Consecutive Sampling Technique Research Articles

Overview of mom's confidence when planning to return low birth weight baby from the hospital

Introduction: Babies with low birth weight are one of the health problems often faced by mothers and families in various countries, including Indonesia. The return of babies with low birth weights from the hospital became a critical stage in their care after a period of intensive hospitalization. Objective: Describe the mother's confidence level when planning to return a baby with a low birth weight to the hospital. Method: quantitative research with a descriptive design involving 29 respondents. This study used non-probability and consecutive sampling techniques to determine subjects who met the inclusion criteria. The measuring instrument uses the Maternal Confidence Questionnaire Instrument, and the analysis results are descriptive data equipped with tables. Results: Most of the self-confidence of mothers planning to return home with high-birth-weight babies from the hospital was high among 16 respondents (55.2%). Factors that influence a mother's confidence include previous experience caring for a child, social support from family and friends, information and education provided by medical personnel, and an adequate financial condition and environment for the care of the baby. Conclusion: The mother's self-confidence plays a crucial role in planning the return of a low-birthweight baby from the hospital. Social support, knowledge of baby care, interaction with health workers, and understanding of the baby's health condition contribute to the mother's confidence. A holistic approach involving adequate social support, information and education, and financial and environmental readiness to increase maternal confidence in caring for a low-birth-weight baby after discharge from the hospital

Association Between Body Mass Index (BMI) and Occurrence of Esophageal Cancer

Aim: Esophageal cancer, one of the leading causes of cancer deaths globally, has been linked to body mass index (BMI). Studies have shown varying associations between BMI and different subtypes of esophageal cancer, namely adenocarcinoma and squamous cell carcinoma. However, there is limited literature from Pakistan on this topic. This study aims to investigate the association between BMI and the occurrence of esophageal cancer in a Pakistani population. Methods: A prospective observational study was conducted at the Oncology Department of Jinnah Postgraduate Medical Center, Pakistan. Participants included patients over 18 years old with suspected adenocarcinoma or squamous carcinoma of the esophagus. The study utilized a non-probability consecutive sampling technique, and data was collected using a predefined proforma. The association between BMI and types of esophageal carcinoma was analyzed using Chi-square tests. Results: The study found a statistically significant relationship between increasing BMI and the risk of developing esophageal adenocarcinoma. Conversely, a lower BMI was associated with a higher risk of squamous cell carcinoma. These findings align with existing literature that suggests different BMI associations with esophageal cancer subtypes. Conclusion: This study underscores the distinct relationships between BMI and different types of esophageal cancer. It highlights the importance of considering BMI as a factor in the risk assessment for esophageal cancer, particularly in the Pakistani population. Keywords: Esophageal Cancer, Body Mass Index (BMI), Adenocarcinoma, Squamous Cell Carcinoma

ARISCAT and LAS VEGAS risk scores for predicting postoperative pulmonary complications after cardiac surgery: a cohort study

Background: Postoperative pulmonary complications (PPCs) could lead to morbidity, mortality, and prolong hospital stay. Different risk scoring systems are used to predict the identification of patients at risk of developing PPCs. The diagnostic accuracies of the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) and Local Assessment of Ventilatory Management During General Anaesthesia for Surgery (LAS VEGAS) risk scores are compared in prediction of PPCs taking pulmonary complication as gold standard in cardiac surgery. Materials and Methods: A prospective cohort study with consecutive sampling technique. A total of 181 patients were included. Quantitative data is presented as simple descriptive statistics giving mean and standard deviation and qualitative variables are presented as frequency and percentages. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracies are also calculated. Results: Total 181 post cardiac surgery patients were analyzed. The median [interquartile range] of age, height, weight, and BMI were 60.0 [52.0 – 67.0] years, 163.0 [156.0-168.0] cm, 71.0 [65.0 – 80.0] kg and [24.2 – 30.4] kg/m2. 127 (70.2%) were male and 54 (29.8%) were female. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of ARISCAT for the prediction of PPCs were (94.9%, 4.65%, 76.1%, 22.9% and 73.4%), whereas LAS VEGAS were (97.1%, 4.65%, 76.5%, 33.3% and 75.1%) respectively. Conclusion: Both the ARISCAT and LAS VEGAS risk scores are of limited value in cardiac surgery patients for the prediction of postoperative pulmonary complications, based on the predicted scores in this study.

Emergency Profile of Pediatric Patients Based on Pediatric Early Warning Score in the Emergency Department of the Adam Malik Hospital

Background: High morbidity and mortality rates in pediatric patients indicate the necessity of a Pediatric Early Warning Score (PEWS) capable of early clinical deterioration identification and providing an opportunity for healthcare professionals to promptly manage patients. This study aimed to serve as foundational data and as an evaluative tool to enhance the proficiency of healthcare workers in assessing patient deterioration. Methods: This study utilized a descriptive method with a cross-sectional design and consecutive sampling technique who were treated from January to December 2022. Results: there were 119 samples, the majority of gender was male (54.6%), the majority of the age group was 1-4 years old (37.8%), and the majority of the disease group was infection (31.1%). Both male and female majority had green PEWS (54.6%) and (45.4%), the majority of patients with an age range of 1 month to 5 years had red PEWS, the majority of infectious disease group had green PEWS, and the majority of patients with green PEWS had discharge outcome. Conclusion: This study provides an overview of characteristics in pediatric patients and shows the majority of pediatric emergency department patients come with non-emergency conditions.

ASSESSMENT OF OBESITY AND ITS ASSOCIATED FACTORS AMONG ADOLESCENT GIRLS IN SELECTED URBAN COMMUNITY, WEST BENGAL

Introduction: Over the world, obesity has spread like wildfire and is now a major public health concern. Obesity in adolescence tends to trace into adulthood and becomes difficult to treat. A child with an increased BMI has a risk of becoming overweight or obese at age 35 and this risk increases with the advancement of age.Aim: This study aims to determine the obesity among adolescent girls and to find out associated factors of obesity among adolescent girls in selected urban communities, West Bengal.Methods: A descriptive survey research was carried out among 1245 adolescents selected through non-probability consecutive sampling technique and from them, 103 obese participants were selected based on BMI values through nonprobability purposive sampling technique. Data was gathered using a validated semi-structured and structured questionnaire. Data were gathered on adolescent’s demographic characteristics and BMI and associated factors of obesity.Result: The result revealed that 8.27% of the respondents were obese, 18.96% of the adolescents were overweight, 54.70 % of the respondents had normal weight and 18.07 % of them had thinness. Chi-Square findings revealed that there was significant association seen between the obesity and age of the adolescent girls (p<0.01), educational status (p<0.001), food habit, family income. The findings of the study have significant implications for nursing practice, education, administration, and research.Conclusion: The prevalence of obesity was observed higher in the age group of above 15 years. The findings of this study indicate that to ensure good health now and in the future, adolescents should be taught the value of a balanced diet, regular exercise, and limiting screen time for primary prevention. The youngster of today is the adult of tomorrow in good health.

Bacterial etiologies, antimicrobial susceptibility pattern and associated factors among patients suspected sterile body site infections at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia.

Sterile body locations are usually associated with clinical urgency and life-threatening illnesses, and they are typically contaminated with diverse bacterial etiologies. If the bacteria acquire resistance to antimicrobial drugs, the public health crisis will only worsen. In developing countries, drug-resistant bacteria are common because of poor surveillance, diagnostic capacity, and control measures. Early diagnosis, and assessing the drug resistance and factors associated with infection are important to combat the drug resistance and treatment. This study aimed to assess the bacterial etiologies, antimicrobial susceptibility pattern, and possible associated factors among patients suspected of sterile body sites. A hospital-based cross-sectional study was conducted from June 2022 to August 2022 at Debre Markos Comprehensive Specialized Hospital in Amhara regional state, Ethiopia. One hundred seven study participants were selected using consecutive convenient sampling techniques. A structured questionnaire was used to collect socio-demographic and clinical data. Gram stain was done for a preliminary report and inoculated into blood agar, MacConkey agar, and chocolate agar and incubated aerobically and micro aerobically at 37°C for 24 h. Antimicrobial susceptibility testing was done by the modified Kirby Bauer's disk diffusion method. Data were analyzed using bivariate and multivariate logistic regression was used. A p-value less than 0.05 is considered as statistically significant. The overall magnitude of sterile body site infection among study participants was 7.5% (14/187). The majority of the isolates were Gram-negative bacteria with the predominant species Enterobacter cloacae accounting for 28.57% (4/14). Among isolates 78.57%(11/14) of them were multidrug-resistant isolates. Being inpatient, co-morbidity, and alcohol consumption were significantly associated with sterile body site infection. In our study, Gram-negative bacteria were the predominant bacteria that infects sterile body fluid. The prevalence of multi-drug resistance bacteria isolates was significantly high. Therefore, before prescribing an empirical treatment, a medical professional should identify the bacterial etiology of sterile body fluids and the susceptibility of microbes to the drug.

Predictors of infective endocarditis associated in-hospital mortality in Ayder Comprehensive Specialized Hospital, Tigray, North Ethiopia: Microbiological,clinical features, and management profiles.

Infective endocarditis (IE) is a continuously evolving disease with a high mortality rate despite different advances in treatment. In Ethiopia, there is a paucity of data regarding IE. Therefore, this study is aimed at assessing IE-related in-hospital mortality and characterization of IE patients based on their microbiological, clinical features, and management profiles in the Ayder Comprehensive Specified Hospital (ACSH). We conducted a hospital-based prospective follow-up study with all consecutive sampling techniques for suspected infective endocarditis patients admitted to ACSH from January 2020 to February 2022. Echocardiography was performed, and three sets of blood samples for blood culture were taken as per the standard protocol. We also performed isolation of microbial etiologies and antimicrobial susceptibility tests. The data was analyzed using STATA version 16. Stepwise logistic regression was run to identify predictors of in-hospital mortality. Effects were measured through the odds ratio at the 5% level of significance. Seventy-four cases of suspected infective endocarditis were investigated; of these, 54 episodes fulfilled modified Duke's criteria. Rheumatic heart disease (RHD) (85.2%) was the most common underlying heart disease. Murmur (94.4%), fever (68.5%), and pallor (57.4%) were the most common clinical findings. Vegetation was present in 96.3% of episodes. Blood culture was positive only in 7 (13%) episodes. Complications occurred in 41 (75.9%) cases, with congestive heart failure being the most common. All patients were managed medically, with no surgical intervention. The in-hospital mortality was 14 (25.9%). IE-related in-hospital mortality was significantly associated with surgery recommendation and myalgia clinical symptoms. IE occurred relatively in a younger population, with RHD as the most common underlying heart disease. There was a high rate of culture-negative endocarditis, and the majority of patients were treated empirically. Mortality was high. The establishment of cardiac surgery and strengthening microbiology services should be given top priority.

Determinants of Disability Among Individuals Living with Schizophrenia Attending Psychiatric Follow-Up Clinic in Jimma, Southwest Ethiopia: An Institution-Based Case-Control Study.

Disability due to schizophrenia ends up with a higher degree of impairment in occupational, social and interpersonal functioning than other chronic illnesses. Despite severe and long-lasting schizophrenia associated disability, little has been explored so far to identify determinants of disability among individuals living with schizophrenia in Ethiopia. To identify the determinants of disability among individuals living with schizophrenia attending the psychiatric follow-up clinic at Jimma Medical Center (JMC). An institution-based unmatched case-control study was conducted among 98 Cases and 98 controls of individuals living with schizophrenia attending the JMC psychiatric clinic from September 1 to October 30, 2022. Consecutive sampling technique was used to recruit the required sample size of both groups. The cases group were participants who scored >12 total on the WHO Disability Assessment Scale version 2-0 (WHODAS 2-0) whereas the control group were those who scored 12 total on the WHODAS 2-0. Being jobless (AOR = 2.29; 95% CI: 1.10-4.77), longer than 5-year duration of illness without treatment (AOR = 3.13; 95% CI: 1.23-7.98), poor social support (AOR = 2.54; 95% CI: 1.04-6.22), negative symptoms (AOR = 2.45; 95% CI: 1.14-5.29), known family history of mental illness (AOR = 3.59; 95%: 1.67-7.73) and risky khat use (AOR = 4.37; 95% CI: 1.86-10.29) were found to be determinants of disability among schizophrenia patients. Joblessness, longer than 5-year duration of illness without treatment, poor social support, negative symptoms, known family history of mental illness and risky khat use were found to be determinants of disability in schizophrenia patients. Interventions targeting reducing of disability and improving quality of life of schizophrenia patients should consider the aforementioned determinants.

Correlation of CD4+ levels and caspase-3 in condyloma acuminata with HIV reactive patients

Background: Human papillomavirus is an infection that causes malignancy because of persistency and modulation of apoptotic pathways, especially caspase-3. Factors that can increase persistency, recurrency, and malignancy of HPV infection include HIV infection with low CD4 levels. There is disagreement or deep molecular understanding of the induction and modulation of apoptosis in HIV-mediated CD4+ T cell depletion, especially in CA. However, it is necessary to see how CD4+ levels can influence caspase-3, so it may open up new avenues for supporting investigation to consider the presence of malignancy or therapeutic strategies regarding CD4+ can induce apoptosis.Purpose: This study aimed to determine whether there is a correlation between CD4+ levels and caspase-3 expression in condyloma acuminata with HIV reactive patients.Methods: This is an analytic observational study with a cross-sectional design. The research was conducted at Dr. Moewardi General Hospital from August to December 2023. Nineteen patients with condyloma acuminata and HIV reactive were included in this study with a consecutive sampling technique. The expression of caspase-3 was assessed using immunohistochemical staining, looking at the percentage of stained cell nuclei and cytoplasm and CD4+ levels with flow cytometry examination—data analysis using Pearson correlation.Results: Respondents in this study were primarily men, self-employed with heterosexual orientation and genito-genital-oral sexual intercourse. The statistical analysis showed no significant relationship (p: 0.300, r: -0.251) between CD4+ levels and caspase-3 expression.Conclusions: While not statistically significant, CD4+ level is reduced in correlation with increased caspase-3 expressions.

Serosurveillance of COVID-19 amongst health care workers in a teaching institution – A prospective cohort study in Puducherry district

ABSTRACT Introduction: The rapid spread and mutation rate of severe acute respiratory syndrome corona virus (SARS-CoV2) demands continuous monitoring in terms of genomic and serosurvival. The current study is designed to track the seroprevalence of health care workers (HCWs) postvaccination, as they may be more susceptible to contracting the SARS-CoV-2 infection compared to the general population. Objective: The objective was to identify the seroprevalence rate for SARS-CoV-2 immunoglobulin G (IgG) antibody (N, S1, S2) amongst HCWs of various levels of exposure working in a tertiary care teaching hospital in Puducherry. Materials and Methods: The present study followed a nonprobability consecutive sampling technique, which involved 216 study participants HCWs from the hospital. IgG antibody levels were measured using EUROIMMUNE Anti SARS-COV-2 ELISA KIT (IG g) ELISA at two points: firstly, 2 weeks after the second dose of vaccination, followed by 2 weeks after the booster dose. Results: Out of the total 216 participants enrolled in the survey, there were 140 males and 76 females, and the maximum number of candidates studied were in the 41–50 age group. Almost 46.7% of the HCWs who participated in the study were seropositive for SARS-CoV-2 in the case of those who were high-risk exposed, while only 30.4% were amongst those who were low-risk exposed. The proportion of study participants who became seropositive increased considerably after the booster dose (65.7%), from 38.0% when tested three months after infection. Conclusion: A significant increase in antibody titres amongst high-risk HCWs postboost vaccination demands continuous monitoring of soluble IgG levels for recommendations of vaccination schedules.

Efficacy of human milk fortification in low-birth-weight infants; A randomized controlled trial

Introduction: Low Birth Weight (LBW), less than 2500grams, has significant effect on baby survival and growth. A good supportive care in addition to breastfeeding is very important. Breast milk fortification role is under research. Aims; To study the Efficacy of Human Milk Fortification in Low-Birth-Weight Infants Materials and Methods: This RCT was conducted at Department of pediatrics Lady Reading Hospital, Peshawar, Pakistan, from October 2021 to March 2022. A total of 60 low birth weight neonates were randomly allocated into two arms (group A fortified) and (group B unfortified) through non probability consecutive sampling technique. One group was given fortified expressed breast milk with 1g sachet of Human Milk Fortifier (HMF). The second group was fed with unfortified breast milk only. Babies were monitored every two-weekly with Biochemical markers. Data was analyzed through descriptive and inferential means using independent T Test. Results: The mean weight of neonates in the supplemented group was 2273.83g (Mean SD = 2273.83g 182.83g) and in the control group it was 2176.67g (Mean SD = 2176.67g 181.86g). Result shows that infants given human milk fortifier gain more weight as compared to breast milk. Statistical analysis also showed significant difference (P value 0.017) Conclusion: It is concluded that use of human fortified milk is helpful in gaining weight in low birth weight infants. It also improves serum calcium and protein levels.

Implementation of Stimulation, Early Detection, and Intervention Programs for Monitoring the Growth and Development of Children Aged 2-3 Years

Starting from growth that supports development, in the end growth and development go hand in hand. An important period in a child's growth and development begins in infancy because basic growth is what will influence and determine the child's subsequent development. The aim of this research is to detect deviations in the development of early childhood children aged 2-3 years at the ECCE Rahmah El Yunusiyyah Padang Panjang through the Stimulation, Detection and Early Intervention of Child Growth and Development (SDICGD) instruments in the Android feature. This research was conducted using a cross-sectional approach. Participants in this study were 26 children aged 2-3 years using a consecutive sampling technique of 10 children whose growth and development were monitored using the SDICGD android application. The results of this study showed that several partisipants experienced malnutrition, one partisipant out of nine normal partisipants. The Developmental Pre-Screening Questionnaire (DPSQ) instrument of the ten child participants contained nine children (90%) who were according to the developmental stage aged 24-36 months, and one child was not according to the developmental stage. The results of the Attention Deficit and Hyperactivity Disorder (ADHD) test showed that three children (60%) were normal, and two children (40%) were hyperactive. Early detection of children's growth and development must be carried out regularly every month, and according to the child's age. For further research, it is hoped that early detection will also be carried out on the development of children's mental health, not just growth and development which is common and widely researched. Schools and parents must play an active role in children's growth and development so that no developmental stages are missed, and children grow and develop according to their age. Keywords: simulation, detection, early intervention, child growth and development, development of children aged 2-3 years

Patterns of multiple sclerosis presentation to the emergency department.

Multiple sclerosis (MS) patients are no strangers to the emergency department (ED) due to the relapsing and progressive nature of the disease and the associated complications. This study aimed to identify patterns of ED visits among patients diagnosed with MS, the underlying causes of these visits, and the factors associated with these visits. This was a single center retrospective cohort study which utilized a non-probability consecutive sampling technique to include all patients diagnosed with MS (471 patients) from March 2016 to October 2021 in King Abdulaziz Medical City, Jeddah, Saudi Arabia. ED visits were categorized as directly related to MS, indirectly related to MS, or unrelated to MS. One in four people with MS visited the ED at least once with a total of 280 ED visits. Most ED visits were ones directly related to MS 43.6%, closely followed by unrelated to MS 41.1%, and then indirectly-related MS visits 15.4%. The most common presenting symptoms in directly-related MS visits were weakness 56.6% and numbness/tingling 56.6% followed by gait impairment 29.5%. Indirectly related to MS or unrelated to MS ED visits were commonly due to neurological 17.7% and gastrointestinal 17.1% causes. Using disease modifying therapy (DMT) was significantly associated with no ED visits (p < 0.001). The use of high-efficacy DMTs was significantly associated with no ED visits than using moderate efficacy DMT (p < 0.001). The use of B-cell depleting therapy (ocrelizumab and rituximab) was significantly associated with no visits to the ED than using any other DMT (p < 0.001). Evidence of brain atrophy on imaging was significantly associated with patients who presented to the ED ≥3 times (p = 0.006, UOR = 3.92). Due to the nature of the disease, many MS patients find themselves visiting the ED due to MS related and unrelated issues. These patients are not only required to be treated by neurologists but also by multiple disciplines. The use of high-efficacy DMTs and B-cell depleting therapy may reduce the total frequency of ED visits. Special attention should be paid to patients who have evidence of brain atrophy on imaging.

E047 Utilization of complementary and alternative medicine in patients with rheumatological conditions at Kenyatta National Hospital

Abstract Background/Aims The utilization of complementary and alternative medicine (CAM) has recently increased, especially among patients with rheumatic diseases, particularly those experiencing pain and mobility limitations. CAM use poses potential risks, such as drug interactions and adherence to conventional medicine. This study aimed to determine the prevalence of CAM use and evaluate the reasons and determinants among patients with rheumatological diseases who attended the rheumatology outpatient clinic at Kenyatta National Hospital (KNH). Methods In this cross-sectional descriptive study, patients with a confirmed diagnosis of rheumatic disease were enrolled at the rheumatology outpatient clinic of KNH. Consecutive sampling technique was employed to select patients. Data collection utilized two validated tools: the self-administered NAFKAM International - CAM-Questionnaire (I-CAM-Q) for assessing the prevalence and primary reasons for CAM utilization and the SF-36 questionnaire to assess the quality of life. CAM use was determined as a percentage of all study participants. Health-related quality of life (HRQOL) was assessed using the SF-36 questionnaire, and the results were compiled to established norms. Mean scores and standard deviations were calculated for each SF-36 subscale, and patients’ overall health-related quality of life was categorized as either good or poor based on a 50% cut-off score. To determine the association between CAM use and socio-demographic factors, as well as HRQOL, the Chi-square test was used, with statistical significance set at a p-value of &amp;lt; 0.05. Results A total of 151 patients, predominantly female (137), with a median age of 45 (IQR 31.5-56.5) years, participated in the study. The prevalence of CAM use was 55.6%. Among the CAM modalities, vitamins/minerals (94%), prayer for health (80.9%), and herbs/herbal products (69%) were the most frequently used. The primary motivation for CAM utilization was to enhance overall well-being, followed by its adoption as an alternative or co-medication due to the high cost of conventional medicine. Dissatisfaction with conventional medicine emerged as the least common reason. CAM use was not influenced by age, gender, marital status, or level of education but was associated with parameters indicating poorer health, as evidenced by the mental component score and physical component score of SF-36. Conclusion The study highlights a significant prevalence of CAM use among patients with rheumatic diseases, indicating a noteworthy trend in healthcare choices. This suggests that many individuals with severe conditions may seek CAM as an adjunctive approach to managing their health. Alternatively, CAM usage might interfere with adherence to conventional medication, potentially exacerbating disease severity. Healthcare professionals should be vigilant in recognizing CAM usage and assessing whether it is preferred over conventional medicine, facilitating informed decisions and patient-centered care. This research contributes valuable insights into the complex landscape of healthcare choices among patients with rheumatological diseases, shedding light on the importance of holistic healthcare management. Disclosure K.M. Juma: None. G.O. Oyoo: None. E.G. Kalman: None.

Effectiveness of H-files and Pro-Taper universal systems in removing Gutta-percha during endodontic retreatment: A comparative study

ObjectiveThis research was aimed at assessing the effectiveness of manual H-files versus a combination of a Pro-Taper universal rotary canal preparation system and retreatment system in removing gutta-percha (GP) during endodontic retreatment, by using a digital radiography technique. MethodsThis ex vivo study used a non-probability consecutive sampling technique. The study sample comprised 60 extracted anterior permanent teeth, each with one root with a straight root canal (RC). After preparation, RCs were obturated with GP and sealer. Subsequently, teeth were stored for 2 weeks in a humid environment at 37 °C. Thirty teeth each were randomly assigned to the control (group I), and experimental (group II) groups. GP removal was performed with H-files {group I) or a combination of a Pro-Taper universal rotary canal preparation system and retreatment system (group 2). Digital radiographs were acquired with Carestream digital radiovisiography software (Kodak; version-VER.6.10.8.3-A), and the presence of residual GP was analyzed. AutoCAD (2006) software was used to demarcate the RC and residual root filling. The residual GP in both groups was compared with independent sample t-tests. ResultsThe remaining root filling did not significantly differ when GP was removed with conventional Hedstrom files versus a combination of Pro-Taper Universal preparation and retreatment file systems. The residual GP was confined to the apical third of the canals in both groups. ConclusionsPro-Taper Universal preparation and retreatment file systems have similar effectiveness to manual H-files in GP removal in straight canals.

Satisfaction with Antiretroviral Therapy Services among People Living with HIV in Baglung District

Introduction: Antiretroviral therapy is the key to control of HIV/AIDS. Patient satisfaction is one of the commonly used outcome measures of patient care. The objective of this study was to assess the satisfaction of antiretroviral therapy (ART) services among People Living with HIV (PLHIV) in Baglung, Nepal. Methods: A descriptive cross-sectional study design was used to carry out this study. The study population consisted of PLHIV attending an ART Centre in Baglung. Non-probability consecutive sampling technique was used to select 113 PLHIV. Validity ensured and pretested interview schedule with four point Likert scale formats for measuring satisfaction was used to collect data from the respondents from June to December 2019. Both descriptive and inferential statistics such as the chi-square test was used to examine the association of the level of satisfaction of ART services with selected variables. Results: Most (77%) of the respondents expressed satisfaction with ART service, reporting a satisfaction score of 43.12 ± 3.492. Notably, young adults were more satisfied with ART services (OR=0.652, p=0.355). No significant association of socio-demographic variables were found with level of satisfaction with ART services. Conclusion: The overall satisfaction level of PLHIV towards ART service was good in this study area. There was no association of socio-demographic factors with level of satisfaction of PLHIV with ART service.

Serum Vitamin B12 Deficiency in Chronic Hemodialysis Patients.

Introduction Essential vitamins like folate and vitamin B12 are crucial for many physiological functions. Patients with renal failure undergoing regular hemodialysis in the general population may experience harmful effects from vitamin B12 deficits. Therefore, this study aimed to determine the frequency of vitamin B12 deficiency in hemodialysis patients and its association with other clinical parameters. Methods This cross-sectional study was conducted at the dialysis unit of Patel Hospital and Lifeline Hospital, Karachi, using a non-probability consecutive sampling technique after obtaining ethical approval from Lifeline Hospital (LLH/HR/02-22). The study duration was sixmonths, from January 10, 2023, to July 22, 2023. A total of 135 adult renal failure patients with ages >18 and <70 yearson maintenance hemodialysis for >1 year were included in the study. The chi-square testwas usedto determine the association between vitamin B12 deficiency and age and gender. A p-value of 0.05 was considered statistically significant. Results The study findings showed that out of 135 patients, 82 (60.7%) were males and 53 (39.3%) were females, with a mean age of 50.80 ± 10.03 years. The duration of hemodialysis was approximately 1-2 years in 98 (72.6%) patients, 2-3 years in 27 (20.0%) patients, and 3-4 years in only 9 (6.7%) patients. The mean serum vitamin B-12 levels were 411.61 ± 224.95 pg/ml, with 30 (22.2%) of the subjects being deficient. In terms of duration of hemodialysis, there was a significant association (p= 0.013). Between patients withnormal4 (4%) and deficient 5 (17%) vitamin B12 and 3-4 years of hemodialysis. Conclusion In this study, we found that a significant proportion of patients on chronic hemodialysis had vitamin B12 deficiency. Moreover, vitamin B12 deficiency was significantly associated with duration of hemodialysis. Therefore, we recommend periodic vitamin B12 testing in hemodialysis patients to avoid any associated complications.

Impact of Prolonged Pregnancy on Mode of Delivery and Fetal Outcome

Background: The “term pregnancy” is defined as the pregnancy that ends between 259 and 294 days (37-42 weeks) of pregnancy from the 1st day of last menstrual period. If the pregnancy continues beyond this mentioned period, it is called prolonged pregnancy. Post-term Pregnancy is one of the commonest obstetric conditions which associated with an increased risk of fetal and neonatal mortality and morbidity as well as an increased maternal morbidity.Objectives: The aim of this study is to determine the frequency of mode of delivery and fetal outcomes in prolonged pregnancy.Material and Methods: It is a Descriptive cross sectional study, conducted from 28th Aug, 2019 to 28thFeb, 2020 at Department of Obs &amp; Gynae, MTI-HMC Peshawar. Sample size was 125 keeping 11% proportion of patients having poor apgar score with 95% confidence interval, 5% level of significance.5% margin of error. Sample collection was accomplished by non-probability, consecutive sampling technique. All patients between 18-40 years of age with 42 weeks of gestation or more by dates or dating scan admitted to Gynae Ward/Labour room, having regular cycles were included in the study.Results: As per descriptive statistics, mean and SDs for age was 25±4.90. Mean and SDs for gravidity was recorded as 2±0.58. Mean and SDs for parity was 2±0.58. Mean and SDs for Apgar score was recorded as 8±0.89. 28 (22.4%) patients were obese. In this study 14 (11.2%) neonates had poor apgar score. Normal vaginal delivery 66(52.8%) was the Frequent mode of delivery followed by assisted vaginal deliveries 48(38.4%) and Caesarean section11(8.8%).Conclusion: In this study, we have concluded that pregnancy should not be allowed to go post-term due to association of higher neonatal morbidity and mortality rate, and should be managed before 42 weeks of gestation.Keywords: Fetal outcome, Post term pregnancy, Poor Apgar Score

Post-Tonsillectomy Pain:Is Cold Steel Dissection Method or Bipolar Diathermy Dissection Method is less Painful?

Background: Pain is one of the sequel of tonsillectomy, as reported in various studies. Tonsillectomy can be done by various methods, so aim of the present study is to evaluate pain of tonsillectomy comparing cold steel dissection method with bipolar diathermy method.Objective: To evaluate post-tonsillectomy pain comparing cold steel dissection method with bipolar diathermy method.Material and Methods: This prospective, randomized, controlled trial was conducted in ENT Department, from 18th January 2021 to January 30th 2022. Post tonsillectomy pain was measured by using visual analogue scale which consists of a 10 cm line with score of 10 means worse pain and score of zero means no pain. In this study a total sample size was 186 patients (i.e. 93 in each group), who were observed by taking the following parameters. Mean ± SD of group A (bipolar diathermy group) = 2.27 ± 1.25. Mean ± SD of group B (cold steel dissection group) = 1.59 ± 1.59. Confidence interval (2-sided) =95%. Power=90%. More over consecutive (nonprobability) sampling technique was used for sample collection.Results: In bipolar dissection group (38%) patients were male and (62%) patients were female. Where as in cold dissection group (40%) patients were male and (60%) patients were female. The mean pain score at 24 hours, 2ndpost operative day, 7th post operative day among two groups was analyzed. In bipolar dissection group, mean pain score at 24 hours was 3.5 ± 0.66, mean pain score at 2nd post operative day was 2.93 ± 0.73 and mean pain score at 7th post operative was 1.59 ± 1.02. Where as in cold dissection group, mean pain score at 24 hours was 3.33 ± 0.53 with a p value of 0.0543, mean pain score at 2ndpost operative day was 2.34 ± 0.60 with a p value of 0.0001and mean pain score at 7th post operative was 1.46 ± 0.82 with a p value of 0.3394.Conclusion: Our study concludes that mean pain score is less in cold steel dissection tonsillectomy as compared to bipolar diathermy tonsillectomy.Keywords: Analogue pain scale, Surgical Diathermy, Tonsillectomy.

A Case Control Study to Assess the Risk Factors for Preterm Deliveries among the Mothers Admitted In Shri Vinoba Bhave Civil Hospital, Silvassa, Dadra And Nagar Haveli

BACKGROUND: According to WHO Preterm delivery is defined as a delivery that occurs before 37 weeks of gestation. “Born too Soon” decade of action on preterm birth, produced by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) together with PMNCH-the world’s largest alliance for Women, Children, and adolescents sounds the alarm on a “Silent emergency” of preterm birth, long under recognized in its scale and severity which is impeding progress in improving children’s health and survival. OBJECTIVE: This study aim to determine the risk factors associate with preterm deliveries among the Mothers admitted in Shri Vinoba Bhave Civil Hospital, Silvassa, Dadra and Nagar Haveli. METHODS: The research design adopted for study was Case- control study. The written permission was obtained from the concerned authority of Shri Vinoba Bhave Civil Hospital, Silvassa for conducting the study. During the data collection period, the investigator established a good rapport with Mothers who had participated in the study and taken written consent from each of them. Samples were assigned using consecutive sampling technique. As per the research design &amp; tool, demographic &amp; maternal related data was collected. After collecting data from 200 samples for control group and 50 samples for case group were analysed using descriptive and inferential statistics. RESULT: A family history of PTD (OR:2.1, p value: 0.001, CI: 0.897-6.610), Height (OR: 1.672, p Value: 0.002, CI: 0.127-21.990), weight gain during pregnancy (OR: 13.070, p value: 0.024, CI: 1.413-120.851), , number of health visited during pregnancy (OR:8.411, p value: 0.001, CI:2.485-28.469), danger sign during pregnancy (OR: 2.01, p value: 0.001, CI:0.080-2.375), hypertension (OR:2.41, p value&lt;0.0001, CI: 0.045-8.348), oligohydramnions (OR: 1.652, p value: 0.004, CI: 0.544-5.817)and PROM (OR: 2.319, p value=0.012, CI:0.012-1.280) were all significant associated with PTD. CONCLUSION: The present study assessed the risk factors for preterm deliveries among the mothers admitted at Shri Vinoba Bhave Civil Hospital, Silvassa, DNH. In this study, a family history of preterm birth, weight gain during pregnancy, danger sign during pregnancy, hypertension, oligohydramnions and PROM. Recognizing the most common risk factors for PTD will help to increase the awareness about high-risk pregnancy, improve the preventive measures of preterm risk factors and modify preterm care protocol.