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Knowledge, Attitude and Practice and Associated Factors on Oxygen Therapy Among Nurses and Midwives in Y12 HMC-2022 Gc

Background: Oxygen is an essential medical therapy which saves a lot of lives. It is administered as a corrective treatment for conditions resulting in hypoxia (low level of oxygen in the blood). So, the nurse should have more skills and experience to performing this procedure in the aim to maintain the patient's life safe and avoid complications associated with incorrect oxygen administration technique. Objective: The study was conducted to assess the level of knowledge, attitude and practice towards oxygen therapy administration and associated factors among nurses and midwives at Yekatit 12 Hospital Medical college in 2022. Method: To achieve the research objectives a hospital based cross-sectional study was applied. The sample size drawn was 198. Pertinent data for the study were gathered through structured questionnaires. Descriptive and multiple logistic regression were used in the analysis of independent and outcome variables. Result: Data is collected from 211 participants and my response rate is (198)93.8%. Among 198 nurse and midwives 50.5% were males, 49.5% with the range of 30-39yrs and most of them (48.5%) have work experience of 6-9yrs.The mean score of knowledge, attitude and practice were 5.7(SD=1.608),4.01(SD=1.837) and 14.5(3.49) respectively. It is found that the level of knowledge was adequate in 117(59.1%) and poor 81 (40.9%) of participants. Practical skill is found to poor in 63.1% of participants and factors associated with this were absences of oxygen therapy guide line, not participating in any training about oxygen therapy and supply of oxygen delivery system with P-value of 0.01, 0.02 and 0.002 respectively. work experience also contributes for poor practice. Conclusion: There is a clear practical gap among nurses and midwives working in Y12HMC and this study also shows as there is poor attitude in almost have of the participants which high compared to another research. The possible associated factors for poor practice were identified as work experience less than 1yr and absence of training and oxygen guideline. So, to enhance safe use of oxygen therapy the referral hospital needs to push its effort for improving the practice and attitude of nurses and midwives towards oxygen therapy by facilitating trainings, increases the availability of guideline and supply of oxygen.

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Gardner Syndrome: A Diagnosis Approach, Clinical Evolution and Review

Introduction: Gardner Syndrome is characterized as an autosomal and dominant genetic mutation. Case Presentation: A 28-year-old man from the state of Gioias arrived at the emergency room accompanied by family members, complaining of recurrent diarrhoea with the presence of mucus and blood, in addition to cramps, abdominal distension, rectal tenesmus and episodes of metrorrhagia. After a thorough investigation, the patient reported having a lesion of about 2 cm in size on the left frontal region, with a firm and fixed consistency, which appeared more than 2 years ago and suggests bone involvement. He also mentioned having sought medical attention 5 years ago due to dental problems and recurrent skin lesions, characterized by cystic lesions, but there was no further investigation at the time. Discussion: It is a syndrome with a variant of familial adenomatous polyposis, presenting a wide range of clinical manifestations, with significant intestinal involvement, as well as osteomas and soft tissue tumours, which in general precede the intestinal clinical picture. The diagnosis of Gardner's Syndrome is made with multiple tools, involving clinical, radiological, endoscopic and genetic exams, and, being early, there is a significant improvement in prognosis. In order to avoid the malignant progression of intestinal polyps, prophylactic colectomy is indicated in most cases, but it is necessary to individualize the follow-up according to the phenotype of the disease. Conclusion: Patients with GS should be screened for intracolonic malignancy annually, as desmoid tumours are a common feature of GS/FAP, resulting in significant morbidity. and even mortality. Thus, early diagnosis, once again, will contribute to a better quality of life in the long term.

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Maternal Healthcare Services Utilization and Associated Factors among Childbearing Age of Women in Liben District, East Borena Zone, Oromia Regional Health Bureau, Ethiopia

Background: Utilization of maternal healthcare services is a fundamental health intervention for preventing maternal morbidity and mortality. Despite its importance, the utilization of maternal healthcare services in Ethiopia is low, especially in rural pastoralist communities. Thus, this study aimed to assess maternal healthcare services utilizations and its associated factors in the Liben district of Guji zone, Oromia region, Southern Ethiopia. Methods: A community-based cross-sectional study was conducted with 416 randomly identified mothers in Liben in September, 2020. The respondents were mothers who had given birth 12 months prior to the survey. The data were collected using interviewer administered questionnaires. The data were entered into Epi-data version 4.1 and analyzed using SPSS version 20. Descriptive, bivariate and multivariate logistic regression analyses were also performed. Result: Sixty percent of mothers had received antenatal care at least once. In this study, only 21.2% and 17.5% of women had delivered their babies at health institutions and utilized early postnatal care services respectively. Maternal education [AOR=2.43(95%CI: 1.22–4.89)], decision making power [AOR=2.40(95% CI: 1.3–23.3)], perceived compassionate & respectful care [AOR=0.30(95%CI: 0.18–0.50)], and planned current pregnancy [AOR=0.22(95% CI: 0.12–0.37)] were significantly associated with utilization of antenatal care. Mother’s age [AOR=3.73(95% CI: 1.53–6.04)], time to travel to health facilities [AOR=1.74(95% CI:1.02– 3.08)], knowledge of danger signs [AOR=3.77(95% CI:2.16–6.57)] and perceived compassionate and respectful care were significantly associated with institutional delivery, whereas recent antenatal care utilization[AOR=5.34(95%CI:1.96–8.65)], planned current pregnancy and knowledge of danger signs [AOR=2.93(95%CI:1.59–5.41)] were found to be significantly associated with postnatal care utilization. Conclusion: Overall, the prevalence of maternal healthcare services utilization was far below the national and regional targets in the study area. Therefore, considering the identified associated factors and providing information and training on these issues to the community could improve and sustain maternal healthcare services utilization.

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Prevalence of Gonorrhea and Associated Knowledge, Attitudes, and Practices among High School Students in Burao City, Somaliland

Background: Gonorrhea, caused by the bacterium Neisseria gonorrhea, is a prevalent sexually transmitted infection (STI) that significantly impacts the health and well-being of individuals worldwide. It is the second most common preventable and treatable STI. In women, gonococcal infections often do not exhibit noticeable symptoms, leading to undetected and untreated infections. This can result in severe complications such as pelvic inflammatory disease, ectopic pregnancy, and infertility. Hence, the objective of this research was to evaluate the prevalence of gonorrhea infection among high school students in Burao city, Somaliland, while also examining their knowledge, attitudes, and practices associated with this infection. Methods: A quantitative method was employed to conduct an institutional-based cross-sectional study in selected schools in Burao city. The sampling method used was systematically random. To collect the data, a structured questionnaire with four parts was utilized. The collected data underwent a thorough process of checking for completeness, cleaning, coding, and entry using Kobo toolbox software (ODK). Subsequently, the data were exported to the Statistical Package for Social Sciences (SPSS) version 27 for analysis. Descriptive statistics were utilized to describe the study population to relevant variables. Furthermore, the chi-square test and odds ratio were performed at a 95% confidence interval using a p value of less than 0.05. Results: The study included 384 participants, with almost equal sex distributions. The response rate was high at 99%. The majority of participants had a negative attitude toward gonorrhea, while a significant proportion had accepted practices. The prevalence of gonorrhea was 2.1%. Logistic regression analysis revealed that good knowledge and a positive attitude toward gonorrhea were associated with higher levels of acceptable sexual practices. Additionally, practices and attitudes toward gonorrhea were strongly associated with each other. Conclusion: According to this study, the level of awareness regarding gonorrhea infection among schoolchildren in Burao city was significantly inadequate. Even though more than half of the students reported no sexual relationships, a considerable number of them were still engaging in risky sexual behaviors such as unprotected sex.

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Niemann-pick Disease: A Diagnostic Approach, Evolution Clinic and Review

Introduction: Niemann-Pick disease is a rare autosomal recessive enzymopathy, which causes a deficiency in the activity of the acid sphingomyelinase enzyme found in liposomal cells, resulting in a defect in the degradation of sphingomyelin into ceramide - the product that makes up the lipid bilayer of the cells. In this way, it generates accumulation and deposition of sphingomyelin mainly in the liver, spleen, brain, bone marrow and lungs, which can cause hepatosplenomegaly, pulmonary/neurological diseases and cytopenia. Case presentation: Male patient, 16 years old, seeks care at a health center, accompanied by his mother, due to the drop in school performance in the last year. According to school assessment, the patient presents gradual cognitive impairment, in addition to dysarthria. Discussion: The disease in this report is rare and can occur in both sexes, with incidence and clinical presentation varying according to each subtype of the pathology. Due to its multisystem involvement, its clinical presentation can be nonspecific and make its diagnosis difficult. Conclusion: It should be noted that this work aims to spread knowledge about this rare pathology, showing the importance of recognizing it in childhood so that the diagnosis can be made as early as possible, bringing better survival for those affected.

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Pattern of Clinical Profile and Outcome of Gillian Barre Syndrome in Sudanese Patients

Introduction: Guillian Barre'-Syndrome (GBS) is an acute, autoimmune disease affecting spinal roots and peripheral nerves, characterized by a rapidly progressive, ascending weakness of the extremity, trunk and even respiratory and facial muscles and with minor sensory and autonomic dysfunction. As in Sudan there is no enough data regarding the pattern of presentation and outcome of GBS, our research aimed to study clinical profile, electrophysiological variant, and outcome of Sudanese patients diagnosed with (GBS). Methods: A multi centers cross-sectional hospital-based study conducted in Khartoum from March to September 2020, 62 patients enrolled in the study, structured questionnaire consists of personal data, clinical history, examination findings, electrophysiological study result, management and outcome is used to assess the clinical profile and outcome of the disease. Results: The study revealed that males and females are equally represented, 70% patients are between 18 years and 50 years. The onset of the weakness was less than or equal 3 days in 33.9% of patients, from 4 to 7 days in 41.9%, from 8 to 14 days in 11.3% and above 14 days in 12.9%.40.3% patients had Evidence of autonomic dysfunction. The majority of patients presented with weakness that started in the lower limbs (93.5%), in (4.8%) the weakness started in the upper limbs and then descend. In (1.6%) the weakness started in the pharyngeal and respiratory muscles from the start. Sensory complains were observed in 54 patients (87.1%), 3 patients (4.8%) developed urinary bladder incontinence and 36 patients (58.1%) had back pain at the onset of the disease. On clinical examination; (98.4%) of patients had absent reflexes, (35.5%) had bilateral facial nerve palsy and (4.8%) had unilateral facial nerve pals. Based on the electrophysiological studies, (37.09 %) were recorded as acute motor axonal neuropathy (AMAN), (29.03%) as acute inflammatory demyelinating poly neuropathy (AIDP) and (29.03%) as acute motor-sensory axonal neuropathy (AMSAN). Regarding the outcome, 30 patients (48.4%) fully recovered, 25 patients (40.3%) recovered with motor deficit, and 7 patients (11.3%) unfortunately died. Conclusion: This study concluded that Guillian Barre'-Syndrome (GBS) in Sudanese population mainly affects age group from 18 to 50 years with variable maximum onset of weakness, presentation and outcome. Lower limb weakness and absent reflexes were the most presenting features. NCS showed axonal type of GBS found to be in nearly 66% of patients and 40% showed clinical evidence of dysautonomia.

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Bulbar Stenosis Revealing Duodenal Ulcer Disease in A Child: About A Case

Duodenal ulcer disease is relatively rare in children. Can be discovered at the stage of bulbar stenosis which is a complication whose treatment is essentially surgical; it is particularly mentioned in the case of chronic vomiting. A young child of 11 years old was admitted to the hospital 08 years ago for chronic vomiting associated with weight loss. He had a personal history of failure to thrive at the age of 6 without obvious etiology, and occasional consumption of shisha. The normal clinical examination contrasted with a biological inflammatory syndrome. An esogastroduodenal endoscopy carried out showed a tight pyloro-bulbar stenosis that could not be overcome, the biopsies taken showed non-specific duodenitis and absence of signs of malignancy, justifying sequential treatment with additional exploration: abdominal-pelvic scan and an esogastroduodenal transit confirming the stenosis. fibrous. Surgical treatment was carried out by a Mikulicz pyloroplasty, with good postoperative outcomes. The child remained asymptomatic. At the age of 20, occurrence of another complication of his ulcer disease such as heavy digestive bleeding requiring hospitalization in the gastroenterology department. The evolution was favorable under massive transfusion and treatment including amoxicillin, clarithromycin and metronidazole (14 days) and omeprazole (7 weeks). An endoscopic check one month later showed complete healing of the ulcer.

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Brain MRI Findings in CKD Patients with and without Parkinsonism, A Case-Control Study

Background: Chronic kidney disease (CKD) poses a major public health concern on a global scale. Patients with CKD have a heightened risk of developing multiple movement disorders like parkinsonism. Timely diagnosis through imaging and effective management may hold the key to mitigating disease symptoms. Methods: 28 individuals with CKD were categorized into two groups, nine patients showing signs of parkinsonism and a control group of nineteen patients without. All participants underwent non-contrast brain MRI scans, including T1, T2, DWI, and FLAIR sequences. We examined the presence or absence of brain MRI findings. The data obtained were analyzed using SPSS-24 and STATA for statistical analysis. Results: Nine patients exhibited parkinsonism symptoms, while nineteen did not. Brain MRI revealed hypointensities in structures like the putamen, globus pallidus, and cerebellar dentate nucleus in both groups. Comparative analysis showed no statistically significant differences in the percentages of these findings (p > 0.05). Similarly, the presence of cerebral atrophy and cerebrovascular disease did not significantly differ between the groups. Factors such as diabetes, hypertension, and history of dialysis also failed to show significant distinctions (p less than 0.05 for all). Conclusion: The correlation between brain MRI alterations in CKD patients with parkinsonism symptoms and those without was not significant. Nevertheless, there was a strong association between the duration of CKD in patients and the presence of parkinsonism-related signs.

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Fate of Papilledema in Cerebral Venous Thrombosis Patients and its Correlation to Affected Cerebral Venous Sinuses

Background: Cerebral venous thrombosis is an important cause of stroke in young and middle-aged adults with estimated (3-4) cases per million annual incidences. Papilledema is the most common sign detected in these patients that can end by blindness if not monitored and treated well. This research aims to assess development and prognosis of papilledema and its association with certain cerebral venous sinuses thrombosis. Evaluation of the optic nerve head has been done clinically and by using optical coherence tomography. Methods: A descriptive analytic hospital-based study was conducted in neurology unit at wad medani teaching hospital from December 2021 to July 2022. 20 patients were included in the study. Data including optical coherence tomography reports was collected at admission and after 2 months. Analysis was done using SPSS version 25 to report frequency of papilledema, 2months visual outcome, correlation of MRI\MRV findings with the development and outcome of papilledema. Results: This study include 20 cerebral venous thrombosis patients with mean age of 35.75 years. Papilledema present in 70% at initial presentation in whom the superior sagittal sinus was affected in 78.6%, after two months period papilledema regressed in80%, 10% developed optic atrophy and10% died. There is clear correlation between the sinus affected and the development of papilledema (P value=0.009); in contrast no relation between the sinus affected and the two months visual outcome of papilledema (P value=0.417). Conclusion: Papilledema regressed in most CVT patients while small number of them developed optic atrophy confirming the importance of regular ophthalmological follow up of CVT patients at frequent intervals using OCT in addition to other papilledema assessment tools in order to prevent irreversible blindness. Affection of certain cerebral venous sinus can predict development of papilledema in CVT patients, but not the outcome.

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