Background Procedures to treat intestinal obstruction range from minimally invasive laparoscopic surgery to more complicated open surgical procedures. It may end with high morbidity and mortality because of different reasons. It is very important to know about the determinants of favorable outcome of surgical management for intestinal obstruction however, little is known about this problem at public hospitals of Southern Ethiopia. Methods Facility based cross sectional study was conducted. A total of 230 medical records which fulfill the inclusion criteria were used for this study. Variables with p value of less than 0.25 in the bivariate analysis were entered in multivariable logistic regression to control confounding. Finally, odds ratio with 95% confidence interval was used to identify variables which were significantly associated with dependent variable. Results According to this study the magnitude of favorable surgical management outcome of intestinal obstruction was 177(77.0%) [95% CI, 71.4, 82.4]. Having small bowel obstruction (AOR = 2.49) [95% CI 1.91, 5.12], having simple bowel obstruction (AOR = 4.32) [95% CI, 2.00, 9.35], early presentation of patients (AOR = 4.44) [95% CI, 1.99, 9.92] and intraoperative procedure other than resection and anastomosis was performed (AOR = 0.45) [95% CI, 0.21, 0.96] were significantly associated with favorable outcome among surgically treated patients. Conclusion The overall magnitude of favorable surgical management outcome of intestinal obstruction was moderate compared to other study. Having small bowel obstruction, having simple bowel obstruction, other procedure other than resection and anastomosis done, and early presentation of patients were significant predictors. Physicians should diagnose intestinal obstruction early and appropriate interventions should be taken on time before the complication happened. On time consultation and decision at the hospital setting is also recommended.
Background: Delay in TB treatment is significant to both disease prognoses at the individual level and within the community. Even though studies conducted in TB treatment delay there is result inconsistencies due to differences in culture, environment and infrastructure. Objective: the aim of the study is to assess the tuberculosis treatment Delay and associated factor among pulmonary tuberculosis patients. Method: Facility based cross sectional study triangulated by Qualitative study was employed on 340 PTB patients in Hadiya zone public health facilities. Three woredas and health facilities were selected by Simple random sampling method. DOTS user at the beginning of data collection was consecutively recruited in to the study until the intended sample size was fulfilled. Multivariable binary Logistic regression was used. A P-value < 0.05 at 95 % CI was considered statistical significance between dependent and predictors variables. Result: Among 340 PTB patients enrolled in the study, of which 49.1% experienced patient delay, 30% health system delay and 49.8% total delay. Unable to read and write, Poor knowledge of TB (AOR 3.96, 95% CI (2.28 6.86), self-treatment (AOR: 2, 95% CI (1.14, 3.93), financial constraint (AOR: 2.092, 95% CI (1.11, 3.945) , Visiting two or more health care providers (AOR: 3.40, 95% CI (1.910 – 6.07), prolonged referral (AOR: 3.004, 95% CI (1.59, 5.67) were independent predictors of delay. Conclusion: Nearly half of the total delay was contributed by patient delay. Unable to read and write, Poor knowledge of TB, self-treatment, financial constraints, prolonged referral, several visit of health care provider of two or more and ever used other drugs rather than Anti-TB drugs were found to have association with patient delay and health system delay. Keywords: Tuberculosis treatment delay, PTB, patient delay and health system delay, Hadiya zone, Ethiopia.
Background: Procedures to treat intestinal obstruction range from minimally invasive laparoscopic surgery to more complicated open surgical procedures. It may end with high morbidity and mortality because of different reasons. It is very important to know about the determinants of favorable outcome of surgical management for intestinal obstruction however, little is known about this problem at public hospitals of Southern Ethiopia. Methods: Facility based cross sectional study was conducted. A total of 230 medical records which fulfill the inclusion criteria were used for this study. Variables with p value of less than 0.25 in the bivariate analysis were entered in multivariable logistic regression to control confounding. Finally, odds ratio with 95% confidence interval was used to identify variables which were significantly associated with dependent variable. Results: According to this study the magnitude of favorable surgical management outcome of intestinal obstruction was 177(77.0%) [95% CI, 71.4, 82.4]. Having small bowel obstruction (AOR=2.49) [95% CI 1.91, 5.12], having simple bowel obstruction (AOR=4.32) [95% CI, 2.00, 9.35], early presentation of patients (AOR=4.44) [95% CI, 1.99, 9.92] and intraoperative procedure other than resection and anastomosis was performed (AOR=0.45) [95% CI, .21, .96] were significantly associated with favorable outcome among surgically treated patients.Conclusion: The overall magnitude of favorable surgical management outcome of intestinal obstruction was moderate compared to other study. Having small bowel obstruction, having simple bowel obstruction, other procedure other than resection and anastomosis done, and early presentation of patients were significant predictors. Physicians should diagnose intestinal obstruction early and appropriate interventions should be taken on time before the complication happened. On time consultation and decision at the hospital setting is also recommended.
UNSTRUCTURED Abstract This scientific perspective of mode of transmission of COVID-19 is to aid scientific community in generating hypothesis. The inadequate evidence on SARS-COV-2 transmission has hindered development of effective prevention strategy and resulted in continues pandemic of the COVID-19. Therefore, in this perspective existing evidences are discussed, hypothesis are generated regarding COVID-19 mode of transmission and recommendations are forwarded based on existing body of knowledge. Two meter (2m) physical distance is not completely safe even for large droplets and wearing face mask is a key in prevention of SARS-COV-2 in public areas and confined space.
BACKGROUND Diclofenac is a Non-steroid Anti-inflammatory drug (NSAID) derived from non-steroidal phenylacetic acid. Diclofenac is a benzene acetic acid derivative used to treat the pain and swelling associated with rheumatic disorders since 1974. It is one of the most widely used non-steroidal anti-inflammatory Drugs (NSAIDs) in the world. A few reports have demonstrated that non-steroidal anti-inflammatory drugs exerted embryo toxicity and teratogenicity among experimental animals but there is no clear evidence of the effect in humans. OBJECTIVE To perform a systematic review on the effect of Diclofenac exposure during Pregnancy on mother and fetus. METHODS This systematic review was conducted in accordance with the JBI methodology for systematic review of effectiveness evidence. A three-step search strategy used in this review. Databases searched included Pub Med, Medline Scopus, Embase, cinihal, Google, different Universities repositories and Google scholar. Titles and abstracts were then screened by two independent reviewers for assessment against the inclusion criteria for the review. Eligible studies were critically appraised by two independent reviewers at the study level. Appraisal was occurred at the outcome level for methodological quality in the review using standardized critical appraisal instruments from the Joanna Briggs Institute (JBI) for observational studies. The data extracted from the studies include specific details about the populations, study methods, interventions, and outcomes of significance to the review objective indicate the specific details. Statistical pooling was not possible due to outcome and nature of data. So, that the findings were presented in narrative form. RESULTS Three relevant articles (two cohort and a nested case control studies) were identified with a total of 1,490,679 participants. Diclofenac exposure during pregnancy increases the risk of low birth weight on fetus, increased risk of spontaneous abortion and increased risk of maternal vaginal bleeding. CONCLUSIONS Exposures to Diclofenac during pregnancy have adverse embryonic and maternal effect. So pregnant women taking Diclofenac may affect mother and fetus and additional primary RCTs are needed.
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