Clinical Epidemiology and Global Health最新文献

{"title":"Ophthalmic surgeries at a Nigerian teaching hospital from the perspectives of undergraduate medical education","authors":"Abdulraheem Olarongbe Mahmoud ,&nbsp;Abdulkabir Ayansiji Ayanniyi ,&nbsp;Yinka Ologunsua ,&nbsp;Susannah Adepoju","doi":"10.1016/j.cegh.2024.101808","DOIUrl":"10.1016/j.cegh.2024.101808","url":null,"abstract":"<div><h3>Background</h3><div>An appraisal of the profile of ophthalmic surgeries performed at Ladoke Akintola University of Technology Teaching Hospital (LAUTECHTH), Ogbomosho, Nigeria over a seven-year period with a view to harnessing their potentials for maximising ophthalmic experiences of medical students.</div></div><div><h3>Methods</h3><div>A retrospective review of ophthalmic surgery records over a seven-year period (2013–2019) at LAUTECHTH.</div></div><div><h3>Results</h3><div>There were 386 eye surgeries, mean ophthalmic surgeries: 4–5/month or 55/year. Most (329, 85.2 %) surgeries were performed on individuals aged at least 45 (range 10–95) years with slight male dominance (1.1:1). The most common indication for surgery was cataract (307, 79.6 %). Most surgeries were elective (362, 93.8 %) and performed under local anaesthesia (367, 95.1 %). Despite the highest number of surgeries being performed in the months of April and September; and lowest during the months of May and October; there was fair distribution across and over the years. Small incision cataract surgery with or without intraocular lens implant (307, 79.6 %) was the most common surgery followed by pterygium excision with adjuvant therapy (37, 9.6 %).</div></div><div><h3>Conclusion</h3><div>The study showed a broad spectrum of eye surgeries, including cataract and pterygium, performed at the teaching hospital, encompassing common conditions that lead to visual impairment or blindness. This exposure provides valuable training opportunities for undergraduate medical students to become physicians especially those aspiring to become ophthalmologists. However, there is a need to increase the overall volume of eye surgeries to enhance the learning experience and potentially influence career choices.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"30 ","pages":"Article 101808"},"PeriodicalIF":2.3,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142422447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of poststroke fatigue and its relationship with clinical characteristics among community-dwelling stroke survivors: A cross-sectional survey","authors":"Akhila Jagadish ,&nbsp;Manikandan Natarajan ,&nbsp;Vasudeva Guddattu ,&nbsp;John M. Solomon","doi":"10.1016/j.cegh.2024.101812","DOIUrl":"10.1016/j.cegh.2024.101812","url":null,"abstract":"<div><h3>Background and objective</h3><div>Poststroke fatigue is widely overlooked due to a lack of awareness, definite cause, and cure. It is influenced by cultural variance in psychosocial factors and stroke epidemiology patterns across different countries. To date, the prevalence of poststroke fatigue has not been determined in the Indian setting. Hence our objective was to estimate the prevalence of fatigue among community-living late subacute and chronic stroke survivors. Additionally, we determined the association between poststroke fatigue and participants’ clinical and demographic data.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among first-time stroke survivors following discharge from two tertiary care hospitals. Medical records were screened and included if they met the criteria for age &gt;18 years, able to follow a two-step command with no existing neurological or systemic conditions that would influence fatigue scores. Telephonic consent was obtained, and an interview was conducted to obtain the scores for fatigue, daytime sleepiness, depression, functional mobility, and disability.</div></div><div><h3>Results</h3><div>A total of 323 participants (mean age: 60.3 ± 12.6 years, mean stroke duration: 8.6 ± 4.4 months) completed the interview. Poststroke fatigue was reported in 11.8 % (n = 38) of the population. Occupational status (χ² = 5.73), functional mobility (χ² = 5.84), and disability scores (χ² = 8.00) were significantly associated (p &lt; 0.05) with fatigue scores. Individuals with disability exhibited five times (OR = 5.00, CI: 1.45–17.23, p = 0.01) higher odds of experiencing fatigue than those without disability.</div></div><div><h3>Conclusion</h3><div>Our study reported a relatively lower prevalence of fatigue among community-living late subacute and chronic stroke survivors. Implementing strategies to address these contributing factors could effectively ease fatigue in individuals recovering from stroke.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"30 ","pages":"Article 101812"},"PeriodicalIF":2.3,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysing of drug patterns in primary healthcare centers in Indonesia based on WHO's prescribing indicators","authors":"Elida Zairina ,&nbsp;Inge Dhamanti ,&nbsp;Ida Nurhaida ,&nbsp;Davina S. Mutia ,&nbsp;Arivazhagan Natesan","doi":"10.1016/j.cegh.2024.101815","DOIUrl":"10.1016/j.cegh.2024.101815","url":null,"abstract":"<div><h3>Background</h3><div>The quality of healthcare service delivery must be appropriate to detect and manage disease effectively. Nonetheless, there is a lack of data on the quality of prescribing patterns and healthcare in primary healthcare centers.</div></div><div><h3>Objective</h3><div>This study aimed to investigate drug use patterns based on the WHO's prescribing indicators among selected primary healthcare centers in Surabaya, East Java, Indonesia.</div></div><div><h3>Methods</h3><div>This study was cross-sectional descriptive. All prescriptions collected from patient medical records were dispensed from the outpatient pharmacy of each primary healthcare center. Data were retrospectively analyzed using WHO's prescribing indicators to measure drug use patterns. Data were entered, cleaned, and analyzed using SPSS Version 27.0.</div></div><div><h3>Results</h3><div>About 2.21 drugs were used on average per encounter. Antibiotics and injections were prescribed in 15.7 % and 1.67 % of the encounters. The most prescribed antibiotics were amoxicillin (87 %), chloramphenicol (6.5 %), and co-trimoxazole (3 %). The percentages of drugs prescribed based on the generic name and the essential drug list were 99.6 % and 76.8 %, respectively. Antibiotic prescribing was significantly associated with patient age and the number of medications prescribed. Patients under 19 were 2.50 times more likely to be given antibiotics (COR: 2.50; 95 % CI: 1.42–4.40). Antibiotic prescribing increases by 0.38 units for each unit, increasing the number of medications prescribed (COR: 0.38; 95 % CI: 0.24–0.59).</div></div><div><h3>Conclusion</h3><div>This study concludes that the prescribing indicators at the five primary healthcare centers in Surabaya, Indonesia differed from the WHO's standards. The antibiotic encounters, injection encounters, and the proportion of drugs prescribed based on the essential drug list were less than the WHO's standards. The study found that the percentage of prescriptions containing generic names was almost fulfilling WHO's indicators. Regulations and monitoring of medicine-prescribing practices are needed to promote rational drug use and minimize adverse drug reactions.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"30 ","pages":"Article 101815"},"PeriodicalIF":2.3,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Putting TB notification into practice among private pharmacies in Mangalore city, India – Did we succeed?","authors":"Saurabh Kumar ,&nbsp;Nishanth Krishna K. ,&nbsp;Sowmya Bhat ,&nbsp;Raveendra H.R. Reddy ,&nbsp;Ravichandra C. ,&nbsp;Sharath Burugina Nagaraja ,&nbsp;Badarudeen M.N.","doi":"10.1016/j.cegh.2024.101775","DOIUrl":"10.1016/j.cegh.2024.101775","url":null,"abstract":"<div><h3>Problem considered</h3><div>Globally, tuberculosis (TB) is the second leading infectious killer after Covid-19 with 1.18–1.43 million deaths in 2022. As per the Global TB Report 2023, an estimated 10.6 million people developed TB in 2022. An estimated 3.1 million cases were missed globally, posing a challenge in breaking the chain of transmission. India is one of the major contributors to the missed cases. Almost 50 % of patients are being treated in the Private sector in India, but fewer are notified to the public health system. This study explored the role of sensitization of pharmacies in TB Case Notification in Mangalore city.</div></div><div><h3>Methods</h3><div>In this study using a before and after intervention design, the programmatic data was utilized to compare the TB case notifications by the private pharmacies using TB reporting formats for mandatory notification. The intervention was sensitization of the pharmacy owners and pharmacists by a trained field assistant and monthly reminder messages using a social media tool. The data was collected for 2 consecutive quarters October 2019–March 2020 in the prescribed formats.</div></div><div><h3>Results</h3><div>Post Intervention, there was an increase in the number of pharmacies reporting TB cases from 6 to 14, and prescriptions were being maintained and shared with the District TB Office. An increased number of case reporting was also observed post-intervention.</div></div><div><h3>Conclusion</h3><div>Intensified sensitization led to improvement in the reporting mechanism of TB case notification by private pharmacies, though it did not translate into a concurrent rise in notification of TB cases in the district.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"30 ","pages":"Article 101775"},"PeriodicalIF":2.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213398424002720/pdfft?md5=d57b0673d9b9765dec86bfc763c1c7d2&pid=1-s2.0-S2213398424002720-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare and economic burden of adverse childhood experiences in Lahore, Pakistan","authors":"Rehan Shakeel,&nbsp;Muhammed Navid Tahir,&nbsp;Nauman Ali Ch,&nbsp;Assia Riaz","doi":"10.1016/j.cegh.2024.101772","DOIUrl":"10.1016/j.cegh.2024.101772","url":null,"abstract":"<div><h3>Objectives</h3><div>Strong evidence links ACEs to adverse health outcomes, such as an increased risk of developing many chronic diseases. This study aimed to find the association between exposure to adverse childhood experiences (ACEs) and chronic health diseases and their healthcare and economic burdens in Lahore city.</div></div><div><h3>Methods</h3><div>The Study involved 385 participants from Lahore, Pakistan. Eligible participants who were 18 or older and below 18 years old were excluded. A cross-sectional study was conducted and the sample was collected using a stratified random sampling method. Cross-tabulation and Chi-Square tests were conducted to examine the relationship between exposure to ACEs and the outcomes of chronic diseases. Risk profiles including relative risk, attributable risk, and population attributable risk were calculated to determine the healthcare burden. The economic burden was calculated using DALYs and healthcare costs.</div></div><div><h3>Results</h3><div>The sample had a 59.8 % male predominance, and the average age was 29. 67 % of participants had at least one ACE-related chronic disease such as anxiety, depression, and stroke. A significant association was found between them (p &lt; 0.05). Due to ACEs, study participants lost 1388 years of a healthy life. At the same time, ACE-related healthcare costs were roughly 4200 million PKR (15.14 million USD).</div></div><div><h3>Conclusion</h3><div>The results revealed an elevated risk of chronic health outcomes connected with experiencing one or more ACEs. Addressing ACEs may improve health, reduce healthcare expenditures, and increase resilience.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"30 ","pages":"Article 101772"},"PeriodicalIF":2.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Did they receive it? Direct Benefit Transfer to tuberculosis patients in Raigarh district, Chhattisgarh, India - A mixed methods study","authors":"Santosh Patoda ,&nbsp;Tanu Anand ,&nbsp;Sairu Philip ,&nbsp;Palanivel Chinnakali ,&nbsp;Abinash Mishra ,&nbsp;Pruthu Thekkur ,&nbsp;Pallavi Indwar ,&nbsp;Jaykumari Choudhary ,&nbsp;Sofia Noor ,&nbsp;Pradip Kumar Jana","doi":"10.1016/j.cegh.2024.101790","DOIUrl":"10.1016/j.cegh.2024.101790","url":null,"abstract":"<div><h3>Background</h3><div>Nutrition support plays critical role in patient centered care of TB. India launched a direct benefit scheme Nikshay Poshan Yojana (NPY) in 2018. However, there is sparse evidence of its implementation status in Chhattisgarh.</div></div><div><h3>Objectives</h3><div>To determine the proportion receiving the NPY incentives, its timeliness and factors associated with non-payment and delays, and to assess utilization patterns of Direct Benefit Transfer (DBT) among the beneficiaries.</div></div><div><h3>Methods</h3><div>It was a mixed-method study, with quantitative component of (Cross-sectional) followed by qualitative component (Descriptive). The data of all tuberculosis patients notified during April 2021toMarch 2022 in Raigarh, Chhattisgarh, India, were extracted from Nikshay-Portal. Beneficiaries registered for treatment in last quarter of 2021–2022, were also contacted to assess the utilization patterns of DBT. Eighteen health care providers (HCPs) were interviewed one-on-one to assess their perception regarding challenges in implementation of NPY and possible solutions.</div></div><div><h3>Results</h3><div>Of 2161 TB patients started on TB treatment, 1912(88.8 %) received at least one benefit. More than half (59.6 %; 1140/1912) of the TB patients who received at least one benefit, received their first benefit within 56 days of notification. Among 255 who responded for utilization pattern of DBT, nearly one third (n = 73,28.6 %) reported to have utilized DBT for buying food. The main challenges for non-receipt/delay in benefits were: difficulty opening bank accounts; “dormant” account policy; changing of Indian Financial System Code (IFSC) of rural and nationalized merged banks; poor internet connectivity; and shortage of human resources or workforce not distributed according to geographic location.</div></div><div><h3>Conclusion</h3><div>Nearly nine out of ten patients received at least one benefit under NPY. However, its utilization for treatment purposes was limited. Bank related, patient related and provider related factors posed major challenges in smooth implementation of the scheme. To improve the scheme's coverage, flexible account opening policies with offline Nikshay-Portal features are required.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"30 ","pages":"Article 101790"},"PeriodicalIF":2.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Mat Pilates intervention on sleep quality in adolescent girls: A single blinded randomised controlled trial","authors":"Afsha Parveen ,&nbsp;Sheetal Kalra ,&nbsp;Supriya Awasthi ,&nbsp;Puneeta Ajmera ,&nbsp;Richa Hirendra Rai ,&nbsp;Mohammad Miraj ,&nbsp;Sonia Pawaria ,&nbsp;Sajjan Pal ,&nbsp;Neha Naagar","doi":"10.1016/j.cegh.2024.101791","DOIUrl":"10.1016/j.cegh.2024.101791","url":null,"abstract":"<div><h3>Background</h3><div>Pilates, a low-to-moderate intensity workout provides an alternative to traditional methods that stimulate both the mind and the body. Adolescent girls often experience sub optimal sleep quality, especially on school days, posing significant health risks. This study aims to investigate the effects of Pilates on the sleep quality of adolescent females.</div></div><div><h3>Methods</h3><div>A single-blinded Randomized Controlled Trial was conducted at a Physiotherapy OPD. Eligible adolescent girls (aged 10–19) with PSQI scores exceeding 5 were enrolled. Sixty participants were allocated each to Group A (Control) or Group B (Mat Pilates) via convenience sampling. Parental consent and participant assent were obtained. Group A maintained daily activities with ergonomic exercises, while Group B underwent Mat Pilates training three times weekly for eight weeks. Data were collected at baseline, at the end of 4th and 8th week.</div></div><div><h3>Result</h3><div>Between-group analysis at the 4th and 8th weeks showed significant differences. Post hoc analysis with Bonferroni adjustment revealed notable improvements from baseline to both time points (p &lt; 0.05). The experimental group achieved a 45.14 % greater reduction in Global PSQI score compared to the control group, indicating significant improvements in sleep quality. The experimental group also showed a substantial 53.39 % improvement in sleep duration and a significant 65 % reduction in sleep latency, outperforming the control group.</div></div><div><h3>Conclusion</h3><div>This study reveals promising improvements in sleep quality, highlighting the potential benefits of Pilates for this demographic. This can be a valuable approach to enhancing sleep quality among adolescent girls, potentially contributing to their overall health and life quality.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"30 ","pages":"Article 101791"},"PeriodicalIF":2.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213398424002884/pdfft?md5=1864f6e53f75baa53cf03e8b180a4d42&pid=1-s2.0-S2213398424002884-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuro-musculoskeletal side effects related to COVID-19 vaccines; A cross sectional study in Iranian healthcare workers","authors":"Masoumeh ZoghAli ,&nbsp;Fateme Hojjati ,&nbsp;Maryam Sadat Mirenayat ,&nbsp;Seyed Mansoor Rayegani","doi":"10.1016/j.cegh.2024.101691","DOIUrl":"10.1016/j.cegh.2024.101691","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to evaluate neuro-musculoskeletal adverse events related to COVID-19 vaccines in Iranian healthcare workers.</div></div><div><h3>Methods</h3><div>In this cross-sectional survey, a questionnaire was used, including patients’ demographic information, vaccination information, and local, flu-like, and neuro-musculoskeletal side effects of vaccines. All data were extracted and analyzed by SPSS ver.24.</div></div><div><h3>Results</h3><div>A total of 500 healthcare workers (381 females, and 119 males), with a Mean ± SD age of 38.06 ± 9.22 years old were recruited; 341 subjects (68.2 %) were vaccinated by Sputnik-V vaccine, 95 subjects (19 %) with AstraZeneca, 40 subjects (8 %) with Sinopharm, and 24 (4.8 %) with Baharat COVID-19 vaccine. Out of 500 participants, COVID-19 vaccines' side effects were reported in 428 subjects (85.6 %) including 339 subjects (67.8 %) with local side effects, 342 subjects (68.4 %) subjects with flu-like side effects, 66 subjects (13.2 %) with neurologic, and 291 subjects (58.2 %) with musculoskeletal side effects. Local pain (67.6 %), fatigue (61.2 %), generalized pain (47.8 %), headache (38.8), upper and lower myalgia (44 %, 36 %), and low back pain (26.8 %) were the most common side effects reported by COVID-19 vaccine recipients. There were significant associations between neuro-musculoskeletal side effects with patients’ sex (P = 0.001), categorized age (less and more than 40 years., P = 0.002), and COVID-19 vaccine types (P &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Among all the neurological and musculoskeletal side effects, upper limb paresthesia, and upper limb myalgia alongside low back pain were the most frequent respectively. No serious side effects requiring medical attention or hospitalization were reported by participants.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"30 ","pages":"Article 101691"},"PeriodicalIF":2.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142323354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engagement in healthcare decision-making and associated factors among patients with chronic non-communicable diseases in Southwest Ethiopia, 2023","authors":"Sadik Abdulwehab ,&nbsp;Yeshitila Belay ,&nbsp;Frezer Kedir ,&nbsp;Ebrahim Yimam ,&nbsp;Admasu Belay","doi":"10.1016/j.cegh.2024.101792","DOIUrl":"10.1016/j.cegh.2024.101792","url":null,"abstract":"<div><h3>Background</h3><div>Chronic Non-communicable diseases require lifelong care involving patients, families, a team of their care providers, and significant others. Additionally, engaging patients in their healthcare decision-making is crucial for achieving better clinical outcomes. This study aimed to assess patients' engagement in healthcare decision-making and associated factors among adults with chronic non-communicable diseases in Southwest Ethiopia.</div></div><div><h3>Methods</h3><div>A cross-sectional study design was used among 422 participants at the public hospital of Jimma town. Study participants were consecutively recruited from May 01 to June 01, 2023. A structured Patient Activation Measure was used to measure patient engagement in healthcare decision-making. Descriptive statistics and binary logistic regression analysis describe the association between dependent and independent variables.</div></div><div><h3>Result</h3><div>A total of 422 patients with chronic diseases participated in the study yielding a response rate of 99.3 %. Slightly greater than one-third (35.8 % (95 % CI: 31.19, 40.41)) of participants in The study area had a high engagement in healthcare decision-making. Residence (Odd ratio 0.27; 95 % confidence interval 0.137–0.534), educational level(Odd ratio 0.168; 95 % confidence interval 0.064–0.443), access to information materials(Odd ratio 0.226; 95 % confidence interval 0.112–0.458), duration(Odd ratio 3.864; 95 % confidence interval 2.083–7.169), health literacy(Odd ratio 1.192; 95 % confidence interval 1.111–1.28), and preference for autonomy(Odd ratio 1.097; 95 % confidence interval 1.058–1.136) were factors statistically associated with patient engagement in healthcare decision-making.</div></div><div><h3>Conclusion</h3><div>One-third of study participants reported high engagement in healthcare decision-making. Thus, healthcare providers should pay attention to patients with low educational levels, who do not have access to information materials, low health literacy levels, and their preference for autonomy to engage them in their healthcare decision-making.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"30 ","pages":"Article 101792"},"PeriodicalIF":2.3,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213398424002896/pdfft?md5=3e530c124ad567b0f25bda4afddb9196&pid=1-s2.0-S2213398424002896-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the mucolytic effectiveness of Ambroxol and N-Acetylcysteine in patients with Acute exacerbation of chronic obstructive pulmonary disease","authors":"Aswin A. Anil ,&nbsp;Devendu Rajesh ,&nbsp;Aishwarya Laxmi Krishnan ,&nbsp;Ciciliya Arun ,&nbsp;Rosemary Thomas ,&nbsp;Prashant Chandra ,&nbsp;Nithya Haridas","doi":"10.1016/j.cegh.2024.101789","DOIUrl":"10.1016/j.cegh.2024.101789","url":null,"abstract":"<div><h3>Introduction</h3><p>Chronic obstructive pulmonary disease (COPD) is the third most fatal disease globally. Acute deterioration of the patient's respiratory symptoms is known as an acute exacerbation of COPD (AECOPD), that goes beyond usual variations and result in change in medications. Ambroxol (ABX) and N-acetylcysteine (NAC), are mainly used as mucolytics in the treatment of AECOPD.</p></div><div><h3>Methodology</h3><p>This prospective observational study examines effectiveness of ABX and NAC in COPD patients by assessing the quality of cough relief, peak expiratory flow rate (PEFR), length of hospital stay, quality of life (QOL) and reduction in symptoms of COPD. Leicester Cough Questionnaire (LCQ); Breathlessness, Cough and Sputum scale (BCSS)and St. George Respiratory Questionnaire (SGRQ) scales are used to evaluate patient condition before and after the treatment.</p></div><div><h3>Results</h3><p>The mean duration of hospital stay for NAC and ABX were found to be 8 ± 3.6 and 9.9 ± 3.9 days, respectively. Lung function in both groups improved with a change in percentage mean score of PEFR. Reduction in symptoms of COPD was evident in both groups by decrease in mean BCSS score from admission to discharge. Our study also demonstrated better QOL in both groups using SGRQ. LCQ showed a mean increase in all domains: physical, psychological and social.</p></div><div><h3>Conclusion</h3><p>It was concluded that both ABX and NAC leads to betterment in lung function, cough relief and control AECOPD. Hence, this study gives a signal to clinicians about these treatment options along with standard therapy of COPD for a better therapeutic outcome.</p></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"30 ","pages":"Article 101789"},"PeriodicalIF":2.3,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213398424002860/pdfft?md5=f8e8d64ccf52e8f450f1f4c7c1885f56&pid=1-s2.0-S2213398424002860-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}