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Comparing Adherence in Cardiac Clinic Versus General Outpatient Clinic: Few Concerns and Way Forward 比较心脏门诊与普通门诊的依从性:几个问题和前进的方向
Pub Date : 2015-11-01 DOI: 10.4103/2141-9248.177981
K. Selvaraj, P. Thekkur, P. Chinnakali
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引用次数: 0
Tropical Diabetic Hand Syndrome. 热带糖尿病手综合征
Pub Date : 2015-11-01 DOI: 10.4103/2141-9248.177978
T C Okpara, B A Ezeala-Adikaibe, O Omire, E Nwonye, J Maluze

Any adult with diabetes in the tropics with hand cellulitis, infection and gangrene qualifies for tropical diabetic hand syndrome (TDHS). We reviewed a 39-year-old woman with a 3-week history of swelling of the left index finger following an insect bite. The swelling progressively increased in size, was very painful, and extended to the palm. There was no history or symptoms suggestive of chronic complications of diabetes. Random blood sugar on presentation was above 600 mg/dl using a glucometer. Examination revealed an edematous left palm draining pus from multiple sinuses, necrotic and gangrenous left index finger extending down to just above the thenar eminence. A diagnosis of TDHS in a patient with hyperosmolar state was made. She was managed accordingly and subsequently underwent aggressive debridement and desloughing. Two fingers were amputated and the wound was allowed to heal by secondary intention.

在热带地区,任何患有糖尿病并伴有手部蜂窝织炎、感染和坏疽的成年人都有可能患上热带糖尿病手综合征(TDHS)。我们接诊了一名 39 岁的女性患者,她被昆虫叮咬后左手食指肿胀,病史长达 3 周。肿胀逐渐增大,非常疼痛,并扩展到手掌。她没有糖尿病慢性并发症的病史或症状。就诊时使用血糖仪检测的随机血糖高于 600 毫克/分升。检查发现,患者左手掌水肿,多处窦道排脓,左手食指坏死、坏疽,一直延伸到肘突上方。诊断结果为高渗状态下的 TDHS。她接受了相应的治疗,随后接受了积极的清创和脱屑手术。她的两根手指被截去,伤口通过继发意向愈合。
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引用次数: 0
Follicular Adenomatoid Odontogenic Tumor in Mandible: A Rare Case Report 下颌骨滤泡性腺瘤样牙源性肿瘤1例报告
Pub Date : 2015-11-01 DOI: 10.4103/2141-9248.177976
U. Belgaumi, M. Parkar, Navdeep Malik, K. Suresh, AM Havewala, P. Bhalinge
Adenomatoid odontogenic tumor (AOT) is a relatively rare, benign, hamartomatous, and cystic odontogenic neoplasm that was first described more than a century ago. The lesion still continues to intrigue experts with its varied histomorphology and controversies regarding its development. The present article describes a case of cystic AOT with an unusual histomorphology associated with an impacted 44 in a 21-year-old male.
腺瘤样牙源性肿瘤(AOT)是一种相对罕见的良性、错构瘤性和囊性牙源性肿瘤,在一个多世纪前首次被描述。病变仍然继续引起专家的兴趣,其不同的组织形态和关于其发展的争议。本文描述了一例囊性AOT与一个不寻常的组织形态与影响44在一个21岁的男性。
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引用次数: 8
Association of Maternal Working Condition with Low Birth Weight: The Social Determinants of Health Approach 母亲工作条件与低出生体重的关系:健康方法的社会决定因素
Pub Date : 2015-11-01 DOI: 10.4103/2141-9248.177982
Z. Mahmoodi, Masoud Karimlou, H. Sajjadi, M. Dejman, Meroe Vameghi, M. Dolatian, Abolfazl Mahmoodi
Background: The socioeconomic conditions have made more job opportunities available to women. This has created interest to conduct studies on the effect of working lifestyle on pregnancy outcomes. Aim: This study was conducted with the aim to assess the relationship between mothers' working status as a social determinant and the incidence of low birth weight (LBW) of the newborn. Subjects and Methods: This case–control study was conducted on 500 women with normal weight infants (control group) and 250 women with LBW infants (case group) in selected hospitals in Tehran. Data were collected using a researcher-made questionnaire, designed to assess the effect of mothers' prenatal lifestyle, as a social determinant, on LBW of the newborn. A section of the questionnaire involved assessment of mother's working condition in terms of the work environment, activities, and job satisfaction. Data were analyzed using Chi-square and logistic regression tests. Results: LBW among employed mothers was 5 times more likely than unemployed ones (odds ratio = 5.35, P < 0.001). Unfavorable work conditions such as humid environment, contact with detergents, and being in one standing or sitting position for long hours were significantly associated with LBW (P < 0.001).Conclusion: The present study showed that unfavorable work conditions were associated with LBW; therefore, they need special attention.
背景:社会经济条件为妇女提供了更多的就业机会。这引起了人们对研究工作生活方式对怀孕结果的影响的兴趣。目的:本研究旨在评估母亲工作状态与新生儿低出生体重(LBW)发生率之间的关系。研究对象和方法:本病例对照研究在德黑兰选定的医院对500名正常体重婴儿(对照组)和250名低体重婴儿(病例组)的妇女进行了研究。数据收集使用研究人员制作的问卷,旨在评估母亲产前生活方式的影响,作为一个社会决定因素,对新生儿的体重。问卷的一个部分包括从工作环境、活动和工作满意度三个方面评估母亲的工作状况。数据分析采用卡方检验和逻辑回归检验。结果:在职母亲发生LBW的可能性是失业母亲的5倍(优势比= 5.35,P < 0.001)。不利的工作条件,如潮湿的环境,接触清洁剂,长时间站立或坐着与LBW显著相关(P < 0.001)。结论:不良工作环境与低体重有关;因此,他们需要特别注意。
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引用次数: 30
Identifying the Optimal Age to Perform Newborn Screening for Hearing Loss in Uganda 确定在乌干达进行新生儿听力损失筛查的最佳年龄
Pub Date : 2015-11-01 DOI: 10.4103/2141-9248.177975
M. Walsh, E. Redshaw, E. Crossley, C. Phillips
Background: Permanent congenital hearing loss affects up to 6/1000 births in developing countries. Currently, in Uganda there is no newborn screening for hearing loss (NSHL) program and no published work on this topic. Within the existing healthcare system there are two opportunities to deliver screening, at birth or 6 weeks of age when infants receive their immunizations. Aim: This study explored the outcomes of otoacoustic emission (OAE) testing in infants at birth and 6 weeks of age, to identify the optimal age for screening. Subjects and Methods: This cross-sectional pilot study recruited 60 consecutive infants from two health centres in Kampala, Uganda. Thirty infants were newborns recruited from the postnatal ward and 30 were aged 4–8 weeks from the immunization clinic, we performed OAE testing on all infants. Results: The results showed 56.7% (17/30) of newborn infants passed OAE testing compared with 90.0% (27/30) of the immunization infants, P < 0.01. Furthermore, of the 11 newborn infants aged ≥24 h of age 90.9% (10/11) passed, compared with the 19 infants <24 h of age where 37% (7/19) passed, P < 0.01. Conclusions: This study demonstrates a higher pass rate for OAE testing for infants ≥24 h of age compared to those <24 h of age. The overall lower pass rate of the newborn infants could be due to external ear debris and middle ear fluid compromising the OAE testing. These findings would support a NSHL programme in Uganda that offers screening to infants ≥24 h of age, to maximize the cost-effectiveness of the program.
背景:永久性先天性听力损失影响发展中国家高达6/1000的新生儿。目前,乌干达没有新生儿听力损失筛查(NSHL)项目,也没有关于这一主题的出版工作。在现有的卫生保健系统中,提供筛查的机会有两种:出生时或婴儿在6周大时接受免疫接种。目的:本研究探讨出生及6周龄婴儿耳声发射(OAE)检测结果,以确定筛查的最佳年龄。对象和方法:这项横断面试点研究从乌干达坎帕拉的两个保健中心连续招募了60名婴儿。从产后病房招募30名新生儿,从免疫诊所招募30名4-8周龄婴儿,我们对所有婴儿进行OAE检测。结果:新生儿OAE检测合格率为56.7%(17/30),免疫组为90.0% (27/30),P < 0.01。≥24 h的11例新生儿合格率为90.9% (10/11),<24 h的19例新生儿合格率为37% (7/19),P < 0.01。结论:本研究表明≥24 h的婴儿OAE检测的通过率高于<24 h的婴儿。新生儿总体通过率较低可能是由于外耳碎片和中耳液体影响了OAE测试。这些发现将为乌干达的NSHL项目提供支持,该项目为≥24小时的婴儿提供筛查,以最大限度地提高该项目的成本效益。
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引用次数: 5
The Influence of Method, Timing of Onset and Duration of Enteral Feeding on the Duration of Hospitalization of Newborn Infants in a Nigerian Special Care Baby Unit 尼日利亚一家特殊护理婴儿病房新生儿肠内喂养方式、开始时间和持续时间对住院时间的影响
Pub Date : 2015-11-01 DOI: 10.4103/2141-9248.177991
T. Ogunlesi, O. Ogunfowora
Background: Feeding practices among high-risk newborn babies have not been extensively studied in the resource-constrained parts of the world. Aim: To describe the pattern of milk use among infants in a resource-poor special care baby unit (SCBU) and relate these to the outcome of hospitalization. Subjects and Methods: Setting – SCBU of Olabisi Onabanjo University Teaching Hospital, Sagamu. Design – Prospective study of consecutively admitted inborn babies within the first 24 h of life. The data analyzed included the weight and estimated gestational age (EGA) of the babies, the age at the onset of and duration of feeds (breast milk and artificial milk [AM]). Results: Out of the 118 infants studied, (78.8%) 93/118 received breast milk and 16.1% (19/118) received AM. The mean age at the commencement of enteral feeding was 3.9 days. The age at the onset of suckling was negatively correlated with the EGA and body weight. The age at the onset and duration of enteral feeding were directly related to the duration of admission. Conclusion: More than three-quarter of the infants hospitalized in the unit received breast milk, but commencement was mostly delayed beyond the 3rd day of life. The duration of admission may be related to the timing of onset and duration of milk use.
背景:在世界上资源有限的地区,高危新生儿的喂养方法尚未得到广泛研究。目的:描述资源贫乏的特殊护理婴儿病房(SCBU)婴儿的牛奶使用模式,并将其与住院结果联系起来。对象和方法:设置-奥拉比西奥纳班乔大学附属医院SCBU。设计:对出生后24小时内连续入院的新生儿进行前瞻性研究。分析的数据包括婴儿的体重和估计胎龄(EGA)、开始喂养(母乳和人工母乳[AM])的年龄和持续时间。结果:118名婴儿中,93/118(78.8%)接受母乳喂养,16.1%(19/118)接受AM治疗。开始肠内喂养时的平均年龄为3.9天。开始哺乳的年龄与EGA和体重呈负相关。发病年龄和肠内喂养时间与入院时间直接相关。结论:在该单位住院的婴儿中,超过四分之三的婴儿接受了母乳喂养,但开始母乳喂养的时间大多推迟到出生后的第3天。入院时间可能与发病时间和牛奶使用时间有关。
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引用次数: 1
Prevalence, Reasons, and Perceived Effects of Khat Chewing Among Students of a College in Gondar Town, Northwestern Ethiopia: A Cross-Sectional Study 埃塞俄比亚西北部贡达尔镇一所大学学生咀嚼阿拉伯茶的流行程度、原因和感知影响:一项横断面研究
Pub Date : 2015-11-01 DOI: 10.4103/2141-9248.177992
F. Teni, A. Surur, A. Hailemariam, A. Aye, G. Mitiku, AE Gurmu, B. Tessema
Background: The estimate of the number of people chewing Khat globally ranges from 5 to 10 million people. Its use may result in a variety of effects due to the different compounds in it with effects on the gastro-intestinal system and nervous system being the principal ones. Aim: To assess the prevalence, factors, and effects of Khat chewing among students of a college in Gondar town, northwestern Ethiopia. Subjects and Methods: An institution-based cross-sectional study was conducted from 15th to 20th of April 2009 on a total sample of 424 students who were selected using stratified random sampling technique. Data were collected by three of the principal investigators using a structured pretested data collection instrument and analyzed by Epi Info version 3.5.2. Results: The lifetime and current prevalence of Khat chewing among the respondents were 42% (168/400) and 32.5% (130/400), respectively. Sex (P < 0.01), religion (P < 0.001), and income (P < 0.01) showed statistically significant variation in Khat chewing. The commonest frequency of Khat chewing was once a day 33.1% (43/130) while alcohol (40.8% [53/130]) and cigarette (40.0% [52/130]) were the mostly used substances with Khat. More than half of the chewers (53.85% [70/130]) reported spending 1–4 h for one Khat chewing ceremony. Financially majority of the chewers reported spending up to 10 Ethiopian Birr (ETB) (1.13 United States Dollar) on Khat ( 54.6% [71/130]) and other substances (64.6% [84/130]). Nearly two-thirds (62.3% [81/130]) of the chewers mentioned seeking concentration during study as their main reason for chewing. Among chewers, 83.1% (108/130) reported they faced problem associated to sleep disturbance, 82.3% (107/130) loss of appetite, and 80.8% (105/130) constipation. Conclusion: The prevalence of Khat chewing was fairly high among the students and the majority among them used other substances together with Khat. Spending of a significant amount of money and facing health problems were reported to be consequences of the habit. The college should take steps to make students aware of the ills of Khat chewing and associated habits.
背景:全球咀嚼阿拉伯茶的人数估计在500万到1000万人之间。由于其成分不同,其使用可产生多种作用,其中对胃肠道系统和神经系统的作用是主要的。目的:了解埃塞俄比亚西北部贡达尔镇某高校学生咀嚼阿拉伯茶的流行情况、影响因素及影响因素。对象与方法:本研究于2009年4月15日至20日采用分层随机抽样方法对424名学生进行了基于机构的横断面研究。数据由3名主要研究者使用结构化预测试数据收集仪收集,并使用Epi Info 3.5.2版本进行分析。结果:调查对象终生咀嚼阿拉伯茶的比例为42%(168/400),目前咀嚼阿拉伯茶的比例为32.5%(130/400)。性别(P < 0.01)、宗教信仰(P < 0.001)、收入(P < 0.01)差异有统计学意义。最常见的咀嚼阿拉伯茶的频率为1次/ d(33.1%, 43/130),与阿拉伯茶最多的是酒精(40.8%,53/130)和香烟(40.0%,52/130)。超过一半的咀嚼者(53.85%[70/130])报告花1-4小时进行一次阿拉伯茶咀嚼仪式。大多数咀嚼者报告在阿拉伯茶(54.6%[71/130])和其他物质(64.6%[84/130])上花费高达10埃塞俄比亚比尔(ETB)(1.13美元)。近三分之二(62.3%[81/130])的咀嚼者表示,在学习中集中注意力是他们咀嚼的主要原因。在咀嚼者中,83.1%(108/130)报告他们面临与睡眠障碍相关的问题,82.3%(107/130)报告食欲不振,80.8%(105/130)报告便秘。结论:学生咀嚼阿拉伯茶的比例较高,多数学生将其他物质与阿拉伯茶混合使用。据报道,这种习惯的后果是花费大量金钱和面临健康问题。学院应该采取措施,让学生意识到咀嚼阿拉伯茶和相关习惯的危害。
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引用次数: 32
Management of Odontogenic Fibromyxoma in Pediatric Nigerian Patients: A Review of 8 Cases 8例尼日利亚儿童牙源性纤维黏液瘤的治疗
Pub Date : 2015-11-01 DOI: 10.4103/2141-9248.177994
Ku Omeje, I. Amole, O. Osunde, AA Efunkoya
Odontogenic fibromyxoma (OFM) is a benign, locally invasive and aggressive nonmetastasizing neoplasm of jaw bones. They are considered relatively rare and known to be derived from embryonic mesenchymal elements of dental origin. Treatment of OFM depends on the size of the lesion and on its nature and behavior. Varying treatment modalities ranging from curettage to radical excision have been documented.Aim; This paper is a review of management of 8 pediatric patients with histologically diagnosed OFM at a Nigerian tertiary health care facility. This was a retrospective study of all patients aged 15 years and below who presented to the Oral and Maxillofacial Surgery Clinic of Aminu Kano Teaching Hospital, Kano, over a 5-year period (January 2008 to December 2012), with a histologic diagnosis of OFM. The information obtained included patients' demographics, as well as their clinical characteristics such as the anatomical site and side of lesions. Other information collated included presenting features, the onset of symptoms, type of treatment carried out, as well as treatment outcome. The data were analyzed and the results presented as frequencies and percentages. Among the 8 patients with OFM, more males (n = 5/8; 62.5%) were affected than females (n = 3/8; 37.5%). The mandible (n = 5/8; 62.5%) was the most frequent site of occurrence, and the anterior mandible was the most favored location (n = 4/8; 50%). Seven patients had excision of the lesion with peripheral ostectomy of the underlying bone while only one patient had a bone resection. These patients have been followed up for at least 1 year, and no recurrence was observed throughout the follow-up period. OFM causes gross facial disfigurement and may result in the destruction of the entire jaw bone; the impact of which may be grave for a growing child. Prompt surgical intervention and follow-up have proven to be adequate management protocol.
牙源性纤维黏液瘤(OFM)是一种良性,局部侵袭性和侵袭性的颌骨非转移性肿瘤。它们被认为是相对罕见的,并且已知来自牙齿起源的胚胎间充质成分。OFM的治疗取决于病变的大小及其性质和行为。不同的治疗方式,从刮除到根治性切除已被记录。本文回顾了尼日利亚一家三级卫生保健机构对8例组织学诊断为OFM的儿科患者的管理情况。这是一项回顾性研究,所有年龄在15岁及以下的患者在5年期间(2008年1月至2012年12月)就诊于卡诺Aminu Kano教学医院口腔颌面外科诊所,组织学诊断为OFM。获得的信息包括患者的人口统计学信息,以及他们的临床特征,如病变的解剖部位和侧面。整理的其他信息包括表现特征、症状开始、进行的治疗类型以及治疗结果。对数据进行分析,结果以频率和百分比表示。8例OFM患者中,男性居多(n = 5/8;62.5%)比女性受影响(n = 3/8;37.5%)。下颌骨(n = 5/8;62.5%)是最常见的发生部位,前下颌骨是最容易发生的部位(n = 4/8;50%)。7例患者切除病变并行周围骨切除术,而只有1例患者行骨切除术。这些患者已随访至少1年,随访期间未见复发。OFM会造成严重的面部畸形,并可能导致整个颌骨的破坏;这对一个成长中的孩子来说可能是严重的影响。及时的手术干预和随访已被证明是适当的治疗方案。
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引用次数: 4
Predictors of Loss to Follow-up Among HIV-infected Patients in a Rural South-Eastern Nigeria Hospital: A 5-year Retrospective Cohort Study 尼日利亚东南部农村医院hiv感染患者随访损失的预测因素:一项5年回顾性队列研究
Pub Date : 2015-11-01 DOI: 10.4103/2141-9248.177988
KN Eguzo, A. Lawal, C. Umezurike, Ce Eseigbe
Background: Patient attrition has been a challenge in managing HIV programs in resource-limited settings. Aim: This study reviews the predictors of loss to follow-up (LTFU) in our hospital and suggests the best practices for dealing with the issue. Subjects and Methods: A 5-year retrospective cohort study of 1256 HIV-infected patients. Baseline CD4 counts, age, gender, year of enrolment, and antiretroviral therapy combination regimen were considered in this study. Kaplan–Meier models were used to estimate the univariate time-to-LTFU and Cox proportional hazards models to identify the multivariate predictors of LTFU. Results: Twenty-four percent (23.9% [301/1256]) of patients were lost to follow-up. Baseline CD4 count, year of enrolment, and drug combination were significant predictors of LTFU. Patients enrolled earlier (2008/2009) were twice as likely to be LTFU compared with those enrolled later (2010–2013). Gender and age did not significantly predict LTFU nor confound other predictors. Conclusion: The program showed higher LTFU rates than most studies in Nigeria and Africa, maybe due to difficulties with the access to the hospital and possible treatment fatigue. This study recommends the provision of transportation subsidies and proactive patient follow-up with “peer-tracking” to reduce LTFU among HIV infected patients, especially in resource-limited settings.
背景:在资源有限的环境中,患者流失一直是管理艾滋病毒项目的一个挑战。目的:本研究回顾我院失访率(LTFU)的预测因素,并提出处理该问题的最佳做法。研究对象和方法:对1256例hiv感染者进行5年回顾性队列研究。本研究考虑了基线CD4计数、年龄、性别、入组年份和抗逆转录病毒联合治疗方案。Kaplan-Meier模型用于估计单变量的时间到LTFU, Cox比例风险模型用于确定LTFU的多变量预测因子。结果:24%(23.9%[301/1256])患者失访。基线CD4计数、入组年份和药物组合是LTFU的重要预测因子。较早入组(2008/2009)的患者发生LTFU的可能性是较晚入组(2010-2013)的两倍。性别和年龄不能显著预测LTFU,也不能混淆其他预测因子。结论:与尼日利亚和非洲的大多数研究相比,该项目显示出更高的LTFU率,可能是由于进入医院的困难和可能的治疗疲劳。本研究建议提供交通补贴和积极的“同行跟踪”患者随访,以减少HIV感染者的LTFU,特别是在资源有限的环境中。
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引用次数: 19
Prevalence of Needlestick Injuries Among Healthcare Workers in the Accident and Emergency Department of a Teaching Hospital in Nigeria 尼日利亚一所教学医院急诊科医护人员中针刺伤的发生率
Pub Date : 2015-11-01 DOI: 10.4103/2141-9248.177973
A. Isara, KE Oguzie, OE Okpogoro
Background: Healthcare workers (HCWs) are continually exposed to hazards from contact with blood and body fluids of patients in the healthcare setting. Aim: To determine the prevalence of needlestick injuries (NSIs) and associated factors among HCWs in the Accident and Emergency Department of the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. Subjects and Methods: This was a cross-sectional study. Data were collected using a structured, self-administered questionnaire and analyzed using IBM SPSS version 20. Univariate, bivariate, and binary logistic regression analyses were done. The level of significance was set at P < 0.05. Results: The prevalence of NSIs 12 months preceding the study was 51.0% (50/98). Doctors 8/10 (80.0%) and nurses 28/40 (70.0%) had the highest occurrence. Recapping of needles 19/50 (38.0%) and patient aggression 13/50 (26.0%) were responsible for most injuries. The majority 31/50 (62.0%) of the injuries were not reported. The uptake of postexposure prophylaxis (PEP) was low 11/50 (22.0%). The factors that were significantly associated with NSI include age 30 years and above (odds ratio [OR] =0.28, confidence interval [CI] = 0.11–0.70), work duration of three years and above (OR = 0.29, CI = 0.11–0.75), and being a nurse (OR = 3.38, CI = 1.49–9.93) or a paramedic (OR = 0.18, CI = 0.06–0.52). Conclusion: The high prevalence of NSIs among the HCWs, especially in doctors and nurses is an indication that HCWs in UBTH are at great risk of contracting blood-borne infections. Efforts should be made to ensure that injuries are reported and appropriate PEP undertaken following NSIs.
背景:卫生保健工作者(HCWs)在卫生保健环境中不断暴露于接触患者血液和体液的危害。目的:了解尼日利亚贝宁市贝宁大学教学医院(UBTH)急诊科医护人员中针刺伤(nsi)的发生率及其相关因素。对象和方法:这是一项横断面研究。使用结构化的自我管理问卷收集数据,并使用IBM SPSS version 20进行分析。进行单因素、双因素和二元逻辑回归分析。P < 0.05为显著性水平。结果:研究前12个月nsi患病率为51.0%(50/98)。医生8/10(80.0%)和护士28/40(70.0%)发生率最高。针盖19/50(38.0%)和患者攻击13/50(26.0%)是造成损伤的主要原因。31/50(62.0%)的损伤未报告。暴露后预防(PEP)的吸收率低11/50(22.0%)。与NSI显著相关的因素包括年龄30岁及以上(优势比[OR] =0.28,可信区间[CI] = 0.11-0.70)、工作年限3年及以上(OR = 0.29, CI = 0.11-0.75)、护士(OR = 3.38, CI = 1.49-9.93)或护理人员(OR = 0.18, CI = 0.06-0.52)。结论:卫生保健工作者,尤其是医生和护士中nsi的高发表明,UBTH卫生保健工作者存在较大的血源性感染风险。应努力确保在nsi后报告伤害并采取适当的PEP。
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引用次数: 27
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