine and Desmopressin. Data on demographics, clinical and laboratory findings, and subjective responses to treatment were gathered. The response was measured based on the frequency of wetting incidents per night and week and compared with pre-treatment data.

Results: Patients were divided into two groups (30 patients in Group 1 and 38 patients in Group 2). The mean age of the patients was 88.97±27.09 months. In the first treatment group, 6 out of 30 patients (20%) experienced a complete treatment response, as did 5 out of 38 patients (13.2%) in the second treatment group. This difference between the groups was not statistically significant. Seven patients (23%) in the Oxybutynin group and 13 patients (34%) in the Tolterodine group reported a lack of response to treatment, a difference that also lacked statistical significance.

Conclusion: For patients resistant to Desmopressin, the addition of anticholinergic drugs elicited a significant response in over half of the patients. However, no benefit was observed in using either Oxybutynin or Tolterodine in the treatment of Desmopressin-resistant enuresis.

Background: Neural tube defects (NTDs) occur as a result of incomplete closure of the neural tube by the embryonic age of 26 to 28 days. Addressing factors associated with NTDs would help to identify and prioritize high-risk women, which in turn guides the preventive strategy. The study aimed to identify factors associated with NTDs among women who gave birth or had a second-trimester abortion at Adama Hospital Medical College, from January 1st to December 31st, 2019.

Methods: Hospital based unmatched case-control study was conducted on 344 women. Data were analyzed with SPSS 20. Descriptive statistics were computed. Binary logistic regression analysis was performed to determine factors associations with NTDs.

Results: The odds of having a fetus with NTDs were 2.19 times higher among women who are not in a marital relationship (AOR = 2.19; 95% CI: 1.13, 4.25). Women with a previous history of Abortion or stillbirth had 3 fold increased risk of having a fetus with NTDs (AOR = 3.05; 95% CI: 1.58, 5.88). Inadequate housing condition nearly doubles the odds of having a fetus with NTDs (AOR = 1.91; 95% CI: 1.20, 3.04). Folic acid or multivitamin supplementation early in pregnancy reduced the odds of having a fetus with NTDs by 43% (AOR = 0.57; 95% CI: 0.35, 0.91).

Conclusion: Being not in a marital relationship, previous history of abortion or stillbirth, and living in inadequate housing conditions were risk factors for NTDs, while multivitamins or folic acid supplementation was a protective factor.

Background: Acute appendicitis is a common cause of hospital admission and emergency laparotomy among children and young adults. Although the diagnosis is clinical, the use of radiological imaging has emerged over the past decades. Its principal use is as a problem-solving tool in equivocal cases. Owing to the increased use of imaging in the last few years, the negative appendicectomy rate has dropped significantly. In this prospective observational study, we compared the diagnostic accuracy of Ultrasonography and Non-Contrast Computed Tomography.

Method: One hundred and eighteen patients with clinically suspected appendicitis followed a designed protocol. Patients underwent appendicectomy after a first performed positive ultrasonography or after a positive Non-Contrast Computed Tomography when Ultrasonography was equivocal or nonspecific. When any other diagnosis was apparent in either imaging modality which could explain the symptomatology in the patient, they were considered negative for acute appendicitis and treated accordingly.

Results: The respective sensitivity, specificity, and accuracy for Ultrasonography, Non-Contrast Computed Tomography, and the whole diagnostic pathway for the diagnosis of acute appendicitis were 70.73%,80.83%, and 78.54; 100%,100%,100%, and 83.6%; and 100%,83.33% and 94.92%.

Conclusion: Using Ultrasonography as the first-line diagnostic tool and Non-Contrast Computed Tomography as a complementary second-line diagnostic tool, appendicitis can be diagnosed with high accuracy and the negative laparotomy rate can be brought down significantly without any increase in the risk of complications. Computed Tomography is superior to Ultrasonography for the diagnosis of acute appendicitis.

Background: This study is aimed to introduce a new technique used in controlling the postpartum bleeding during normal vaginal delivery.

Methods: This study was conducted on 150 pregnant women aged 18 years or more who were eligible for normal vaginal delivery. After placental delivery, Mostafa Maged maneuver was applied. The amount of blood loss was estimated by counting the number of pads immediately before applying the maneuver compared to the number of pads immediately after applying the maneuver to determine the effectiveness of the Mostafa Maged maneuver.

Results: The study revealed that 15.3% of the study group had atony, and 23.3% were complicated with postpartum hemorrhage. In terms of blood loss, the average number of pads used before Mostafa Maged compression was (2.8) pads, with a range of 1 to 6 pads. The mean blood loss volume was (353.3±158.5) ml ranging between 125 and 750 ml. we should consider that Mostafa Maged maneuver is immediately applied after placental delivery. That is why small amount of 125 ml of blood loss in few patients is estimated, which decreased to (0.54±0.14) pads ranging between 0.5 and 1 pad with a mean (65.2±17.7) ml blood loss ranging between 60 and 125 ml after applying Mostafa Maged maneuver during normal vaginal delivery. There was a statistical decrease in the number of pads and volume of blood loss after Mostafa Maged maneuver.

Conclusion: Mostafa Maged maneuver was found to be effective in stopping and preventing postpartum bleeding during vaginal delivery as this maneuver is used as a prophylaxis against post-partum hemorrhage in patients with risk factors of postpartum hemorrhage. It is also used to control post-partum hemorrhage during vaginal delivery. It has been proven to be tolerable, easy to learn and easy to perform.

Background: Patients with chronic obstructive pulmonary disease (COPD) experience an increased risk of perioperative pulmonary complications. The aim of this study was to evaluate the effect of albuterol spray on hypoxia and bronchospasm in patients with COPD under general anesthesia.

Methods: This single-center, double-blind, parallel-group, randomized clinical trial was performed on 120 smoking patients with COPD who were referred to 5 Azar Educational Hospital in Gorgan, Northern Iran, in 2021. Twenty minutes before general anesthesia and also after completion of surgery and before extubation, 60 patients in the intervention group were inhaled with 2 puffs of albuterol spray. In the control group, patients were inhaled with 2 puffs of placebo spray. In perioperative period, the occurrence of wheezing, bronchospasm, coughing, hemodynamic changes, postoperative shivering, dyspnea, and nausea and vomiting were evaluated in all patients. The Consolidated Standards of Reporting Trials (CONSORT) checklist was used to report important aspects of this study.

Results: The mean age of the patients was 52.34 ±8.95 years, and 115 (95.8%) of them were males while the rest were females. The difference between systolic blood pressure before induction of anesthesia (after administration of albuterol spray) between the group receiving albuterol spray and the group not receiving it was statistically significant (p=0.04). Also, the difference between the mean arterial oxygen saturation before tracheal extubation (after re-administration of albuterol spray) between the albuterol spray group and the non-albuterol group was statistically significant (p = 0.03). Wheezing and recurrent cough after induction of anesthesia and after extubation (after albuterol spray administration) was lower in the albuterol group than in the control group (p<0.05). No significant side effects were detected in the albuterol-treated group.

Conclusion: According to the results of this study, it seems that the prophylactic use of albuterol spray is useful in reducing the incidence of wheezing and recurrent cough before induction of anesthesia in COPD patients with smoking.

Background: Strengthening disaster resilience is important to protect existing development and in anticipation of various disasters and risks due to disasters such as the COVID-19 pandemic. This study aims to determine resilience among individuals in dealing with the COVID-19 pandemic in Indonesia based on the capital domains.

Methods: This study used a cross-sectional design with 97 Indonesian people and was conducted using an online survey in May-December 2020. Data were analysed using multivariable logistic regression.

Result: The results showed that 45.36% of the respondents had low resilience. Respondents whose expenses increased had 6.36 times higher odds of good resilience compared to respondents whose expenses decreased (AOR=6.36,95%CI=1.26-32,p=0.025). Respondents whose expenses were not affected had 12.32 times higher odds of having good resilience than respondents whose expenses were reduced (AOR=12.32,95%CI=1.82-83.40, p=0.01). Respondents with larger families had 32% lower odds of having good resilience than those with fewer family members (AOR=0.68, 95%CI=0.47-0.98, p=0.038). Respondents with no quarantine facilities had 65% lower odds of good resilience than those with quarantine facilities (AOR=0.35, 95%CI 0.13-0.95, p=0.04).

Conclusion: Economic and physical capital as the part of capital domains showed a significant association with resilience during COVID-19 pandemics. Economic capital variables that had association with resilience were money expenses and the number of family members in household. Physical capital had a relationship with resilience were the availability of quarantine facilities. Government could encourage cooperation within the community to share economic resources. Local government could provide isolation facilities in local area.