Rija Shahid, Sana Fatima, Talia Ahmed, Eiraj Khan, Bakhtawar Mir, Muhammad Arslan Mughal, Tayyab Khan
Background: Various imaging modalities including EUS (Endoscopic ultrasound), CT abdomen (Computed tomography), MRCP (Magnetic resonance cholangiopancreatography), and ERCP (Endoscopic retrograde cholangiopancreatography) are used for diagnosis of choledocholithiasis. ERCP allows direct visualization of bile duct through endoscope, and it also helps in retrieval of stones. On the other hand, MRCP is a noninvasive procedure which uses strong magnetic field to visualize hepatobiliary system. In patients with choledocholithiasis calculi appear as dark filling defects within high signal intensity fluid at MRCP. This study compares the diagnostic accuracy of MRCP in comparison to ERCP in patients with choledocholithiasis. This study aims to compare sensitivity and specificity of MRCP in comparison to ERCP in diagnosing choledocholithiasis. Methodology: This comparative cross-sectional study included 170 patients with clinical diagnosis of choledocholithiasis who presented in Liver Center, Holy Family Hospital, Rawalpindi, during the year 2017. Non-probability consecutive sampling technique and a set of established inclusion and exclusion criteria was used to enroll patients. Data was collected by a self-structured questionnaire. Information about the demographic details and findings of ERCP and MRCP were noted on that questionnaire. Data analysis was done using SPSS 25. Results: Out of 170 patients, 111 (65.29%) were females and 59 (34.71%) were males. The mean of age for study population was 45.68 with standard deviation (SD) of ±12.40. ERCP confirmed stones in 95 patients while in case of MRCP 87 true positives, 55 true negatives, 20 false positives, and 8 false negatives cases were noted. According to these results, the sensitivity and specificity were 91.6% and 73.3% respectively for MRCP against ERCP. Whereas positive predictive value and negative predictive values were 81.3 and 87.3% respectively for MRCP in comparison to ERCP. Conclusion: MRCP has 91.6% sensitivity compared to ERCP. Although MRCP is a comparatively noninvasive procedure, but ERCP remains the diagnostic modality of choice for choledocholithiasis. MRCP could be used in diagnosis of choledocholithiasis instead of ERCP when there are contraindications of ERCP or when no therapeutic role of ERCP is required. Recommendations: MRCP should be used when only diagnostic role of ERCP is needed. MRCP should be used when there are contraindications of ERCP. Level of expertise should be increased for MRCP and ERCP.
{"title":"Sensitivity and Specificity of Magnetic Resonance Cholangiopancreatography against Endoscopic Retrograde Cholangiopancreatography in Diagnosing Choledocholithiasis","authors":"Rija Shahid, Sana Fatima, Talia Ahmed, Eiraj Khan, Bakhtawar Mir, Muhammad Arslan Mughal, Tayyab Khan","doi":"10.47672/ajhmn.1156","DOIUrl":"https://doi.org/10.47672/ajhmn.1156","url":null,"abstract":"Background: Various imaging modalities including EUS (Endoscopic ultrasound), CT abdomen (Computed tomography), MRCP (Magnetic resonance cholangiopancreatography), and ERCP (Endoscopic retrograde cholangiopancreatography) are used for diagnosis of choledocholithiasis. ERCP allows direct visualization of bile duct through endoscope, and it also helps in retrieval of stones. On the other hand, MRCP is a noninvasive procedure which uses strong magnetic field to visualize hepatobiliary system. In patients with choledocholithiasis calculi appear as dark filling defects within high signal intensity fluid at MRCP. This study compares the diagnostic accuracy of MRCP in comparison to ERCP in patients with choledocholithiasis. This study aims to compare sensitivity and specificity of MRCP in comparison to ERCP in diagnosing choledocholithiasis. \u0000Methodology: This comparative cross-sectional study included 170 patients with clinical diagnosis of choledocholithiasis who presented in Liver Center, Holy Family Hospital, Rawalpindi, during the year 2017. Non-probability consecutive sampling technique and a set of established inclusion and exclusion criteria was used to enroll patients. Data was collected by a self-structured questionnaire. Information about the demographic details and findings of ERCP and MRCP were noted on that questionnaire. Data analysis was done using SPSS 25. \u0000Results: Out of 170 patients, 111 (65.29%) were females and 59 (34.71%) were males. The mean of age for study population was 45.68 with standard deviation (SD) of ±12.40. ERCP confirmed stones in 95 patients while in case of MRCP 87 true positives, 55 true negatives, 20 false positives, and 8 false negatives cases were noted. According to these results, the sensitivity and specificity were 91.6% and 73.3% respectively for MRCP against ERCP. Whereas positive predictive value and negative predictive values were 81.3 and 87.3% respectively for MRCP in comparison to ERCP. \u0000Conclusion: MRCP has 91.6% sensitivity compared to ERCP. Although MRCP is a comparatively noninvasive procedure, but ERCP remains the diagnostic modality of choice for choledocholithiasis. MRCP could be used in diagnosis of choledocholithiasis instead of ERCP when there are contraindications of ERCP or when no therapeutic role of ERCP is required. \u0000Recommendations: MRCP should be used when only diagnostic role of ERCP is needed. MRCP should be used when there are contraindications of ERCP. Level of expertise should be increased for MRCP and ERCP.","PeriodicalId":7672,"journal":{"name":"American Journal of Health, Medicine and Nursing Practice","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90941323","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}
Purpose: Paracetamol is the most used medication worldwide; due to its analgesic and antipyretic effect; it had been included within the recommended regimen for COVID-19 patients. This study aimed at exploring the changes in the incidence of paracetamol overdose during pandemic compared to pre-pandemic periods. Methodology: Through a record-based study, all cases of paracetamol overdose who had been reported to the ministry of health in Saudi Arabia in the period between January 2019 and December 2020 were included in the study. Data stored in electronic form were retrieved and analyzed using SPSS version 26. Frequency distribution was used to describe categorical variables. Findings: Two hundred and forty four paracetamol overdose cases were reported in 2020 (during the pandemic) compared to 449 in 2019 (pre-pandemic) with dominance of females (62.6%) and Saudis (86.7%). Most cases ingested paracetamol orally mainly in solid forms (76.5%), and they were mostly diagnosed as confirmed cases on admission (84.6%). The great majority recovered and discharged (87.8%). The overall annual incidence of paracetamol in (pre-pandemic) was 1.32/100,000 which dropped markedly during pandemic to 0.71/100,000. Conclusion: There was a general decline in the incidence of paracetamol overdose during COVID-19 pandemic, with relative increase in incidence in home incidents and in children. Recommendation: Health education to the public to increase their awareness about proper and safe use of paracetamol is highly recommended, as well as introducing instructions and guidelines for practitioners about prescribing it.
{"title":"Characteristic of Paracetamol Overdose Before and During COVID-19 Pandemic, Saudi Arabia, 2019-2020","authors":"R. Saqah, Jaber Sharaheeli, Lamman Abdulkareem","doi":"10.47672/ajhmn.1145","DOIUrl":"https://doi.org/10.47672/ajhmn.1145","url":null,"abstract":"Purpose: Paracetamol is the most used medication worldwide; due to its analgesic and antipyretic effect; it had been included within the recommended regimen for COVID-19 patients. This study aimed at exploring the changes in the incidence of paracetamol overdose during pandemic compared to pre-pandemic periods. \u0000Methodology: Through a record-based study, all cases of paracetamol overdose who had been reported to the ministry of health in Saudi Arabia in the period between January 2019 and December 2020 were included in the study. Data stored in electronic form were retrieved and analyzed using SPSS version 26. Frequency distribution was used to describe categorical variables. \u0000Findings: Two hundred and forty four paracetamol overdose cases were reported in 2020 (during the pandemic) compared to 449 in 2019 (pre-pandemic) with dominance of females (62.6%) and Saudis (86.7%). Most cases ingested paracetamol orally mainly in solid forms (76.5%), and they were mostly diagnosed as confirmed cases on admission (84.6%). The great majority recovered and discharged (87.8%). The overall annual incidence of paracetamol in (pre-pandemic) was 1.32/100,000 which dropped markedly during pandemic to 0.71/100,000. \u0000Conclusion: There was a general decline in the incidence of paracetamol overdose during COVID-19 pandemic, with relative increase in incidence in home incidents and in children. \u0000Recommendation: Health education to the public to increase their awareness about proper and safe use of paracetamol is highly recommended, as well as introducing instructions and guidelines for practitioners about prescribing it.","PeriodicalId":7672,"journal":{"name":"American Journal of Health, Medicine and Nursing Practice","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76130810","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}
Purpose: Poisoning is one of the leading causes of morbidities and mortalities worldwide. Due to COVID-19 pandemic, there was a dramatic increase in the use of detergents and disinfectants, both in health care and domestic settings. As Clorox is the most used for these purposes; it was expected that there would be changes in the characteristics of Clorox poisoning. Therefore, the current study aimed to investigate characteristics of Clorox poisoning in Saudi Arabia during Covid-19 pandemic compared to the pre-pandemic period. Methodology: Through a record-based study; all Clorox poisoning cases reported to the ministry of health in 2019 (n=267) representing pre-pandemic and 2020 (n=198) representing during the pandemic periods were collected. The data were retrieved from the electronic database, and it was analyzed using SPSS version 26. Categorical variables are represented as frequency distribution. Finding: There was a decrease in the total number of reported Clorox poisoning cases from 267 pre-pandemic to 198 cases during the pandemic. Females were slightly more than males (55.7% vs 44.3%), and most of the cases were in the age groups (1-5 years) and (20-39 years) (27.3%). The overwhelming majority of the cases occurred at home) (96.3%), with a higher percentage during the pandemic than pre-pandemic (98.0% vs 95.1%), and few minorities occurred intentionally (9.3%). Most of the cases arrived the hospital in stable conditions, with few cases (17.0%) needed antidotes. The great majority of the cases recovered before discharge. The overall incidence of Clorox poisoning reached to 0.57/100,000 population during the pandemic, compared to 0.78/100,000 in the pre-pandemic. Conclusion: There was a decline in incidence of Clorox poisoning during the pandemic; with a relative increase in home incidents, with nausea and vomiting as most common symptoms and all cases recovered. Recommendation: It is highly recommended to plan for a health education messages about safe store and using of detergents and disinfectants.
目的:中毒是全世界发病率和死亡率的主要原因之一。由于2019冠状病毒病大流行，在卫生保健和家庭环境中，洗涤剂和消毒剂的使用急剧增加。因为高乐氏是用于这些目的最多的;预计高乐氏中毒的特征会发生变化。因此，本研究旨在调查2019冠状病毒病大流行期间沙特阿拉伯高乐氏中毒与大流行前相比的特征。方法:通过基于记录的研究;收集了2019年(n=267)代表大流行前和2020年(n=198)代表大流行期间向卫生部报告的所有高乐氏中毒病例。数据从电子数据库中检索，并使用SPSS version 26进行分析。分类变量用频率分布表示。发现:报告的高乐氏中毒病例总数从大流行前的267例减少到大流行期间的198例。女性略多于男性(55.7%比44.3%)，以1 ~ 5岁和20 ~ 39岁年龄组(27.3%)居多。绝大多数病例发生在家中(96.3%)，大流行期间的百分比高于大流行前(98.0%对95.1%)，少数人为发生(9.3%)。大多数病例到达医院时病情稳定，需要解毒剂的病例很少(17.0%)。绝大多数病例在出院前就康复了。在大流行期间，高乐氏中毒的总发病率达到0.57/10万人，而大流行前为0.78/10万人。结论:大流行期间高乐氏中毒发生率有所下降;随着家庭事件的相对增加，恶心和呕吐是最常见的症状，所有病例都康复了。建议:强烈建议计划关于安全储存和使用洗涤剂和消毒剂的健康教育信息。
{"title":"Characteristic of Clorox Poisoning before and during COVID-19 Pandemic, Saudi Arabia, 2019-2020.","authors":"Hamoud Marzuq Alrougi, Jaber Sharaheeli","doi":"10.47672/ajhmn.1146","DOIUrl":"https://doi.org/10.47672/ajhmn.1146","url":null,"abstract":"Purpose: Poisoning is one of the leading causes of morbidities and mortalities worldwide. Due to COVID-19 pandemic, there was a dramatic increase in the use of detergents and disinfectants, both in health care and domestic settings. As Clorox is the most used for these purposes; it was expected that there would be changes in the characteristics of Clorox poisoning. Therefore, the current study aimed to investigate characteristics of Clorox poisoning in Saudi Arabia during Covid-19 pandemic compared to the pre-pandemic period. \u0000Methodology: Through a record-based study; all Clorox poisoning cases reported to the ministry of health in 2019 (n=267) representing pre-pandemic and 2020 (n=198) representing during the pandemic periods were collected. The data were retrieved from the electronic database, and it was analyzed using SPSS version 26. Categorical variables are represented as frequency distribution. \u0000Finding: There was a decrease in the total number of reported Clorox poisoning cases from 267 pre-pandemic to 198 cases during the pandemic. Females were slightly more than males (55.7% vs 44.3%), and most of the cases were in the age groups (1-5 years) and (20-39 years) (27.3%). The overwhelming majority of the cases occurred at home) (96.3%), with a higher percentage during the pandemic than pre-pandemic (98.0% vs 95.1%), and few minorities occurred intentionally (9.3%). Most of the cases arrived the hospital in stable conditions, with few cases (17.0%) needed antidotes. The great majority of the cases recovered before discharge. The overall incidence of Clorox poisoning reached to 0.57/100,000 population during the pandemic, compared to 0.78/100,000 in the pre-pandemic. \u0000Conclusion: There was a decline in incidence of Clorox poisoning during the pandemic; with a relative increase in home incidents, with nausea and vomiting as most common symptoms and all cases recovered. \u0000Recommendation: It is highly recommended to plan for a health education messages about safe store and using of detergents and disinfectants.","PeriodicalId":7672,"journal":{"name":"American Journal of Health, Medicine and Nursing Practice","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88024526","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}
Ibrar Ahmad, Hoor Maab Kaifi, Fahim Ullah, Adan Javed, H. Tahir, M. Rahman
Purpose: To figure out the prevalence of malnutrition among patients with Type-2 Diabetes Mellitus (T2DM) in tertiary care hospital Methodology: The study adopted a cross-sectional study. The study took place in Endocrine and Medicine Departments of Lady Reading Hospital, Peshawar, Pakistan from September 2019 to March 2020. A total number of 259 patients of T2DM were screened for screened for nutritional assessment with the help of nurse and supporting staff. The data was recorded with the help of question are and Subjective Global Assessment form (SGA). The nutritional risk parameters and malnutrition status was figured out and the data collected was statistically analyzed with the help of MS Excel and SPSS 22.0. Findings: The results of the current findings revealed that 123 patients out of 259 were at moderate risk of malnutrition, while 136 patients were highly at malnutrition risk. Similarly, 162 patients were sorted out to have the status of moderate malnutrition while 97 patients were severely mal-nourished. Among various categories of BMI the highest frequency has been shown by Obese Class-I with highest risk malnutrition risk and severe malnourished frequency. The Correlation Coefficient R2 value of 0.923. The Chi-Square value of 187.69 and p-value (1.214e-38) nullifies the Null hypothesis. Conclusion: Based on the findings of this study, it may be concluded that a wholesome ratio of T2DM are at nutritional risk or having the status of malnutrition in hospitalized patients. Secondly, it may also be inferred that the largest number of T2DM could be assumed at Obese Class-I of BMI distribution.
{"title":"Prevalence of Malnutrition among Patients with Type-2 Diabetes Mellitus in Tertiary Care Hospital in Pakistan","authors":"Ibrar Ahmad, Hoor Maab Kaifi, Fahim Ullah, Adan Javed, H. Tahir, M. Rahman","doi":"10.47672/ajhmn.1132","DOIUrl":"https://doi.org/10.47672/ajhmn.1132","url":null,"abstract":"Purpose: To figure out the prevalence of malnutrition among patients with Type-2 Diabetes Mellitus (T2DM) in tertiary care hospital \u0000Methodology: The study adopted a cross-sectional study. The study took place in Endocrine and Medicine Departments of Lady Reading Hospital, Peshawar, Pakistan from September 2019 to March 2020. A total number of 259 patients of T2DM were screened for screened for nutritional assessment with the help of nurse and supporting staff. The data was recorded with the help of question are and Subjective Global Assessment form (SGA). The nutritional risk parameters and malnutrition status was figured out and the data collected was statistically analyzed with the help of MS Excel and SPSS 22.0. \u0000Findings: The results of the current findings revealed that 123 patients out of 259 were at moderate risk of malnutrition, while 136 patients were highly at malnutrition risk. Similarly, 162 patients were sorted out to have the status of moderate malnutrition while 97 patients were severely mal-nourished. Among various categories of BMI the highest frequency has been shown by Obese Class-I with highest risk malnutrition risk and severe malnourished frequency. The Correlation Coefficient R2 value of 0.923. The Chi-Square value of 187.69 and p-value (1.214e-38) nullifies the Null hypothesis. \u0000Conclusion: Based on the findings of this study, it may be concluded that a wholesome ratio of T2DM are at nutritional risk or having the status of malnutrition in hospitalized patients. Secondly, it may also be inferred that the largest number of T2DM could be assumed at Obese Class-I of BMI distribution.","PeriodicalId":7672,"journal":{"name":"American Journal of Health, Medicine and Nursing Practice","volume":"70 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91403976","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}
Petronella Mueni Kiteng’u, Lillian Muiruri, Oluoch Musa
Purpose: To determine the influence of staffs’ knowledge on preparedness of catholic mission hospitals for health service delivery during emergency inflow of patients in Nairobi County, Kenya. Methodology: A cross sectional descriptive study design was used with quantitative approach for data collection and analysis. Four tier-3 Catholic Mission Hospitals were purposively selected and a stratified random sample of 647 members of staff from different cadres was taken. A structured questionnaire was used to collect data. Data was analyzed using STATA software v.16, where descriptive statistics were presented using frequencies and percentages whereas inferential statistics were presented using correlation and regression analysis. Findings: The study found out that staff training and exercises for knowledge and skills influenced preparedness of Catholic Mission Hospitals for health service delivery during emergency influx of patients. A positive and significant relationship was found at (r=0.211; p<0.01). This means that the hospitals are perceived as prepared for health service delivery during emergency influx of patients. However, staff drills (staff exercises) at (r = -0.147; p<0.05) were found insignificantly influencing services delivery. This means that the hospitals would be unprepared even if staff drills were in place. Recommendations: The study recommends that the managers of catholic hospitals should have scheduled staff trainings and drills for efficient and timely response in times of need for emergency service deliver. Policy guidelines on skills acquisition for the staff in the health institutions need to be developed to guide the trainings and frequent drills to sharpen the theory and practice of the healthcare team.
{"title":"The Influence of Staffs’ Knowledge on Preparedness of Catholic Mission Hospitals for Health Service Delivery during Emergency Inflow of Patients in Nairobi County, Kenya","authors":"Petronella Mueni Kiteng’u, Lillian Muiruri, Oluoch Musa","doi":"10.47672/ajhmn.1131","DOIUrl":"https://doi.org/10.47672/ajhmn.1131","url":null,"abstract":"Purpose: To determine the influence of staffs’ knowledge on preparedness of catholic mission hospitals for health service delivery during emergency inflow of patients in Nairobi County, Kenya. \u0000Methodology: A cross sectional descriptive study design was used with quantitative approach for data collection and analysis. Four tier-3 Catholic Mission Hospitals were purposively selected and a stratified random sample of 647 members of staff from different cadres was taken. A structured questionnaire was used to collect data. Data was analyzed using STATA software v.16, where descriptive statistics were presented using frequencies and percentages whereas inferential statistics were presented using correlation and regression analysis. \u0000Findings: The study found out that staff training and exercises for knowledge and skills influenced preparedness of Catholic Mission Hospitals for health service delivery during emergency influx of patients. A positive and significant relationship was found at (r=0.211; p<0.01). This means that the hospitals are perceived as prepared for health service delivery during emergency influx of patients. However, staff drills (staff exercises) at (r = -0.147; p<0.05) were found insignificantly influencing services delivery. This means that the hospitals would be unprepared even if staff drills were in place. \u0000Recommendations: The study recommends that the managers of catholic hospitals should have scheduled staff trainings and drills for efficient and timely response in times of need for emergency service deliver. Policy guidelines on skills acquisition for the staff in the health institutions need to be developed to guide the trainings and frequent drills to sharpen the theory and practice of the healthcare team.","PeriodicalId":7672,"journal":{"name":"American Journal of Health, Medicine and Nursing Practice","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78702894","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}
Esther A Silas, C. Nwankwo, A. Afonne, Ogochukwu T Obionwu, A. M. Ibekwe
Purpose: This study determined factors influencing the use of oral rehydration solution among mothers with children below five years of age attending Holy Rosary Specialist Hospital and Maternity Waterside in Onitsha North LGA, Anambra State. Methodology: A cross-sectional descriptive design was adopted in conducting the study among mothers with children under five years attending Rosary Specialist Hospital and Maternity, Waterside in Onitsha North Local Government Area, Anambra State. A sample size of one hundred and fifty (150) women was selected by convenience sampling techniques. A self-structured questionnaire with a reliability coefficient of 0.98 was used in gathering the necessary data suitable for the study which were analysed with SPSS version 20.0. Findings: It was discovered that majority of the women 141(94.6%) have heard of ORS and they have adequate understanding of the solution, the two different types of oral rehydration solutions (that is solution from oral rehydration salt and salt sugar solution) but do not use SSS hence lack adequate knowledge of its preparation. Also, the mothers 116(95.9%) used ORS when their children had diarrhoea while the remaining 5(4.1%) did not use ORS because their children never had diarrhoea. 65(43.6%) of the women have all the materials needed for the preparation of SSS while 70(47.0%) which were the majority did not know the materials required for the preparation of ORS hence they could not indicate if they had the materials or not. From the hypothesis tested, there is a significant relationship between mothers’ level of education (p=0.030), mother’s occupation (p=0.024), number of under five children (p=0.045) and the use of ORS. From the study, it was ascertained that socio-demographic factors like mother’s level of education, occupation and number of under five children affected the use of ORS in the population used. Mother’s level of knowledge of the solution, availability and accessibility of the ORS sachet (environmental factor) and the occurrence of diarrhoea in a child (Child factor) also affect use of ORS. Recommendations: Health workers in the health care facilities should intensify their effort in the provision of adequate health education to the mothers (may be to be incorporated into antenatal care health talks) on the preparation of Salt Sugar Solution (SSS) type which is cost effective and readily available. Also the hospital management should ensure that Oral Rehydration salt sachets are available in the hospitals and at an affordable price so as to ensure authenticity of the product used by the women.
{"title":"Factors Influencing the Use of Oral Rehydration Solution among Mothers of Under Five Children Attending Holy Rosary Specialist Hospital and Maternity Waterside In Onitsha North Lga, Anambra State.","authors":"Esther A Silas, C. Nwankwo, A. Afonne, Ogochukwu T Obionwu, A. M. Ibekwe","doi":"10.47672/ajhmn.1095","DOIUrl":"https://doi.org/10.47672/ajhmn.1095","url":null,"abstract":"Purpose: This study determined factors influencing the use of oral rehydration solution among mothers with children below five years of age attending Holy Rosary Specialist Hospital and Maternity Waterside in Onitsha North LGA, Anambra State. \u0000Methodology: A cross-sectional descriptive design was adopted in conducting the study among mothers with children under five years attending Rosary Specialist Hospital and Maternity, Waterside in Onitsha North Local Government Area, Anambra State. A sample size of one hundred and fifty (150) women was selected by convenience sampling techniques. A self-structured questionnaire with a reliability coefficient of 0.98 was used in gathering the necessary data suitable for the study which were analysed with SPSS version 20.0. \u0000Findings: It was discovered that majority of the women 141(94.6%) have heard of ORS and they have adequate understanding of the solution, the two different types of oral rehydration solutions (that is solution from oral rehydration salt and salt sugar solution) but do not use SSS hence lack adequate knowledge of its preparation. Also, the mothers 116(95.9%) used ORS when their children had diarrhoea while the remaining 5(4.1%) did not use ORS because their children never had diarrhoea. 65(43.6%) of the women have all the materials needed for the preparation of SSS while 70(47.0%) which were the majority did not know the materials required for the preparation of ORS hence they could not indicate if they had the materials or not. From the hypothesis tested, there is a significant relationship between mothers’ level of education (p=0.030), mother’s occupation (p=0.024), number of under five children (p=0.045) and the use of ORS. From the study, it was ascertained that socio-demographic factors like mother’s level of education, occupation and number of under five children affected the use of ORS in the population used. Mother’s level of knowledge of the solution, availability and accessibility of the ORS sachet (environmental factor) and the occurrence of diarrhoea in a child (Child factor) also affect use of ORS. \u0000Recommendations: Health workers in the health care facilities should intensify their effort in the provision of adequate health education to the mothers (may be to be incorporated into antenatal care health talks) on the preparation of Salt Sugar Solution (SSS) type which is cost effective and readily available. Also the hospital management should ensure that Oral Rehydration salt sachets are available in the hospitals and at an affordable price so as to ensure authenticity of the product used by the women.","PeriodicalId":7672,"journal":{"name":"American Journal of Health, Medicine and Nursing Practice","volume":"98 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75821999","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}
I. Ullah, I. Ahmed, Farrukh Nawab, Khalil Khan Zahir, Irfanullah Khattak
Background: In this prospective cohort study (flap-off epi-eye-surgery), the results of femtosecond optical maser-assisted in situ keratomileusis (femto-eye-surgery) and epipolis eye-surgery refractile surgery for myopia were compared. Purpose: Comparison of the results of eye-surgery myopia or myopic astigmia improvement by a six- multidimensional amaris exciter optical maser and establish that both femto- eye-surgery and flap-off epi-eye-surgery are safe, effective, and predictable in Amanat eye hospital Rawalpindi. The duration of the study was July 2019- July 2021. Sample size was 400 eyes, 200 patients, 81 male and 119 female. The study was conducted after the ethical approval of the hospital ethical committee. Methods: Four hundred (400) eyes from 200 individuals were divided into two groups in this prospective cohort study. For femto-eye-surgery flaps, a femtosecond optical maser was used, while an epikeratome (flap-off) was used for epi-eye-surgery flaps. The researchers measured uncorrected distance graphicalacuity (u.d.v.a), corrected distance graphical acuity (c.d.v.a), visible bending (m.r), corneal asphericity (q-value), and corneal higher-order aberrations (hoas) before and after surgery. In both groups, the improvement in logmar udva following refractile surgery was statistically significant (p< 0.001 for all); it was significantly higher for femto-eye-surgery 1 day and 1 week postoperatively (p <0.001 for femto-eye-surgery, respectively). Results: Logarithm of the minimum angle of resolution (logmar) of udva after refractile surgery was statistically significant for both groups (p = 0.002); it was significantly higher for femto-eye-surgery than flap-off epi-eye-surgery (0.03 *0.06 logmar (femto-eye-surgery) and 0.54 * 0.31 logmar (flap-off epi-eye-surgery ) at 1 day postoperatively; 0.02 *0.05 logmar (f the increase in spherical aberration (z4,0) in flap-off epi-eye-surgery was reater than femto-eye- surgery : 0.626 ± 0.232 μm and 0.479 ± 0.139 μm in the front cornea; 0.556 ± 0.227 μm and 0.430 ± 0.137 μm in the total cornea (p = 0.016 and p = 0.017). There was no significant impact of the changes to the corneal hoa in the back of the eye on the corneal hoa in general. Conclusion: Despite the fact that femto-eye-surgery generated better early graphics results than flap-off epi-eye-surgery, there was no significant difference in the results one week following surgery.
{"title":"The Graphical Results of Myopia after Refractive Surgical Treatment by Femto2nd Optical Maser-Assisted and Epiboly’s LASEK (Eye-Surgery) have Remained Comparable.","authors":"I. Ullah, I. Ahmed, Farrukh Nawab, Khalil Khan Zahir, Irfanullah Khattak","doi":"10.47672/ajhmn.1080","DOIUrl":"https://doi.org/10.47672/ajhmn.1080","url":null,"abstract":"Background: In this prospective cohort study (flap-off epi-eye-surgery), the results of femtosecond optical maser-assisted in situ keratomileusis (femto-eye-surgery) and epipolis eye-surgery refractile surgery for myopia were compared. \u0000Purpose: Comparison of the results of eye-surgery myopia or myopic astigmia improvement by a six- multidimensional amaris exciter optical maser and establish that both femto- eye-surgery and flap-off epi-eye-surgery are safe, effective, and predictable in Amanat eye hospital Rawalpindi. The duration of the study was July 2019- July 2021. Sample size was 400 eyes, 200 patients, 81 male and 119 female. The study was conducted after the ethical approval of the hospital ethical committee. \u0000Methods: Four hundred (400) eyes from 200 individuals were divided into two groups in this prospective cohort study. For femto-eye-surgery flaps, a femtosecond optical maser was used, while an epikeratome (flap-off) was used for epi-eye-surgery flaps. The researchers measured uncorrected distance graphicalacuity (u.d.v.a), corrected distance graphical acuity (c.d.v.a), visible bending (m.r), corneal asphericity (q-value), and corneal higher-order aberrations (hoas) before and after surgery. In both groups, the improvement in logmar udva following refractile surgery was statistically significant (p< 0.001 for all); it was significantly higher for femto-eye-surgery 1 day and 1 week postoperatively (p <0.001 for femto-eye-surgery, respectively). \u0000Results: Logarithm of the minimum angle of resolution (logmar) of udva after refractile surgery was statistically significant for both groups (p = 0.002); it was significantly higher for femto-eye-surgery than flap-off epi-eye-surgery (0.03 *0.06 logmar (femto-eye-surgery) and 0.54 * 0.31 logmar (flap-off epi-eye-surgery ) at 1 day postoperatively; 0.02 *0.05 logmar (f the increase in spherical aberration (z4,0) in flap-off epi-eye-surgery was reater than femto-eye- surgery : 0.626 ± 0.232 μm and 0.479 ± 0.139 μm in the front cornea; 0.556 ± 0.227 μm and 0.430 ± 0.137 μm in the total cornea (p = 0.016 and p = 0.017). There was no significant impact of the changes to the corneal hoa in the back of the eye on the corneal hoa in general. \u0000Conclusion: Despite the fact that femto-eye-surgery generated better early graphics results than flap-off epi-eye-surgery, there was no significant difference in the results one week following surgery.","PeriodicalId":7672,"journal":{"name":"American Journal of Health, Medicine and Nursing Practice","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76333182","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}
Shad Muhammad, M. Ikram, A. Khan, I. Ahmed, Ziafat Rehman, Salma Ghulam
Purpose: The study objectives were to evaluate the efficacy and safety of SOF and VLP combination in HCV-infected patients on Hemodialysis (HD) in the local community as usual Pakistani practice. Methodology: In this study, 252 patients were given treatment who participated. Patients who maintain their hemodialysis are often given a combination of SOF and VLP. Before beginning the drug, the patient had testing that included an upper GI endoscopy, genotyping, measurement of the viral load, and a liver brow scan. Patients were administered SOF and VLP at dosages of 400 mg/day and 100 mg/day, respectively, for the duration of the study. Between March 2019 and March 2021, this study was conducted at the Department of Kidney Diseases at LRH Hospital in Peshawar, Pakistan, which was an observational, prospective, single-center study. 27 HCV-HD patients were on a SOF/VLP regimen during the experiment. The ICH-GCP criteria were surveyed in an intended manner. During the data analysis, a p-value of 0.05 or below was considered statistically significant. Results: Forty percent ofthe patients were male, and sixtypercent were female between the ages of 27 and ninety. According to the findings of 252 participants (n = female 14, 43.5 percent and n = male 18, 45.5 percent), 21 subjects were naïve, and six issues were in the treatment-experienced group (with SOF/RBV), with a mean age of 35.5 years and a standard deviation of 9.6 years. At the post-treatment follow-up visit after 12 weeks of therapy with SOF/VLP, the sustained virological response (SVR) rate was 100 percent (252 of 252), indicating that all of the patients had successfully recovered from their infection. During the study, not a single patient had a virological setback or was lost to follow-up. The most common adverse effects (AEs) recorded were nausea, headache, and tiredness; however, there were no reports of significant AEs. In addition, there were no cases of therapy being stopped prematurely owing to adverse effects. Conclusion: Patients in regular care in Pakistan who have HCV and are receiving HD are offered an extraordinarily efficient, risk-free, and well-tolerated treatment consisting of the total dosage of SOF-VLP given for 12 weeks.
{"title":"The Efficacy and Adverse Effects of Combining Sofosbuvir and Velpatasvir in Viral Hepatitis C Hemodialysis in Pakistani Population.","authors":"Shad Muhammad, M. Ikram, A. Khan, I. Ahmed, Ziafat Rehman, Salma Ghulam","doi":"10.47672/ajhmn.1079","DOIUrl":"https://doi.org/10.47672/ajhmn.1079","url":null,"abstract":"Purpose: The study objectives were to evaluate the efficacy and safety of SOF and VLP combination in HCV-infected patients on Hemodialysis (HD) in the local community as usual Pakistani practice. \u0000Methodology: In this study, 252 patients were given treatment who participated. Patients who maintain their hemodialysis are often given a combination of SOF and VLP. Before beginning the drug, the patient had testing that included an upper GI endoscopy, genotyping, measurement of the viral load, and a liver brow scan. Patients were administered SOF and VLP at dosages of 400 mg/day and 100 mg/day, respectively, for the duration of the study. Between March 2019 and March 2021, this study was conducted at the Department of Kidney Diseases at LRH Hospital in Peshawar, Pakistan, which was an observational, prospective, single-center study. 27 HCV-HD patients were on a SOF/VLP regimen during the experiment. The ICH-GCP criteria were surveyed in an intended manner. During the data analysis, a p-value of 0.05 or below was considered statistically significant. \u0000Results: Forty percent ofthe patients were male, and sixtypercent were female between the ages of 27 and ninety. According to the findings of 252 participants (n = female 14, 43.5 percent and n = male 18, 45.5 percent), 21 subjects were naïve, and six issues were in the treatment-experienced group (with SOF/RBV), with a mean age of 35.5 years and a standard deviation of 9.6 years. At the post-treatment follow-up visit after 12 weeks of therapy with SOF/VLP, the sustained virological response (SVR) rate was 100 percent (252 of 252), indicating that all of the patients had successfully recovered from their infection. During the study, not a single patient had a virological setback or was lost to follow-up. The most common adverse effects (AEs) recorded were nausea, headache, and tiredness; however, there were no reports of significant AEs. In addition, there were no cases of therapy being stopped prematurely owing to adverse effects. \u0000Conclusion: Patients in regular care in Pakistan who have HCV and are receiving HD are offered an extraordinarily efficient, risk-free, and well-tolerated treatment consisting of the total dosage of SOF-VLP given for 12 weeks.","PeriodicalId":7672,"journal":{"name":"American Journal of Health, Medicine and Nursing Practice","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89870939","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}
Advera V Mtatina, Lilian Teddy Mselle, D. Mwakawanga, D. Sando, D. Mkoka
Purpose: The purpose of the study is to assess the effects of upright and supine birth positions on maternal and new-born outcomes including maternal blood losses, duration of labor, perineum tear or intact, and APGAR score of the new-born in the first and fifth minutes in two District hospitals in Tanzania. Methodology: A quasi-experimental study design using a quantitative approach was conducted to assess the maternal and new-born outcomes in the in intervention study group (upright) and non-intervention group (supine). A convenient sample of 150 parturient were included, among them 73 formed an intervention group and 77 were in the non-intervention group. Data analysis was done using SPSS version 23 whereby STATA software was used to assess the effect of the independent variables (birth positions) to the dependent variables (maternal and new-born outcomes). Results were compared using chi-square test at P-value <0. 05 Findings: Among of women who assumed upright birth position were experienced good maternal and new-born outcomes more than those in supine position. 93% and 96% of women in upright had short labour in 1st and 2nd stage respectively compered 24.68% and 44% in supine respectively (P-value <0.001). Maternal blood loss and perineum status had no significant differences in both positions while the APGAR score of the new-born in upright (p=0.018) were more advanced than those in supine group. The study revealed that, Upright birth positions provides positive effects to maternal and new-born more than supine positions. The findings of this study will help pregnant women to have choice on birthing position they feel comfortable to use during labour and delivery. Recommendation: The Ministry of Health should build capacity of midwives to be able to conduct labour using alternative birthing positions including upright position.
{"title":"Maternal and New-Born Outcomes When Using Upright and Supine Birth Positions During Labour and Delivery: A Quasi-Experimental Study","authors":"Advera V Mtatina, Lilian Teddy Mselle, D. Mwakawanga, D. Sando, D. Mkoka","doi":"10.47672/ajhmn.1076","DOIUrl":"https://doi.org/10.47672/ajhmn.1076","url":null,"abstract":"Purpose: The purpose of the study is to assess the effects of upright and supine birth positions on maternal and new-born outcomes including maternal blood losses, duration of labor, perineum tear or intact, and APGAR score of the new-born in the first and fifth minutes in two District hospitals in Tanzania. \u0000Methodology: A quasi-experimental study design using a quantitative approach was conducted to assess the maternal and new-born outcomes in the in intervention study group (upright) and non-intervention group (supine). A convenient sample of 150 parturient were included, among them 73 formed an intervention group and 77 were in the non-intervention group. Data analysis was done using SPSS version 23 whereby STATA software was used to assess the effect of the independent variables (birth positions) to the dependent variables (maternal and new-born outcomes). Results were compared using chi-square test at P-value <0. 05 \u0000Findings: Among of women who assumed upright birth position were experienced good maternal and new-born outcomes more than those in supine position. 93% and 96% of women in upright had short labour in 1st and 2nd stage respectively compered 24.68% and 44% in supine respectively (P-value <0.001). Maternal blood loss and perineum status had no significant differences in both positions while the APGAR score of the new-born in upright (p=0.018) were more advanced than those in supine group. The study revealed that, Upright birth positions provides positive effects to maternal and new-born more than supine positions. The findings of this study will help pregnant women to have choice on birthing position they feel comfortable to use during labour and delivery. \u0000Recommendation: The Ministry of Health should build capacity of midwives to be able to conduct labour using alternative birthing positions including upright position.","PeriodicalId":7672,"journal":{"name":"American Journal of Health, Medicine and Nursing Practice","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84701021","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}
Jamal A. Mohamed, R. Migisha, Felix Oyania, A. Wesonga, A. Mohamed, Martin Situma
Background: Omphalocele and gastroschisis are the most common major congenital abdominal wall defects (CAWDs) globally. Mortality among neonates major CAWDs is higher in low-income countries than in high-income countries. This study described the patterns and short-term clinical outcomes of infants with gastroschisis and omphalocele at a regional referral hospital in southwestern Uganda. Methods: A case series was conducted at Mbarara Regional Referral Hospital ten months. Children born with CAWD during the study period 54 samples size were consecutively recruited into the study. Data were entered, cleaned, and analyzed using Stata version 15. Descriptive statistics were performed where continuous variables were summarized using median and interquartile ranges, while categorical variables were summarized using frequencies and proportions. Time to mortality was assessed using Kaplan–Meier survival analysis. Results: A total of 54 newborns were recruited into the study, of which 40 (70.04%) had Gastroschisis and 14(25.93%) had omphalocele. The median age of the infants was 9 days with an interquartile range of 4 to 21days. Of the 54 newborns, 30(69.2%) were male within the age group of 1-10 days. Mortality was higher in babies with complex gastroschisis (22) than simple gastroschisis (10). Not administering antibiotics and low birth weight were the factors associated with mortality among infants diagnosed with gastroschisis and omphalocele in the neonatal period. Conclusion: The most common observed defect was gastroschisis, Mortality was generally high among children presenting with gastroschisis. Complex gastroschisis has a poorer prognosis than simple gastroschisis over 30 days follow up period. Non-use of antibiotics before referral to a health facility and low birth weight were the factors associated with mortality among infants diagnosed with gastroschisis and omphalocele in the neonatal period. Recommendation: The most common pattern observed was Gastroschisis. The majority of children presenting with Omphalocele were more likely to survive for 30 days. There is a need for timely referral for babies born with congenital anterior abdominal wall defects.
背景:脐膨出和胃裂是全球最常见的先天性腹壁缺陷(CAWDs)。低收入国家重症新生儿死亡率高于高收入国家。本研究描述了在乌干达西南部一家地区转诊医院胃裂和脐膨出婴儿的模式和短期临床结果。方法:在姆巴拉拉地区转诊医院进行了为期10个月的病例系列研究。在研究期间出生的CAWD儿童连续招募了54个样本量。使用Stata version 15输入、清理和分析数据。进行描述性统计，其中连续变量使用中位数和四分位数范围进行汇总，而分类变量使用频率和比例进行汇总。采用Kaplan-Meier生存分析评估死亡时间。结果:共纳入54例新生儿，其中腹裂40例(70.04%)，脐膨出14例(25.93%)。婴儿的中位年龄为9天，四分位数范围为4至21天。54例新生儿中，30例(69.2%)为1 ~ 10日龄男性。复杂性腹裂婴儿的死亡率(22)高于单纯性腹裂婴儿(10)。未使用抗生素和低出生体重是与新生儿期诊断为胃裂和脐膨出的婴儿死亡率相关的因素。结论:胃裂是最常见的缺陷，儿童胃裂死亡率普遍较高。在30天随访期内，复杂性胃裂的预后比单纯性胃裂差。在转诊到卫生机构之前未使用抗生素和低出生体重是与新生儿期诊断为胃裂和脐膨出的婴儿死亡率相关的因素。建议:观察到的最常见的类型是胃裂。大多数出现脐膨出的儿童更有可能存活30天。先天性前腹壁缺损婴儿需要及时转诊。
{"title":"Patterns and Short Term Outcome of Children with Major Congenital Anterior Abdominal Wall Defects Admitted At Mbarara Regional Referral Hospital, South Western Uganda, from September 2019 to June 2020.","authors":"Jamal A. Mohamed, R. Migisha, Felix Oyania, A. Wesonga, A. Mohamed, Martin Situma","doi":"10.47672/ajhmn.1074","DOIUrl":"https://doi.org/10.47672/ajhmn.1074","url":null,"abstract":"Background: Omphalocele and gastroschisis are the most common major congenital abdominal wall defects (CAWDs) globally. Mortality among neonates major CAWDs is higher in low-income countries than in high-income countries. This study described the patterns and short-term clinical outcomes of infants with gastroschisis and omphalocele at a regional referral hospital in southwestern Uganda. \u0000Methods: A case series was conducted at Mbarara Regional Referral Hospital ten months. Children born with CAWD during the study period 54 samples size were consecutively recruited into the study. Data were entered, cleaned, and analyzed using Stata version 15. Descriptive statistics were performed where continuous variables were summarized using median and interquartile ranges, while categorical variables were summarized using frequencies and proportions. Time to mortality was assessed using Kaplan–Meier survival analysis. \u0000Results: A total of 54 newborns were recruited into the study, of which 40 (70.04%) had Gastroschisis and 14(25.93%) had omphalocele. The median age of the infants was 9 days with an interquartile range of 4 to 21days. Of the 54 newborns, 30(69.2%) were male within the age group of 1-10 days. Mortality was higher in babies with complex gastroschisis (22) than simple gastroschisis (10). Not administering antibiotics and low birth weight were the factors associated with mortality among infants diagnosed with gastroschisis and omphalocele in the neonatal period. \u0000Conclusion: The most common observed defect was gastroschisis, Mortality was generally high among children presenting with gastroschisis. Complex gastroschisis has a poorer prognosis than simple gastroschisis over 30 days follow up period. Non-use of antibiotics before referral to a health facility and low birth weight were the factors associated with mortality among infants diagnosed with gastroschisis and omphalocele in the neonatal period. \u0000Recommendation: The most common pattern observed was Gastroschisis. The majority of children presenting with Omphalocele were more likely to survive for 30 days. There is a need for timely referral for babies born with congenital anterior abdominal wall defects.","PeriodicalId":7672,"journal":{"name":"American Journal of Health, Medicine and Nursing Practice","volume":"459 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76334538","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}
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