Descriptive Cross-sectional Study Research Articles

A study on clinico-demographic and microbiological profile of surgical site infection (SSI) in a tertiary care hospital, Kolkata: An alarming trend

The Centres for Disease Control and Prevention (CDC) estimates surgical site infections SSI is major contributor of healthcare associated infections (HAI). Multidrug resistant (MDR) Gram-negative bacilli are emerging pathogens. This study aimed to determine the magnitude of SSI and identify predominant pathogens with their antimicrobial susceptibility patterns. It is a hospital-based descriptive cross-sectional study including 2070 suspected SSI specimens from 25809 surgeries between 1July 2021 to 30 June 2023. Organisms’ identification and AST was done by both conventional and automated methods. Data was collected and analysed on MS-Excel sheet with various charts and tables. In our study SSI rate was 6.3%, much higher than previous study (2.83%) from this institution. SSI rate was highest in plastic surgery (8.2%). Major pathogens of SSI were Gram-negative bacilli e.g., (26.34%), (25.59%) and (74.69%) was predominant among Gram-positive cocci. Gram-negative bacilli including enterobacterales and non-fermenter and showed resistance to major classes of broad- spectrum antibiotics. Methicillin resistance (MRSA) was 43.9%, which indicates need to improve infection control practices. Our study showed significant higher proportion of SSI as compared to previous studies from the same institute with alarming number of isolated MDR Gram-negative bacilli. So, this study focusses the need of robust infection control practices and strict implementation of antimicrobial stewardship to overcome challenges of antimicrobial resistance.

Out Of Pocket Expenditure Of End Stage Renal Disease Patients For Maintenance Haemodialysis.

Background: End stage renal disease (ESRD) is a major and growing public health problem in Bangladesh. It is linked to higher hospitalization rates, lost productivity, illness, and early death, and it is a major cost on people, health care systems, and societies. Haemodialysis as a life saving measure can save patients but out-of-pocket expenditure of Haemodialysis in Bangladesh is high in comparison to their monthly family income. Therefore, it places a significant financial strain on the families of the disease victims. The aim of this study was to find out the out-of-pocket expenditure of ESRD patients for maintenance haemodialysis. Methods: This descriptive cross sectional study was carried out among 160 ESRD patients getting haemodialysis at Dialysis centre of a selected tertiary government hospital in Dhaka during the period of January to December 2022. Simple random sampling technique was followed. Data were collected by face to face interview with a semi-structured questionnaire and by check list reviewing medical documents. Results: The mean (±SD) age of the respondents was 49.28 ±12.706 years. Majority (60.6%) were male and 39.4% were female. Majority (29.4%) had secondary followed by 21.9% who had higher secondary level of education. About three fourths (71.9%) were from urban, 18.8% from rural, 8.1% from semi-urban areas and 1.3% were slum dwellers. The median of monthly family income was Tk. 20000 (interquartile range 15750). The median (IQR) total direct cost was Tk. 15983 (7203). The mean (±SD) total indirect cost was Tk. 5431.25±1128.17. The mean (±SD) total haemodialysis cost was Tk. 24205.59 ±17164.580. Conclusion: Out-of-pocket expenditure of Haemodialysis in Bangladesh is high in comparison to monthly family income and it poses huge financial burden to the families of the victims of end stage renal disease. The study recommended cost effective measures like subsidized or free of cost treatment of ESRD and free of cost haemodialysis of patients to reduce the financial burden of the families. Bangladesh Armed Forces Med J Vol 56 No (1) June 2023, pp 28-34

Profile and Prevalence of Oral and Maxillofacial Diseases Among Armed Forces Personnel and Their Families in Military Dental Centre, Cumilla

Background: Oral and maxillofacial diseases encompass a wide range of conditions in and around oral cavity and in maxillofacial region. It includes maxillofacial trauma, cyst and tumour of jaw bones, conditions involving impacted wisdom teeth, oral premalignant and malignant lesions, fascial space infection around maxillofacial region, temporomandibular joint disorder, dental implantology, salivary gland disorder and congenital defects of jaw bones. Maxillofacial region is more vulnerable to sustain injuries in the battlefield. In peace time, various maxillofacial diseases reduce the overall performances of the troops. The aim of this study is to delineate rank wise distribution of armed forces personnel reported with maxillofacial diseases, gender distribution, types of maxillofacial diseases, different types of surgical procedures performed and types of anesthesia used. Methods: A descriptive cross-sectional study was conducted to assess the prevalence of maxillofacial diseases among the armed forces personnel and their entitled family members during the period of 1st January 2019 to 31st December 2019 in Military Dental Centre, Cumilla. Purposive sampling technique and semi structured questionnaire was used to include the patients in this study.Data were analyzed by using Statistical Packages for Social Sciences (SPSS) version 25. Results: A total of 170 cases were evaluated and treated. Male patients were 110(65%) and female were 60(35%). Among the military personnel numbers of sainik (privates) were highest 32(35%). Impacted wisdom teeth cases were mostly found 80(47%). In case of impacted teeth mesio angular impactions were most 35(35%). In case of maxillofacial pathological conditions cystic lesions were most in number 22(39%) (n=56). Maxillofacial soft tissue laceration cases were highest 05(29%) (n=17) among all trauma patients. Surgical extraction of wisdom teeth were mostly performed surgery 80(59%) (n=138). In regards to administration of anesthesia, 128(93%) cases were performed under local anesthesia and 10(7%) were under general anesthesia. Conclusion: The present study imparts valuable perception about the types and prevalence of maxillofacial diseases and the treatment modalities among the armed forces personnel and their families in Cumilla area. Bangladesh Armed Forces Med J Vol 56 No (2) December 2023, pp 24-30

Comparative characterization of supragingival plaque microbiomes in malocclusion adult female patients undergoing orthodontic treatment with removable aligners or fixed appliances: a descriptive cross-sectional study

ObjectivesThis study aimed to explore the effects of removable aligners and fixed appliances on the supragingival bacterial communities in adult female patients undergoing orthodontic treatment.MethodsSupragingival plaque samples from 48 female individuals underwent microbiome analysis (16S rRNA gene sequencing) using PacBio Sequel sequencing. The study included 13 adults without orthodontic treatment needs as the control group (Group C), and 35 patients with comparable initial orthodontic conditions who received treatment at a university clinic in Beijing, China. The treatment involved either traditional fixed brackets (Group B, n = 17) or Invisalign® aligners (Group AT, n = 18). Bioinformatics methods were used for data analysis.ResultsFrom the 48 plaque samples, a total of 334,961 valid reads were obtained, averaging 6,978 sequences per sample. The 16S rDNA sequences were classified into 25,727 amplicon sequence variants (ASVs). Significant variances in alpha and beta diversity among the groups were noted. Group B microbiome exhibited an increased presence of Gram-negative bacteria. At the phylum level, Actinobacteriota was significantly more prevalent in Group C samples, while Bacteroidota was enriched in Group B samples. Family-level relative abundance analysis showed a notable increase in Saccharibacteria (formerly TM7) and Prevotellaceae in Group B. Genus-level analysis revealed a significant rise in Lautropia in Group AT. Fixed orthodontic appliances were linked to oral microbiome changes, notably an enhanced relative abundance of anaerobes, including periodontal pathogens.ConclusionThe observation points to the impact of orthodontic appliance on the oral microbial community, highlighting the difference between traditional braces (Group B) and clear aligners (Group AT)in terms of the predominance of anaerobic and gram negative bacteria. This emphasizes the importance of considering the microbiological effects when choosing orthodontic appliance and underscores the need for tailored oral hygiene practices for individuals undergoing these treatments. This research might provide insights that could assist in the development of innovative cleaning techniques and antibacterial materials.

Profile of Cases of Death Due to Coronary Artery Disease: An Autopsy Based Descriptive Study

Background: Most common cause of sudden cardiac death is coronary artery disease, which contributes to 75 to 90%. The present study is undertaken to describe the profile of autopsy cases of coronary artery disease. Methods:Descriptive cross-sectional study was conducted in all cases of sudden and unexpected death brought for autopsy a tertiary level centre in southern Kerala during a period of one year. Gross and microscopical examination of heart and coronary arteries were studied and in cases with coronary artery disease, associated factors like previous history of illness, personal habits, family history of illness, body mass index, abdominal circumference, horizontal earlobe crease were described in detail. Categorical variables were represented as frequency and percentage, continuous variables as mean and standard deviation and association was tested using Chi square test. Conclusions: Statistically significant association (p value = 0.001) was observed between the horizontal earlobe crease and occlusive coronary artery disease. No significant association was obtained between the obesity parameters like body mass index, waist to hip ratio and occlusive coronary artery disease. Majority of the cases with significant occlusion was observed in the left anterior descending artery.The most common site of thrombus was in the proximal third of left anterior descending artery.

Evaluation of Pneumonia Among Under-five Hospitalized Children – A Study in A Tertiary Level Military Hospital in Bangladesh

Background: Pneumonia is one of the leading causes of mortality among under-five children contributing to 15% of deaths all over the world. More than 95% of all new cases of pneumonia in children less than 5 years occur in developing countries. The aim of this study is to evaluate the socio-demographic characteristics, clinical profile, laboratory parameters and management of hospitalized children presenting with pneumonia. Methods: A descriptive cross-sectional study was conducted among 178 children aged between 02-59 months who were admitted into Paediatrics ward of Combined Military Hospital (CMH), Jashore during the period of July 2020 to December 2021were evaluated. Data were collected by a trained physician from history, clinical examinations, laboratory findings and chest x-ray immediately after admission using a structured questionnaire with purposive sampling technique. All x-ray films were evaluated by radiologist and paediatrician independently. Results: A total of 178 cases suffering from pneumonia were studied. Among them majority (87.08%) of children were below 36 months of age with the highest frequency of pneumonia was seen bellow 12 months (42.70%) age group. 112(62.92%) patients were male and 66(37.08%) patients were female with male-female ratio 1.7:1. Most of the patients were of normal birth weight (81.46%), fully immunized (84.27%), better maternal education, from nuclear family (81.46%) and were exclusive breast feed (70.22%). Fever, cough, breathing difficulty, tachypnoea and crackles were present nearly all patients with pneumonia. Chest x-ray suggestive of bronchopneumonia in most of the cases (91.01%). All patients received antibiotics, duration of hospital stay ranged from 03 to 14 days, mean stay was about 05 days. Nearly all the patients (97.52%) were recovered and discharged with advice. Conclusion: Most of the patients with pneumonia were below 36 months of age with male predominance. Fever, cough, fast or difficult breathing were as a feature of pneumonia. Prompt administration of antibiotics to children with pneumonia significantly reduces the morbidity and mortality. Bangladesh Armed Forces Med J Vol 56 No (2) December 2023, pp 31-37

Dementia Risk Awareness, Health Behaviors and Motivation for Dementia Prevention in Middle-Aged and Older Adults in Türkiye.

This study aimed to investigate factors influencing motivation for dementia preventive behaviors in a population aged 40 and over. We conducted a descriptive cross-sectional study between December 2022 and May 2023, involving 483 participants in an online survey. We collected data on dementia risk awareness, healthy lifestyle choices, and motivation for dementia risk reduction. The majority of respondents, comprising 41.6%, demonstrated a moderate level of risk awareness, with 50.5% believing that prevention is beyond anyone's control. Motivations for lifestyle change were significantly higher in women (p < .001) and `participants with university degree education (p < .05). Regression analysis identified gender (female), education level (higher education), and dementia risk awareness, emerged as significant predictors of motivation to change lifestyle (beta: .138, beta: .136, beta: .114, p < .001, respectively). This study underscores the importance of risk awareness in motivating dementia prevention, suggesting avenues for future research to explore specific determinants of motivation to reduce dementia risks.

Current approach to genetic testing and genetic evaluation referrals for adults with congenital heart disease

BackgroundCongenital heart disease (CHD) is the most common congenital anomaly. Up to 33% have an identifiable genetic etiology. Improved medical and surgical management of CHD has translated into longer life expectancy and a rapidly growing population of adults living with CHD. The adult CHD (ACHD) population did not have access during childhood to the genetic technologies available today and therefore have not had a robust genetic evaluation that is currently recommended for infants with CHD. Given this potential benefit; the aims of this study were to determine how ACHD cardiologists offer genetics services to patients and identify the indications that influence decision-making for genetics care.MethodsWe performed a descriptive cross-sectional study of ACHD cardiologists. A study-developed questionnaire was distributed via emailed REDCap link. The recruitment email was sent to 104 potential respondents. The survey was open from 06/2022 to 01/2023.ResultsThirty-five cardiologists participated in the study (response rate of 34%). Most cardiologists identified as white (77%) and male (66%). Cardiologists were more likely to refer patients to genetics (91%) than to order testing themselves (57%). Of the testing ordered, chromosomal testing (55%) was ordered more than gene sequencing (14%). Most cardiologists would refer a patient with a conotruncal lesion (interrupted aortic arch) over other indications for a genetics evaluation. There were more reported barriers to ordering genetic testing (66%) compared to referring to genetics for a genetics evaluation (23%). Cardiologists were more confident recognizing features suggestive of a genetic syndrome than ordering the correct test (p = 0.001). Regarding associations between clinical factors and current practices, more years in practice trended towards less referrals and testing. Evaluating a greater number of patients (p = 0.11) and greater confidence recognizing syndromic features (p = 0.12) and ordering the correct test (p = 0.09) were all associated with ordering more testing.ConclusionTesting for microdeletion syndromes is being offered and completed in the ACHD population, however testing for single-gene disorders associated with CHD is being under-utilized. Developing guidelines for genetic testing in adults with CHD could increase access to genetic services, impact medical management, reduce uncertainty regarding prognosis, and inform recurrence risk estimates.

التدفق النفسي وعلاقته بالعنف الإلكتروني لدى مستخدمي الألعاب الإلكترونية من المراهقين في المملكة العربية السعودية

The study aimed to investigate the relationship between psychological flow and electronic violence among adolescent gamers in Saudi Arabia. The research was conducted on a sample of 450 male and female teenagers, to investigate the differences in the levels of psychological flow and electronic violence based on the following variables, family status (living with both parents, living with one parent, living with relatives), and age (12-21 years old). Descriptive cross sectional study was conducted using a self-structured questionnaire consisted from 27 questions about psychological flow and 8 questions about electronic violence, answered on a Likert scale ranging from strongly disagree to strongly agree. results: There was no significant relationship between the psychological flow scale and the electronic violence scale among adolescent gamers in Saudi Arabia. Additionally, the results showed no statistically significant differences in the mean scores of adolescent gamers' psychological flow based on age and family status, as well as no statistically significant differences in the mean scores of adolescent gamers' electronic violence based on age and family status.

CLINICAL CHARACTERISTICS OF AURICULAR KELOIDS TREATED SURGICALLY AT 108 MILITARY CENTRAL HOSPITAL

Purpose: to describe the clinical characteristics of surgically treated auricular keloids. Subjects and methods: Cross-sectional descriptive study on 45 patients with auricular keloid surgery at 108 Military Central Hospital during the period from June 2020 to June 2023. Study subjects had their past medical history taken, clinical examination, and lesion size measured to record research indicators. Results: The study subjects had an average age of 20.7 ± 4.4 years old, all patients were female, accounting for 100%. The main cause of keloids is ear piercing, accounting for 97.7%. Surgical auricular keloids have an average size of 4 ± 3.5 cm2, the main location of keloids is in the helix accounting 44.1% and the earlobe accounting for 41.93%, the number of keloids is from 1 to 5. Conclusion: auricular keloids are mainly found in teenagers with an average age of 20.7 years old, 100% are female patients, 97.7% are caused by piercing. The location of keloids treated by surgery is in the earlobe and helix areas account for 44.1% and 41.93%, respectively; On average, there are 1.76 keloids/person, the average auricular keloid size is 4.07±3.58 cm, mainly in groups 3 and 4 according to Michael Tirgan's classification (1).

ASSESSMENT OF NT-PROBNP LEVELS IN PATIENTS WITH CARDIAC ARRHYTHMIAS

Background: NT-proBNP is a valuable biomarker for the diagnosis and treatment of cardiovascular diseases, including arrhythmias. Objective: To evaluate NT-proBNP levels in patients with arrhythmias and analyze the correlation between NT-proBNP levels and several variables. Subjects and Methods: A cross-sectional descriptive study was conducted on 158 patients with arrhythmias from December 2023 to March 2024 at the Arrhythmias Treatment Department of Cho Ray Hospital. Clinical and paraclinical characteristics were analyzed; NT-proBNP levels were compared between patients with arrhythmias with and without heart failure (HF); and the correlation between NT-proBNP levels and several factors was analyzed using R software version 4.3.1. Statistical significance was considered at P &lt; 0.05. Results: The NT-proBNP level (Median [IQR]) in patients with arrhythmias (n = 158) was 367 (61.9-1297) pg/ml. NT-proBNP levels were higher in patients with arrhythmias with HF (n = 41) than in those without HF (n = 117), at 1273 (498-4173) vs. 210 (51-875) pg/ml (P &lt; 0.001). Univariate analysis showed that age, weight, HGB, EF, creatinine, and eGFR were statistically significantly correlated with NT-proBNP. Conclusions: The NT-proBNP level in patients with arrhythmias was 367.3 (61.9-1297) pg/ml; it was higher in patients with arrhythmias with HF than in those without HF. NT-proBNP level was statistically significantly correlated with age, weight, HGB, EF, creatinine, and eGFR.

Determination of the effect of preoperative knee joint function on postoperative quality of life in patients with total knee arthroplasty.

Primary total knee arthroplasty (TKA) is one of the most successful procedures for end-stage knee osteoarthritis. To determine the effect of preoperative knee joint function on postoperative quality of life in patients undergoing primaryTKA. This descriptive cross-sectional study was conducted with a total of 208 patients in the orthopedics and traumatology clinic. Data were gathered with a personal information form, the Oxford Knee Score (OKS), and the EQ-5D-5L Quality Of Life Scale in the preoperative period,at postoperative 6th week, and at postoperative 3rd month. The data were analyzed using descriptive statistics, one-way analysis of variance (ANOVA), correlation analysis, and simple linear regression analysis. The mean age of the patients was 65.65 ± 7.01 years. Most patients (86.1%) were women, and 51.4% underwent left TKA. OKS scores indicated poor knee function preoperatively and gradually increased at postoperative 6th week and 3rd month. Preoperative OKS was a significant predictor of postoperative knee joint function and quality of life. This study shows that preoperative knee joint function significantly affects postoperative knee joint function and quality of life. These results demonstrate the importance of the surgery timing and suggest that performing surgery earlier in functional decline may be associated with a better outcome.

Cramming Analysis Based on Time to Start Studying and Time the Exam being Held

Aims: to explore the time that crammer start to study and the time of exam being held and relate this two with the result of the remedial exams which conducted electronically (computer based). Study Design: simple descriptive cross sectional study Place and Duration of Study: conducted during January to February 2024 in the faculty of Medicine, Universitas Kristen Indonesia, Jakarta-Indonesia. Sample: respondents who join the remedial exam during 2022. Methodology: electronic questionnaire regarding time to start studying being distributed prior the exam/test. Sufficient explanation regarding the research is given before consent is politely requested to each exam’s participant. Data obtained from questionnaire were combined with demography data (gender, place of residence) and the result of the exam. Results: Cramming conducted by 69.7% of our respondents, with the involvement of male student is more common compared to female student and regarding their place of residence, more student that live in their own house with their family do the cramming. Most of the perpetrator started studying at 20.00 – 24.00 pm. Students passing rate in this study were low. Female students score better when they did not cram while only male students who conduct cramming and still fail the exam get a slightly higher mean score than male students who fail the exam and did not cram. Female students got a slightly higher mean score than male students. Conclusion: Cramming is risk taking like gambling behavior. It can give negative impact to the perpetrator’s mental health. The phenomenon of cramming is quite common, especially among male student, but the passing rate was poor. Cramming mostly started late at night. Male students who fail the exam tend to get higher grades if they cramming while on the other hand our female student tend to get higher score in they did not cram.

A comprehensive investigation of biopsychosocial determinants influencing primary dysmenorrhea among university students

ABSTRACT Dysmenorrhea, characterized by pain and related symptoms, significantly impacts women’s quality of life in work and education, prompting a comprehensive evaluation of associated factors. The objective of this study was to utilize structural equation modeling (SEM) to analyze and assess the biopsychosocial factors influencing dysmenorrhea among university students. Three hundred and thirty-nine university students were included in this cross-sectional descriptive study. Data were collected using the Participant Information Form, the Beck Anxiety Scale (BAS), the Beck Depression Scale (BDS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Adverse Childhood Experiences Scale (ACES), the Pain Catastrophizing Scale (PCS) and the Visual Analogue Scale (VAS). It was determined that the variables of pain onset (t = 3.24, p < .05) and age at menarche (t = -2.16, p < .05) showed a significant relationship with the model. The variables of the PCS (t = 16.87, p < .001), BDS (t = 3.06, p < .05), and BAS (t = 5.13, p < .001) showed a significant relationship with the model. Social factors in the model were examined, and a family history of dysmenorrhea and the ACES variables did not contribute significantly to the model (p > .05). The study indicates primary dysmenorrhea influenced by biological and psychological factors. Nurses should conduct holistic assessments and provide comprehensive care for affected women.

Determination of birth prevalence of sickle cell disease using point of care test HemotypeSC™ at Rundu Hospital, Namibia

BackgroundSickle cell disease (SCD), a noncommunicable disease, has the greatest burden in sub-Saharan Africa. The majority of children (50–90%) with SCD die before their 5th birthday, with approximately 150,000–300,000 annual SCD child deaths in Africa. In developed countries, newborn screening (NBS) has been shown to improve the survival of children with sickle cell disease, with under5 childhood mortality reduced tenfold due to interventions performed before the development of complications. Point –of-care tests have been developed for resource limited settings to expand NBS. The aim of this study was to determine the birth prevalence of sickle cell disease in Namibia using the HemoTypeSC™ point-of-care test.MethodsA cross-sectional descriptive study was carried out at Rundu Intermediate Hospital in the Kavango East Region. Two hundred and two (202) well newborns within 72 h of birth were recruited for the study from 22 February to the 23th March 2023. Descriptive statistics were used to compute the haemoglobin types of the study participants.ResultsThe majority of the participants (n = 105, 52%) were females, and (n = 97,48%) were males. The median age of the participants was 23 h (Q1, Q3; 11; 33),) with an age range of 2–98 h. Sickle cell trait was present in 9.4% of the screened newborns, no homozygous disease was detected, and 90.6% had Hb AA.ConclusionsThis study is the first to measure HbS gene carriage at birth using HemotypeSC point-of-care testing in Namibia. There was a moderate prevalence of sickle cell traits but no SCD. This baseline study may provide the foundation for larger epidemiological surveys to map HbS gene carriage in Namibia to provide evidence for policy makers to fashion appropriate SCD newborn screening services.

Assessment of the knowledge, attitude and practices of the informed consent process in oral healthcare among dental students in Makerere University Dental Hospital, Uganda

IntroductionInformed consent is an ethical and legal component of healthcare. It ensures patient autonomy and allows patients to make decisions regarding their treatment. In dental care, informed consent is particularly important because most dental procedures are invasive. Since dental students are future dentists, they need to learn about their ethical obligations and accountability through the informed consent process as this is critical to patients’ well-being. This study aimed to determine dental students’ knowledge, attitudes, and practices of the informed consent process for oral health care in Makerere University Dental Hospital, Uganda.Study methodologyThis was a descriptive cross-sectional study using quantitative methods. It was carried out at Makerere University Dental Hospital and third, fourth, and fifth-year students (n = 102) pursuing a Bachelor of Dental Surgery program took part in the survey. A self-administered structured questionnaire was used to assess their knowledge, attitudes, and practices of informed consent for oral health care. Collected data were entered into Epi-data version 3.1, where it was cleaned, coded, and imported to STATA version 14 software for statistical analysis.ResultsAbout two-thirds 67 (65.7%) of the participants were males. The mean age was 25 (SD = 3.21) years. The majority (90%) of the students had a high level of knowledge of the informed consent process. About (80%) had a positive attitude towards informed consent and (85%) most often practiced the informed consent process. Based on bi-variate analysis, training on informed consent, year of study, age, and sex were significantly associated with the informed consent process. However, there was no significant risk factor associated with informed consent in multiple logistic regression analysis.ConclusionThe study findings highlighted high levels of knowledge, positive attitude, and practice of the informed consent process among the clinical dental students. Continuous training is necessary to remind dental students about the importance of informed consent in healthcare, not only for complex procedures.

The misuse of codeine containing medicines: Perceptions and behaviours of qualified pharmacy professionals

Background: Pharmacy professionals working in community pharmacies frequently provide pharmacist-initiated therapy, including codeine-containing medicines. Codeine is an opioid with great potential for misuse, adding to the global opioid epidemic burden. Professional pharmacy personnel are the first intervention point in relation to management of codeine use. This study highlights the importance of pharmacy professionals’ perceptions and behaviours in combatting the opioid epidemic.Methods: A descriptive cross-sectional study was conducted. Simple random sampling included pharmacy professionals in the metropolitan city of Johannesburg. An electronic questionnaire was distributed via e-mail and data analysed descriptively.Results: Findings indicate that pharmacy personnel routinely ask patients about codeine use (n = 48; 53.9%), avoid dispensing over-the-counter (OTC) codeine as an initial treatment (n = 61; 69%) and express confidence to identify and manage codeine misuse (n = 69; 77.5%). Despite this, increased patient demands for OTC codeine (n = 69; 77.5%) were concerning, highlighting the ease of availability from internet sources (n = 76; 85.4%) and multiple pharmacies (n = 84; 94.4%). Apprehension about the lack of patient awareness on adverse health consequences (n = 66; 74.2%) and the risk of codeine dependence (n = 79; 88.8%) was expressed.Conclusion: Growing concern regarding availability and accessibility of codeine-containing medicines within the community pharmacy sector is highlighted. Adverse health consequences of codeine misuse and dependence are not understood by customers and the ineffective information provided by pharmacy personnel was highlighted as a concern.Contribution: The results of this study give insight to the influence of dispensing personnel’s attitude towards the growing challenges with respect to codeine containing medication abuse.

Energy expenditure and effort of patients with stroke during sit to stand: A pilot study

Background: Sit-to-stand (STS) is a mechanically demanding task. Little is known about the energy expenditure (EE) and the perceived effort of patients with stroke during STS.Objectives: The objectives of our study were to assess the perceived effort and EE of patients with stroke when moving from STS and to determine whether an association between actual energy expended and patient-perceived effort exists.Method: This descriptive cross-sectional pilot study assessed participants’ EE and perceived effort during STS, with a triaxial accelerometer and the modified Borg scale (MBS), respectively.Results: The team screened 428 individuals for potential inclusion, with nine participants (n = 5 female, 55.5%) meeting the criteria for our pilot study. Participants had a mean age of 52.77 (standard deviation [SD] ± 11.33) years, the majority had a haemorrhagic stroke (n = 6, 66.6%) and left hemiplegia (n = 6, 66.6%), and they were assessed 9.11 (SD ± 6.57) days post-stroke. The mean EE during STS was 2.82 (SD ± 1.9) kCal. Most participants (n = 7, 77.77%) perceived STS as more than a ‘moderate’ effort on the MBS. The correlation coefficient between the metabolic equivalent of task (METs) and MBS was r = 0.34 (p = 0.38).Conclusion: Our study found a fair positive correlation between METs and MBS for patients with stroke during STS.Clinical implications: The increased EE shown can be a key point for rehabilitation to lessen the extent of EE during STS. Further research is warranted.

Functional availability of medical oxygen for the management of hypoxaemia in Cameroon: A nationwide facility-based cross-sectional survey.

Medical oxygen is essential for managing hypoxaemia, which has a multifactorial origin, including acute and chronic lung diseases such as pneumonia, asthma, and severe malaria. The coronavirus disease 2019 (COVID-19) revealed substantial gaps in the availability and accessibility of safe medical oxygen, especially in low- and middle-income countries (LMICs). This study aimed to assess the availability and sources, as well as the barriers to the availability of functional medical oxygen in hospitals in Cameroon. This was a nationwide cross-sectional descriptive study conducted from 26 March to 1 June 2021. Using a convenient sampling technique, we sampled accredited public and private COVID-19 treatment centres in all ten regions in Cameroon. Representatives from the selected hospitals were provided with a pre-designed questionnaire assessing the availability, type, and state of medical oxygen in their facilities. All analyses were performed using R. In total, 114 hospitals were included in this study, with functional medical oxygen available in 65% (74/114) of the hospitals. About 85% (23/27) of the reference hospitals and only 59% (51/87) of the district hospitals had available functional medical oxygen. Compared to district hospitals, reference hospitals were more likely to have central oxygen units (reference vs. district: 10 vs. 0%), oxygen cylinders (74 vs. 42%), and oxygen concentrators (79 vs. 51%). The most common barriers to the availability of medical oxygen were inadequate oxygen supply to meet needs (district vs. reference hospitals: 55 vs. 30%), long delays in oxygen bottle refills (51 vs. 49%), and long distances from oxygen suppliers (57 vs. 49%). The availability of medical oxygen in hospitals in Cameroon is suboptimal and more limited in districts compared to reference hospitals. The cost of medical oxygen, delays related to refills and supplies, and long distances from medical sources were the most common barriers to availability in Cameroon.

Assessment of Stigma, Violence and Coping Mechanisms Among HIV Infected People Who Inject Drugs in Akwa-Ibom State, Nigeria

People who inject drugs (PWIDs) living with HIV face high levels of stigma, violence, and rape due to their risky lifestyles, potentially facilitating the spread of HIV. This study assessed the level and type of stigma and violence among PWIDs attending Heartland Alliance in Akwa Ibom State and their coping mechanisms. This descriptive cross-sectional study of 442 PWIDs receiving care at four one-stop shops in the state was conducted using mixed methods. Quantitative data were collected through pretested structured questionnaires and an adopted stigma scale, administered by trained research assistants using Computer Assisted Personal Interviewer (CAPI). For qualitative data, one focus group discussion (FGD) was held at each site with 8-10 purposively selected PWIDs, and transcripts were analyzed thematically. The study findings reveals that most respondents were male (78%) with a mean age of 32.7±7 years. Pentazocine use was common (52%), and 18% shared needles, with 15% sharing blood after injections among friends. More than half (58%) missed more than one dose of ARVs in the past week. Perceived stigma (59%) was more common than internal stigma (18%), with predictors being student status, non-disclosure of HIV status, and non-adherence to treatment. PWIDs Physical violence (47.5%) and verbal abuse (37.1%) were prevalent among PWIDs. Female PWIDs had a ninefold higher risk of rape. Coping mechanisms included isolation, increased substance use, battle readiness, and positive reframing. &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: PWIDs face significant levels of stigma, violence, and non-adherence, jeopardizing treatment outcomes and perpetuating STI, HIV, and blood-borne infection transmission. Establishing harm-reduction programs is essential to address these vulnerabilities and the consequences associated with drug use.