Pub Date : 2021-01-01DOI: 10.36648/1989-5216.21.13.32
Taysa Leite de Aquino, Jaiany Rodrigues Libório, Ana Luiza Menezes Santana Bezerra, Giovana Macêdo Egídio Cavalcante, Dara Fern, A. Duarte, A. Martin, J. D. A. D. Paula, M. L. Neto
Introduction: Depression, being the most disabling disease in the world and presenting high morbidity and mortality, requires an effective treatment to ensure the maintenance of the patients' quality of life. About a third of patients do not respond adequately to antidepressant treatment. New pharmacological therapies are being approached in order to reduce the unfavourable outcomes resulting from this pathology. Objective: To develop a systematic review of the literature on the new possibilities of pharmacological treatments for depression in the last four years. Method: A systematic review was carried out following the PRISMA protocol (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). We have included studies on the effectiveness of new pharmacological therapies in patients with major depressive disorder and treatment-resistant depression. Results: In the treatment of the Major Depressive Disorder (MDD), the use of brexpiprazole 1 mg/day in addition to the usual Antidepressant Treatment (ADT) resulted in significant improvement in the main symptoms. Already referring to treatments for treatment-resistant depression (TRD): nasal esketamine proved beneficial in the short term, Intravenous (IV) ketamine also appears as an effective therapy. Conclusion: The use of brexpiprazole 1 mg/day associated with an antidepressant, and the use of lactobacilli represent a new option for those with MDD. In addition, ketamine, riluzole, and cariprazine appear as new hopes for those who have not yet achieved remission of the depressive disorder with the use of more than two antidepressants.
{"title":"New Pharmacological Therapeutic Approaches for Depressive Disorders: A Systematic Review","authors":"Taysa Leite de Aquino, Jaiany Rodrigues Libório, Ana Luiza Menezes Santana Bezerra, Giovana Macêdo Egídio Cavalcante, Dara Fern, A. Duarte, A. Martin, J. D. A. D. Paula, M. L. Neto","doi":"10.36648/1989-5216.21.13.32","DOIUrl":"https://doi.org/10.36648/1989-5216.21.13.32","url":null,"abstract":"Introduction: Depression, being the most disabling disease in the world and presenting high morbidity and mortality, requires an effective treatment to ensure the maintenance of the patients' quality of life. About a third of patients do not respond adequately to antidepressant treatment. New pharmacological therapies are being approached in order to reduce the unfavourable outcomes resulting from this pathology. Objective: To develop a systematic review of the literature on the new possibilities of pharmacological treatments for depression in the last four years. Method: A systematic review was carried out following the PRISMA protocol (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). We have included studies on the effectiveness of new pharmacological therapies in patients with major depressive disorder and treatment-resistant depression. Results: In the treatment of the Major Depressive Disorder (MDD), the use of brexpiprazole 1 mg/day in addition to the usual Antidepressant Treatment (ADT) resulted in significant improvement in the main symptoms. Already referring to treatments for treatment-resistant depression (TRD): nasal esketamine proved beneficial in the short term, Intravenous (IV) ketamine also appears as an effective therapy. Conclusion: The use of brexpiprazole 1 mg/day associated with an antidepressant, and the use of lactobacilli represent a new option for those with MDD. In addition, ketamine, riluzole, and cariprazine appear as new hopes for those who have not yet achieved remission of the depressive disorder with the use of more than two antidepressants.","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88708221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1989-5216.21.13.11
Namera Thahaby, Afzal Hoque Ak, A. Bhat, Salha Hamdani
Background: Information regarding open garbage dumps may cause public health dilemma within the community and cause stray dog proliferation. Most wastes have a family origin and stray dogs are largely attracted by these foods. Methods: The information, besides as attitudes and perception on rabies, is thus vital for the prevention of human deaths. Two sources i.e., primary and secondary sources were utilized for identifying the probable factors responsible for increased dog population. Results: Regarding the major factors associated with increases dog population, the respondents (both the people 99.68% and commercial 100%) believed that open garbage dumps are a public health barrier in the area and commence to stray dog proliferation. Conclusion: Open garbage dumps are a public health problem in the Srinagar area. Till date only around 2,000 sterilizations were conducted and also around 2,000 stray dogs were administered the anti-rabies vaccine, however this is too less in comparison with the total population of dogs and still, the ballot of dogs from the particular zones of Srinagar is deficient.
{"title":"The Major Factors Associated with Increased Dog Population Vis-a-Vis Spread of Rabies within Srinagar District of Kashmir Valley, India","authors":"Namera Thahaby, Afzal Hoque Ak, A. Bhat, Salha Hamdani","doi":"10.36648/1989-5216.21.13.11","DOIUrl":"https://doi.org/10.36648/1989-5216.21.13.11","url":null,"abstract":"Background: Information regarding open garbage dumps may cause public health dilemma within the community and cause stray dog proliferation. Most wastes have a family origin and stray dogs are largely attracted by these foods. Methods: The information, besides as attitudes and perception on rabies, is thus vital for the prevention of human deaths. Two sources i.e., primary and secondary sources were utilized for identifying the probable factors responsible for increased dog population. Results: Regarding the major factors associated with increases dog population, the respondents (both the people 99.68% and commercial 100%) believed that open garbage dumps are a public health barrier in the area and commence to stray dog proliferation. Conclusion: Open garbage dumps are a public health problem in the Srinagar area. Till date only around 2,000 sterilizations were conducted and also around 2,000 stray dogs were administered the anti-rabies vaccine, however this is too less in comparison with the total population of dogs and still, the ballot of dogs from the particular zones of Srinagar is deficient.","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84742628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1989-5216.21.13.08
K. Wilkosz, K. Wita, M. Wybraniec, M. Wita, Joanna Fluder, Monika Malta, Jarosław Chmurawa, Andrzej Kubicjus
Background: The number of studies confirming the importance of Cardiac Rehabilitation (CR) towards the reduction of mortality and morbidity has increased. On the basis of scientific evidence, we developed a care program in Poland for patients with myocardial infarction I (MC-AMI (in Polish KOS-zawal). There is a lack of data on possible improvement in long-term prognosis among women after acute myocardial infarctions (AMI), who were also involved with CR. Aim: The aim of the study is to compare the male and female population who participate in MC-AMI, regarding major cardiovascular events (MACE), defined as a composite of death, recurrent myocardial infarction, and hospitalization for heart failure in a one-year follow-up. Methods: This is a prospective research study from a single cardiology care centre. The study compares two groups: women and men who have agreed to participate in the MC-AMI program. Results: As such, 529 patients were included in the study: 167 women and 362 men. In the 12-month follow-up, the incidence of MACE events was not statistically significantly, as observed in the study groups (11.38% vs. 11.33%; P=0.98). Cox multivariate regression analysis of the surveyed population also revealed that coronary heart disease, diabetes mellitus type II, and previous percutaneous coronary intervention was significantly related to the primary endpoint. Conclusion: Women who participate in the MC-AMI program do not exhibit a worse prognosis following MACE, compared to men in 12-month follow-up. Given the benefits of the program, the percentage of women participating in the program should definitely improve.
背景:越来越多的研究证实心脏康复(CR)对降低死亡率和发病率的重要性。在科学证据的基础上，我们在波兰为心肌梗死I (MC-AMI，波兰语为koszawal)患者制定了一个护理方案。缺乏关于急性心肌梗死(AMI)后参与CR的女性长期预后可能改善的数据。目的:本研究的目的是比较参与MC-AMI的男性和女性人群在主要心血管事件(MACE)方面的差异，MACE定义为死亡、复发性心肌梗死和心力衰竭住院的复合随访一年。方法:这是一项来自单一心脏病学护理中心的前瞻性研究。这项研究比较了两组同意参加MC-AMI项目的女性和男性。结果:因此，529名患者纳入研究:167名女性和362名男性。在12个月的随访中，MACE事件的发生率无统计学意义，在研究组中观察到(11.38% vs 11.33%;P = 0.98)。调查人群的Cox多因素回归分析也显示冠心病、糖尿病II型、既往经皮冠状动脉介入治疗与主要终点显著相关。结论:在12个月的随访中，与男性相比，参与MC-AMI计划的女性在MACE后的预后并不差。考虑到该计划的好处，参加该计划的女性比例肯定会提高。
{"title":"Long-Term Outcomes in Women and Men Population Participating In Program of Managed Care after Acute MyocardialInfarction (MC-AMI): A 12-Months Follow-Up from a Single Cardiology Care Centre","authors":"K. Wilkosz, K. Wita, M. Wybraniec, M. Wita, Joanna Fluder, Monika Malta, Jarosław Chmurawa, Andrzej Kubicjus","doi":"10.36648/1989-5216.21.13.08","DOIUrl":"https://doi.org/10.36648/1989-5216.21.13.08","url":null,"abstract":"Background: The number of studies confirming the importance of Cardiac Rehabilitation (CR) towards the reduction of mortality and morbidity has increased. On the basis of scientific evidence, we developed a care program in Poland for patients with myocardial infarction I (MC-AMI (in Polish KOS-zawal). There is a lack of data on possible improvement in long-term prognosis among women after acute myocardial infarctions (AMI), who were also involved with CR. Aim: The aim of the study is to compare the male and female population who participate in MC-AMI, regarding major cardiovascular events (MACE), defined as a composite of death, recurrent myocardial infarction, and hospitalization for heart failure in a one-year follow-up. Methods: This is a prospective research study from a single cardiology care centre. The study compares two groups: women and men who have agreed to participate in the MC-AMI program. Results: As such, 529 patients were included in the study: 167 women and 362 men. In the 12-month follow-up, the incidence of MACE events was not statistically significantly, as observed in the study groups (11.38% vs. 11.33%; P=0.98). Cox multivariate regression analysis of the surveyed population also revealed that coronary heart disease, diabetes mellitus type II, and previous percutaneous coronary intervention was significantly related to the primary endpoint. Conclusion: Women who participate in the MC-AMI program do not exhibit a worse prognosis following MACE, compared to men in 12-month follow-up. Given the benefits of the program, the percentage of women participating in the program should definitely improve.","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"138 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77391425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Anemia is defined as reduction in red cell mass which, will decreases oxygen-carrying capacity of red blood cells to tissues that can be determined in the laboratory by reduction in haemoglobin concentration (haemoglobin level of less than 11 gm/dl) or haematocrit value is less than 33%. Anemia in pregnant women is often caused by iron deficiency, which is the most common nutrient deficiency in the world, affecting more than two billion people globally. Inadequate intake or absorption of iron conjunction with blood loss during pregnancy may contribute to anemia. Iron deficiency and consequent anemia during pregnancy could be associated with severe complication like increase risks of maternal mortality and morbidity, premature delivery and low birth weight. In pregnant women, an adequate iron status is important to ensure a complication related to pregnancy as well as a normal development of the embryo, foetus and maturity of the new born child. Objectives: To assess the prevalence of iron deficiency anemia and associated factors among pregnant women attending Antenatal care (ANC) follow up at Dodola General Hospital, West Arsi zone, Oromia Region, south East Ethiopia 2018 G.C. Methods: An institutional based cross-sectional study was conducted from February 5 to March 30, 2018 G.C. Systematic random sampling technique was employed to select each participant. Data was checked, coded and analyzed by using SPSS version 20 Software, Odds ratio with corresponding 95% confidence interval was used to determine the association between independent and dependent variables. Multivariate logistic regression analysis was performed to determine the independent factors associated with iron deficiency anemia in these pregnant women and finally presented by tables and chart. Results: The prevalence of iron deficiency anemia was 19.3%. Multivariate logistic regression analysis revealed that pregnant women who had monthly income less than or equal to one thousand birr, Antenatal care visit one times, History of vaginal bleeding, Women who ate only injera with shiro and women who drunks caffeine containing drinks with food during their pregnancy were factors significantly associated with iron deficiency anemia. Conclusion and Recommendations: The prevalence of iron deficiency anemia among pregnant women in this study was relatively low. The hospitals should give special attention for pregnant women to attend Ante natal care and health professionals should advice the pregnant women on nutrition as well as effects of taking caffeine containing drinks during their pregnancy.
背景:贫血被定义为红细胞数量减少，红细胞对组织的携氧能力降低，可在实验室通过血红蛋白浓度降低(血红蛋白水平低于11克/分升)或红细胞压积值低于33%来确定。孕妇贫血通常是由缺铁引起的，缺铁是世界上最常见的营养缺乏症，影响着全球20多亿人。怀孕期间铁的摄入或吸收不足以及失血可能导致贫血。怀孕期间缺铁和随之而来的贫血可能与严重并发症有关，如增加产妇死亡率和发病率、早产和低出生体重的风险。在孕妇中，足够的铁水平对于确保妊娠并发症以及胚胎、胎儿和新生儿的正常发育非常重要。目的:评估埃塞俄比亚东南部奥罗米亚地区西阿尔西区Dodola总医院2018年产前保健(ANC)随访孕妇缺铁性贫血的患病率及其相关因素。方法:2018年2月5日至3月30日，采用基于机构的横断面研究方法，采用系统随机抽样技术选择每个参与者。采用SPSS version 20软件对数据进行检验、编码和分析，采用相应95%置信区间的比值比来确定自变量与因变量之间的相关性。对这些孕妇进行多因素logistic回归分析，确定与缺铁性贫血相关的独立因素，最后以表格形式呈现。结果:缺铁性贫血患病率为19.3%。多因素logistic回归分析显示，月收入小于等于1000 birr的孕妇、产前检查1次、阴道出血史、孕期只吃含shiro的injera以及孕期在食物中饮用含咖啡因的饮料是缺铁性贫血的显著相关因素。结论和建议:本研究中孕妇缺铁性贫血的患病率相对较低。医院应特别注意孕妇参加产前护理，保健专业人员应就孕妇在怀孕期间服用含咖啡因饮料的营养和影响向孕妇提供建议。
{"title":"Prevalence of Iron Deficiency Anemia and Associated Factors among Pregnant Women Attending Antenatal Care Follow up at Dodola General Hospital West Arsi Zone Oromia Region South East Ethiopia","authors":"Fikadu Nugusu Dessalegn, Tilahun Ermeko Wanamo, Debebe Wordofa","doi":"10.36648/1989-5216.21.13.40","DOIUrl":"https://doi.org/10.36648/1989-5216.21.13.40","url":null,"abstract":"Background: Anemia is defined as reduction in red cell mass which, will decreases oxygen-carrying capacity of red blood cells to tissues that can be determined in the laboratory by reduction in haemoglobin concentration (haemoglobin level of less than 11 gm/dl) or haematocrit value is less than 33%. Anemia in pregnant women is often caused by iron deficiency, which is the most common nutrient deficiency in the world, affecting more than two billion people globally. Inadequate intake or absorption of iron conjunction with blood loss during pregnancy may contribute to anemia. Iron deficiency and consequent anemia during pregnancy could be associated with severe complication like increase risks of maternal mortality and morbidity, premature delivery and low birth weight. In pregnant women, an adequate iron status is important to ensure a complication related to pregnancy as well as a normal development of the embryo, foetus and maturity of the new born child. Objectives: To assess the prevalence of iron deficiency anemia and associated factors among pregnant women attending Antenatal care (ANC) follow up at Dodola General Hospital, West Arsi zone, Oromia Region, south East Ethiopia 2018 G.C. Methods: An institutional based cross-sectional study was conducted from February 5 to March 30, 2018 G.C. Systematic random sampling technique was employed to select each participant. Data was checked, coded and analyzed by using SPSS version 20 Software, Odds ratio with corresponding 95% confidence interval was used to determine the association between independent and dependent variables. Multivariate logistic regression analysis was performed to determine the independent factors associated with iron deficiency anemia in these pregnant women and finally presented by tables and chart. Results: The prevalence of iron deficiency anemia was 19.3%. Multivariate logistic regression analysis revealed that pregnant women who had monthly income less than or equal to one thousand birr, Antenatal care visit one times, History of vaginal bleeding, Women who ate only injera with shiro and women who drunks caffeine containing drinks with food during their pregnancy were factors significantly associated with iron deficiency anemia. Conclusion and Recommendations: The prevalence of iron deficiency anemia among pregnant women in this study was relatively low. The hospitals should give special attention for pregnant women to attend Ante natal care and health professionals should advice the pregnant women on nutrition as well as effects of taking caffeine containing drinks during their pregnancy.","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78538003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1989-5216.21.13.22
Jaap Wonders
Physical therapists and other therapists often treat patients with tendinopathy, which is a condition that occurs frequently and has poor prognosis and long recovery time. Multiple lifestyle factors have found to be risk factors for tendinopathy. Lifestyle factors such as exercise and movement, nutrition, sleep and psychosocial factors are often interrelated and can create a vicious spiral for patients with tendinopathy. Unhealthy lifestyle factors can cause chronic pain, low-grade inflammation, elevated adiposity, higher waist-to-rib ratio, greater body mass index, overweight, obesity, high cholesterol, metabolic syndrome, diabetes type II, rheumatoid arthritis and inflammatory-related diseases, which are the main factors explaining the association between lifestyle factors and tendinopathy. Single or multiple lifestyle interventions are available for the treatment of patients with tendinopathy. Both exercise and movement and nutritional interventions tend to improve tendon health and recovery of tendinopathy indirectly by decreasing adiposity, weight, diabetic symptoms, low-grade inflammation and pain. They are also likely to improve blood levels, bone and muscle health, and collagen synthesis of tendons, tendon function and tendon-related pain. Sleep, psychological factors, smoking behaviour and alcohol use also affect tendon pain and tissue healing. Physical therapists and other therapists may incorporate interventions as part of the treatment of tendinopathy targeted at improving sleep and psychosocial factors. Smoking behaviour and alcohol use should be discouraged, for which multiple interventions are available. The purpose of this commentary article is to inform physical therapists and other therapists about lifestyle factors as risk factors and treatment options in tendinopathy.
{"title":"Lifestyle Factors as Risk Factors and Treatment Options in Tendinopathy .","authors":"Jaap Wonders","doi":"10.36648/1989-5216.21.13.22","DOIUrl":"https://doi.org/10.36648/1989-5216.21.13.22","url":null,"abstract":"Physical therapists and other therapists often treat patients with tendinopathy, which is a condition that occurs frequently and has poor prognosis and long recovery time. Multiple lifestyle factors have found to be risk factors for tendinopathy. Lifestyle factors such as exercise and movement, nutrition, sleep and psychosocial factors are often interrelated and can create a vicious spiral for patients with tendinopathy. Unhealthy lifestyle factors can cause chronic pain, low-grade inflammation, elevated adiposity, higher waist-to-rib ratio, greater body mass index, overweight, obesity, high cholesterol, metabolic syndrome, diabetes type II, rheumatoid arthritis and inflammatory-related diseases, which are the main factors explaining the association between lifestyle factors and tendinopathy. Single or multiple lifestyle interventions are available for the treatment of patients with tendinopathy. Both exercise and movement and nutritional interventions tend to improve tendon health and recovery of tendinopathy indirectly by decreasing adiposity, weight, diabetic symptoms, low-grade inflammation and pain. They are also likely to improve blood levels, bone and muscle health, and collagen synthesis of tendons, tendon function and tendon-related pain. Sleep, psychological factors, smoking behaviour and alcohol use also affect tendon pain and tissue healing. Physical therapists and other therapists may incorporate interventions as part of the treatment of tendinopathy targeted at improving sleep and psychosocial factors. Smoking behaviour and alcohol use should be discouraged, for which multiple interventions are available. The purpose of this commentary article is to inform physical therapists and other therapists about lifestyle factors as risk factors and treatment options in tendinopathy.","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79284581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1989-5216.21.13.21
Girum Fufa, Tilahun Ermeko Wanamo, A. Mohammed, Abate Lette Wodera
Introduction: Community-Based Health Insurance (CBHI) schemes are emerging tool for providing financial protection for poor people living developing countries like Ethiopia. In Ethiopia, Community-Based Health Insurance (CBHI) was piloted in 13 districts and finally expanded to 427 districts, but satisfaction of community for the scheme and health service delivery is yet limited. Therefore, this study aimed to assess the satisfaction level of Community for health insurance. Methods: A facility based cross-sectional study design was conducted from March and April, 2019 in Arsi Nagele Woreda health centers. Three hundred ninety eight participants who visited the health care facility during the study period were included for the study. The data was entered to Epi-data version 3.1 and exported to Statistical Packages for Social Sciences (SPSS) version 21.0 for analysis Results: A total of 399 patients were participated in the study, yielding a response rate of 95%. 63.1% were male and 36.9% were females. The findings of the study showed that the overall client satisfaction level of CBHI with the health services received from the targeted health centers were 63.4%. Age, educational status, waiting time, drugs availability and knowledge were predictors for Clients satisfaction regarding service of community based health insurance. Qualitative dimension showed that the most unsatisfactory aspects for the Community Based Health Insurance (CBHI) health service were lack of skill personnel and availability of drugs at health facilities. Conclusion and recommendations: This study showed higher clients’ satisfaction level when compared to similar studies in the country. Young age, lack of drugs and supplies, poor information provision, long waiting time at consultation, were found to be the major predictors of dissatisfaction. Therefore, the district health offices should address and work on this predictor to regulate clients’ satisfaction for Community Based Health Insurance (CBHI).
{"title":"Assessing Factors Associated with Poor Community Based Health Insurance for Client Satisfaction Level with Public Health Care Services in Negele Arsi District Health Centers, West Arsi Zone Ethiopia","authors":"Girum Fufa, Tilahun Ermeko Wanamo, A. Mohammed, Abate Lette Wodera","doi":"10.36648/1989-5216.21.13.21","DOIUrl":"https://doi.org/10.36648/1989-5216.21.13.21","url":null,"abstract":"Introduction: Community-Based Health Insurance (CBHI) schemes are emerging tool for providing financial protection for poor people living developing countries like Ethiopia. In Ethiopia, Community-Based Health Insurance (CBHI) was piloted in 13 districts and finally expanded to 427 districts, but satisfaction of community for the scheme and health service delivery is yet limited. Therefore, this study aimed to assess the satisfaction level of Community for health insurance. Methods: A facility based cross-sectional study design was conducted from March and April, 2019 in Arsi Nagele Woreda health centers. Three hundred ninety eight participants who visited the health care facility during the study period were included for the study. The data was entered to Epi-data version 3.1 and exported to Statistical Packages for Social Sciences (SPSS) version 21.0 for analysis Results: A total of 399 patients were participated in the study, yielding a response rate of 95%. 63.1% were male and 36.9% were females. The findings of the study showed that the overall client satisfaction level of CBHI with the health services received from the targeted health centers were 63.4%. Age, educational status, waiting time, drugs availability and knowledge were predictors for Clients satisfaction regarding service of community based health insurance. Qualitative dimension showed that the most unsatisfactory aspects for the Community Based Health Insurance (CBHI) health service were lack of skill personnel and availability of drugs at health facilities. Conclusion and recommendations: This study showed higher clients’ satisfaction level when compared to similar studies in the country. Young age, lack of drugs and supplies, poor information provision, long waiting time at consultation, were found to be the major predictors of dissatisfaction. Therefore, the district health offices should address and work on this predictor to regulate clients’ satisfaction for Community Based Health Insurance (CBHI).","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"106 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76135306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1989-5216.21.13.16
G. Chatzis
Our knowledge of coronavirus disease-2019 (COVID-19) and its cardiovascular implications is growing every day. The pandemic has raised the question of whether to continue offering heart transplantations due to concerns regarding the risk for exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during hospitalization and challenges in curbing the infection with high levels of immunosuppression. We present the case of a 47-year-old woman who presented with COVID-19 on immunosuppression therapy due to recent heart transplantation four months before admission. The patient’s condition worsened, and despite monitoring and treatment updates, she died on day 19 of admission. Although most immunocompromised persons effectively clear a SARS-CoV-2 infection, this case highlights the potential for ongoing and accelerated viral evolution associated with an immunocompromised state. Patients can manifest acute rejection in the months following transplantation surgery, which can ultimately lead to death.
{"title":"Complications of a Heart Transplanted Patient with COVID-19 Infection","authors":"G. Chatzis","doi":"10.36648/1989-5216.21.13.16","DOIUrl":"https://doi.org/10.36648/1989-5216.21.13.16","url":null,"abstract":"Our knowledge of coronavirus disease-2019 (COVID-19) and its cardiovascular implications is growing every day. The pandemic has raised the question of whether to continue offering heart transplantations due to concerns regarding the risk for exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during hospitalization and challenges in curbing the infection with high levels of immunosuppression. We present the case of a 47-year-old woman who presented with COVID-19 on immunosuppression therapy due to recent heart transplantation four months before admission. The patient’s condition worsened, and despite monitoring and treatment updates, she died on day 19 of admission. Although most immunocompromised persons effectively clear a SARS-CoV-2 infection, this case highlights the potential for ongoing and accelerated viral evolution associated with an immunocompromised state. Patients can manifest acute rejection in the months following transplantation surgery, which can ultimately lead to death.","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"142 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80186235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.36648/1989-5216.21.13.28
Ana Luiza Menezes Santana Bezerra, A. Morgado, Esther Barbosa Gonçalves Felix, Francisco Marcos Bezerra Cunha, M. Neto, Ana Luíza de Aguiar Rocha Martin
Understanding the SARS-CoV-2 pathophysiology regarding neural system contamination and damage is necessary for clinical and therapeutic approaches, which may reduce the damage caused by the disease. In this regard, it is important to highlight that, besides the direct effect on neurons, the inflammatory state caused by a dysregulation of the immune system due to infection are both factors responsible for neurological phenomena of the disease. The presence of the virus in the bloodstream, its ability to directly penetrate the NS through peripheral nerves and the weakening of the blood-brain barrier are added to the tropism of SARS-CoV-2 by ACE-2 receptors, which favours the appearance of brain manifestations, associated with metabolic complications in the autoimmune processes induced by viral clinical condition. It is essential to remember that the cerebrovascular events have been increasingly reported in infected patients and are associated with the hypercoagulability caused by the disease. The activation of the coagulation cascade and deregulation of physiological anticoagulant mechanisms, such as protein C system and the disintegration of fibrin, are possible causes of this hypercoagulable state present in COVID-19. Even though it is still not evident whether the impairment of the nervous system is a result of direct infection by SARS-CoV-2 or of a diffuse inflammatory process affecting various organs and systems generating multiple manifestations, including those of the nervous system, we highlight that the quantity of drugs administered in intensive care units also can interfere with neurological conditions.
{"title":"Beyond The Lungs: SARS-CoV-2 Pathways to the Nervous System and Its Consequences","authors":"Ana Luiza Menezes Santana Bezerra, A. Morgado, Esther Barbosa Gonçalves Felix, Francisco Marcos Bezerra Cunha, M. Neto, Ana Luíza de Aguiar Rocha Martin","doi":"10.36648/1989-5216.21.13.28","DOIUrl":"https://doi.org/10.36648/1989-5216.21.13.28","url":null,"abstract":"Understanding the SARS-CoV-2 pathophysiology regarding neural system contamination and damage is necessary for clinical and therapeutic approaches, which may reduce the damage caused by the disease. In this regard, it is important to highlight that, besides the direct effect on neurons, the inflammatory state caused by a dysregulation of the immune system due to infection are both factors responsible for neurological phenomena of the disease. The presence of the virus in the bloodstream, its ability to directly penetrate the NS through peripheral nerves and the weakening of the blood-brain barrier are added to the tropism of SARS-CoV-2 by ACE-2 receptors, which favours the appearance of brain manifestations, associated with metabolic complications in the autoimmune processes induced by viral clinical condition. It is essential to remember that the cerebrovascular events have been increasingly reported in infected patients and are associated with the hypercoagulability caused by the disease. The activation of the coagulation cascade and deregulation of physiological anticoagulant mechanisms, such as protein C system and the disintegration of fibrin, are possible causes of this hypercoagulable state present in COVID-19. Even though it is still not evident whether the impairment of the nervous system is a result of direct infection by SARS-CoV-2 or of a diffuse inflammatory process affecting various organs and systems generating multiple manifestations, including those of the nervous system, we highlight that the quantity of drugs administered in intensive care units also can interfere with neurological conditions.","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86632861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：