Tertiary Health Care Institution Research Articles

Pediatricians' knowledge and attitude toward hearing loss and newborn hearing screening programs

IntroductionEarly detection of hearing loss is important to the management of infants and young children with hearing loss. Pediatricians are often the first to encounter a child suspected to have hearing loss. The objective of this study is to evaluate the knowledge and attitude of newborn hearing screening and management of hearing in among pediatricians. MethodsA cross-sectional survey-based study utilizing a validated questionnaire that was distributed to pediatricians in single tertiary academic health care institution that aims to evaluate the knowledge and attitudes related to children with hearing loss and newborn hearing screening. ResultsA total of 67 pediatricians agreed to participate and were involved in our study. Mean age was 35 years and 44.1% were males. The majority (79.4%) thought it was very important to have a newborn hearing screening program. However, two-thirds (64.7%) were unsure that there is a universal hearing screening program in the country. Never the less, the majority of the respondents (75%) were at least somewhat confident in explaining the hearing screening program process in our institution. There was a gap in the knowledge of our pediatricians with regard to the process of dealing with a newborn who failed screening program and the candidacy for cochlear implants. Also, some participants were unsure whether to refer a child with hearing impairment to an otolaryngologist or not. Most of the participants thought that physicians need more information related to permanent hearing loss. ConclusionThere are gaps in Pediatricians knowledge and awareness towards hearing loss assessment and management in newborns. This likely requires further academic collaboration between specialties to improve the care of newborns. Future research should focus on the auditory and speech outcome and rehabilitation awareness.

Physicochemical Assessment of Ambient Indoor Air Quality of a Tertiary Health Care Institution in South-Eastern Nigeria

Physicochemical Assessment of Ambient Indoor Air Quality of a Tertiary Health Care Institution in South-Eastern Nigeria

Comparative study of marginal mandibulectomy vs segmental or hemi- mandibulectomy in oral cavity cancers

Surgery is the most well-established mode of initial definitive treatment for the majority of oral cancers. The most important decision in terms of tumor ablation in oral cancers when the jaws are potentially involved is the management of the mandible. The present study was conducted at a tertiary healthcare institute among 61 patients who underwent bony resection for Squamous Cell Carcinoma (SCC) close to the mandible, adherent or directly invading this bone, from January 2021 to December 2021. Records of the patients were reviewed. The patients whose surgical resection involved a marginal or segmental mandibulectomy and with a minimum follow-up of 24 months were included in the analysis. Adequate clinical information was available in 61 patients. Size of mandibular resection greater than 4 cm and tumor infiltration beyond the resection margins are correlated with poor survival rates, but no differences between marginal or segmental mandibulectomies could be shown, as was the case in other reports. When gross bone involvement has occurred, segmental resection is the method of choice. Careful case selection will allow a favorable oncologic outcome with preservation of mandibular contour.

Risk Stratification in Oral Cancer: A Novel Approach.

BackgroundOral squamous cell carcinoma (OSCC) is a common head and neck cancer with high morbidity and mortality. Currently, treatment decisions are guided by TNM staging, which omits important negative prognosticators such as lymphovascular invasion, perineural invasion (PNI), and histologic differentiation. We proposed nomogram models based on adverse pathological features to identify candidates suitable for treatment escalation within each risk group according to the National Comprehensive Cancer Network (NCCN) guidelines.MethodsAnonymized clinicopathologic data of OSCC patients from 5 tertiary healthcare institutions in Asia were divided into 3 risk groups according to the NCCN guidelines. Within each risk group, nomograms were built to predict overall survival based on histologic differentiation, histologic margin involvement, depth of invasion (DOI), extranodal extension, PNI, lymphovascular, and bone invasion. Nomograms were internally validated with precision–recall analysis and the Kaplan–Meier survival analysis.ResultsLow-risk patients with positive pathological nodal involvement and/or positive PNI should be considered for adjuvant radiotherapy. Intermediate-risk patients with gross bone invasion may benefit from concurrent chemotherapy. High-risk patients with positive margins, high DOI, and a high composite score of histologic differentiation, PNI, and the American Joint Committee on Cancer (AJCC) 8th edition T staging should be considered for treatment escalation to experimental therapies in clinical trials.ConclusionNomograms built based on prognostic adverse pathological features can be used within each NCCN risk group to fine-tune treatment decisions for OSCC patients.

Awareness And Practice of Cross Infection Control in Prosthodontics Department among the Undergraduates, Graduates and Postgraduates in a Tertiary Dental Health Care Institution

Objective: To evaluate the awareness and practice of cross infection control among the undergraduates,graduates and postgraduates in Prosthodontics Department of a tertiary dental health care institution.Study Design: Cross-sectional survey.Place and Duration of Study: The study was carried out in March 2022 to May 2022, at ProsthodonticsDepartment of Armed forces institute of Dentistry (AFID), a tertiary dental health care institution, Rawalpindi.Materials and Methods: Self-administered questionnaires were distributed. Data was analysed using IBM SPSSStatistics 24 software and descriptive statistics including frequencies were calculated.Results: The response rate was 100%. 99.2% participants had knowledge of sterilization, disinfection andasepsis. 98.5% believed that cross infection control is important in prosthodontics; 80% believed thatsterilization protocol is being followed in the tertiary dental health care institute. 88.5% used gloves and 86.5%disinfected dentures before final insertion. 66% did not use eyewear, 75.4% did not disinfect rubber bowl inbetween patients. 56.9% did not disinfect facebow before sending it to dental laboratory.Conclusion: The overall knowledge, attitude and performance of participants included in this study were foundto be satisfactory. Workshops and awareness programs should be conducted on regular basis for the studentsfrom the beginning of preclinical years of under graduation of dentistry.How to cite this: Rehman B, Bano V, Afzal S, Arshad M, Rehan A, Mustafa S. Awareness And Practice of Cross Infection Control in Prosthodontics Department among the Undergraduate, Graduates and Postgraduates in a Tertiary Dental Health Care Institution. Life and Science. 2022; 3(3): 134-140. doi: http://doi.org/10.37185/LnS.1.1.239

Nursing Care Needs Assessment of Persons with Substance Use Disorder

Substance use is a major concern in many parts of the world. It affects people across all strata and classes. This study uses a qualitative case study approach to gain an in-depth understanding of the needs of patients with substance use disorder (SUD) and to synthesise the outcome from each of the cases. Five cases of inpatients admitted with diagnosis of SUD in a tertiary mental healthcare institute were selected through purposive sampling technique, and data were collected through observations, interviews and documents. Participants were the patients and their caregiver. Individual cases were analysed and their needs were identified in categories and finally the identified common needs were organised into broader themes. The themes that emerged were grouped into biological, physical health, social, familial, disease-related and psychological needs. These findings can be put to use to give effective care to patients with SUD and further interventions can be designed with these specific aspects in mind.

Dietary Factors Influencing the Caries Status of Adults in Karachi, Pakistan: Initial Findings.

Objective: The objective was to identify the relationship between the dietary factors related to increases in the number of dental caries among an adult population group. Methods: A cross-sectional study was conducted involving adult patients and their accompanying person, aged 18 years and above (n = 1730) visiting the dental outpatient department (OPD) of a public sector tertiary healthcare institute in Karachi, Pakistan. A 39-item Food Frequency Questionnaire (FFQ) was administered to the patients, followed by a dental caries assessment using Radke’s WHO criteria. Caries assessment data were transformed into the DMFT Index (D = decayed, M = missing, F = filled teeth). Factor analysis (FA) was performed using Stata v. 11.0, followed by assessing the internal consistency of the FFQ. Multilogistic analysis was performed to explore the association between dental caries (cut-off = 5) and other independent variables, considering a p-value < 0.05 as significant. Results: The mean age of participants in the group was 32.65 ± 10.49 years. The number of female participants (934; 54%) was higher than male participants (796; 46%). Of the total, 951 (52%) participants were married. The internal consistency value for the FFQ, as measured by Cronbach’s alpha, was 0.80. In addition to age and gender, out of four dietary patterns, only “cereals” were found to be significantly (p < 0.05) associated with increased DMFT. Conclusion: This study established that the high intake of cereals is a contributory factor to the high prevalence of dental caries among adults.

Cancer risk factors and cancer in transgender versus cisgender people: Real-world data from a tertiary health care institution.

6538 Background: Data are sparse regarding the prevalence of cancer and cancer risk factors among transgender people. Transgender people experience structural stigma and extreme rates of violence that may contribute to cancer through multiple mechanisms. The purpose of this study was to assess cancer risk factors and cancer in transgender people in a single institutional electronic health record (EHR) and compare the rates to those among cisgender, or non-transgender, people. Methods: Using a combination of structured gender identity data, diagnosis codes, and keyword searches, we identified a cohort of transgender people seen at our institution, a large tertiary care center. We next identified a cohort of cisgender people matched by age, year of first encounter in our EHR, and years of follow-up. Among these cohorts, we searched for cancer, premalignant lesions, human immunodeficiency virus (HIV), human papilloma virus (HPV), and hepatitis and assessed body mass index (BMI) and smoking status through structured EHR fields. Lastly, we compared the prevalence of cancer, premalignant lesions, and cancer risk factors between the two cohorts using chi-square tests. If expected cell sizes were &lt;5, exact tests were used. Results: We identified cohorts of 923 transgender and 1846 cisgender people matched by age, follow-up time, and year of the first encounter. Rates of smoking (42 versus 34%, p &lt; 0.0001), BMI ≥ 40 (21% versus 13%, p &lt; 0.0001), and HIV (3 versus 0%, p &lt; 0.0001) were significantly higher among transgender compared with cisgender people. Rates of premalignant lesions and cancer did not significantly differ between cohorts. Conclusions: In this large sample of patients seen at our institution, rates of several cancer risk factors were higher for transgender than cisgender people. No differences were demonstrated in prevalence of premalignant lesions and cancer between groups. These data require confirmation in larger national datasets. Interventions that decrease structural oppression and provide support for tobacco cessation, decreased transmission of HIV, and access to high-quality food and exercise are also called for. [Table: see text]

Impact of Guided Nutrition Intervention on the Anthropometric and Biochemical Profile of Non-Communicable Disease Patients in Nigeria; A Multi Facility Based Study

ObjectivesThis study was designed to assess the impact on guided nutrition intervention on the anthropometry and biochemical profile control of patients with non-communicable diseases in Nigeria. MethodsNinety-two in-patients suffering from non-communicable diseases with metabolic complications were recruited from six Nigerian tertiary health care institutions using a quasi-experimental design and purposive sampling technique. Informed consent and ethical approval were obtained. The respondents were subjected to six months of guided/individualised nutrition interventions which comprised; nutrition counselling, formulation/administration of disease appropriate therapeutic diets and close monitoring/follow up. Descriptive statistics were computed for the continuous variables, paired t-test was used to evaluate the impact of the intervention. ResultsResults showed a significant (p < 0.05) reduction in respondents’ weight (78.07 to 76.05 kg) and Body Mass Index (28.68–27.82 kg/m2) status. Mean systolic (135.41 to 129.52 mmHg) and diastolic (84.17 to 78.05 mmHg) blood pressure values dropped significantly after the intervention. Fasting blood sugar of the subjects significantly (t = 4.84; p = 0.00) declined (136.19 to 120.82 mg/dl), while a significant (t = –2.48; p = 0.02) elevation in mean packed cell volume of the patients was recorded. There was no significant (p < 0.05) effect of the intervention on the serum electrolytes except chloride (101.66 to 95.24 mmol/l) which recorded a significant (t = 2.16; p = 0.42) reduction. ConclusionsAppropriate nutrition/dietary interventions significantly improved the health and nutritional status of the patients. Longitudinal studies and clinical trials that will validate the impact of nutrition interventions on the health outcomes of NCD patients in sub-Saharan Africa should be conducted. Funding SourcesNone

Prevalence of Primary Types of Headache and Its Impact on Daily Life in Health Care Professionals in a Tertiary Care Health Institution

Background: Headache is characterized by the painful and disabling disorder of the central nervous system CNS. The most common symptoms experienced by the person suffering from the headache are pain in head, neck and face. Objective: This study aims to assess the prevalence of primary types of headaches, knowledge of their types, their impact on the productivity and work efficiency of the healthcare professionals in a tertiary care health institution. Study design: This cross sectional study was conducted at Neurology Department, Fauji Foundation Hospital, Rawalpindi for duration of 1 year from December 2020 to December 2021. Material and Methods: An estimated number of 1000 adult healthcare professionals aged above 18 were included in this research. Simple convenience sampling technique was used for sampling. According to the Inclusion criteria the individual should be an adult healthcare professional. According to the exclusion criteria Individuals below the age of 18, not a part of the tertiary care hospital were excluded. Data was collected through using a structured questionnaire comprised of three sections. Results: To proceed with this study, 1000 healthcare professionals were selected for this survey. The participants submitted questionnaires. The respondents include 440 doctors and 560 nurses. Their age was from 20 to 60 years. The ages of the doctors were above thirty and the age of the nurses was above 25 years. Among them, 6 participants were identified with two basic types of primary headache, and 36 were suffering from other kinds of issues like CDH, neuralgia, and unknown types of headache. Only two nurses were suffering from MOH. Sleep patterns also play role in headache disorders. Conclusion: This study predicted that the probability of primary headache issues is greater in medical care professionals as compared to the general public. Both nurses and doctors are more prevalent to headache issues. Multiple factors are linked with the prevalence of headache issues i.e. gender, age, sleep patterns, and night shifts. These factors may lead to migraine and TTH. For the welfare of health of medical professionals, there is a need for awareness related to different health issues and all the factors causing headache disorders. Keywords: Headache disorders, neuralgia, Sleep patterns, and primary headache.

Pattern of adverse effects following ChAdOx1 nCoV-19 COVISHIELD vaccine in tertiary healthcare institution in North India: A retrospective observational study

: Adverse effects following vaccination must be reported and assessed in order to promote the patient safety and well-being.: The aim of this study was to observe the pattern of adverse drug reactions (ADRs) following ChAdOx1 nCoV-19 (COVISHIELD) Vaccine.: Study was conducted at Dr. RPGMC, Kangra at Tanda, which has a dedicated COVID-19 hospital, ADR monitoring Centre, COVID-19 vaccination Centre &amp; a hospital with 700 bedded multi-specialty tertiary healthcare Centre situated in North India. Assessment was carried-out for the pattern of ADRs reported by the volunteers receiving COVID-19; ChAdOx1 nCoV-19 (COVISHIELD) vaccine from January to December 2021. Data such as age, gender, drug intake, types of ADRs, treatment and outcome of the reactions were collected. Each reported patient was assessed individually. Causality assessment was done on WHO scale. ADR profiling on the basis of site, onset, organ system affected, duration, whether urgent referral was required or not and resolution of signs &amp; symptoms.The data is analyzed and expressed as mean ± standard deviation &amp; percentages.: A total of 21,115 volunteers got vaccinated at our Centre from 16 January 2021 to 31 December 2021. Less than 1% (201) vaccinees reported AEFIs and all those who reported AEFIs had mild symptoms and recovered. Immune system related adverse effects (55.2%) were most common. Fever, drowsiness, headache, vomiting, injection site pain/swelling/tenderness and body aches were the most commonly reported adverse effects.: Reporting of vaccine adverse effects and availability of safety data on public platform is an important factor in increasing the vaccine acceptability by the people and henceforth better health. ChAdOx1 nCoV-19 COVISHIELD vaccine is proved to be a safe vaccine against COVID-19 in adults.

Pattern of adverse drug effects reported by patients being treated in a tertiary healthcare institution in North India: A retrospective observational study

: Patient safety and well-being is favored by reporting adverse drug effects timely and precisely. Pharmacovigilance contributes to post-marketing surveillance and ensures that necessary changes may be done to the drug labels accordingly.: The study was aimed at observing, analyzing and reporting various adverse effects due to prescribed drug intake for patient conditions and disease being treated at our tertiary healthcare institution.: Study was conducted at Dr. RPGMC, Kangra at Tanda, which is a multi-specialty tertiary healthcare hospital with 700 beds and an ADR monitoring Centre situated in the lap of western Himalayas in North India. Pattern of ADRs reported by the volunteers receiving drug therapy from January to December 2021 was assessed. Data pertaining to age, gender, drug intake, types of ADRs, treatment and outcome of the reactions was collected. Individual assessment was done for each patient. WHO scale was used for causality assessment. ADR profiling was carried out based on site, onset, organ system affected, duration, whether urgent referral was required or not and resolution of signs &amp; symptoms.The data was analyzed using Microsoft excel 2019 and expressed as mean ± standard deviation &amp; percentages.: A total of 83 patients reported ADRs (adverse drug reactions). These were reported to IPC, Ghaziabad through our AMC (Adverse Drug Reaction Monitoring Centre) from 1 January 2021 to 31 December 2021. Gastro-intestinal system related adverse effects (35%) were most common followed by skin (22.9%) and CNS (12%) adverse effects. GI adverse effects included anorexia, dyspepsia, diarrhoea, oral ulcers, nausea, vomiting, weight-loss and raised liver function tests.: ADRs occur commonly but are often undetected. Even if detected they remain underreported as most of the health care professionals are unaware about pharmacovigilance. Therefore, mass sensitization and reward to those who report ADRs vigilantly is the need of the hour to promote patient safety.

Concerned, yet committed: A tertiary hospital healthcare workers’ concerns and readiness in the face of the COVID-19 pandemic

Background: Healthcare workers (HCWs) are a vital resource in every society. The concerns of HCWs during pandemics are unique as they have to consider multiple issues including their health as well as the risks to their loved ones. The coronavirus disease 2019 (COVID-19) pandemic provides no exception in testing HCWs’ readiness.Purpose: We aim to study the concerns and preparedness of HCWs at Singapore General Hospital (SGH), a tertiary healthcare institution, during the COVID-19 pandemic. Of interest were the differences between HCWs from the emergency department (ED) compared to other non-ED locations.Methods: A cross-sectional study was carried out in the form of a voluntary survey containing 34 questions. All data were anonymous. Chi-square analysis and Bonferroni correction were carried out to ascertain the significance of the associations between the two groups.Results: A total of 1249 responses were received. Of all respondents, 57 percent felt that their jobs put them at great risk of exposure to COVID-19 while 67 percent accepted the risk as part of their job and 60 percent were still afraid of falling ill. Among the respondents, 78 percent responded that they would not look for another job while almost half considered it acceptable if their colleagues resigned. There were significant differences between ED and non-ED staff in terms of feeling that not only they but also those close to them were at high risk of exposure to the disease, people avoiding them and their families due to their job and ED staff feeling that there would be increased workload but inadequate manpower to handle the demands.Conclusion: Despite previous experience with pandemics, this study highlights that there still are issues faced by HCWs that need to be addressed in order for them to function effectively. Although there are differences between ED and non-ED HCWs’ concerns, all HCWs need to be recognized as crucial stakeholders and due attention should be given to them.

Prevalence of Under Nutrition and Its Risk Factors among Children below Two Years of Age in a Tertiary Health Centre in West Bengal

Background: Malnutrition in under five children is prevalent widely. It affects growth as well as development; also causes higher morbidity and mortality among children significantly. This public health problem is multi-factorial.&#x0D; Aim and Objectives: This study was conducted to estimate the prevalence of under nutrition and its risk factors among children up to 2 years of age attending a tertiary health care institution of Kolkata.&#x0D; Material and methods: This cross-sectional study was conducted among children aged 0 – 23 months, attending the Immunization clinic of CMSDH, Kolkata, during December, 2019 –January, 2020. Data were collected by interviewing the accompanying caregivers, anthropometric measurements of the study subjects and review of records.&#x0D; Results: Among 135 children studied, the prevalence of stunting was 14.1% (5.8% severely stunted), underweight was 9.7% (3.8% severely underweight), wasting was 18.5% (8.1% were SAM).Younger age group (0-6 months),boys and children having inappropriate feeding for age were at increased risk of under nutrition. Children having working mothers, birth spacing of &lt;3 years, LBW and delayed initiation of breastfeeding (&gt;1hour) were at higher risk of stunting and underweight. Incorrect age of introduction of complementary feeding had higher risk of wasting.&#x0D; Conclusion: Several risk factors for malnutrition were found which are amenable to prevention.

OUTCOME OF MESHPLASTY V/S HERNIORRAPHY IN INGUINAL HERNIA REPAIR IN A TERTIARY CARE INSTITUTE-A PROSPECTIVE STUDY

A hernia is defined as a protrusion, bulge, or projection of an organ or a part of an organ through the body wall that normally contains it.There is still very limited evidence regarding prevalence, particularly in low-income countries, but hernia repair is an extremely common general surgical procedure. The current hospital based prospective study was conducted among 102 patients, 51 participants enrolled in Mesh repair and 51 for Herniorrhaphy presenting to the Department of General Surgery at tertiary health care institute. with objectives to study the hernia repair with mesh versus without mesh. Outcomes like hernia recurrence, postoperative pain, duration of operation, postoperative hospital stay, time to return to activities of daily living &amp; also to evaluate the benefits and complications of different inguinal hernia repair techniques in adults studied. Total 102 patients were considered between age group of 15 to 35 years for present study from Aug.2019 to Jan.2022,after applying inclusion and exclusion criteria. In each group 51 patients were operated.Majority of patients for mesh repair (70%) &amp; tissue repair (60%) were belonged to 21-25 &amp; 15 -20 years of age group respectively. Mean operation time for tissue repair (41.8 4.6) was more as compare to mesh repair (39.7 4.3).Outcome like post-operative stay, post-operative pain, days required for return to daily basic activities were significantly more for tissue repair as compared to mesh repair. In case of post-operative pain scale majority of mesh group will have chronic pain compared with Tissue repair group. Hematoma &amp; urinary retention were statistically more significant in tissue repair (p&lt;0.05).Wound infections,seroma,recurrence,reduced testicular perfusion,reduced sperm count were more in mesh repair as compare to tissue repair out of that only seroma shows significant in mesh repair . Concluded that the tissue repairs does not use a mesh, this makes tissue repair cost effective. Postoperative pain is significantly less initially with Mesh repair but increased on day 7 and chronic pain is seen with mesh repair but is not significant statistically. Most of the complications between 2 groups are not statistically significant except for seroma significant in mesh repair,hematoma and urinary retention significant in tissue repair.

Study of efficacy of spray dried lactobacillus reuteri for helicobacter pylori infection treatment

The present study was conducted to study the effectiveness of spray dried Lactobacillus reuteri in treatment of Helicobacter pylori infection at a tertiary healthcare institute. We evaluated the compliance and outcome of spray dried Lactobacillus reuteri in the treatment of patients with Helicobacter pylori. In our study, we included patients who were positive for Helicobacter pylori on Rapid Urease test. We assessed Rapid urease test findings on follow up visit among the study subjects and observed that 63.64% study subjects reported Helicobacter pylori negative after treatment with spray dried Lactobacillus reuteri. The study showed that majority of the study subjects were females (54.55%), whereas 45.45% subjects were males, M:F ratio in the current study was 1:1.2. and the mean age of the study subjects was 41.61 ± 10.84 years. 54.55% study subjects belonged to rural area, whereas 45.45% subjects belonged to urban area. Our study’s results are comparable and similar to the other studies which show that Lactobacillus reuteri (Probiotics) are useful in the Helicobacter pylori infection treatment.

Pattern of Respiratory Diseases and Comorbidities in Patients Attending Casualty Department

Background: The common causes of respiratory emergencies include pneumonias, acute severe asthma, acute exacerbation of Chronic Obstructive Pulmonary diseases (COPD), TB, lung cancers, pneumothorax, pleural effusion, pulmonary embolism and Acute Respiratory Distress Syndrome (ARDS) from other causes. Aims and Objectives: To study patterns and co-morbidities of respiratory disease in patients attending casualty department. Materials and Methods: This Cross Sectional Study was conducted on 193 patients of Respiratory disease attending emergency department in Medical College and tertiary health care institute. Study was conducted for a period of 2 years (August 2018 to December 2020). Patients were enrolled after matching inclusion and exclusion criteria. Institutional ethics committee permission was taken prior study. Observations and Results: The most common age group amongst study population was 51 to 60 years (39.4%) followed by 61 to 70 years (37.8%) and more than 70 years (19.2%). There was male predominance (76.7%) amongst study population as Most of the study population had normal BMI (55.4%) followed by Underweight (27.5%) and Overweight (13.5%). Most of the study population were Farmer (37.3%) followed by Housewife (23.5%), Labourer (11.8%) and Shopkeeper (9.8%). The most common clinical features amongst study population was Breathlessness (100%) followed by Cough with expectoration (58%) and dry cough (22%). Most of the study population had mMRC Dyspnoea Grade 3 (48.2%) followed by grade 2 (30.1%), grade 4 (11.9%), grade 1 (9.8%). COPD (38%) was the most common respiratory disease amongst study population followed by Pleural effusion (19%), Asthma (15%), Pulmonary TB (11%), Pneumonia (6%), Pneumothorax (4%), ARDS (3%), ILD (2%), Pulmonary embolism (1%) and Swine flu (1%). Diabetes (46%) was the most common comorbidity amongst study population followed by Hypertension (36%), Ischemic Heart Disease (15%), Chronic Liver Disease (11%), Chronic kidney Disease (8%), Pneumonia (6%), Pneumothorax (4%) and Malignancy (2%). Conclusion: In the present study, Diabetes (46%) was the most common comorbidity amongst study population followed by Hypertension (36%), Ischemic Heart Disease (15%), Chronic Liver Disease (11%), Chronic kidney Disease (8%), Pneumonia (6%), Pneumothorax (4%) and Malignancy (2%). This findings was comparable with the study conducted by Sonisha Gupta et al. (2016)41, among these patients 10 (35.7%) were diabetic, 16 (57.1%) hypertensive, 6 (21.4%) had cardiac problem and 17 (60.7%) joint pain.

Knowledge of Hypertension and Practice of Hypertension Control among Hypertensive Patients in University of Port Harcourt Teaching Hospital (UPTH), Nigeria

Background: Hypertension remains a major public health challenge and cause of morbidity and mortality globally. Patients’ knowledge of hypertension among other factors could influence their practice of hypertension control measures. Purpose: This study aimed to determine the knowledge and practice of hypertensive patients towards hypertension control as well as identify factors influencing the practice of hypertension control in the University of Port Harcourt Teaching Hospital (UPTH), a tertiary healthcare institution in Nigeria. Materials and Methods: This cross-sectional descriptive study was carried out at the University of Port Harcourt Teaching Hospital (UPTH). One hundred and twenty (120) consenting hypertensive patients attending a clinic at the outpatient department were recruited for this study. A pre-tested structured questionnaire incorporating sociodemographic characteristics and questions on knowledge, practice and factors affecting hypertension control was administered to the patients. Data obtained was presented using frequencies, percentages, mean and standard deviation. Spearman rank correlation was used for correlation analysis of data. Statistical significance was set at p&lt;0.05. Results: Study participants demonstrated good knowledge with a mean knowledge score of 3.68±0.30. However, poor practice in the control of hypertension with a mean practice score of 2.59±0.48 was observed. Financial constraint was identified as the factor affecting the practice of hypertension control among hypertensive patients (mean score 3.09±0.66). There were statistically significant positive correlations between mean practice score with age (r=0.269, p=0.005) and educational status (r=0.232, p=0.017). Significant negative correlations between the mean practice score and financial constraint (r= -0.246, p=0.011), negative side effects of drugs (r= -0.318, p=0.001), herbal medicine use (r= -0.207, p=0.034), failure to remember (r= -0.225, p=0.020) as well as perceived absence of symptom (r= -0.261, p=0.007) were observed. Conclusion: Hypertensive patients attending clinics at the outpatient department of UPTH demonstrated good knowledge of hypertension though this did not translate to good practice in hypertension control. Poor practice in hypertension control was associated with age, educational status, financial constraint, a side effect of drugs, herbal medicine use, failure to remember and perceived absence of symptoms.

Prevalence and Predictors of COVID-19 Vaccine Hesitancy among Health Care Workers in Tertiary Health Care Institutions in a Developing Country: A Cross-Sectional Analytical Study

Background. The coronavirus disease 2019 (COVID-19) pandemic highlighted the challenges and impact of vaccine hesitancy and the role of health care institutions in mounting an effective pandemic response. The study objective was to determine the prevalence and predictors of COVID-19 vaccine hesitancy among health care workers in tertiary health care institutions in Nigeria. Methods. A cross-sectional analytical design that used convenience and snowballing techniques to enroll 347 health care workers from tertiary health care institutions in Imo State, Nigeria, from September 28 to October 14, 2021. Data was collected using a structured online questionnaire and bivariate and multivariate analyses were done using SPSS at a level of significance set at p ≤ 0.05 . Result. The prevalence of vaccine hesitancy was 35.4%. HCWs of the Pentecostal faith (aOR: 2.52) and males (aOR: 2.72) were significantly more likely to be COVID-19 vaccine hesitant. About 30% of the respondents reported that they trusted information from the Internet and social media relating to COVID-19 and its vaccine. However, respondents who felt there was enough information about the vaccine and its safety were more than two and a half times more likely to be vaccine-hesitant (aOR: 2.77). About 20% and 31% of the respondents, respectively, stated that the government has an ulterior motive and that they did not trust the vaccine manufacturers. However, respondents who do not trust the government were more than two and a half times more likely to be COVID-19 vaccine hesitant (aOR: 2.69). Conclusion. The issues of vaccine hesitancy among health care workers in a developing country appear to be fundamental and very challenging to resolve. Therefore, the approach of instituting government vaccine uptake mandates for health care workers may be the solution for tackling vaccine hesitancy in health care institutions.

Short-Term Analysis of the Changes in the Bone Mineral Density of the Proximal Femur After Uncemented Total Hip Arthroplasty: A Prospective Study of 110 Patients.

IntroductionMechanical loading continuously exposes the bone to remodeling processes. Increased load leads to a gain in bone mass, and reduced load results in a loss. After inserting a prosthesis, the proximal femur is bypassed in loading as the bodyweight shifts distally. This lack of load induces bone resorption according to Wolff’s law. To avoid this bone resorption, the implant's bending stiffness should be less than the femoral bone. Dual-energy X-ray absorptiometry (DEXA) is a well-accepted method to measure periprosthetic bone mineral density (BMD) after total hip arthroplasty (THA). Since the strength and durability of the fixation of a femoral prosthesis in cementless hip arthroplasty depend largely on the quantity and quality of the surrounding bone, preoperative and postoperative evaluation of the quantity and quality of the femoral bone is very important in the long-term prognosis of hip arthroplasty.Materials and methodsA prospective study of 110 patients in the age group of 25-60 years who underwent uncemented total hip arthroplasty in our tertiary healthcare institution was performed. An uncemented, fully hydroxyapatite-coated implant from a single manufacturer was used in all the patients. All the patients were mobilized on the first post-operative day. The BMD was measured at the proximal femur and the distal tip using a DEXA scan. Gruen zones were used for calculating BMD at different anatomical locations in the femur, with particular importance to zones 1, 4, and 7.ResultsThe pre-operative BMD in all zones measured, viz. zones 1, 4, and zone 7 of the affected side, was found to be significantly lower as compared to the BMD values on the control side (P< 0.05). The mean change in the mean BMD was calculated for all the zones and compared with each other using an unpaired t-test. The mean BMD changes were found to be significantly higher in zone 7 in comparison to both zones 1 and 4 (p<0.05).ConclusionSignificant periprosthetic bone loss after uncemented THA in the femur was noted in Gruen zones 1, 4, and 7 during the first six months after THA, with the greatest bone loss in the femoral calcar area (zone 7). The lower the preoperative BMD of the patient, the greater the postoperative bone loss.