Amoakoh-Coleman, Mary; Ansah, Evelyn K.; Agyepong, Irene Akua; Grobbee, Diederick E; Gbenga A Kayode; Klipstein-Grobusch, Kerstin
Objective To identify demographic, maternal and community predictors of skilled attendance at delivery among women who attend antenatal clinic at least once during their pregnancy in Ghana. Design A cross-sectional study using the 2008 Ghana Demographic and Health Survey (DHS) data. We used frequencies for descriptive analysis, χ2 test for associations and logistic regression to identify significant predictors. Predictive models were built with estimation of area under the receiver operating ...
Venna Guru Prasad
Full Text Available Background: To assess seroprevalence of HIV among antenatal women and the extent of utilization of therapeutic interventions to minimize the risk of mother to child transmission. Methods: Pregnant women attending antenatal clinic of a medical college in a rural area of Nalgonda district of Andhra Pradesh, India from August 2006 to July 2009 were tested for HIV by Rapid Test which included pre and post test counseling. Antiretroviral prophylaxis with nevirapine was given to seropositive mother-baby pairs during delivery. Results: Of the 5809 new antenatal booking visits 4848 attended pretest counseling and 4698 accepted HIV testing. Fifty three women were found to be seropositive. Sero-prevalence rate of HIV infection was 1.12%. Ten had opted for pregnancy termination. Out of forty three deliveries four were intrauterine deaths. All the newborns received nevirapine prophylaxis. Conclusions: The seroprevalence of HIV infection among antenatal women is 1.12% which was high as the institute is located in Andhra Pradesh which is a known high prevalence state. Thirty one babies tested after 18 months of age were negative. Nine babies died before they reached 18 months of age. [Int J Reprod Contracept Obstet Gynecol 2012; 1(1.000: 17-21
Yang Fan(杨帆); Zhou Hua(周华); Hong Fuchang(洪福昌); Luo Bin(罗斌); Cai Yumao(蔡于茂); Wen Lizhang(文立章); Zhang Chunlai(张春来)
Abstract Background: The Nnewly reported cases of congenital syphilis have been increaseding substantially over the past few years. To control the epidemic, a municipal program aimed at preventing mother-to-child transmission of syphilis was introduced in July, 2001,which was designed aimed to screen all pregnant women for syphilis at their first visit to antenatal clinics or at admission to hospitals in Shenzhen.Objectives: The aim of the study is tTo determine the prevalence of syphilis among women attending antenatal clinics and other medical institutions in Shenzhen and identifies its patterns of infection.Methods: Upon giving informed consent, w Women who attended antenatal care centers in Shenzhen from January to December 2003 were included in this study subject to obtaining informed consent. A blood sample was harvested for syphilis screened for syphilising by using rapid plasma reagent test (RPR) and confirmed by TPHA for those who were RPR positive. The women with pregnant syphilispositive serology were systematically interviewed to obtain. During the interview, their demographic detailsinformation, patterns of risk behaviors and other data. Data were collected andwere analyzed retrospectively.Results: Among Of 118,235 pregnant women surveyed,555 pregnant women were confirmed to have syphilis (prevalence of 4.69%), with a incidence of 4.69‰. 123women were excluded from the analysis because of incomplete medical records. Of 432 infected subjects with complete medical records, the average age was 26.8, with a range of 19 to 41. 7.41% (32/432) of them suffered from primary syphilis, 3.24% (14/432) were ofhad secondary syphilis, and 89.35%(386/432) had latent syphilis. Without any conspicuous clinical signs and symptoms. Conclusions: The prevalence of syphilis among the pregnant women in our series was high an most of them were asymptomatic. Screening for syphilis among pregnant women in Shenzhen is of importantce for the prevention of mother
Ahenkorah, Benjamin; Nsiah, Kwabena; Baffoe, Peter
The study determined the sociodemographic and obstetric characteristics of pregnant women which contribute to the risk of developing anaemia. A cross-sectional study was conducted among 400 pregnant women attending their first antenatal visit at the Bolgatanga Regional Hospital Antenatal Clinic. Anaemia was significantly associated (p < 0.05) with younger maternal age, parity, gravidity, trimester of pregnancy, and source of drinking water. Multivariate logistic regression identified the following factors with adjusted odds ratios (aOR) and 95% confidence intervals (CI): unemployment (aOR = 4.76 (CI: 2.26–11.33); p < 0.0001), rural dwelling (aOR = 3.10 (CI: 2.16–4.91); p = 0.0071), primigravida (aOR = 2.13 (CI: 1.34–3.18); p = 0.0201), nulliparity (aOR = 1.92 (CI: 1.23–2.86); p = 0.0231), first antenatal visit at second trimester (aOR = 1.71 (CI: 1.33–3.12); p = 0.0149) and first antenatal visit at third trimester (aOR = 2.73 (CI: 1.24–4.35); p = 0.0017), drinking from well and boreholes (aOR = 2.78 (CI: 2.27–5.21); p < 0.0001), and the presence of domestic livestock (aOR = 2.15 (CI: 1.33–3.68); p = 0.0019). This study has shown the various sociodemographic and obstetric factors which significantly contribute to anaemia in pregnancy. PMID:27242947
A. W. Wekesa
Full Text Available Intestinal helminth infections during pregnancy are associated with adverse outcomes including low birth weight and prenatal mortality. The infections are a major public health problem in developing countries. A hospital based survey was undertaken for six months to determine the infection prevalence, intensity, and risk factors. The study involved expectant women attending antenatal clinic. Stool samples were screened microscopically for helminth ova using Kato Katz technique. Information on risk factors was collected using semistructured questionnaire and analyzed using SPSS. Epidemiological data was analysed using descriptive statistics and multivariate analysis. The overall prevalence of infection was 21 (13.8%. Ascariasis was the most prevalent 10 (6.5%, hookworm infection was 6 (3.9%, and trichuriasis was 2 (1.3%. Pregnant women aged below 29 years (OR = 3.63, CI = 0.87–11.75 and those with primary level of education (OR = 3.21, CI = 0.88–11.75 were at a higher risk of infection compared to those aged ≥ 29 years with secondary level of education. Hand washing was significantly associated with reduced likelihood of infection (OR = 0.18, 95% CI = 0.06–0.57. It was concluded that intestinal helminth infections were prevalent among pregnant women. We recommended that all expectant women visiting antenatal clinics be screened for intestinal helminth infections and positive cases be advised to seek treatment.
To determine the frequency of vaginal candidiasis in clinically symptomatic and asymptomatic cases of pregnant women attending routine antenatal clinic. A total of 110 pregnant women were nonrandomly recruited by convenient sampling. The studied variables included the demographic data information on parity, trimester of pregnancy, presence of vaginal discharge and the presence or absence of diabetes. Vulva and vagina were inspected for signs of inflammation and discharge with sterile speculum and vaginal specimens were collected with sterile cotton tipped swabs. Swabs were subjected to Gram staining and examined microscopically for the diagnosis of candidiasis. The frequency of vaginal candidiasis during pregnancy was found to be 38%, in which 27% were symptomatic and 11% were asymptomatic group. Increased ratio of infection was observed in multigravida and diabetic women. There was no marked differences in results with respect to age and trimester of pregnancy. Although there is generally a high frequency of vaginal candidiasis, an increased ratio of vaginal candidiasis in multigravida and diabetic pregnant women requires these women to be routinely screened for vaginal candidiasis regardless of symptomatic status. (author)
Parikh U R
Full Text Available Introduction: Hemoglobinopathies are a group of genetic disorders of hemoglobin in which there is abnormal production or structure of the hemoglobin molecule. Aim: The present study attempted to find out the occurrence of hemoglobinopathies and the spectrum of different types of hemoglobinopathies in the study population. Material & Method: We conducted a cross-sectional descriptive study based on records of screening program for hemoglobinopathies in the hematology unit of the pathology department of our hospital. The study population comprised of all the women attending antenatal clinics in their first trimester, who were screened for hemoglobinopathies in our hospital from January 2013 to August 2013. Primary screening is done by naked eye single tube osmotic fragility test (NESTROFT to screen β thalassemia and solubility test with sodium metabisulfite for sickle cell abnormality in all cases. The diagnosis is verified by HPLC in suspected positive cases. The results of RBC Indices, NESTROFT and solubility tests are compared. Result: Majority of our patients are 21-25 years age group (60 %. Out of all patients 51.03 % patients have microcytic hypochromic anemia. Sensitivity, specificity and efficiency of NESTROFT and solubility tests are counted. . Sensitivity, specificity and efficiency of NESTROFT is 100 %, 83.16 % and 84 % while for solubility tests they are 50 %, 86.55 % and 86.4 % respectively. Conclusion: Although NESTROFT and solubility tests are less reliable, they are cheaper and easier to perform. As per cost effectiveness study, it is better to use them as a primary screening tool.
Tadesse, Endale; Teshome, Million; Merid, Yared; Kibret, Belayhun; Shimelis, Techalew
Background Untreated asymptomatic bacteriuria (ASB) during pregnancy may cause serious complications including pyelonephritis and delivery of premature or low-birth-weight infants. However, little is known about asymptomatic bacteriuria in pregnancy in Ethiopia. This study aimed to assess the prevalence of asymptomatic bacteriuria, bacterial agents, and their antibiotic susceptibility pattern in pregnant women attending antenatal clinic of the Hawassa Teaching and Referral Hospital. Methods A...
Chiduo, M; Theilgaard, Z P; Bakari, V;
This study aimed to determine the prevalence of sexually transmitted infections (STIs) among HIV-infected and uninfected pregnant women in Tanga, Tanzania. Retrospective data on syphilis and HIV status during 2008-2010 were collected from antenatal clinic (ANC) records. Prospective data were...
Full Text Available INTRODUCTION: Obesity in pregnancy is associated with increased risk of complications and adverse outcomes in mother and child. Childhood adverse experiences are known to have numerous negative physical and emotional sequelae. We aimed to examine if exposure to abuse and/or neglect in childhood increased the likelihood of pre-pregnancy obesity. METHODS: Demographic and clinical data including weight, height, mental health as measured by the General Health Questionnaire and exposure to childhood trauma as measured by the childhood trauma questionnaire was collected from 239 women attending antenatal care at an Australian tertiary hospital. RESULTS: More than one quarter of women were obese prior to pregnancy and approximately 20% of women self reported experiencing moderate to severe physical, sexual or emotional abuse. Almost 60% of women scored in the clinical range on the GHQ. Pre-pregnancy obesity in women attending antenatal care was associated with a self-reported history of emotional or physical abuse with those exposed to moderate or severe emotional or physical abuse having increased odds of being obese prior to pregnancy (O.R. and 95% CI: 2.40; 1.19-4.84 and 2.38; 1.18-4.79 respectively. There was no significant association between other forms of childhood maltreatment, demographic or current mental health status and pre-pregnancy obesity. CONCLUSIONS: The high rates of obesity, mental health problems and self reported childhood maltreatment in the Australian antenatal population are serious public health concerns due to the extra health risks conferred on mother and offspring. Exposure to physical or emotional abuse during childhood increases the likelihood of obesity in women attending antenatal care. Further research is required to determine reasons for this association.
Purushottam A Giri
Full Text Available Background: Many antenatal clinics (ANC-based HIV surveillance systems in India have limited coverage of remote rural sites, a weakness that compromises adequate estimation, monitoring, and development of effective preventive and care programs. To address this void in rural area of western Maharashtra, we conducted antenatal clinic-based sentinel surveillance to know the prevalence of HIV infection among rural pregnant women. Materials and Methods: A cross-sectional study was carried out at ANC clinic, Dept. of Obstetrics and Gynaecology of Pravara Rural Hospital, Loni, Maharashtra. A total of 12,171 pregnant women from rural area accepted HIV testing after counseling who attending ANC clinic in Pravara Rural Hospital, Loni, during January 2008 to December 2011 were included in the study. Data were entered in Microsoft excel and percentage and proportion was calculated. Results: In the present study, out of 12171 pregnant women from the rural area accepted HIV testing after counseling who attending ANC clinic, only 50 (0.41% were HIV positive and remaining 12, 221 (99.59% were HIV negative. The study showed that the prevalence of HIV among pregnant women was 0.41%. Out of the 50 HIV positive pregnant women studied majority, 32 (64.0%, were primigravidas and 18 (36.0% were multigravidas. Conclusion: In our study all 12171 pregnant women from the rural area accepted HIV testing after counseling and prevalence of HIV was found to be 0.41%. The need of the hour is to provide universal access to these services by involving the NGO′s and the private sector.
Malata, Address; Chirwa, Ellen
Childbirth information received by mothers during antenatal period influences their satisfaction with the care during perinatal period. It is important for the midwives to know the type of information that satisfies their clients. This study found that the childbirth information that mothers received during antenatal period did not satisfy them. On the other hand, although some of the information received at home was useful, some information had potential to cause fear, anxiety and ill health...
Full Text Available The apparent decline in immunity of pregnant women appears to promote the growth of both com-mensal and non-commensal microorganisms. The objective of the study was to determine the prevalence of asymptomatic bacteriuria in pregnant women visiting the University hospital, Ku-masi. This prospective hospital-based study was carried out between April-June 2009. A total of 200 pregnant women were recruited for this study. The ages of the women ranged from 15 to 46 years. About 5-10mls of clean catch urine was cultured on Cysteine Lactose Electrolyte Deficient (CLED agar aerobically at 37oC . Isolates were identified to the species level using standard proto-col. Antibiotic sensitivity test were carried out using the Kirby-Bauer disc diffusion method. Of the 200 women examined, 19 had significant bacteriuria representing a prevalence of 9.5% in the study population. Pregnant women in their second trimester from the study had the highest prevalence of significant bacteriuria (52.6% with age ranges between 30-34 years having the highest prevalence (36.8%. Nulliparous women were 35 (17.5% with 3 (8.6% testing positive for bacteriuria and 165 (82.5% were multiparous with 16 (9.7% testing positive for bacteriuria. E. coli (36.8% was the common bacteria isolate from this study. From this study, asymptomatic bacteriuria is common among antenatal women in the population studied. It is therefore recommended that periodic test-ing of pregnant women is advocated and those found to be infected need to be treated to avoid complications.
Musa Abdel-Raouff; Mohamed Mobarak Elbasheir
Objective:To determine the sero-prevalence of Toxoplasma gondii (T. gondii) infection among pregnant Sudanese women. Methods:One hundred and sixty three pregnant women attending antenatal care in Omdurman Maternity Hospitals, Khartoum, Sudan during June to August in 2013 were enrolled and screened for immunoglobulin G (IgG) and IgM antitoxoplasma antibodies using enzyme linked immunosorbent assay technique. Results:Among 163 pregnant women, 33 (20.2%) were positive for (IgG) antitoxoplasma antibodies, while 130 (79.8%) were seronegative. None of the examined women had IgM antitoxoplasma antibodies. The highest rate of infection (26.7%) was detected among women aged 21-29 years. No statistically significant relation was observed between T. gondii sero-prevalence and the other variable of risk factors studied. Conclusions: Over 79% Sudanese women screened for antitoxoplasma IgG antibodies were seronegative and they were at risk of seroconversion during pregnancy. Moreover, the study showed that screening of T. gondii infections during antenatal care should be considered in Khartoum state as the main strategy to minimize congenital toxoplasmosis.
Lund, Stine; Nielsen, Birgitte B; Hemed, Maryam; Boas, Ida M; Said, Azzah; Said, Khadija; Makungu, Mkoko H; Rasch, Vibeke
pregnancy. METHODS: This study was an open label pragmatic cluster-randomised controlled trial with primary healthcare facilities in Zanzibar as the unit of randomisation. 2550 pregnant women (1311 interventions and 1239 controls) who attended antenatal care at selected primary healthcare facilities were...... measure was four or more antenatal care visits during pregnancy. Secondary outcome measures were tetanus vaccination, preventive treatment for malaria, gestational age at last antenatal care visit, and antepartum referral. RESULTS: The mobile phone intervention was associated with an increase in antenatal...
Vipul Mansukhbhai Khakhkhar
Full Text Available Abstract: Background: Majority of the transmission of Hepatitis-B in India and other developing countries occurs by vertical transmission from an infected carrier mother to the neonate, intrapartum or antenatally. Up to 90% of babies born to carrier mothers may also become carriers and they are at a very high risk of developing chronic liver disease at a younger age. Aims & Objectives: Present study was done to know the determination of sero-markers of hepatitis B surface antigen (HBsAg amongst pregnant women. Further, to find prevalence of HBeAg and Anti HBe-IgM Ab amongst HBsAg positive pregnant women. Methods: A retrospective study was done based on review of records of pregnant women. Blood samples were collected from 2050 pregnant women with age ranging from 16-40 years during the January 2001 to December 2003. Screening of HBs Ag was done by RPHA method and positive HBsAg tests were confirmed by ELISA. The positive samples were then further tested for HBeAg and Anti-HBe-IgM Ab. Results: Amongst, 2050 pregnant women, 63 (3.07% were positive by RPHA and ELISA. Significant statistical association was found between HBsAg positive carriers 63, with HBeAg positive 11 (17.46% and Anti-HBe IgM Ab positive 18 (28.57% samples (χ2=128.14, P<0.001. Statistically significant association was not found for age group (χ2=8.05, P>0.05, history of disease (χ2=6.56, P>0.05 and trimester of pregnancy (χ2=1.66, P>0.05 with HBsAg positivity in pregnant women. Though, highest HBsAg positivity was found with age group of 21-25 year (4.20%, history of Jaundice (13.95% and third trimester of pregnancy (3.56%. Conclusion: Screening of pregnant women for HBsAg is presently practiced in order to identify those neonates at risk of transmission. However, HBsAg positive mothers should further be screened for HBV markers particularly, the test for HBeAg and Anti-HBe-IgM-Ab which suggests high chances of carrier state. [National J of Med Res 2012; 2(3.000: 362-365
N.C. Iriemenam, A.O. Dosunmu, W.A. Oyibo & A.F. Fagbenro-Beyioku
Full Text Available Background & objectives: Little information exists on the compliance of pregnant women to malaria managementin malaria endemic countries. This study was designed to access knowledge, attitude, perception and homemanagement of malaria among consenting pregnant women attending antenatal care (ANC clinic.Methods: In total, 350 pregnant women were randomly recruited during their ANC Clinic in Lagos. Structuredquestionnaires were administered in a two-stages research design; first during their early months of ANC visitand the second approximately 1–2 months before delivery. Information on occupation, parity, symptoms used torecognise malaria, treatment sources, control measures, knowledge factors, anti-vector measures, health-seekingpractices, malaria parasitaemia and packed cell volume (PCV were recorded.Results: The results revealed that 78.9% of the pregnant women identified infected mosquitoes as the cause ofmalaria while 86% of the pregnant women identified stagnant water as its breeding sites. Knowledge of thebenefit of insecticide-treated mosquito bednets was less prominent as most of the selected subjects decried itshigh market price. Our data also showed that educational programme targeted on potential mothers is beneficial.Overall, 27.4% (96/350 of the pregnant women had peripheral malaria infection with 88.5% (85/96 of theparasite positive women infected with Plasmodium falciparum and 11.5% (11/96 with P. malariae. PCV rangedfrom 20–40% (median 33.9% with 25.7% (90/350 of the pregnant women being anaemic with PCV <33%. Wefound an association between malaria infection and occupation, and this association was not influenced byparity.Interpretation & conclusion: Our findings revealed that improvement in knowledge and education of women ofchild-bearing age has an influential impact on malaria control
Ilusanya, O. A. F.; T.O. Adesetan; H.O. Egberongbe; A.T. Otubushin
To evaluate the prevalence, predisposing factors and aetiological agents of asymptomatic bacteriuria in pregnant women attending antenatal clinic at State Hospital, Ado-Ekiti, Ekiti State, Nigeria. One hundred (100) pregnant women were screened. Clean catch midstream urine samples were collected, examined microscopically and cultured. Questionnaires were administered to determine the possible predisposing factors to asymptomatic bacteriuria. 52(52%) out of the 100 women screened were positive...
Luján, Jhonny; Arrázola de Oñate, Wouter; Delva, Wim; Claeys, Patricia; Sambola, Fulgencia; Temmerman, Marleen; Fernando, Joaquim; Folgosa, Elena
Objective. To determine the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and syphilis in pregnant women. Methods. A cross-sectional study was conducted among women attending antenatal care clinics (ANCs). Blood samples were tested for syphilis using the rapid plasma reagin (RPR) and treponemal haemagglutination (TPHA) tests; CT and NG were diagnosed using a manual polymerase chain reaction assay on first-void urine samples. A socio-demographic questionnaire was com...
Estimation of the incidence of bacterial vaginosis and other vaginal infections and its consequences on maternal/fetal outcome in pregnant women attending an antenatal clinic in a tertiary care hospital in North India
Full Text Available Aims: This study was undertaken to estimate the incidence of bacterial vaginosis (BV and other vaginal infections during pregnancy and its association with urinary tract infections (UTI and its consequences on pregnancy outcome, maternal and fetal morbidity and mortality. Settings and Design: Prospective cohort study. Materials and Methods: The present prospective cohort study was conducted on 200 women attending the antenatal clinic (ANC of a tertiary hospital. All pertinent obstetric and neonatal data covering antenatal events during the course of pregnancy, delivery, puerperium and condition of each newborn at the time of birth were collected. BV was detected by both Gram stain and gold standard clinical criteria (Amsel′s composite criteria. Statistical analysis used: Data were analyzed using SPSS version 9. Fischer′s exact test, chi square tests and Student′s′ test has been used for analysis. The probability of 5% was considered as significant for continuous variables such as age, period of gestation and birth weight. Odds ratio (OR and confidence interval (CI with 95% probability were determined. Results: The incidence of bacterial vaginosis was 41 in 200 patients. Adverse outcomes such as preterm labor, PROM and fetal complications were found more in pregnant women who had bacterial vaginosis (N=41, bacterial vaginosis with UTI (N=14 as compared to those without bacterial vaginosis (N=118. Conclusions: The incidence of poor pregnancy outcome was higher in bacterial vaginosis with UTI. Prevention of BV and UTI is cost effective to minimize the pregnancy-related complications and preterm labor to decrease in perinatal and maternal mortality and morbidity. We recommend all antenatal patients should be screened for the presence of bacterial vaginosis, other infections and UTI.
Manabe, Yukari C; Namale, Gertrude; Nalintya, Elizabeth; Sempa, Joseph; Ratanshi, Rosalind Parkes; Pakker, Nadine; Katabira, Elly
Background Syphilis infection during pregnancy leads to avoidable morbidity and mortality and remains a significant problem in sub-Saharan Africa. Despite global initiatives to increase the proportion of pregnant women screened, implementation has been slow. We sought to investigate the feasibility of adding syphilis screening within an integrated antenatal HIV clinic. Methods Pregnant women attending the HIV antenatal clinic were sequentially enrolled and consenting participants answered a q...
Varghese, Jophy; Mary P Chacko; Rajaiah, Molly; Daniel, Dolly
Background & objectives: Detection of maternal alloimmunization against red cell antigens is vital in the management of haemolytic disease of the foetus and newborn (HDFN). This study was conducted to measure the presence of allosensitization to blood group antibodies in the antenatal women attending a tertiary care hospital and to observe the proportion of minor blood group antibodies to assess the benefit of screening for the same. Methods: All antenatal women registered in the hospital bet...
Jophy Varghese; Chacko, Mary P.; Molly Rajaiah; Dolly Daniel
Background & objectives: Detection of maternal alloimmunization against red cell antigens is vital in the management of haemolytic disease of the foetus and newborn (HDFN). This study was conducted to measure the presence of allosensitization to blood group antibodies in the antenatal women attending a tertiary care hospital and to observe the proportion of minor blood group antibodies to assess the benefit of screening for the same. Methods: All antenatal women registered in the hospital...
Chris Zacharias Thomas, Surekha A., Suguna A. , Kurian Jose Puthur, Pretesh Kiran, Sulekha T.
Full Text Available "Background: Antenatal anxiety can adversely affect pregnancy outcome, have an impact on maternal competence in childcare. Lot of emphasis has been given on antenatal depression but studies addressing the anxiety issues are few. Objectives were to study the prevalence of anxiety, using the Perinatal Anxiety Screening Scale (PASS and to identify the risk factors associated with anxiety among antenatal women attending the Anekal Taluk Hospital, Bangalore. Method: This was a cross sectional study, done at Anekal between April and May 2014 among 146 antenatal women by convenience sampling. Results: The mean [SD] age of the study population was 22.52 ± 3.04 years. Majority (89.73% were housewives and 43.2% were in the third trimester of pregnancy. Of the 146 antenatal women, 22.6% of women screened positive for anxiety. Anxiety was significantly associated with primigravida, low parity and previous abortions. Multivariate regression analysis showed significant association of anxiety with period of gestation and gravidity. Conclusion: The findings of the study highlight the importance of routine screening for antenatal anxiety in primary health care. "
Full Text Available Abstract Background Most pertinent studies of inadequate antenatal care concentrate on the risk profile of women booking late or not booking at all to antenatal care. The objective of this study was to assess the outcome of pregnancies when free and easily accessible antenatal care has been either totally lacking or low in number of visits. Methods This is a hospital register based cohort study of pregnancies treated in Kuopio University Hospital, Finland, in 1989 – 2001. Pregnancy outcomes of women having low numbers (1–5 of antenatal care visits (n = 207 and no antenatal care visits (n = 270 were compared with women having 6–18 antenatal visits (n = 23137. Main outcome measures were: Low birth weight, fetal death, neonatal death. Adverse pregnancy outcomes were controlled for confounding factors (adjusted odds ratios, OR: s in multiple logistic regression models. Results Of the analyzed pregnant population, 1.0% had no antenatal care visits and 0.77% had 1–5 visits. Under- or non-attendance associated with social and health behavioral risk factors: unmarried status, lower educational level, young maternal age, smoking and alcohol use. Chorio-amnionitis or placental abruptions were more common complications of pregnancies of women avoiding antenatal care, and pregnancy outcome was impaired. After logistic regression analyses, controlling for confounding, there were significantly more low birth weight infants in under- and non-attenders (OR:s with 95% CI:s: 9.18 (6.65–12.68 and 5.46 (3.90–7.65, respectively more fetal deaths (OR:s 12.05 (5.95–24.40 and 5.19 (2.04–13.22, respectively and more neonatal deaths (OR:s 10.03 (3.85–26.13 and 8.66 (3.59–20.86, respectively. Conclusion Even when birth takes place in hospital, non- or under-attendance at antenatal care carries a substantially elevated risk of severe adverse pregnancy outcome. Underlying adverse health behavior and possible abuse indicate close surveillance of the
K.P. Msyamboza; E.J. Savage; P.N. Kazembe; S. Gies; G. Kalanda; U. D'Alessandro; B.J. Brabin
To evaluate the impact of a 2-year programme for community-based delivery of sulfadoxine-pyremethamine (SP) on intermittent preventive treatment during pregnancy coverage, antenatal clinic attendance and pregnancy outcome. Fourteen intervention and 12 control villages in the catchment areas of Chikw
Full Text Available Background & objectives: Detection of maternal alloimmunization against red cell antigens is vital in the management of haemolytic disease of the foetus and newborn (HDFN. This study was conducted to measure the presence of allosensitization to blood group antibodies in the antenatal women attending a tertiary care hospital and to observe the proportion of minor blood group antibodies to assess the benefit of screening for the same. Methods: All antenatal women registered in the hospital between January 2008 and January 2009, were screened for irregular antibodies using a commercial 3-cell antibody screening panel. Antibody identification was performed on samples found positive using a commercial 11 cell-panel. Results: Screening was performed on 5347 women, 339 (6.34% of whom were Rh negative. Allosensitization was found in 79 women (1.48%; confidence interval 1.17 -1.84. In 29 of these 79 (37% women the allo-antibodies could not be identified. In the remaining 50 women, 54 antibodies were characterized. A total of 40 clinically significant antibody specificities were identified among 36 women, of whom four were Rh(D positive. Allosensitization with clinically significant antibodies was found in 9.43 per cent (confidence interval 6.55-13.06 Rh(D negative and in 0.08 per cent (confidence interval .02-0.2 Rh(D positive women. Anti D was the most frequent antibody found in 8.85 per cent Rh(D negative women. The remaining clinically significant antibodies identified included anti-C, c, E, Jk a , Jk b , M and S. In Rh(D negative women, anti-D and antibodies of the Rh system contributed 83.3 and 94.4 per cent of clinically significant antibodies. However, in Rh(D positive women, non-Rh antibodies comprised three out of four clinically significant antibodies. Interpretation & conclusions: The presence of alloimmunization in our study corroborated with data reported from India. The most frequent antibody was anti-D. However, a significant fraction was
Full Text Available To evaluate the prevalence, predisposing factors and aetiological agents of asymptomatic bacteriuria in pregnant women attending antenatal clinic at State Hospital, Ado-Ekiti, Ekiti State, Nigeria. One hundred (100 pregnant women were screened. Clean catch midstream urine samples were collected, examined microscopically and cultured. Questionnaires were administered to determine the possible predisposing factors to asymptomatic bacteriuria. 52(52% out of the 100 women screened were positive for asymptomatic bacteriuria. 6(11.5% out of these had mixed bacterial growth while 46(88.5% subjects had one type of bacteria. 36% had non-significant bacterial growth. 12(12% yielded viable growth of Candida albicans. Staphylococcus aureus was the predominant bacteria followed by Escherichia coli. Pregnant women in their third trimester had the highest prevalence of asymptomatic bacteriuria (60.3%. The age group 30-40 years had the highest prevalence (62.5%.Women with parity range of 1-2 has the highest prevalence rate of 80% while the least 27.3% was found in parity range of 0 (no previous pregnancy Full time housewives had highest prevalence while Christian pregnant women had higher prevalent rate (66.7% than their Muslim counterparts (58.1% Routine screening of the urine of pregnant women for asymptomatic bacteriuria and personal hygiene was emphasized so as to reduce maternal and foetal complications associated with pregnancy.
Full Text Available Abstract Background The potential of antenatal care for reducing maternal morbidity and improving newborn survival and health is widely acknowledged. Yet there are worrying gaps in knowledge of the quality of antenatal care provided in Tanzania. In particular, determinants of health workers' performance have not yet been fully understood. This paper uses ethnographic methods to document health workers' antenatal care practices with reference to the national Focused Antenatal Care guidelines and identifies factors influencing health workers' performance. Potential implications for improving antenatal care provision in Tanzania are discussed. Methods Combining different qualitative techniques, we studied health workers' antenatal care practices in four public antenatal care clinics in the Kilombero Valley, south-eastern Tanzania. A total of 36 antenatal care consultations were observed and compared with the Focused Antenatal Care guidelines. Participant observation, informal discussions and in-depth interviews with the staff helped to identify and explain health workers' practices and contextual factors influencing antenatal care provision. Results The delivery of antenatal care services to pregnant women at the selected antenatal care clinics varied widely. Some services that are recommended by the Focused Antenatal Care guidelines were given to all women while other services were not delivered at all. Factors influencing health workers' practices were poor implementation of the Focused Antenatal Care guidelines, lack of trained staff and absenteeism, supply shortages and use of working tools that are not consistent with the Focused Antenatal Care guidelines. Health workers react to difficult working conditions by developing informal practices as coping strategies or "street-level bureaucracy". Conclusions Efforts to improve antenatal care should address shortages of trained staff through expanding training opportunities, including health worker
Aderemi O. Kehinde; Adedapo, Kayode S.; Aimaikhu, Christopher O.; Odukogbe, Akin-tunde A.; Olayemi, Oladapo; Salako, Babatunde
Untreated asymptomatic bacteriuria can lead to urinary tract infection (UTI) in pregnancy with devastating maternal and neonatal effects such as prematurity and low birth weight, higher fetal mortality rates and significant maternal morbidity. We carried out a two year (April 2007 to March 2009) cross-sectional epidemiological study to determine the prevalence of significant bacteriuria among asymptomatic antenatal clinic attendees at two antenatal clinics (ANCs) in University College Hospita...
Tsi N. Njim, MD
Background: Despite relatively high number of women who attend antenatal care (ANC) in Cameroon, there is an ever-increasing maternal mortality ratio, and pregnancy outcomes remain inadequate. A new suggested Optimal ANC Package includes attending ANC in the first trimester. This study assesses the overall ANC coverage, the percentage, and pregnancy outcomes among women who attended and did not attend ANC in the first trimester in the Buea Regional Hospital (BRH) in Cameroon. Methods: A c...
Dahl, Viktor; Mellhammar, Lisa; Bajunirwe, Francis; Björkman, Per
Abstract A problem commonly encountered in programs for prevention of mother-to-child-transmission (PMTCT) of HIV in sub-Saharan Africa is low rates of HIV test acceptance among pregnant women. In this study, we examined risk factors and reasons for HIV test refusal among 432 women attending three antenatal care clinics offering PMTCT in urban and semi-urban parts of the Mbarara district, Uganda. Structured interviews were performed following pre-test counselling. Three-hundre...
Khogali, M; Zachariah, R; Reid, A J; Alipon, S C; Zimble, S; Gbane, M; Etienne, W; Veerman, R; Hassan, A; Harries, A D
In a pastoralist setting in Ethiopia, we assessed changes in attendance between the first and subsequent antenatal care (ANC) visits following the implementation of non-monetary incentives in a primary health care centre over a 3-year period from October 2009 to September 2012. Incentives included the provision of a bar of soap, a bucket, a mosquito net, sugar, cooking oil, a jerrycan and a delivery kit. The first ANC visits increased by 48% in the first year to 60% in the second. Subsequent visits did not show a similar pattern due to ruptures in incentive stocks. Incentives appear to increase ANC attendance; however, ruptures in stock should be avoided to sustain the effect. PMID:26423755
Early and consistent intervention with pregnant smokers can reduce the incidence of adverse pregnancy outcomes associated with smoking during pregnancy. A survey of 470 pregnant women was conducted to establish the care they received in relation to smoking whilst attending routine public antenatal appointments. The overall prevalence of smoking was 23.5%. Age, level of education and nationality were associated with smoking status with younger, less educated Irish women being most likely to smoke. Women attending for their first visit were much more likely to be asked about their smoking status 71 (85.5) versus 68 (17.8) and advised to quit if they were smokers 11 (73.3) versus 11 (15.7). None of the women were offered specific assistance to help them stop smoking or had a follow-up appointment arranged specifically to do with smoking. 167 women (35.6) were exposed to passive smoking in their own homes.
Full Text Available Background: All antibodies to red cell antigens, other than naturally occurring anti-A and anti-B are considered unexpected. They can be either alloantibodies or auto antibodies. In pregnant women, these antibodies may cross the placenta and cause haemolytic disease of the foetus and newborn (HDFN. Timely detection of such antibodies in antenatal women is essential for early management of HDFN. Methods: A prospective cross-sectional study was carried out on 2060 multiparous pregnant women attending the Government Maternity Hospital, Tirupati to detect prevalence of unexpected antibodies. The women were grouped and typed for ABO and rhesus (Rh D antigens by tube method and screened for alloantibodies by column agglutination technology. The medical and detailed obstetric history of these women were reviewed. Results: The overall prevalence of alloantibodies was 1.1%. There was a statistically significant difference between alloimmunization rates in the Rh D-antigen negative and D-antigen positive women (12.8% versus 0.3%. The antibodies detected in this study were, anti-D (63.8%, anti-D+C (13.7%, anti-C, anti-E, anti-M, anti-Le a , and anti-Leb (4.5% each. Anti-D contributed to 77.3% of total alloimmunization in this study. Conclusions: In spite of the introduction of prophylactic Rh- immunoglobulin, anti-D (77.3% is still a common antibody identified in the antenatal women of our region. In developing countries like India, universal antenatal antibody screening, though desirable may not be justified at present as the cost and infrastructure required would be immense. However, it is necessary to impose properly formulated protocols to screen at least the pregnant women with adverse obstetric history.
Methods: A total of 174 antenatal women of and #8804;28 weeks of gestation who had no clinical features of urinary tract infection were recruited for this study over a period of 6 months. Midstream urine sample was collected and sent for routine examination and culture-sensitivity testing. Results: Significant bacteriuria was detected in 22 (12.6% antenatal women. Of them 13 (59.1% belonged to the age group 26-30 years. Nearly half of the culture positive cases, that is 10 (45.5% were educated upto primary school and they belonged to socioeconomic status class 4. Majorities (68% were in the second trimester of pregnancy and the commonest organism isolated was E. coli. Conclusions: Undetected and untreated asymptomatic bacteriuria leads to chronic drug resistant infection, hypertension, anemia, etc. in the mother and prematurity, intrauterine growth restriction etc. in the fetus. Hence it is important to do urine culture for all women during antenatal check-up. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 437-441
Tenthani, Lyson; Haas, Andreas D; Egger, Matthias; Van Oosterhout, Joep J; Jahn, Andreas; Chimbwandira, Frank; Tal, Kali; Myer, Landon; Estill, Janne; Keiser, Olivia
Malawi adopted the Option B+ strategy in 2011. Its success in reducing mother-to-child transmission depends on coverage and timing of HIV testing. We assessed HIV status ascertainment and its predictors during pregnancy. HIV status ascertainment was 82.3% (95% confidence interval: 80.2 to 85.9) in the pre-Option B+ period and 85.7% (95% confidence interval: 83.4 to 88.0) in the Option B+ period. Higher HIV ascertainment was independently associated with higher age, attending antenatal care more than once, and registration in 2010. The observed high variability of HIV ascertainment between sites (50.6%-97.7%) and over time suggests that HIV test kit shortages and insufficient numbers of staff posed major barriers to reducing mother-to-child transmission. PMID:25950205
Full Text Available BACKGROUND: Antenatal care (ANC is a key strategy to improve maternal and infant health. However, survey data from sub-Saharan Africa indicate that women often only initiate ANC after the first trimester and do not achieve the recommended number of ANC visits. Drawing on qualitative data, this article comparatively explores the factors that influence ANC attendance across four sub-Saharan African sites in three countries (Ghana, Kenya and Malawi with varying levels of ANC attendance. METHODS: Data were collected as part of a programme of qualitative research investigating the social and cultural context of malaria in pregnancy. A range of methods was employed interviews, focus groups with diverse respondents and observations in local communities and health facilities. RESULTS: Across the sites, women attended ANC at least once. However, their descriptions of ANC were often vague. General ideas about pregnancy care - checking the foetus' position or monitoring its progress - motivated women to attend ANC; as did, especially in Kenya, obtaining the ANC card to avoid reprimands from health workers. Women's timing of ANC initiation was influenced by reproductive concerns and pregnancy uncertainties, particularly during the first trimester, and how ANC services responded to this uncertainty; age, parity and the associated implications for pregnancy disclosure; interactions with healthcare workers, particularly messages about timing of ANC; and the cost of ANC, including charges levied for ANC procedures - in spite of policies of free ANC - combined with ideas about the compulsory nature of follow-up appointments. CONCLUSION: In these socially and culturally diverse sites, the findings suggest that 'supply' side factors have an important influence on ANC attendance: the design of ANC and particularly how ANC deals with the needs and concerns of women during the first trimester has implications for timing of initiation.
Erin V W Andrew
Full Text Available BACKGROUND: Appropriate antenatal care (ANC is key for the health of mother and child. However, in Papua New Guinea (PNG, only a third of women receive any ANC during pregnancy. Drawing on qualitative research, this paper explores the influences on ANC attendance and timing of first visit in the Madang region of Papua New Guinea. METHODS: Data were collected in three sites utilizing several qualitative methods: free-listing and sorting of terms and definitions, focus group discussions, in-depth interviews, observation in health care facilities and case studies of pregnant women. Respondents included pregnant women, their relatives, biomedical and traditional health providers, opinion leaders and community members. RESULTS: Although generally reported to be important, respondents' understanding of the procedures involved in ANC was limited. Factors influencing attendance fell into three main categories: accessibility, attitudes to ANC, and interpersonal issues. Although women saw accessibility (distance and cost as a barrier, those who lived close to health facilities and could easily afford ANC also demonstrated poor attendance. Attitudes were shaped by previous experiences of ANC, such as waiting times, quality of care, and perceptions of preventative care and medical interventions during pregnancy. Interpersonal factors included relationships with healthcare providers, pregnancy disclosure, and family conflict. A desire to avoid repeat clinic visits, ideas about the strength of the fetus and parity were particularly relevant to the timing of first ANC visit. CONCLUSIONS: This long-term in-depth study (the first of its kind in Madang, PNG shows how socio-cultural and economic factors influence ANC attendance. These factors must be addressed to encourage timely ANC visits: interventions could focus on ANC delivery in health facilities, for example, by addressing healthcare staff's attitudes towards pregnant women.
Ayele, Tadesse Awoke; Azale, Telake; Alemu, Kassahun; Abdissa, Zewditu; Mulat, Haregewoin; Fekadu, Abel
Background Depression is the most prevalent psychiatric disorder during pregnancy and is associated with psychosocial and clinical obstetric factors. Depressive disorders are not only common and chronic among women throughout the world but also principal sources of disability. The scarce information and limited attention to the problem might aggravate the consequence of the problem and can limit the intervention to be taken. Therefore, the current study was conducted to determine the prevalence and identify associated factors for antenatal depression. Methods Institutional based cross-sectional study was conducted by taking a sample of 388 pregnant women coming for ANC service at Gondar University Hospital. Systematic random sampling technique was employed to recruit the study participants. Structured, pretested and interview administered questionnaire was used to collect related information while Beck Depression Inventory (BDI) was used to assess individuals`depression condition. A cut off point with high sensitivity and specificity was determined and internal consistency of the tool was checked (Cronbach alpha = 0.82). Ep Info V. 2002 and STATA 12 were used for data entry and analyses, respectively. Adjusted Odds Ratio with its 95% CI was used to declare the statistical significance of the factors. Results Depression among pregnant women was found to be 23% (95%CI: 18.48%, 26.86%). Factors significantly associated with depression were: woman`s age (20 to 29, AOR = 0.18,95% CI:0.07,0.49), occupation (housewife, AOR = 2.57,95%CI:1.21,5.46, merchant and daily laborers, AOR = 3.44 (1.38,8.58), previous pregnancy (No, AOR = 4.74,95% CI:1.58,14.17) and previous ANC follow up pattern (irregular, AOR = 11.43,95% CI:3.68,35.49), no follow up, AOR = 11.98, 95% CI:4.73,30.33). Conclusion Depression symptoms are common in pregnant mothers in the study area and interventions that would address the aforementioned factors would benefit to tackle further complications. PMID
Tsi N. Njim, MD
Full Text Available Background: Despite relatively high number of women who attend antenatal care (ANC in Cameroon, there is an ever-increasing maternal mortality ratio, and pregnancy outcomes remain inadequate. A new suggested Optimal ANC Package includes attending ANC in the first trimester. This study assesses the overall ANC coverage, the percentage, and pregnancy outcomes among women who attended and did not attend ANC in the first trimester in the Buea Regional Hospital (BRH in Cameroon. Methods: A cross-sectional study was carried out among 200 consenting pregnant women presenting for delivery at the BRH. A bivariate analysis was used to compare the frequencies of various pregnancy outcomes within the the two categories of women who attended and who did not attend first trimester ANC. Results: Ninety-six percent of the women attended at least 1 ANC visit with 20.5% of these women attending ANC in the first trimester and 60.2% attending at least 4 visits. Sociodemographic and obstetric factors were not found to be associated with attending ANC in the first trimester. Also, there was no statistically significant association between all the late pregnancy outcomes assessed and attending ANC in the first trimester. Conclusions and Global Health Implications: Trends in most sub-Saharan countries seem to suggest that most women do not attend first trimester ANC. This could have negative consequences on overall perinatal outcome. More user-friendly educational programs for women of childbearing age is required in such regions to address this situation.
Lindstrand, A; Bergström, S; Bugalho, A.; Zanconato, G; Helgesson, A M; Hederstedt, B.
OBJECTIVES--To elucidate whether recent syphilis infection is significantly more prevalent among women with mid-trimester miscarriage than among antenatal care attenders in midtrimester pregnancy. DESIGN--Two categories of pregnant women were compared regarding serological signs of syphilis. Rapid Plasma Reagin (RPR) analyses were done in Mozambique and Veneral Disease Research Laboratory (VDRL) tests in Sweden. In case of RPR and/or VDRL positivity, Treponema pallidum haemagglutination (TPHA...
Full Text Available Abstract Background Indigenous Australians are a small, widely dispersed population. Regarding childbearing women and infants, inequities in service delivery and culturally unsafe services contribute to significantly poorer outcomes, with a lack of high-level research to guide service redesign. This paper reports on an Evaluation of a specialist (Murri antenatal clinic for Australian Aboriginal and Torres Strait Islander women. Methods A triangulated mixed method approach generated and analysed data from a range of sources: individual and focus group interviews; surveys; mother and infant audit data; and routinely collected data. A retrospective analysis compared clinical outcomes of women who attended the Murri clinic (n=367 with Indigenous women attending standard care (n=414 provided by the same hospital over the same period. Both services see women of all risk status. Results The majority of women attending the Murri clinic reported high levels of satisfaction, specifically with continuity of carer antenatally. However, disappointment with the lack of continuity during labour/birth and postnatally left some women feeling abandoned and uncared for. Compared to Indigenous women attending standard care, those attending the Murri clinic were statistically less likely to be primiparous or partnered, to experience perineal trauma, to have an epidural and to have a baby admitted to the Neonatal Intensive Care Unit, and were more likely to have a non-instrumental vaginal birth. Multivariate analysis found higher normal birth (spontaneous onset of labour, no epidural, non-instrumental vaginal birth without episiotomy rates amongst women attending the Murri clinic. Conclusions Significant benefits were associated with attending the Murri clinic. Recommendations for improvement included ongoing cultural competency training for all hospital staff, reducing duplication of services, improving co-ordination and communication between community and tertiary
Ananthi Kasinathan; Prasad Thirumal
Background: Asymptomatic bacteriuria is the presence of actively multiplying bacteria within the urinary tract in the absence of any symptoms. Antenatal women are more susceptible to urinary tract infection because of the anatomical and physiological changes which occur during pregnancy. Aim of current study was the aim of this study was to determine the prevalence of asymptomatic bacteriuria in pregnant women, the organisms responsible and to treat the same. Methods: A total of 174 antena...
Suresh B; Sreedhar Babu KV; Arun R; Jothibai DS; Bharathi T
Background: All antibodies to red cell antigens, other than naturally occurring anti-A and anti-B are considered unexpected. They can be either alloantibodies or auto antibodies. In pregnant women, these antibodies may cross the placenta and cause haemolytic disease of the foetus and newborn (HDFN). Timely detection of such antibodies in antenatal women is essential for early management of HDFN. Methods: A prospective cross-sectional study was carried out on 2060 multiparous pregnant women...
Fanta Wondimagegn; Worku Alemayehu
Abstract Background In Gambella region, inhabitants owe socio-cultural factors that might favor refusal for HIV testing service utilization among Antenatal Care attendees. Objective To assess determinants for refusal of HIV testing service utilization among ANC attendees in Gambella Region. Methods A comparative cross sectional study was conducted among ANC attendees from March 2008 to May 2008 in four selected health facilities of Gambella region. Sample size of 332 participants (83 who refu...
Nnko, Soori; Changalucha, John; Mosha, Jacklin; Bunga, Catherine; Wamoyi, Joyce; Peeling, Rosanna; Mabey, David
Infection with syphilis during pregnancy could cause spontaneous abortion, low birth weight and stillbirth. To prevent adverse pregnancy outcomes caused by syphilis, the World Health Organization (WHO) recommends syphilis screening and treatment of all pregnant women attending antenatal care (ANC) services. Rapid syphilis testing (RST) demonstration project was introduced at ANC clinics in Tanzania in 2009, to assess the feasibility, acceptability and its impact on uptake of syphilis screening service. Data collection was composed of in-depth interviews with health workers and pregnant women attending ANC. Additionally, from the health facility registers we extracted information on the uptake of antenatal care services, including number of pregnant women screened and treated for syphilis. Introduction of RST at health facilities was appreciated by pregnant women attending ANC and health workers. Following the introduction of RST services at ANC clinics, we observed a significant increase of the uptake of syphilis screening. Pregnant women appreciated RST service since it reduced the frequency of their visits to the health facilities and shortened the duration that they spent at the clinics. Moreover, the provision of same-day screening and treatment services helped women to save money that they would have to spend on transportation for the follow up visits. Health workers felt that RST simplified procedures to diagnose syphilis, and enabled the health workers to test and treat large numbers of clients in a shorter period of time. Our study demonstrates that, it is feasible to introduce RST service in antenatal clinics. The RST was appreciated by health workers and pregnant women, since it simplifies syphilis screening procedures, saves the time that pregnant women used to waste to wait for the results, and saves the cost that women would have to spend on transportation to come back for treatment. PMID:26685146
Kehinde, Aderemi O; Adedapo, Kayode S; Aimaikhu, Christopher O; Odukogbe, Akin-Tunde A; Olayemi, Oladapo; Salako, Babatunde
Untreated asymptomatic bacteriuria can lead to urinary tract infection (UTI) in pregnancy with devastating maternal and neonatal effects such as prematurity and low birth weight, higher fetal mortality rates and significant maternal morbidity. We carried out a two year (April 2007 to March 2009) cross-sectional epidemiological study to determine the prevalence of significant bacteriuria among asymptomatic antenatal clinic attendees at two antenatal clinics (ANCs) in University College Hospital and Adeoyo Maternity Hospital, both in Ibadan, Nigeria.All consenting ANC attendees without UTI were enrolled in the study. Urine specimens of 5 to 10 ml collected from each subject were examined microscopically for white blood cells, red blood cells and bacteria. The specimens were further cultured on MacConkey agar using a sterile bacteriological loop that delivered 0.002 ml of urine. Colony counts yielding bacterial growth of more than 10(5)/ml of pure isolates were considered significant.Of the 473 subjects studied, 136 had significant bacteriuria, giving a prevalence rate of 28.8%. The highest age specific prevalence (47.8%) was found in the 25-29 year olds while only one (0.7%) was found in the teenage group. A large percentage (64.0%) of subjects with significant bacteriuria had tertiary education, compared with 4.4% who had no formal education but the association was not statistically significant (X(2) = 0.47, p = 0.79). The majority (75.8%) of subjects with significant bacteriuria had no previous history of abortion, while 20 (14.7%) had one previous abortion and only three (2.1%) admitted to three previous abortions (X(2) = 5.16, p = 0.16). The majority (69.8%) of those with significant bacteriuria presented at second trimester while 38 (28.0%) presented at third trimester (X(2) = 6.5, p = 37).Only 22 (4.6%) of the studied subjects presented at first trimester, and 3 (13.7%) of these had significant bacteriuria.The prevalence of asymptomatic bacteriuria is high
Marinda Asiah Nuril Haya
Full Text Available AbstrakLatar belakang: Papua merupakan salah satu propinsi di Indonesia dengan angka kematian ibu tertinggi di Indonesia. Penolong persalinan terlatih dan asuhan antenatal (ANC merupakan salah satu faktor yang penting untuk menurunkan angka kematian ibu. Tujuanstudi ini untuk mengidentifikasi pengaruh ANC dan beberapa faktor yang lain terhadap kemungkinan persalinan yang ditolong oleh perawat/bidan di Papua.Metode: Studi potong lintang dengan sampling purposif dilakukan terhadap perempuan yang mempunyai anak balita yang datang ke Posyandu pada 15-30 Januari 2014 di 24 desa wilayah pegunungan tengah Jayawijaya, Papua. Karakteristik demografi, praktek ANC dan persalinan didapatkan melalui wawancara. Subjek diklasifikasikan ke dalam 2 kelompok, yang bersalin didampingi perawat/bidan dan yang menolong sendiri atau ditolong keluarga. Analisis dilakukan dengan regresi Cox dengan waktu konstan. Hasil: Dari 469 subjek, 391 subjek yang dianalisis terdiri dari 280 subjek yang melahirkan ditolong sendiri/ keluarga dan 111 subjek yang ditolong perawat/bidan. Subjek yang yang melahirkan di hutan atau kandang hina hanya 3 orang. Dibandingkan dengan yang tidak pernah ANC, subjek yang melakukan ANC di Posyandu 5,6 kali kemungkinan melahirkan ditolong perawat/bidan [risiko relatif suaian (RRa = 5,60; interval kepercayaan 95% (CI = 2,99-10,47]. Selain itu, subjek yang mendapatkan pemeriksaan ANC oleh bidan dan kunjungan ANC 4 kali memiliki kemungkinan lebih tinggi untuk melahirkan ditolong perawat/bidan, masing-masing 4,9 kali (RRa = 4,89; 95% CI = 2,70-8,86 dan 6,9 kali (RRa = 6.90; 95% CI = 3,59-13,27.Kesimpulan: Asuhan antenatal adalah cara untuk meningkatkan angka persalinan yang ditolong oleh tenaga tenaga perawat/bidan di Papua. (Health Science Indones 2014;2:60-6Kata kunci: asuhan antenatal, persalinan oleh perawat/bidan, PapuaAbstractBackground: Papua has one of the highest maternal mortality rates in Indonesia. Nurse/midwife birth attendants and regular
Grishma Chauhan, Anupam Verma, R.K.Bansal, Rachana Prasad
Full Text Available Objective: The present study reports the socio demographic and clinical profile of 127 HIV positive antenatal women and their husbands. The findings of the study will be helpful for policy decision makers to address the issues of a specific vulnerable group. Materials and Methods: During Jan 2007 to Dec 2008, a total 282 ante-natal women were referred to 5 PPTCT centres for HIV testing and counseling. Of these 127 (45% antenatal women who came to collect their reports could be contacted for this study. The husbands of the 127 HIV positive antenatal women were contacted to collect their information. Result: Mean Age of HIV positive antenatal women was 25.5 ±3.8 years, more than 50% were in the age group of 20-25 years and 18.9% of HIV positive antenatal women were illiterate. HIV positivity rate in spouse was 80%. Two third women were diagnosed HIV positive in 2nd & 3rd trimester of pregnancy. Among the positive 60 (47.3% were primi gravidas, 27 (21.3% mothers were not tested for CD4 count. However 98 (77% mothers were registered in ART centre and 35% HIV positive an-tenatal women were on ART. Conclusion: HIV positive pregnant women were younger, primi and housewives. HIV positive antenatal women need to be followed rigorously to link them to ART services.
Aim: To describe health professional's treatment of pregnant overweight or obese women at an antenatal clinic in Nairobi, Kenya. Method: A descriptive qualitative method was used including interviews with 11 health professionals at an antenatal clinic in Nairobi, Kenya. The interviews were semi-structured and consisted of five open-ended question. The result was then analysed through a systematic content analyse. Result: Four categories were identified. The methods used to state gestational ...
Frequency of syphilis among pregnant women attending Combined Military Hospital Abbottabad Study Design: Descriptive study. Material and Methods: A screening for syphilis of 500 married pregnant women presenting to antenatal clinics was carried out using the qualitative Rapid Plasma Regent (RPR) test/ Venereal Disease Research Laboratory (VDRL) test. The Treponema Palladium Haem-Agglutination Assay (TPHA) test was used as confirmatory test for all Venereal Disease Research Laboratory (VDRL) test positive cases. Results: A total of 8 women (1.6%) were positive for Venereal Disease Research Laboratory (VDRL) test. Out of these 4 (0.8%) were positive for Treponema Palladium Haem-Agglutination Assay (TPHA) test. All of these cases have bad obstetrical history. Conclusion: The sero-positivity of Venereal Disease Research Laboratory (VDRL) test is (1.6%), considered high among pregnant women reporting in obstetrics clinics of Combined Military Hospital Abbottabad. Similarly sero-positivity of Treponema Palladium Haem-Agglutination Assay (TPHA) test is (0.8%) considered high among the Venereal Disease Research Laboratory (VDRL) test population. Therefore Screening of syphilis in pregnancy especially in patients having bad obstetrical history (BOH) should be incorporated into the study. (author)
Heywood Peter; Hunter Cynthia L; Titaley Christiana R; Dibley Michael J
Abstract Background Antenatal, delivery and postnatal care services are amongst the recommended interventions aimed at preventing maternal and newborn deaths worldwide. West Java is one of the provinces of Java Island in Indonesia with a high proportion of home deliveries, a low attendance of four antenatal services and a low postnatal care uptake. This paper aims to explore community members' perspectives on antenatal and postnatal care services, including reasons for using or not using thes...
Befekadu, Abdi; Dhekama, Nezif Hussein; MOHAMMED, Mohammed Adem
Self-medication is the selection and use of non-prescription medicines by individuals own initiatives to treat self-recognized illnesses or symptoms. It is practiced significantly worldwide even though its type, extent and reasons for its practice may vary. In this study we aimed to determine the prevalence of self-medication and contributing factors among pregnant women attending antenatal care at JUSH, Jimma town, south west Ethiopia. A prospective hospital based cross-sectional study with ...
Abinet Arega Sadore; Lakew Abebe Gebretsadik; Mamusha Aman Hussen
Background. In Ethiopia, higher proportions of pregnant women are anemic. Despite the efforts to reduce iron deficiency anemia during pregnancy, only few women took an iron supplement as recommended. Thus, this study aimed to assess compliance with iron-folate supplement and associated factors among antenatal care attendant mothers in Misha district, South Ethiopia. Method. Community based cross-sectional study supported with in-depth interview was conducted from March 1 to March 30, 2015. Th...
McClure, R J; Newell, S J; Edwards, S
A study was carried out to identify the characteristics of children who do not attend appointments at general outpatient clinics. Over six months, 359 children who had an appointment at a general clinic were studied using a questionnaire given to parents (74% response rate) and by inspection of case notes. Based on their first appointment in the study period, children were divided into 'attenders' (n = 262) and 'non-attenders' (n = 97) for analysis. Non-attenders were significantly more likel...
Full Text Available Abstract Background Bangladesh is committed to the fifth Millennium Development Goal (MDG-5 target of reducing its maternal mortality ratio by three-quarters between 1990 and 2015. Since the early 1990s, Bangladesh has followed a strategy of improving access to facilities equipped and staffed to provide emergency obstetric care (EmOC. Methods We used data from four Demographic and Health Surveys conducted between 1993 and 2004 to examine trends in the proportions of live births preceded by antenatal consultation, attended by a health professional, and delivered by caesarean section, according to key socio-demographic characteristics. Results Utilization of antenatal care increased substantially, from 24% in 1991 to 60% in 2004. Despite a relatively greater increase in rural than urban areas, utilization remained much lower among the poorest rural women without formal education (18% compared with the richest urban women with secondary or higher education (99%. Professional attendance at delivery increased by 50% (from 9% to 14%, more rapidly in rural than urban areas, and caesarean sections trebled (from 2% to 6%, but these indicators remained low even by developing country standards. Within these trends there were huge inequalities; 86% of live births among the richest urban women with secondary or higher education were attended by a health professional, and 35% were delivered by caesarean section, compared with 2% and 0.1% respectively of live births among the poorest rural women without formal education. The trend in professional attendance was entirely confounded by socioeconomic and demographic changes, but education of the woman and her husband remained important determinants of utilization of obstetric services. Conclusion Despite commendable progress in improving uptake of antenatal care, and in equipping health facilities to provide emergency obstetric care, the very low utilization of these facilities, especially by poor women, is a
Full Text Available Abstract Background Antenatal, delivery and postnatal care services are amongst the recommended interventions aimed at preventing maternal and newborn deaths worldwide. West Java is one of the provinces of Java Island in Indonesia with a high proportion of home deliveries, a low attendance of four antenatal services and a low postnatal care uptake. This paper aims to explore community members' perspectives on antenatal and postnatal care services, including reasons for using or not using these services, the services received during antenatal and postnatal care, and cultural practices during antenatal and postnatal periods in Garut, Sukabumi and Ciamis districts of West Java province. Methods A qualitative study was conducted from March to July 2009 in six villages in three districts of West Java province. Twenty focus group discussions (FGDs and 165 in-depth interviews were carried out involving a total of 295 respondents. The guidelines for FGDs and in-depth interviews included the topics of community experiences with antenatal and postnatal care services, reasons for not attending the services, and cultural practices during antenatal and postnatal periods. Results Our study found that the main reason women attended antenatal and postnatal care services was to ensure the safe health of both mother and infant. Financial difficulty emerged as the major issue among women who did not fulfil the minimum requirements of four antenatal care services or two postnatal care services within the first month after delivery. This was related to the cost of health services, transportation costs, or both. In remote areas, the limited availability of health services was also a problem, especially if the village midwife frequently travelled out of the village. The distances from health facilities, in addition to poor road conditions were major concerns, particularly for those living in remote areas. Lack of community awareness about the importance of these
Abirami Lakshmy Jayachandran; Ukkiravel Gnanasambandam; Balan K.; Sangeetha, A.V.; T. S. Vijayalakshmi
Background: Asymptomatic bacteriuria (ASB) occurring in pregnant women can lead onto complications like acute pyelonephritis, hypertensive disease of pregnancy, premature delivery and intrauterine growth retardation if untreated. Methods: The present study aims to estimate the occurrence of asymptomatic bacteriuria in antenatal women and to study the antibiotic susceptibility pattern of the isolates. The Gram staining, pus cell count and culture was performed for 120 urine samples. Antibi...
Renu Gupta; Shaily Agarwal; Neetu Singh; Rimjhim Jain; Arti Katiyar; Almas siddiqui
Background: Nutrition is the fundamental pillar of human life. All human beings need a balanced amount of nutrients for proper functioning of body system. Inadequate nutrition during pregnancy has a negative impact on the pregnant mother as well as short and long term consequences on the newborn. This study aims to assess knowledge and attitude of antenatal women about maternal nutrition in pregnancy and highlights the need of interventions aimed at promoting awareness about healthy diet duri...
Chandola, A; Young, Y.; McAlister, J.; Axford, J S
Patients with musculoskeletal disorders commonly seek treatment outside orthodox medicine (complementary therapy). In patients attending hospital clinics we investigated the prevalence of such behaviour and the reasons for it. Patients attending rheumatology and orthopaedic clinics who agreed to participate were interviewed on the same day by means of a structured questionnaire in three sections: the first section about demographic characteristics; the second about the nature and duration of ...
Shah, SA; Kristensen, S; Memon, MA; Usman, G; Ghazi, A; John, R; Sathiakumar, N; Vermund, SH
Objectives Sexually transmitted infections are thought by some to be rare in socially conservative Muslim countries. Little is known about prevalence of syphilis in Pakistani women from the general population. We determined syphilis prevalence in a multi-center cross-sectional study of low risk pregnant women in Karachi, Pakistan. Methods We administered a structured questionnaire and obtained a blood sample for syphilis serology (rapid plasma reagin test with Treponema pallidum hemagglutination assay confirmation) from all women giving informed consent over six weeks in 2007. Results The prevalence of confirmed syphilis was less than one percent (0.9%; 95%CI: 0.4, 1.8) in a sample size of 800 women recruited from three urban sites (≈1% refusal rate). Women who lived in an area where male drug use is prevalent (Ibrahim Hyderi Hospital) had 1% (1.5%) higher prevalence rates than women from the other two sites 0.5%. Conclusions We documented higher-than-expected syphilis seroprevalence rates in a low risk population of antenatal clinic attendees in Pakistan. Bridge populations for syphilis may include drug users, who are usually married, and Hijras or their clients. Hijras are transgender and/or transvestite men who may provide sex for money to men. In accordance with our results, the national policy for syphilis control in Pakistan should be modified to include universal syphilis screening in antenatal clinics with subsequent partner notification. PMID:22356034
Grote, Nancy K.; Bledsoe, Sarah E.; Swartz, Holly A.; Frank, Ellen
Objective: To minimize barriers to care, ameliorate antenatal depression, and prevent postpartum depression, we conducted a pilot study to assess the feasibility of providing brief interpersonal psychotherapy (IPT-B) to depressed, pregnant patients on low incomes in an obstetrics and gynecological (OB/GYN) clinic. Method: Twelve pregnant,…
I. E. Bakhlaev
Full Text Available Cervical cancer (CC morbidity is analyzed on the basis of the data of the Karelian cancer register over the period 1998-2007. During this period, 816 cases of CC were registered and 126 were found at an antenatal clinic (AC. Its early detection rate was ascertained to be 96% during screening at the AC. A comprehensive examination was made in 1742 women with various cervical diseases, of them 37.5% were infected with human papillomavirus (HPV. High-grade dysplasia and carcinoma in situ were diagnosed in 6.6% of the HPV-infected patients. Large-scale screening for HPV infection and pretumor disorders with their further treatment will aid in reduc- ing CC morbidity and mortality rates.
Abinet Arega Sadore
Full Text Available Background. In Ethiopia, higher proportions of pregnant women are anemic. Despite the efforts to reduce iron deficiency anemia during pregnancy, only few women took an iron supplement as recommended. Thus, this study aimed to assess compliance with iron-folate supplement and associated factors among antenatal care attendant mothers in Misha district, South Ethiopia. Method. Community based cross-sectional study supported with in-depth interview was conducted from March 1 to March 30, 2015. The sample size was determined using single population proportion to 303. Simple random sampling technique was used to select the study participants. Bivariate and multivariable logistic regression analyses were employed to identify factors associated with compliance to iron-folate supplement. Results. The compliance rate was found to be 39.2%. Mothers knowledge of anemia (AOR = 4.451, 95% CI = (2.027,9.777, knowledge of iron-folate supplement (AOR = 3.509, 95% CI = (1.442,8.537, and counseling on iron-folate supplement (AOR = 4.093, 95% CI = (2.002,8.368 were significantly associated with compliance to iron-folate supplement. Conclusions. Compliance rate of iron-folate supplementation during pregnancy remains very low. This study showed that providing women with clear instructions about iron-folate tablet intake and educating them on the health benefits of the iron-folate tablets can increase compliance with iron-folate supplementation.
Full Text Available AIMS AND OBJECTIVES: To estimate serum uric acid level in normal pregnancy and pregnancy induced hypertension at different duration as pregnancy advances and to evaluate its place in determining severity of pregnancy induced hypertension. MATERIALS AND METHODS: A longitudinal study was carried out among forty cases of normal pregnancy and forty cases of pregnancy induced hypertension attending antenatal outpatient department of Gauhati Medical College and Hospital. Serum uric acid level was estimated colorimetrically by using Uricase method in the Department of Physiology, Gauhati Medical College. Statistical analysis was carried out applying ANOVA test using IBM SPSS 16. RESULTS: Serum Uric Acid level was found to be significantly higher in study group as compared to control g roup. The mean values of serum uric acid level in study group were 4.07 mg/dl, 4.44 mg/dl and 5.27mg/dl as compared to 3.14mg/dl, 3.11 mg/dl and 3.71 mg/dl in control group at 20 - 24 weeks, 24 - 28 weeks and 32 - 40 weeks of gestation respectively. Also, the leve l of serum uric acid was found to be increased with increasing severity of pregnancy induced hypertension. CONCLUSION: A definite rise in serum uric level was found in cases of pregnancy induced hypertension and its level increases with increasing severity of the disease.
Disclosure experience to partner and its effect on intention to utilize prevention of mother to child transmission service among HIV positive pregnant women attending antenatal care in Addis Ababa, Ethiopia
Sendo, Endalew Gemechu; Cherie, Amsale; Erku, Tadese Asfaw
Background Disclosure of HIV status has become an entry criterion for prevention of mother to child transmission programs in resource-constrained countries. However, little has been explored about the prevalence of, barriers to, outcomes and factors associated with HIV status disclosure among HIV positive pregnant women in Ethiopia. Method Cross- sectional study was conducted among 107 pregnant women who were attending antenatal care in public centers from April to June 2011 in Addis Ababa ca...
Amit Kumar Mishra, Smita Panda, Prakash Chandra Panda
Full Text Available Introduction: In INDIA almost 20000 people die (40% of world death each year from rabies. Most of these deaths could be prevented by post exposure prophylaxis with wound washing, rabies immunoglobulin & vaccination. Local wound management alone can reduce viral load by up to 80%. Objective: To study self-wound management practices in animal exposure patients before attending a tertiary level ARV clinic. Methodology: Data regarding wound management was collected by individual interview of patients attending the ARV clinic during OCT 2011 to MAR 2012. The data collected in the form of a questionnaire. Analysis of data was done in the Department Of Community Medicine, V.S.S. Medical College, Burla. Results: Total 493 cases of animal exposure were attended during the study period. Most common biting animal was dog (94.5%. 31% of cases were under the age of 10 years & 23% belongs to the age of 10-19 years. Male to female ratio was 3:1. Most of the cases (91% were of category III exposure. Immediate management of wound was practiced by 63-77% of cases before visiting ARV clinic; only 2% wash the wound with running water & soap for 15 minutes. 39% of cases applied Dettol/savlon at the wound side & other 38% applied turmeric, red chilli, kerosene, Band-Aid & ghee locally. Most cases (61% reported to ARV clinic within 24hours.
Full Text Available To determine the extent to which women plan and prepare for pregnancy.Cross-sectional questionnaire survey of pregnant women attending three maternity services in London about knowledge and uptake of preconception care; including a robust measure of pregnancy planning, and phone interviews with a range of health care professionals.We recruited 1173/1288 (90% women, median age of 32 years. 73% had clearly planned their pregnancy, 24% were ambivalent and only 3% of pregnancies were unplanned. 51% of all women and 63% of those with a planned pregnancy took folic acid before pregnancy. 21% of all women reported smoking and 61% reported drinking alcohol in the 3 months before pregnancy; 48% of smokers and 41% of drinkers reduced or stopped before pregnancy. The 51% of all women who reported advice from a health professional before becoming pregnant were more likely to adopt healthier behaviours before pregnancy [adjusted odds ratios for greatest health professional input compared with none were 2.34 (95% confidence interval 1.54-3.54 for taking folic acid and 2.18 (95% CI 1.42-3.36 for adopting a healthier diet before pregnancy]. Interviews with 20 health professionals indicated low awareness of preconception health issues, missed opportunities and confusion about responsibility for delivery of preconception care.Despite a high level of pregnancy planning, awareness of preconception health among women and health professionals is low, and responsibility for providing preconception care is unclear. However, many women are motivated to adopt healthier behaviours in the preconception period, as indicated by halving of reported smoking rates in this study. The link between health professional input and healthy behaviour change before pregnancy is a new finding that should invigorate strategies to improve awareness and uptake of pre-pregnancy health care, and bring wider benefits for public health.
Ab Rahman, Norazida; Sivasampu, Sheamini; Mohamad Noh, Kamaliah; Khoo, Ee Ming
Background The world population has become more globalised with increasing number of people residing in another country for work or other reasons. Little is known about the health profiles of foreign population in Malaysia. The aim of this study was to provide a detailed description of the health problems presented by foreigners attending primary care clinics in Malaysia. Methods Data were derived from the 2012 National Medical Care Survey (NMCS), a cross sectional survey of primary care enco...
Kefale; Awoke; Endalkachew; Nibret; Abaineh; Munshea
Objective: To determine the prevalence of toxoplasmosis and to assess the possible risk factors associated with the infection among pregnant women attending antenatal care center at Felege Hiwot Referral Hospital, Bahir Dar town, northwest Ethiopia. Methods: A hospital based cross-sectional study was designed to determine the prevalence of toxoplasmosis among pregnant women. Three hundred eighty four serum samples were collected from November 2013 to January 2014. Data on socio-demographic and predisposing factors were collected from each study participant with simple random sampling technique. The serum samples were examined for anti- Toxoplasma gondii(T. gondii) antibodies using latex agglutination test. Results: The overall seroprevalence of T. gondii among the pregnant women was 18.5%. All of T. gondii positive cases found to be positive only for Ig G antibody. Significant association was observed between seroprevalence and presence of domestic cats [AOR=2.85, 95% CI: 1.66-4.90, P=0.000], consumption of raw or undercooked meat [AOR=1.98, 95% CI: 1.15-2.43, P=0.014] and history of abortion [AOR=2.47, 95% CI: 1.40-4.34, P=0.002]. No significant association was observed between seroprevalence and socio-demographic characters, gestational age, gravidity, consumption of raw vegetable, and blood transfusion. Conclusions: The seroprevalence of toxoplasmosis among pregnant women in Bahir Dar town was relatively high. Presence of domestic cats at home and consumption of raw or undercooked meat were identified as main risk factors for T. gondii infection. Therefore, health education towards avoiding eating raw or undercooked meat and avoiding contact with cats are recommended for prevention of miscarriage or defects during pregnancy.
Marlow, Heather M.; Maman, Suzanne; Groves, Allison K.; Moodley, Daya
We explored contraceptive decision-making among South African antenatal clinic attendees, fertility intent post-HIV diagnosis, and women’s experiences at government health facilities. Data are from in-depth interviews with HIV negative and HIV positive women. We interviewed women in Zulu; interviews were recorded, transcribed and translated. We conducted qualitative analyses of interviews. Women were the dominant decision-makers about contraceptive use, whether they involved their partners or...
Winestone, Lena E.; Bukusi, Elizabeth A.; Cohen, Craig R.; Kwaro, Daniel; Kley, Nicole; Turan, Janet M.
The aim of this study was to explore the perspectives of healthcare providers on the advantages and disadvantages of integrating HIV care services, including highly active antiretroviral therapy (HAART), into antenatal care (ANC) clinics in rural Kenya. We conducted a qualitative study using in-depth interviews and thematic analysis; 36 healthcare providers from 6 health centres in Nyanza Province, Kenya participated. Effects on service providers included increased workload due to the incorpo...
Nyagaka, Benuel; Kiptoo, Michael K; Lihana, Raphael W; Khamadi, Samoel A; Makokha, Ernest P; Kinyua, Joyceline G; Mwangi, Joseph; Osman, Saida; Lagat, Nancy J; Muriuki, Joseph; Okoth, Vincent; Gicheru, Michael; Ng'ang'a, Zipporah; Songok, Elijah M
HIV genetic recombination and high mutation rate increase diversity allowing it to escape from host immune response or antiretroviral drugs. This diversity has enabled specific viral subtypes to be predominant in specific regions. To determine HIV-1 subtypes among seropositive antenatal clinic attendees in Kenya's North Rift Valley, a cross-sectional study was carried out on 116 HIV-1-positive blood samples. Proviral DNA was extracted from peripheral blood mononuclear cells by DNAzol lysis and ethanol precipitation. Polymerase chain reactions using specific primers for HIV-1 gag and population sequencing on resulting amplicons were carried out. Phylogenetic analysis revealed that 81 (70%) were subtype A1, 13 (11%) subtype D, 8 (7%) subtype C, 3 (3%) subtype A2, 1 (1%) subtype G, and 10 showed possible recombinants: 5 (4%) subtype A1D, 4 (3%) subtype A1C, and 1 (1%) subtype A2C. These data support the need to establish circulating subtypes for better evaluation of effective HIV diagnostic and treatment options in Kenya. PMID:21827277
Acheampong, I.; N. Amidu; Bio, F.Y.; Quaye, L; Obirikorang, C.; Addo, K.
The apparent decline in immunity of pregnant women appears to promote the growth of both com-mensal and non-commensal microorganisms. The objective of the study was to determine the prevalence of asymptomatic bacteriuria in pregnant women visiting the University hospital, Ku-masi. This prospective hospital-based study was carried out between April-June 2009. A total of 200 pregnant women were recruited for this study. The ages of the women ranged from 15 to 46 years. About 5-10mls of clean ca...
Parikh U R; Goswami H M; Mehta R C; Patel P S; Gonsai R N
Introduction: Hemoglobinopathies are a group of genetic disorders of hemoglobin in which there is abnormal production or structure of the hemoglobin molecule. Aim: The present study attempted to find out the occurrence of hemoglobinopathies and the spectrum of different types of hemoglobinopathies in the study population. Material & Method: We conducted a cross-sectional descriptive study based on records of screening program for hemoglobinopathies in the hematology...
Laure Stella Ghoma Linguissi; Bolni Marius Nagalo; Cyrille Bisseye; Thrse S Kagon; Mahamoudou Sanou; Issoufou Tao; Victoire Benao; Jacques Simpor; Bibiane Kon
Objective:To evaluate the prevalence of toxoplasmosis and rubella among pregnant women at Ouagadougou in Burkina Faso. Methods: All patient sera were tested for rubella and toxoplasmosis anti-IgG using commercial ELISA kits (PlateliaTM Rubella IgG and Platelia™Toxo IgG). The presence of anti-rubella and anti-toxoplasmosis IgM in serum samples was tested using commercial ELISA kits Platelia Rubella IgM and Platelia Toxo IgM. Results:Among all the pregnant women tested for toxoplasmosis and rubella, their prevalence were 20.3%and 77.0%, respectively. Pregnant women in the age group of 18-25 years showed the highest frequency of anti-toxoplasmosis (34.5%) and anti-rubella IgG (84.6%). The prevalence of anti-toxoplasma and anti-rubella IgG decreased between 2006 and 2008 from 32.7%to 12.1%and 84.6%to 65.0%, respectively. There was no significant association between age and the mean titer of anti-toxoplasmosis IgG among pregnant women. Conclusions: The diagnosis of toxoplasmosis and rubella is necessary in pregnant women in Burkina Faso because of the low immunization coverage rate of rubella and the high level of exposure to these two infections which can be harmful to the newborn if contracted by women before the third trimester of pregnancy.
Musheke, M.; Bond, V.; Merten, S
Background: Couple HIV testing has been recognized as critical to increase uptake of HIV testing, facilitate disclosure of HIV status to marital partner, improve access to treatment, care and support, and promote safe sex. The Zambia national protocol on integrated prevention of mother-to-child transmission of HIV (PMTCT) allows for the provision of couple testing in antenatal clinics. This paper examines couple experiences of provider-initiated couple HIV testing at a public antenatal clinic...
Full Text Available Gemma HornSurgical Department, Perth Royal Infirmary, Perth, ScotlandIntroduction: Osteoporosis is a common disease that affects both women and men but is more prevalent in postmenopausal women. Reviews suggest that dietary-derived calcium is vital in maintaining adequate calcium balance. Sources of dietary calcium intake among adult patients attending an osteoporosis clinic were reviewed.Method: Two hundred and ninety-one patients attending an osteoporosis clinic were given an eleven-item food questionnaire to complete. The results were compared to the recommended daily allowance of 700 mg.Results: The overall mean intake was 657 mg/day with little difference between age or gender. The best foods for supplying calcium were cheese and milky drinks.Conclusion: This study has confirmed that suboptimal calcium intakes remain common. Dairy sources of calcium remain important. More awareness is needed to convey the importance of dietary calcium and bone health to avoid the development of osteoporosis.Keywords: osteoporosis, clinic, food questionnaire, calcium, dietary intake, bone health
Owoaje, Eme T.; Adedoyin D. Omidokun; Ige, Olusimbo K.
Background: Few studies have assessed pregnant women’s perceptions regarding prevention of mother to child of HIV and the available services at the primary health care level in Nigeria.Objective: Assessment of knowledge and perception of antenatal clinic (ANC) attendees regarding Prevention of Mother to Child Transmission (PMTCT) of HIV at primary health care facilities in south-west Nigeria.Method: A cross-sectional survey was conducted amongst 400 antenatal attendees in a Primary Health Car...
Lilford, R J; Kelly, M; Baines, A.; Cameron, S.; Cave, M.; Guthrie, K.; Thornton, J
OBJECTIVE--To compare the effectiveness of three methods of taking an antenatal history on the quality of obstetric care. DESIGN--Randomised controlled trial. SETTING--Antenatal clinic of St James's University Hospital, Leeds. SUBJECTS--2424 women attending the hospital for the first (booking) visit. INTERVENTIONS--Histories were taken by midwives using an unstructured paper questionnaire, a structured paper questionnaire (incorporating a checklist), or an interactive computerised questionnai...
Full Text Available Colleen Doyle,1–3 David Dunt,2 David Ames,1 Suganya Selvarajah11National Ageing Research Institute, Royal Melbourne Hospital Royal Park Campus, Parkville, Victoria, Australia; 2Centre for Health Policy, Programs and Economics, University of Melbourne, Parkville, Victoria, Australia; 3Australian Catholic University, Fitzroy, Victoria, AustraliaBackground: There is good evidence for the positive benefits of pulmonary rehabilitation (PR in the prevention of hospital admissions, lower mortality, and improved health-related quality of life. There is also increasing evidence about the impact of PR on mental health and, in particular, mood disorders. We aimed to identify how depression in chronic obstructive pulmonary disease (COPD patients in Victoria, Australia, is being managed in PR, to identify the prevalence of depressive symptoms among COPD patients who attend PR, and to determine whether patients with depressive symptoms or anxiety symptoms dropped out of PR early.Method: Of 61 PR clinics, 44 were invited and 22 agreed to participate. Telephone interviews were conducted to see how depression and anxiety in COPD patients were being recognized and managed in these clinics. A total of 294 questionnaires were distributed to patients by clinic coordinators to determine the prevalence of anxiety/depression, as measured by the Hospital Anxiety and Depression Scale. Coordinators were contacted to provide information on whether respondents dropped out of rehabilitation early or continued with their treatment at 2–4 months post program.Results: Seven clinics were not aware of local guidelines on assessment/treatment/management of mood. Four clinics did not use any screening tools or other aids in the recognition and management of depression and/or anxiety. Overall, eight clinics participating in this study requested advice on suitable screening tools. The patient survey indicated that the mean depression score on the Hospital Anxiety and Depression
Catchpole, M; Connor, N; Brady, A.; Kinghorn, G.; Mercey, D; Band, B; Thin, N
OBJECTIVES: To investigate how attenders with sexually transmitted disease (STD) differ from the general population with respect to sexual behaviour, and to identify which attenders at genitourinary medicine (GUM) clinics are at particular behavioural risk for acquiring STD. DESIGN: Multicentre cross sectional survey. SETTING: Two genitourinary medicine clinics, one in London and one in Sheffield SUBJECTS: 20,516 patients attending the two clinics over an 18 month period. MAIN OUTCOME MEASURE...
Sushila Godara; Ritu Hooda; Smiti Nanda; Sonika Mann
Background : The purpose of this study was to determine the compliance of the pregnant women and factors related to iron tablet consumption behavior among pregnant women. Response to iron deficiency anemia is related to the dose and schedule of a iron tablets and diet. Noncompliance reduces treatment benefits and is associated with poorer prognosis. Methods: A detailed questionnaire designed to assess the antenatal women compliance. Eight hundred and sixty women of 16-30wks pregancy who re...
Increasing Partner Attendance in Antenatal Care and HIV Testing Services: Comparable Outcomes Using Written versus Verbal Invitations in an Urban Facility-Based Controlled Intervention Trial in Mbeya, Tanzania.
Theuring, Stefanie; Jefferys, Laura F; Nchimbi, Philo; Mbezi, Paulina; Sewangi, Julius
In many Sub-Saharan African settings male partner involvement in antenatal care (ANC) remains low, although great benefits for maternal and infant health outcomes have been long recognised, in particular regarding the prevention of HIV transmission. Yet there is paucity on evidence regarding the effectiveness of strategies to increase male partner involvement. This controlled intervention trial in Ruanda Health Centre in Mbeya, Tanzania, assessed the effectiveness of invitation letters for male involvement in ANC. Pregnant women approaching ANC without partners received official letters inviting the partner to attend ANC. A control group was instructed to verbally invite partners. Partner attendance was recorded at two subsequent ANC visits. Rates for male partner return, couple voluntary counselling and testing (CVCT), and influencing factors were analysed. From 199 ANC clients in total, 97 were assigned to the invitation letter group; 30 of these (30.9%) returned with their male partners for ANC. In the control group of 102 women, 28 (27.5%) returned with their partner. In both groups CVCT rates among jointly returning couples were 100%. Partner return/CVCT rate was not statistically different in intervention and control group (OR 1.2, p = 0.59). Former partner attendance at ANC during a previous pregnancy was the only factor found to be significantly linked with partner return (p = 0.03). Our study demonstrates that rather simple measures to increase male partner attendance in ANC and CVCT can be effective, with written and verbal invitations having comparable outcomes. In terms of practicability in Sub-Saharan African settings, we recommend systematic coaching of ANC clients on how to verbally invite male partners in the first instance, followed by written invitation letters for partners in case of their non-attendance. Further studies covering both urban and rural settings will be more informative for effective translation into policy. PMID:27043707
Full Text Available Abstract Background With the accessibility of prevention of mother to child transmission (PMTCT services in sub-Saharan Africa, more women are being tested for HIV in antenatal care settings. Involving partners in the counselling and testing process could help prevent horizontal and vertical transmission of HIV. This study was conducted to assess the feasibility of couples' voluntary counseling and testing (CVCT in antenatal care and to measure compliance with PMTCT. Methods A prospective cohort study was conducted over eight months at two public antenatal clinics in Kigali, Rwanda, and Lusaka, Zambia. A convenience sample of 3625 pregnant women was enrolled. Of these, 1054 women were lost to follow up. The intervention consisted of same-day individual voluntary counselling and testing (VCT and weekend CVCT; HIV-positive participants received nevirapine tablets. In Kigali, nevirapine syrup was provided in the labour and delivery ward; in Lusaka, nevirapine syrup was supplied in pre-measured single-dose syringes. The main outcome measures were nurse midwife-recorded deliveries and reported nevirapine use. Results In eight months, 1940 women enrolled in Kigali (984 VCT, 956 CVCT and 1685 women enrolled in Lusaka (1022 VCT, 663 CVCT. HIV prevalence was 14% in Kigali, and 27% in Lusaka. Loss to follow up was more common in Kigali than Lusaka (33% vs. 24%, p = 0.000. In Lusaka, HIV-positive and HIV-negative women had significantly different loss-to-follow-up rates (30% vs. 22%, p = 0.002. CVCT was associated with reduced loss to follow up: in Kigali, 31% of couples versus 36% of women testing alone (p = 0.011; and in Lusaka, 22% of couples versus 25% of women testing alone (p = 0.137. Among HIV-positive women with follow up, CVCT had no impact on nevirapine use (86-89% in Kigali; 78-79% in Lusaka. Conclusions Weekend CVCT, though new, was feasible in both capital cities. The beneficial impact of CVCT on loss to follow up was significant, while
Vo, Baotran N.; Cohen, Craig R.; Smith, Rachel M.; Bukusi, Elizabeth A.; Onono, Maricianah; Doolan, Katie; Washington, Sierra; Turan, Janet M.
A cluster randomized controlled trial was initiated in Kenya to determine if full integration (FI) of HIV care, including HAART, into antenatal care (ANC) clinics improves health outcomes among HIV-infected women and exposed infants, compared to a non-integrated (NI) model. This paper examines ANC clients’ satisfaction with and preferences regarding HIV-integrated services. In this cross-sectional study, pregnant women attending five FI clinics (n=185) and four NI clinics (n=141) completed an...
Perumal, Nandita; Cole, Donald C; Ouédraogo, Hermann Z; Sindi, Kirimi; Loechl, Cornelia; Low, Jan; Levin, Carol; Kiria, Christine; Kurji, Jaameeta; Oyunga, Mary
Background Antenatal care (ANC) is a key strategy to decreasing maternal mortality in low-resource settings. ANC clinics provide resources to improve nutrition and health knowledge and promote preventive health practices. We sought to compare the knowledge, attitude and practices (KAP) among women seeking and not-seeking ANC in rural Kenya. Methods Data from a community-based cross-sectional survey conducted in Western Province, Kenya were used. Nutrition knowledge (NKS), health knowledge (HK...
PUBLISHED BACKGROUND: Driving is an increasingly important form of transport for older people. Dementia is common in later life and will eventually lead to driving cessation, which reduces the public health risk of impaired driving but also impairs access to services. The factors associated with driving cessation in dementia are uncertain. OBJECTIVE: To examine the demographic, psychometric and personal factors associated with driving cessation in patients attending a memory cli...
Full Text Available To describe the uptake of and factors associated with HIV prevalence among pregnant women in a large-scale home-based HIV counseling and testing (HBCT program in western Kenya.In 2007, the Academic Model Providing Access to Healthcare Program (AMPATH initiated HBCT to all individuals aged ≥13 years and high-risk children <13 years. Included in this analysis were females aged 13-50 years, from 6 catchment areas (11/08-01/12. We used descriptive statistics and logistic regression to describe factors associated with HIV prevalence.There were 119,678 women eligible for analysis; median age 25 (interquartile range, IQR: 18-34 years. Of these, 7,396 (6.2% were pregnant at the time of HBCT; 4,599 (62% had ever previously tested for HIV and 2,995 (40.5% had not yet attended ANC for their current pregnancy. Testing uptake among pregnant women was high (97%. HBCT newly identified 241 (3.3% pregnant HIV-positive women and overall HIV prevalence among all pregnant women was 6.9%. HIV prevalence among those who had attended ANC in this pregnancy was 5.4% compared to 9.0% among those who had not. Pregnant women were more likely to newly test HIV-positive in HBCT if they had not attended ANC in the current pregnancy (AOR: 6.85, 95% CI: 4.49-10.44.Pregnant women who had never attended ANC were about 6 times more likely to newly test HIV-positive compared to those who had attended ANC, suggesting that the cascade of services for prevention of mother-to-child HIV transmission should optimally begin at the home and village level if elimination of perinatal HIV transmission is to be achieved.
Hinton, Devon; Chau, Ha; Nguyen, Lim; Nguyen, Mai; Pham, Van Thang; Quinn, Sarah; Tran, Minh
This study surveys Vietnamese refugees attending two psychiatric clinics to determine both the prevalence of panic disorder (PD) as well as panic attack subtypes in those suffering PD. A culturally valid adaptation of the SCID-panic module (the Vietnamese Panic Disorder Survey or VPDS) was administered to 100 Vietnamese refugees attending two psychiatric clinics. Utilizing culturally sensitive panic probes, the VPDS provides information regarding both the presence of PD and panic attack subty...
Hinton, Devon; Ba, Phalnarith; Peou, Sonith; Um, Khin
This study surveys Khmer refugees attending two psychiatric clinics to determine both the prevalence of panic disorder as well as panic attack subtypes in those suffering panic disorder. A culturally valid adaptation of the SCID-panic module, the Cambodian Panic Disorder Survey (CPDS), was administered to 89 consecutive Cambodian refugees attending these psychiatric clinics. Utilizing culturally sensitive panic probes, the CPDS provides information regarding both the presence of panic disorde...
Bhandary Sulatha; Khanna Rajesh; Rao Krishna; Rao Lavanya; Lingam Kamala; Binu V
Aim: Corneal blindness accounts for 3.42% of blindness in Malaysia; the rate of eye donation is low. The aim of the study was to assess the awareness about eye donation and willingness to donate eyes among attendants of patients at various clinics in Melaka, Malaysia. Materials and Methods: This observational study was conducted on attendants who accompanied patients (n = 400) visiting various outpatient departments of the General Hospital and two peripheral clinics in Melaka between A...
Conkling Martha; Shutes Erin L; Karita Etienne; Chomba Elwyn; Tichacek Amanda; Sinkala Moses; Vwalika Bellington; Iwanowski Melissa; Allen Susan A
Abstract Background With the accessibility of prevention of mother to child transmission (PMTCT) services in sub-Saharan Africa, more women are being tested for HIV in antenatal care settings. Involving partners in the counselling and testing process could help prevent horizontal and vertical transmission of HIV. This study was conducted to assess the feasibility of couples' voluntary counseling and testing (CVCT) in antenatal care and to measure compliance with PMTCT. Methods A prospective c...
Full Text Available Background : The purpose of this study was to determine the compliance of the pregnant women and factors related to iron tablet consumption behavior among pregnant women. Response to iron deficiency anemia is related to the dose and schedule of a iron tablets and diet. Noncompliance reduces treatment benefits and is associated with poorer prognosis. Methods: A detailed questionnaire designed to assess the antenatal women compliance. Eight hundred and sixty women of 16-30wks pregancy who received iron tablets daily for 90 consecutive days in Rohtak city of Haryana state. Results: The results showed that compliance among pregnant women, regarding iron supplementation, was observed by 80.47% women, non compliance was observed by 14.42 % while over compliance was observed only by 5.11% women. Compliance was better observed in educated patients as compared to uneducated i.e.62.14% versus 37.86%. The reasons for non compliance were side effects 29.03% , suffering from pregnancy complications and taking multiple drug supplements 22.58% , long term taking of iron tablets 19.35%, not liking pharmaceutical preparations 16.94%, forgetfullness 9.68% and not liking due to poor quality of iron tablet supplied by government were 2.42%. Almost all the women believed that the doctor, pharmacist and nurse explained the instructions for intake of iron tablets and diet to them and they followed those instructions. Conclusion: This study shows that compliance is related to education of the pregnant women and proper explanation of instructions by doctor, pharmacist and nurses, help to improve the compliance but much can be done to improve existing iron supplementation programs in developing countries by ensuring that iron tablets of good quality are available at all levels of health care. Key Words: Compliance, Pregnant Women, Iron Deficiency Anemia.
Grzeskowiak, Luke E; Dekker, Gustaaf; Rivers, Karen; Roberts-Thomson, Kate; Roy, Anil; Smith, Brian; Bowden, Jeffery; Bryce, Robert; Davies, Michael; Beilby, Justin; Wilson, Anne; Middleton, Philippa; Ruffin, Richard; Karnon, Jonathan; Clifton, Vicki L.
Background Pregnancy presents a unique situation for the management of asthma as it can alter the course of asthma severity and its treatment, which in turn can affect pregnancy outcomes. Despite awareness of the substantial adverse effects associated with asthma during pregnancy, little has been done to improve its management and reduce associated perinatal morbidity and mortality. The aim of this randomized controlled trial is to evaluate the clinical and cost effectiveness of an Antenatal ...
Vale Francisco A.C.
Full Text Available We describe clinical and socio-demographic features of patients with dementia attended in a tertiary outpatient clinic during a three years period (56.9% of the total attendance. Most of them were men, white, from the local community, urban district. Nobody had a job at the moment, two thirds of them got social welfare benefit. They lived with their family, the caregiver being the spouse or a daughter. The education level was very low, a quarter of them being illiterate. They were referred mostly from the public health care service, by neurologists or psychiatrists due to cognitive disorders. Family history as well as individual history of previous neurological/psychiatric disorders were frequent, especially alcoholism, stroke, head trauma and dementia. The neurological exam showed abnormalities in two thirds of cases, chiefly extra-pyramidal and pyramidal signs. Alzheimer's disease was the most frequent cause, followed by cerebrovascular disorder; alcoholism and normal pressure hydrocephalus were also frequent causes. Most patients presented concomitant non-etiological neurological/psychiatric disorders, mainly alcoholism and depression, and non-neurological/psychiatric diseases, predominantly hypertension, cardiopathy and diabetes. Most patients had been referred under medication, frequently politherapy, including psychotropics.
The objective of this study was to ascertain the prevalence of antenatal care, use of food supplements during pregnancy and lactation and factors responsible for not taking them in Tarlai, an urban slum of Islamabad. A Cross-sectional survey of 100 married women in the age range 15-45 years women utilizing and not utilizing antenatal care facilities during their previous pregnancy was carried out in April 2004. Data was collected through a structured questionnaire and processed and analyzed by using SPPS 10.0. Use of supplements was found high in women attending antenatal care. Realization of the importance of taking a healthy diet during pregnancy was significantly higher among women utilizing antenatal care. In most of the women's the diet remain unchanged. 56% women attended the antenatal care clinics. Those not taking food supplements, 39% were non affording, 21% had no concept of their benefits, 36% did not like to take and 4% felt nausea and vomiting. Just over 50% women received antenatal care. Utilization of antenatal care showed a positive impact on awareness of taking food supplements during pregnancy and lactation. (author)
Full Text Available OBJETIVO: Descrever a freqüência de utilização de corticosteróide antenatal e a evolução clínica dos recém-nascidos pré-termo. MÉTODOS: Estudo observacional prospectivo tipo coorte de todos os neonatos com idade gestacional entre 23 e 34 semanas nascidos na Rede Brasileira de Pesquisas Neonatais entre agosto e dezembro de 2001. Os prontuários médicos foram revistos, as mães entrevistadas e os pré-termos acompanhados. A análise dos dados foi realizada com o teste do qui-quadrado, t de Student, Mann-Whitney, ANOVA e regressão logística múltipla, com nível de significância de 5%. RESULTADOS: Avaliaram-se 463 gestantes e seus 514 recém-nascidos. As gestantes tratadas tiveram mais gestações prévias, consultas de pré-natal, hipertensão arterial e maior uso de tocolíticos. Suas crianças apresentaram melhores escores de Apgar no 1º e 5º minutos, menor necessidade de intervenção na sala de parto e menor SNAPPE II. Nasceram com maior peso e idade gestacional, receberam menos surfatante exógeno, ventilação mecânica e oxigenoterapia. Após regressão logística, o uso pré-natal de corticosteróides manteve de forma independente o efeito protetor para as condições de nascimento e para a diminuição do tempo de ventilação mecânica e esteve associado com aumento na ocorrência de sepse neonatal. CONCLUSÃO: O uso do corticosteróide antenatal foi associado a melhor atendimento pré-natal. As crianças nasceram em melhores condições e tiveram melhor evolução, porém com maior risco de infecção.OBJECTIVES: To describe the use of antenatal corticosteroid and clinical evolution of preterm babies. METHODS: An observational prospective cohort study was carried out. All 463 pregnant women and their 514 newborn babies with gestational age ranging from 23 to 34 weeks, born at the Brazilian Neonatal Research Network units, were evaluated from August 1 to December 31, 2001. The data were obtained through maternal
Jeppesen, Maja Haunstrup; Ainsworth, Mark Andrew
INTRODUCTION: Non-attendance is a global health-care problem. The aim of the present study was 1) to investigate if a telephone reminder could reduce the non-attendance rate, 2) to study reasons for non-attendance and 3) to evaluate if a permanent implementation would be economically advantageous...... in a gastroenterology outpatient clinic like ours. METHODS: This was a comparative intervention study with a historical control group in a gastroenterology outpatient clinic. The study lasted six months. Patients with a scheduled appointment in the first three-month period received no reminder...... (control group, n = 2,705). Patients in the following three-month period were reminded by telephone one weekday in advance of their appointment, when possible (intervention group, n = 2,479). Non-attending patients in the intervention group received a questionnaire. Based on the results, a financial cost...
Congenital unilateral hydronephrosis is a relatively frequent and often asymptomatic condition diagnosed in utero. The natural history and significance of congenital hydronephrosis on the development and long-term consequences on renal function is not sufficiently known. The present diagnostic methods do not provide prediction of the functional consequences of a potential presence of an obstruction. However, renography is an important method affecting the clinical treatment of children with prenatal unilateral hydronephrosis, and is the only method that satisfactory can provide serial accurate measurements of differential renal function. The present review briefly summarizes the clinical impact of renography in neonatally discovered hydronephrosis in relation to the pathophysiological characteristics of congenital unilateral hydronephrosis. (orig.)
Enciso, Reyes; Sundaresan, Santosh; Yekikian, Matthew; Mulligan, Roseann
Periodicity of dental visits for children is based on age and disease susceptibility. Frequently mobile dental clinics are unable to provide follow-up care at recommended intervals. This study compared the oral health of children attending the mobile clinic (MC) twice with matched children by age, gender, race, and ZIP code attending for the first time. Dental charts (n=888) were reviewed and scored for decayed and filled surfaces. Seventy-eight children (mean age 9.6 years; 98.7% Hispanic) attended the clinic twice over a mean interval between visits of 1.5 years. These children had statistically significant lower rates of decay in deciduous and permanent tooth surfaces than matched children visiting the clinic for the first time (pdecay in their deciduous and permanent teeth than at the first visit (pdecay in teeth, even when the interval between visits is longer than current recommendations. PMID:26548689
Exalto, Lieza G.; van der Flier, Wiesje M.; Scheltens, Phillip; Biessels, Geert Jan
OBJECTIVES: To determine the association between markers of glycemia and cerebrospinal fluid (CSF) amyloid beta 1-42 (A beta 42) and tau levels in patients attending a memory clinic. DESIGN: Cross-sectional study. SETTING: Memory clinic. PARTICIPANTS: Two hundred forty-five consecutive patients atte
Sujatha, R.; Nawani, Manju
Background: Symptomatic and asymptomatic bacteriuria (ASB) is common in pregnant women. Pregnancy enhances the progression from ASB to symptomatic bacteriuria, which if left untreated, could lead to acute pyelonephritis and other adverse outcomes such as prematurity, postpartum, hypertensive disease, anaemia, UTIs and higher foetal mortality rates.
Abidoye, R. O.; Olukoya, A. A.
Compared blood screening data for 200 urban and rural pregnant women in Nigeria. Found that rural subjects had a greater incidence of moderate anemia than did urban subjects, and corpuscular hemoglobin concentrations fell with increased gestational age. No relationship was found between hemoglobin counts and nutrition habits. (HTH)
Robinson-Bassey G. C.
Conclusions: Based on these findings it was recommended among others that midwives should be involved in appropriate education of expectant mothers especially new ones to help improve breastfeeding preparedness among them; women should be engaged in occupation that allow them enough time to breastfeed and employers should make adequate provisions for breastfeeding mothers in order to encourage them. [Int J Reprod Contracept Obstet Gynecol 2016; 5(4.000: 1071-1076
Agnes T. Masango- Makgobela
Full Text Available Background: Many patients move from one healthcare provider or facility to another, disturbing the continuity that enhances holistic patient care.Objectives: To investigate the reasons given by patients for attending Karen Park Clinic rather than the clinic nearest to their homes.Methods: A cross-sectional descriptive study was conducted during 2010. Three hundred and fifty patients attending Karen Park Clinic were given questionnaires to complete, with the following variables: place of residence; previous attendance at the clinic nearest their home; services available at their nearest clinic; and their willingness to attend their nearest clinic in future.Results: Respondents were from Soshanguve (153; 43.7%, Mabopane (92; 26.3%, Garankuwa (29; 8.3% and Hebron (20; 5.7% and most were women (271; 77.4% aged 26–45 (177; 50.6%. Eighty per cent (281 of the patients had visited their nearest clinic previously and 54 of these (19.2% said they would not return. The reasons for this were: long waiting time (88; 25.1%; long queues (84; 24%; rude staff (60; 17%; and no medication (39; 11.1%.Conclusion: The majority of patients who had attended their nearest clinic were adamant that they would not return. It is necessary to reduce waiting times, thus reducing long queues. This can be achieved by having adequate, satisfied healthcare providers to render a quality service and by organising training for management. Patients can thus be redirected to their nearest clinic and the health centre’s capacity can be increased by procuring adequate drugs. There is a need to follow up on patients’ complaints about staff attitudes.
Arkell, J; Osborn, D P J; Ivens, D; King, M B
We used qualitative methods to explore factors, which might explain increased anxiety in patients attending a sexually transmitted infection (STI) clinic. Twenty patients, who scored significantly for anxiety on the Hospital Anxiety and Depression Scale (HADS) attended a 20-minute interview. This explored factors contributing to their current psychological symptoms. Transcripts revealed three main themes. First were factors related to possible STIs and the clinic visit. These included health anxieties about HIV or fertility and clinic factors, including staff attitudes and clinic location. Second were factors unrelated to the clinic, including previous emotional difficulties or substance misuse. Third were issues concerning stigma, embarrassment and shame. The origins of anxiety in STI patients are multifactorial and difficult to identify during brief appointments. Despite modern clinics and attitudes, stigma and embarrassment remain prominent. Interventions to address these factors could improve psychological health in this patient group. PMID:16643678
Pillai, R; Bhangu, N; Narayanan, M; Yoong, W
Missed outpatient appointments result in the inefficient utilisation of resources and have secondary effects on the health of the non-attenders, as well as on other patients who have to wait longer for their appointments. The first part of the study involved retrospective analysis of trends of non-attendance based on a computerised database of all gynaecology appointments over 12 months. The second comprised a prospective case-control study in which women who missed their gynaecology outpatient appointments (index cases) over 2 months were compared with patients who attended the same clinics matched for indication for referral (control cases). The overall non-attendance rate over 12 months was 16.1%, of whom 42% were recurrent non-attenders. Data from 105 defaulters were compared with 105 non-defaulters who attended the same clinics. Defaulters were significantly younger, single or separated and were more likely to be 'follow-ups' rather than new cases (all p appointment letter and actual appointment date was significantly related to non-attendance (p = 0.01) and there was a trend to a greater degree of smoking and alcohol ingestion in the defaulter group (p = 0.059). Comparison of other variables such as severity of symptoms, parity, source of referral and fluency of English did not reach statistical significance (p > 0.05). This prospective study has demonstrated certain profiles which are common to defaulters and which can be used to develop strategies to minimise non-attendance. Examples include reducing the time interval between sending the appointment letter and actual appointment date and selectively over-booking younger, single women who smoke. PMID:22296428
Full Text Available Introduction: In medical education, particularly in residency courses, most of the training occurs in real clinical environments. Workplace-based learning profoundly affects students’ knowledge, attitudes, and practice; therefore, it should be properly planned. Due to the extensiveness of the clinical environment and its importance in training residents, investigating how residents learn in these environments and detecting factors that influence effectiveness will help curriculum designers to promote residents’ learning by improving their learning environment. Therefore, our qualitative content analysis study, aimed to examine the experiences and perspectives of internal and surgical residents and their attending physicians about learning in clinical settings. Methods: This qualitative content analysis study was conducted through purposeful sampling. Semi-structured interviews were conducted with 15 internal and surgical residents and 15 of their attending physicians at educational hospitals of Tehran University of Medical Sciences. Results: The main categories explored in this study were hidden curriculum, learning resources, and learning conditions. In the context of clinical environment and under its individual culture, residents learn professionalism and learn to improve their communication skills with patients and colleagues. Because of clinical obligations such as priority of treating the patients for education or workload of the attending physicians, residents acquire most of their practical knowledge from colleagues, fellows, or follow-up patients in different learning conditions (such as: educational rounds, morning reports and outpatient clinics. They see some of their attending physicians as role models. Conclusion: Changing cultural and contextual factors is of prime importance to promote a learning-oriented environment in a clinical setting. The present findings will help curriculum planners and attending physicians to improve
Charles Bitamazire Businge
Full Text Available Background: The prevalence of HIV among antenatal clients in South Africa has remained at a very high rate of about 29% despite substantial decline in several sub-Saharan countries. There is a paucity of data on risk factors for incident HIV infection among antenatal mothers and women within the reproductive age bracket in local settings in the Eastern Cape, South Africa. Objective: To establish the risk factors for incident HIV infection among antenatal clients aged 18–49 years attending public antenatal clinics in rural Eastern Cape, South Africa. Design: This was an unmatched case–control study carried out in public health antenatal clinics of King Sabata District Municipality between January and March 2014. The cases comprised 100 clients with recent HIV infection; the controls were 200 HIV-negative antenatal clients. Socio-demographic, sexual, and behavioral data were collected using interviewer-administered questionnaires adapted from the standard DHS5 women's questionnaire. Multivariate logistic regression models were used to identify the independent risk factors for HIV infection. A p<0.05 was considered statistically significant. Results: The independent risk factors for incident HIV infection were economic dependence on the partner, having older male partners especially among women aged ≤20 years, and sex under the influence of alcohol. Conclusions: Therefore, effective prevention of HIV among antenatal mothers in KSDM must target the improvement of the economic status of women, thereby reducing economic dependence on their sexual partners; address the prevalent phenomenon of cross-generation sex among women aged <20 years; and regulate the brewing, marketing, and consumption of alcohol.
AK Khatri, Suraj Sirohi, Sanjay Dixit, Shailesh Rai, Dhruvendra Pandey
Background: Safe maternity with improved neonatal outcomes is predicated on proper antenatal care services. Exercise has become a fundamental aspect of women's lives and an important constituent of antenatal care. Objective: To find out effectiveness of antenatal exercise in facilitating normal labor and also other benefits associated with antenatal exercise during pregnancy. Methodology: A cross-sectional study was conducted in urban area (private clinic and government institution) of ...
Cohen, Jenny K; Santos, Glenn-Milo; Moss, Nicholas J; Coffin, Phillip O; Block, Nikolas; Klausner, Jeffrey D
Although poor clinic attendance is associated with increased morbidity and mortality among HIV-infected individuals, less is known about predictors of retention and the acceptability of targeted interventions to increase regular clinic attendance. To better understand which patients are at risk for irregular clinic attendance and to explore interventions to aid in retention to care, we surveyed patients attending two outpatient HIV clinics affiliated with the University of California, San Francisco. A total of 606 participants were surveyed, and the analysis was restricted to the 523 male respondents. Of this group, 45% (N = 299) reported missing at least one visit a year. Missing a clinic visit was associated with being African American (aOR = 1.99; 95%CI 1.12-3.52), being a man who has sex with both men and women (aOR=2.72; 95%CI 1.16-6.37), and reporting at least weekly methamphetamine use (aOR=5.79; 95%CI 2.47-13.57). Participants who reported a monthly income greater than $2000 were less likely to miss an appointment (aOR = 0.56; 95%CI 0.34-0.93). Regarding possible retention interventions, most patients preferred phone calls over other forms of support. These findings support the need for ongoing engagement support with particular attention to at-risk sub-groups. PMID:26654093
Dickey, W; Morrow, J I
Data obtained from new patient referral letters to regional and peripheral neurology clinics were studied prospectively over a 6-month period in an attempt to determine factors predicting non-attendance. Attendance at peripheral clinics was significantly better, confirming their value. At regional clinics, factors associated with non-attendance were male sex, patient age less than 50 years, urban home address, referral from Accident and Emergency Departments, symptom duration less than 12 mon...
Fennema, J S; van Ameijden, E J; Coutinho, R A; van Doornum, G J; Henquet, C J; van den Hoek, J A
INTRODUCTION--Patients attending a clinic for sexually transmitted diseases (STD) in general have engaged in at risk sexual behaviour. Therefore they are at increased risk of acquiring HIV through sexual contact. OBJECTIVE--To determine the HIV prevalence among patients attending a STD clinic in Amsterdam. METHODS--An anonymous cross sectional study was conducted in two 5-week periods in Spring and Autumn 1991. RESULTS--Of the 2362 patients attending the clinic during the study period, 2292 (...
PURPOSE: This paper aims to determine the reasons why patients miss clinic appointments and to ascertain patients\\' views on the implementation of reminder systems and penalty fees to reduce the rates of did not attend (DNAs). Overall, the paper seeks to establish novel ways to run a more efficient out-patient department (OPD) service to improve waiting times and access for patients to limited neurology resources. DESIGN\\/METHODOLOGY\\/APPROACH: A questionnaire-based study was approved by the audit committee and was offered to 204 out-patients attending the neurology clinics over a three-month period (July to September 2009). The patients\\' demographic details and non-attendance records were reviewed. The paper aimed to ascertain, from the patients\\' perspective, why people failed to attend clinic appointments. Each participant was asked their views on how they felt their public hospital service might reduce the number of DNAs at their neurology OPD. FINDINGS: A total of 204 patients took part. Participants had a mean age of 31 years (range 25-75 years) with a modal peak in the 26 to 35 age bracket. Almost 10 per cent of those surveyed admitted to missing a hospital out-patient appointment in the past. The most common reason was that they simply "forgot" (28 per cent). DNA rates by age range were proportionally similar to the overall age profile of attenders. Over 55 per cent said they would like a pre-appointment reminder via a mobile telephone text message, 19 per cent preferred a pre-appointment telephone call, and 19 per cent an e-mail. Of those surveyed, 47 per cent said they would be willing to pay a fee on booking that could be refunded on attending for their appointment. The majority of these felt Euro 20 was the most appropriate amount (39 per cent). The rate of acceptance for various fee amounts was uniform across age ranges. Over half (52 per cent) said that they would agree to a "buddy" system whereby the appointment reminder was sent to the patient
Full Text Available Background. Regular clinic attendance for antiretroviral (ARV drug refills is important for successful clinical outcomes in HIV management. Methods. Clinic attendance for ARV drug refills and medication adherence using a clinic-based pill count in 392 adult patients receiving antiretroviral therapy (ART in a district hospital in Uganda were prospectively monitored over a 28-week period. Results. Of the 2267 total scheduled clinic visits, 40 (1.8% were missed visits. Among the 392 clients, 361 (92% attended all appointments for their refills (regular attendance. Clinic attendance for refills was statistically significantly associated with medication adherence with regular attendant clients having about fourfold greater odds of achieving optimal (≥95% medication adherence [odds ratio (OR=3.89, 95% CI: 1.48 to 10.25, exact P=.013]. In multivariate analysis, clients in age category 35 years and below were less likely to achieve regular clinic attendance. Conclusion. Monitoring of clinic attendance may be an objective and effective measure and could be a useful adjunct to an adherence measure such as pill counting in resource-constrained settings. Where human resource constraints do not allow pill counts or other time-consuming measures, then monitoring clinic attendance and acting on missed appointments may be an effective proxy measure.
Bos, JM; Fennema, JSA; Postma, MJ
Objective: To estimate the cost-effectiveness of universal HIV screening of patients attending a clinic for sexually transmitted diseases (STD) in Amsterdam. Design: Cost effectiveness analysis. Methods: A Bernoulli model for the secondary transmission of HIV was linked with epidemiological data on
Malhotra, S.; Chadda, R.
SUMMARY This is a retrospective study of specific developmental disorders in children who attended a child guidance clinic of the department of Psychiatry, PGI over a span of 6 years. A total of twenty-eight such children were identified. Majority (22) had speech or language disorder and 10 had some associated psychiatric problem. There were no significant sex differences. Some clinical correlates are described.
Mamata Sharma Neupane; Kalpana Dhakal Sharma; Sangharshila Basnet; Pratik Adhikary; Harish Chandra Neupane; Bijay Aryal
Urinary tract infection (UTI) is the most common bacterial infection in young and elderly women. Despite the higher incidence of bacteriuria in elderly women, most UTI research has been conducted in young women. Hence, the present paper investigates the assessment of UTI in postmenopausal women attending OPD Clinic of Chitwan Medical College, Bharatpur, Chitwan, Nepal. A cross-sectional study was conducted in OPD clinic of Chitwan Medical College Teaching Hospital from December, 2012 to April...
Nursel Dilek; Ahmet Yaşar Yücel; Aziz Ramazan Dilek; Yunus Saral; Zülal Aşcı Toraman
Objective: We aimed to investigate the types of dermatophytes and dermatophytosis in Elazığ region to provide appropriate information for therapy planning and public health prevention.Methods: A total of 652 patients who attending to outpatient clinic between June 2007 – May 2008 with clinical signs of dermatophytosis were included in this study. All samples, including with negative results on direct microscopy were cultivated in Sabouraud dextrose agar (Oxoid), mycobiotic agar (Acumedia) ...
Ledgerwood, David M.; Alessi, Sheila M.; Hanson, Tressa; Godley, Mark D.; Petry, Nancy M.
Contingency management (CM) is effective in enhancing retention in therapy. After an 8-week baseline, four community-based substance abuse treatment clinics were exposed in random order to 16 weeks of standard care with CM followed by 16 weeks of standard care without CM or vice versa. In total, 75 outpatients participated. Patients who were enrolled in the clinics when the CM treatment phase was in effect attended a significantly greater percentage of therapy sessions than patients who were ...
Full Text Available OBJECTIVES: Initiation of antiretroviral therapy (ART during pregnancy is critical to promote maternal health and prevent mother-to-child HIV transmission (PMTCT. The separation of services for antenatal care (ANC and ART may hinder antenatal ART initiation. We evaluated ART initiation during pregnancy under different service delivery models in Cape Town, South Africa. METHODS: A retrospective cohort study was conducted using routinely collected clinic data. Three models for ART initiation in pregnancy were evaluated ART 'integrated' into ANC, ART located 'proximal' to ANC, and ART located some distance away from ANC ('distal'. Kaplan-Meier methods and Poisson regression were used to examine the association between service delivery model and antenatal ART initiation. RESULTS: Among 14 617 women seeking antenatal care in the three services, 30% were HIV-infected and 17% were eligible for ART based on CD4 cell count <200 cells/µL. A higher proportion of women started ART antenatally in the integrated model compared to the proximal or distal models (55% vs 38% vs 45%, respectively, global p = 0.003. After adjusting for age and gestation at first ANC visit, women who at the integrated service were significantly more likely to initiate ART antenatally (rate ratio 1.33; 95% confidence interval: 1.09-1.64 compared to women attending the distal model; there was no difference between the proximal and distal models in antenatal ART initiation however (p = 0.704. CONCLUSIONS: Integration of ART initiation into ANC is associated with higher levels of ART initiation in pregnancy. This and other forms of service integration may represent a valuable intervention to enhance PMTCT and maternal health.
Bos, JM; van der Meijden, WI; Swart, W; Postma, MJ
HIV screening for attenders of clinics for sexually transmitted disease (STD) may identify individuals with high-risk sexual behaviour and avert HIV infections in partners. Extending our previous analysis in AIDS, we performed an economic evaluation of HIV screening of STD-clinic attenders in Rotter
Cheong, Y M; Ng, Y P; Chin, C S; Thambu, J
Vaginal discharge is a common complaint of women attending gynaecological clinics. The purpose of this study was to compare the occurrence of commonly implicated microorganisms in vaginal discharge amongst women with or without the complaint, attending a gynaecological and family planning clinic. The association of Gardnerella vaginalis with bacterial vaginosis was also studied. It was found that there were no significant differences between the cases and controls in the isolation rate of Gardnerella vaginalis, Torulopsis glabrata, Ureaplasma urealyticum, Mycoplasma ssp and Group B streptococcus (p greater than 0.05). Only the isolation rate of Candida albicans was significantly higher in the cases than controls (p less than 0.01). However, there was a significant association of G. vaginalis with bacterial vaginosis. PMID:1387449
Almualm, Yasmin; Alkaff, Sharifa Ezat; Aljunid, Syed; Alsagoff, Syed Sagoff
This study was carried out to determine the level of support towards the proposed National Health Insurance scheme among Malaysian patients attending specialist clinics at the National University of Malaysia Medical centre and its influencing factors. The cross sectional study was carried out from July-October 2012. 260 patients were selected using multistage sampling method. 71.2% of respondents supported the proposed National Health insurance scheme. 61.4% of respondents are willing to pay ...
Killaspy, H; Banerjee, S.; King, M.; LLOYD, M
BACKGROUND: What should happen when an outpatient fails to attend a psychiatric clinic? Guidelines from the General Medical Services Committee suggest that general practitioners (GPs) have no further responsibility of care for a patient once a referral to a psychiatrist has been made. This raises questions about the formulation of effective management plans for those patients with whom psychiatric services find it difficult to engage due to non-compliance with assessment and follow-up. AIMS: ...
Introduction Untreated STIs may have serious complications. Knowledge of STIs is important in order to prevent this, and to promote care seeking and treatment. Previous studies have found knowledge to be associated with sexual behavior and socioeconomical factors. The aim of our study was to describe the knowledge of STIs among women attending primary health care clinics in Moshi, Tanzania, to identify their sources of knowledge and evaluate if the level of knowledge is associated with soc...
Full Text Available OBJECTIVE To study the clinical profile of dibetic foot ulcers of patients attending surgical OPD in rural medical college. MATERIAL AND METHODS Clinical profile of 40 patients of diabetic foot ulcers was studied. All the patients were subjected to complete haemogram, fasting and PP blood sugar, LFT, KFT, lipid profile, urine R/E, pus c/s, colour doppler of lower limb and x-ray foot. RESULTS Majority of patients with diabetic foot ulcers were of age group 41–70, male, diabetes mellitus of duration more than 6 years, had intermittent claudication and single ulcer.
Narasimharao, K. L.; Mitra, S. K.; Pathak, I. C.
Antenatal appendicular perforation leading to localized meconium peritonitis and intestinal obstruction is reported in a premature neonate. The baby was successfully treated by a limited ileocaecal resection.
Tadesse Belayneh; Mulat Adefris; Gashaw Andargie
Background. Early booking of antenatal care (ANC) is regarded as a cornerstone of maternal and neonatal health care. However, existing evidence from developing countries indicate that lots of pregnant woman begin ANC booking lately. Objective. It was aimed to assess timing of ANC booking and associated factors among pregnant women attending ANC clinic at University of Gondar Hospital, 2013. Methods. An institution based cross-sectional study design was used to collect data with a face-to-face...
Coleman, L; Ingham, R
This paper presents findings from a survey of 424 people attending nine young people's clinics within the Southampton Community Health NHS Trust. In addition to recording some descriptive background data on the people attending the clinics, one major aim of the study was to investigate whether talking to the sexual partner about contraception before their first intercourse together and delaying this first intercourse influenced contraceptive use. Overall, 40 per cent of people attending the clinics were aged 16 or under, although there was some variation between clinics in the age groups attracted. Most clients were female (88 per cent), had ever had sexual intercourse (92 per cent), reported four or more lifetime partners (42 per cent) but only one partner within the last six months (73 per cent) and were currently in a relationship (75 per cent). Potential for contraception and sexually transmitted infection was widespread; 46 per cent (of non-virgins) had had intercourse without contraception at least 'a few times' and 18 per cent used condoms 'rarely' or 'never'. In terms of first intercourse with current/most recent partner, 17 per cent had not used any contraception and 32 per cent had failed to use condoms. The most important findings from this study were that use of contraception (and condoms in particular) on the occasion of first intercourse with the current or most recent partner was significantly associated with the following; if partners had talked to each other about contraception before having intercourse together for the first time (p<0.001), and also if this first intercourse was delayed beyond four weeks as opposed to over a few days of first 'going-out' together (p<0.001). Suggestions for further in-depth research are made. PMID:9855715
Purushottam A Giri
Full Text Available Background: Tuberculosis (TB is the most common serious opportunistic infection in HIV positive patients and is the manifestation of AIDS in more than 50% of cases in developing countries. TB can occur at any time during the course of HIV infection. Aim: To describe the socio-demographic profile and prevalence of pulmonary tuberculosis (HIV/TB co-infection among HIV positive patients been attended at the antiretroviral therapy clinic (ART clinic at tertiary care teaching hospital of western Maharashtra, India. Materials and Methods: A cross-sectional study was carried out at the ART clinic of Pravara Rural Hospital, Loni, from June 2011 to May 2012. A total of 1012 HIV positive patients, who attended ART clinic, receiving ART treatment during the study period, were included in the analysis. The statistical analysis was performed using SPSS software (Version 17.0. Results: This study showed 1012/172 (17% prevalence of pulmonary tuberculosis among HIV positive patients, of which 87 (50.58% were males and 85 (48.42% were females. Low CD4 count (< 50/μl had statistically significant association with HIV/TB co-infection as compared to HIV infection only ( P < 0.0001. Conclusion: The study showed that 17% of HIV infected persons had tuberculosis co-infection. More strategic preventive measures that enhance body immunity among HIV patients are highly needed as early as possible before they develop active tuberculosis.
Becker, H; Bester, M.; N. Reyneke; Labadarios, D; Monyeki, K.D.; N.P. Steyn
The aim of this study was to determine nutrition knowledge and dietary practices of hypertensive adults attending hypertensive clinics at Day Hospitals in the Cape Metropole. Ten Day Hospitals were randomly selected from a total of 31 Day Hospitals and the first participants attending the hypertension clinics per day were recruited. A total of 85 participants were evaluated. The weight, height, waist and hip circumference of each participant was measured, as well as their blood pressure. Know...
SAMUR ERGÜVEN, Sara; Kılınç, Yeliz; Delilbaşı, Ertan; Işık, Berrin
OBJECTIVE: The aim of this study was to assess the dental anxiety levels of patients attending the Oral and Maxillofacial Surgery clinic in a dental faculty and to evaluate the associated factors that might be related with the dental anxiety.MATERIALS AND METHOD: Questionnaires were applied to patients attending the Department of Oral and Maxillofacial Surgery Clinic, Faculty of Dentistry, Gazi University between February 1, 2013 and January 1, 2014 (n=1165). The questionnaire included a Modi...
Wilson, M. J.; Marelich, W. D.; Lemp, G F; Ascher, M S; Kerndt, P; Kizer, K W
To evaluate the distribution of the human immunodeficiency virus type 1 (HIV-1) epidemic among California women, we analyzed HIV-1 seroprevalence and risk factors among women attending sexually transmitted disease (STD) clinics in 21 local health jurisdictions. Using standardized protocols developed by the Centers for Disease Control, we tested unlinked serum specimens from women attending participating STD clinics in 1989. We analyzed demographic characteristics, HIV risk exposure groups, an...
Gunasekera Henadira Appuhamilage Kamani Mangalika; Silva Koththigoda Cankanamge; Dhammike Priyadarshana; Prathapan Shamini; Mananwatte Sujatha; Weerasinghe Geeganage; Abeygunasekera Nalaka
Background: In Sri Lanka little is known about the prevalence of Chlamydia trachomatis (CT) infection. Objective was to determine the prevalence of CT in female patients attending sexually transmitted disease (STD) clinics in the Colombo district. Materials and Methods: A descriptive cross-sectional study was carried out for the prevalence of CT in all female patients (n = 168) more than 18 years of age, attending two STD clinics in the Colombo district from January to May 2012. Endocervical ...
J O Omoaregba; O Morakinyo; James, O B; A O Lawani
Background: Female infertility is highly co-morbid with mental illness. In Nigeria, very few studies have been conducted to determine the pattern of mental illness among women with infertility. We aimed to determine the pattern of mental illness in a sample of women with female infertility as well as its associated correlates.Patients and Methods: A cross sectional two-stage survey of women (n=100) attending an infertility clinic was conducted in a teaching hospital in Nigeria. A 30-item GHQ ...
WHO estimates that 20% of persons living with HIV/AIDS are in their 20s and one out of twenty adolescents contract a sexually transmitted disease (STD) each year. A total of 303 adolescents and youths (10-24 years of age) attending an STD clinic were subjected to a questionnaire to assess sexual behavioural patterns that predisposed them to STD. Scope of the questions included age at initiation of sexual intercourse, partner at first exposure, number of sexual partners, use of condoms,...
Full Text Available Abstract Background Podoconiosis is a lymphoedema of non-infectious cause which results in long-term ill health in affected individuals. Simple, effective treatment is available in certain parts of Ethiopia, but evidence indicates that not all patients continue collecting treatment supplies from clinic sites once started. We used qualitative techniques to explore factors related to discontinued attendance at outreach clinics of a non-government organization in southern Ethiopia. Methods A cross-sectional qualitative study was conducted in four clinic sites through unstructured in-depth interviews, key informant interviews and focus group discussions with the involvement of 88 study subjects. Results Discontinuation of clinic visits is common among podoconiosis patients. The reasons were: remoteness from the clinic sites, unrealistic expectation of ‘special’ aid, worry about increasing stigma, illness and misconceptions about treatment. Conclusions Several of these factors are remediable through community and individual information and education. Appropriate routes to deliver this information must be identified. Certain factors (such as distance to clinic sites and stigma require substantial expansion of services or liaison with village-level government health services.
Full Text Available Aim: Corneal blindness accounts for 3.42% of blindness in Malaysia; the rate of eye donation is low. The aim of the study was to assess the awareness about eye donation and willingness to donate eyes among attendants of patients at various clinics in Melaka, Malaysia. Materials and Methods: This observational study was conducted on attendants who accompanied patients (n = 400 visiting various outpatient departments of the General Hospital and two peripheral clinics in Melaka between August and October 2007. The participants answered a questionnaire (Malay and English versions which included demographic profile, awareness of eye donation, knowledge regarding facts of eye donation, and willingness to donate eyes. Univariate and multivariate logistic regression was performed at 5% level of significance. Results: Awareness of eye donation was observed in 276 (69% participants. Multivariate analysis showed that awareness was more among females when compared to males (P = 0.009. Of the 276 participants who were aware of eye donation, only 34.42% were willing to donate eyes. Willingness was more among the Indian race (P = 0.02 and males (P = 0.02. Educational status did not influence the willingness to donate eyes. Conclusions: Although majority of participants were aware of eye donation, willingness to donate eyes was poor.
Full Text Available Objective: We aimed to investigate the types of dermatophytes and dermatophytosis in Elazığ region to provide appropriate information for therapy planning and public health prevention.Methods: A total of 652 patients who attending to outpatient clinic between June 2007 – May 2008 with clinical signs of dermatophytosis were included in this study. All samples, including with negative results on direct microscopy were cultivated in Sabouraud dextrose agar (Oxoid, mycobiotic agar (Acumedia and potato dextrose agar (Oxoid. Results: Dermatophytes were isolated in 142 (21.8% out of all samples. Of the isolates 70.4% were Trichophyton rubrum, 15.4% were Trichophyton mentagrophytes, 4.2% were , 4.2% were Microsporum canis, 2.8% were Epidermophyton floccosum, 2.11% were Trichophyton violaceum, 0.7% were Trichophyton tonsurans.Conclusion: Trichophyton rubrum was most frequently isolated dermatophytosis agent in Elazığ region.
Full Text Available WHO estimates that 20% of persons living with HIV/AIDS are in their 20s and one out of twenty adolescents contract a sexually transmitted disease (STD each year. A total of 303 adolescents and youths (10-24 years of age attending an STD clinic were subjected to a questionnaire to assess sexual behavioural patterns that predisposed them to STD. Scope of the questions included age at initiation of sexual intercourse, partner at first exposure, number of sexual partners, use of condoms, exposure to commercial sex workers (CSWs, previous infection with STDs and role of alcohol. Their diagnosis was based on history, clinical findings and laboratory confirmation. Adolescents and youths accounted for 30% of the total number of patients attending the STD clinic during this period. The male to female ratio was 1:0.95. Ninety-six percent (290 were single while 4% (13 were married. Seventy-two percent (217 were students. Age at onset of sexual activity was 10-20 years in 80%, 85% practiced risky sexual behaviour, patronising casual partners was frequent especially after alcohol use, 10% had been exposed to CSWs, condom use was poor, number of sexual partners varied between 1 and 5 and previous infections were not professionally treated. Adolescents and young people are sexually active and practice risky sexual behavioural patterns. Adolescents and youths account for a high percentage of patients patronising the STD clinic. Sexual education and youth friendly reproductive health services are urgently needed to curb the spread of HIV/AIDS/STDs.
Moe, Nina; Pedersen, Bård; Nordbø, Svein Arne; Skanke, Lars Høsøien; Krokstad, Sidsel; Smyrnaios, Anastasios; Døllner, Henrik
Background Respiratory viruses often have been studied in children with respiratory tract infection (RTI), but less knowledge exists about viruses in asymptomatic children. We have studied the occurrence of a broad panel of respiratory viruses in apparently healthy children attending day care, taking into account the influence of possible confounding factors, such as age, clinical signs of respiratory tract infection (RTI), location (day-care section) and season. Methods We have studied 161 children in two day-care centers, each with separate sections for younger and older children, during four autumn and winter visits over a two-year period. A total of 355 clinical examinations were performed, and 343 nasopharyngeal samples (NPS) were analyzed by semi-quantitative, real-time, polymerase chain reaction (PCR) tests for 19 respiratory pathogens. Result Forty-three percent of all NPS were PCR-positive for ≥ 1 of 13 virus species, with high species variation during visits. Rhinovirus 26% (88/343 NPS), enterovirus 12% (40/343) and parechovirus 9% (30/343) were detected in every visit, and the rates varied in relation to age, day-care section and season. Ten other viruses were detected in ≤ 3% of the NPS. Generally, viruses occurred together in the NPS. In 24% (79/331) of the clinical examinations with available NPS, the children had clear signs of RTI, while in 41% (135/331) they had mild signs, and in 35% (117/331) the children had no signs of RTI. Moreover, viruses were found in 70% (55/79) of children with clear signs of RTI, in 41% (55/135) with mild signs and in 30% (35/117) without any signs of RTI (p < 0.001). Conclusions Positive PCR tests for respiratory viruses, particularly picornaviruses, were frequently detected in apparently healthy children attending day care. Virus detection rates were related to age, presence of clinical signs of RTI, location in day care and season. PMID:27433803
Cook, L. S.; Koutsky, L A; Holmes, K. K.
INTRODUCTION--A recent study comparing heterosexual men with and without confirmed sexually transmitted diseases (STDs) in an urban STD clinic showed that uncircumcised men were less likely than circumcised men to have genital warts detectable by clinical examination (adjusted odds ratio 0.7, 95% confidence interval 0.4, 0.9). Based on these initial findings we hypothesised that the appearance and anatomic distribution of genital warts, and possibly treatment response, may be different for ci...
Megha Antwal; Rohan Gurjar; Shweta Chidrawar; Jyoti Pawar; Sunil Gaikwad; Narayan Panchal; Varsha Kale; Madhuri Thakar; Arun Risbud; Srikanth Tripathy
Background & objectives: Human immunodeficiency virus (HIV) has infected several million individuals in India. Various interventions have been implemented for early detection and prevention of transmission of HIV infection. This has progressively changed the clinical profile of HIV infected individuals and this study documents the clinical presentation of individuals positive for HIV in 2010, in Pune, Maharashtra, India. Methods: This cross-sectional study included subjects who had come ...
Full Text Available Introduction: Urinary tract infection (UTI is a common cause of morbidity in patients attending our hospital. Recently UTI has become more complicated and difficult to treat because of appearance of pathogens with increasing resistance to the commonly used antimicrobial agents. Objectives: The main aim of the study was to determine the bacteriological profile and antibiotic susceptibility pattern of UTI patients attending our hospital. Materials and Methods: 1843 patients complaining of fever with or without urinary symptoms attending medicine and nephrology clinics of Jawaharlal Nehru Medical College Hospital, Aligarh from June 2012 to July 2014 were analysed. Clean catch mid-stream urine specimens collected from each subject were subjected to urine culture and sensitivity tests. Patients with age 15 to 85 years were included. Results: Significant bacteriuria was detected in 33.4% patients. Diabetes, obstructive uropathy, and previous instrumentation were the major risk factors identified. The most common pathogens isolated were Escherichia coli (52.4%, Klebsiella pneumoniae (12.3% and Citrobacter spp. (9.1%. Most susceptible antibiotic was Amikacin, Cefoperazone-sulbactum, Piperacillin-tazobactum and Nitrofurantoin for most of the isolates. E. coli which was the main isolate was found to be most susceptible to Amikacin (78.3%, Cefoperazone-sulbactum (72.8%, Piperacillin-tazobactum (70.5%, Gentamicin (69.3%, Nitrofurantoin (67.3%, Cefoperazone (64.1% and Ceftriaxone (61.6%. Conclusion: This study highlights the common pathogens causing UTI in our area and their antibiotic sensitivity patterns which could help clinicians in starting rational empirical antibiotic therapy for such patients while awaiting urine culture reports. This would significantly decrease the incidence of drug resistance and be more cost effective to the patients.
Full Text Available Abstract Background The internet is a relatively new medium of disseminating health information. Studies on Internet usage for health information are mainly done in developed countries and very few studies have been carried out in developing countries. Methods The Internet usage of patients who were attending specialist clinics in Teaching Hospital Karapitiya and Southern Hospital in Galle, Sri Lanka was investigated. The study was carried out on the following specialities; General Medicine, Pediatrics, General Surgery and Cardiothoracic surgery. Information was collected using an investigator-administered questionnaire while patients were waiting for a consultation. Results Three hundred and fifty five patients (or guardians in the Pediatric clinic participated in the study. One hundred seventy two (48.3% participants have heard about the Internet. There was a relationship between awareness of the Internet and age, educational level and the clinic attended. There was no difference of awareness depending on the gender or the hospital. Only three participants (0.97% have used the Internet to find information about their disease conditions. Close relatives searched the Internet about the conditions of two participants. Altogether, the Internet was used to search information on the disease condition of five participants (1.4%. Conclusion Very low usage of the Internet for health information retrieval in this study is probably due to low awareness of the Internet and low educational level. This low usage of Internet and the associated reasons shown in this study can be generalized to Sri Lanka and probably to other low-income countries that have lower educational level than Sri Lanka.
Afolabi, B M; Brieger, W R; Salako, L A
Parents and caregivers often try various treatment modalities for their sick children before bringing them to clinic. Many community-based studies have documented home and self-treatment practices, often with the aid of patent medicine vendors, but less is known about prior treatment behaviour of caregivers who actually reach a government clinic. This study, therefore, aimed at documenting the treatment provided by caregivers prior to their attendance at a public hospital. Beginning in April 1996, a year-long study was conducted among 1,943 sick children and their caregivers who attended the largest government-owned paediatric hospital in Lagos, Nigeria. The major complaints mentioned by the caregivers included fever, cough, and diarrhoea. Most (89%) caregivers had administered some form of medicine to the child prior to the clinic visit, and on average, 2.5 medications had been given. Associations were found between major complaint and type of medicine given: fevers were associated with antimalarial drugs and analgesics (antipyretics), cough was associated with cough syrup and analgesics, while diarrhoea was associated with antidiarrhoeal drugs. Although one-fifth of the children had received an antibiotic, provision of antibiotics was not associated with a particular complaint/illness. Since caregivers appeared to use perceived complaints/illnesses as a treatment guide, this can form the basis of safer and more appropriate recognition of illness and home management. In addition, the information obtained in this study can be used for training clinicians to inquire about home management and, thus, for making more informed decisions about their own treatment and prescribing practices. PMID:15190811
Adenike O. Omosun
Full Text Available Background: Child adoption is a recommended alternative form of infertility management. Infertility is of public health importance in Nigeria and many other developing nations. This is a result of its high prevalence and especially because of its serious social implications as the African society places a passionate premium on procreation in any family setting. Objectives: The aim of this study was to determine the knowledge, attitude and practice of child adoption amongst women attending infertility clinics in teaching hospitals in Lagos State and to determine the factors that influence their attitude and practice towards it.Method: A cross-sectional descriptive design was used. Data were collected by using a structured questionnaire which was interviewer-administered. The study was conducted in the two teaching hospitals in Lagos State (LUTH [Lagos University Teaching Hospital] and LASUTH [Lagos State University Teaching Hospital] from amongst 350 women attending the gynaecological clinics. All the patients under management for infertility at the gynaecology clinics during the period of the study were interviewed.Results: Many respondents (85.7% had heard of child adoption and 59.3% of them knew the correct meaning of the term. More than half of the respondents (68.3% said that they could love an adopted child but less than half of them (33.7% were willing to consider adoption. Only 13.9% has ever adopted a child. The major reason given for their unwillingness to adopt was their desire to have their own biological child. Factors that were favourable towards child adoption were Igbo tribe identity, an age above 40 years, duration of infertility above 15 years, and knowing the correct meaning of child adoption.Conclusion: There is a poor attitude to adoption even amongst infertile couples. Interventions need to be implemented to educate the public on child adoption, to improve their attitude towards adoption and to make it more acceptable.
Feliciano Chanana Paquissi; Arminda Bimbi Paquissi Cuvinje; Almeida Bailundo Cuvinje
Background. Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis, whose prevalence is increasing worldwide, and is associated with all-cause mortality. However, no study has assessed this disease in Huambo. The aim of this study was to evaluate the prevalence of PAD in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. Methods. A cross-sectional study, including 115 patients aged 40 years and older attending an outpatient service. ...
Clausen, Frederik Banch; Christiansen, Mette; Steffensen, Rudi;
and analyzed for the presence of the RHD gene by real-time polymerase chain reaction targeting two RHD exons. Prediction of the fetal RhD type was compared with serologic typing of the newborn in 2312 pregnancies, which represented the first 6 months of routine analysis. RESULTS: For the detection of.......087%) were not detected, and antenatal RhIG was not given. CONCLUSION: These data represent the first demonstration of the reliability of routine antenatal fetal RHD screening in D-, pregnant women to ascertain the requirement for antenatal RhD prophylaxis. Our findings should encourage the implementation of...
Fah, Tong Seng; MMed, Noorazah Abdul Aziz; Liew, Chin Gek; Omar, Khairani
Introduction: Identifying clinical features that differentiate acute febrile thrombocytopaenia from acute febrile illness without thrombocytopaenia can help primary care physician to decide whether to order a full blood count (FBC). This is important because thrombocytopaenia in viral fever may signify more serious underlying aetiology like dengue infection.
Pulmonary disease remains the major cause of morbidity in patients with cystic fibrosis (CF). However, of 115 patients attending a regional CF clinic we noted 16 cases (14%) with co-morbid conditions. Of this group, 4 of 115 patients (3.5%) had renal problems including both structural and functional defects and 4 (3.5%) had neurological disorders, 3 of which were types of epilepsy. Notably, 3 of 115 patients (2.6%) had different forms of neoplasia, all of which required significant surgical and\\/or chemotherapeutic intervention. There is now increasing evidence of the association between digestive tract malignancy and CF, which further complicates management of these already complex cases.
BACKGROUND:: stress in pregnancy is common and impacts negatively on women, infants and families. A number of factors contribute to high levels of stress in pregnancy, including financial concerns, marital discord, low support systems and low socio-economic status. OBJECTIVES:: the aim of this study was to evaluate stress anxiety levels and depressive symptoms among low risk women in an area in Ireland that was particularly impacted by the 2008 economic crisis. DESIGN:: a quantitative descriptive cross-sectional design was used. Data were collected using the Edinburgh Postnatal Depression Scale (EPDS), the Perceived Stress Scale and the State Trait Anxiety Inventory (STAI). Data was collected at a single time during the second trimester. SETTING:: this paper reports a case study of one maternity service in Ireland. Participants included low risk pregnant women who were attending the hospital clinic for routine antenatal care. RESULTS:: of 150 questionnaires distributed, 74 completed questionnaires were returned indicating a 49.3% return rate. Findings indicated high levels of stress, anxiety and depressive symptomatology among participants. There were no significant difference in mean EPDS score for different age groups (F4,69=2.48, P=0.052), living arrangements (F4,68=0.90, P=0.5) or usual occupation (F4,69=1.45, P=0.2). A score of ≥12 was taken as indicative of probable antenatal depression and 86.5% of participants responded with a score of 12 or above. PSS scores were also high and more than three quarters of respondents scored ≥15 (75.6%) and more than a third had scores ≥20 (35.1%), out of a total score of 40. There was a significant difference in mean PSS score between the different age groups (F4,69=3.60, P=0.010) but not for living arrangements or usual occupation. A STAI score of ≥39 was taken as indicative of antenatal anxiety, and 74.3% of participants responded with a score of 39 or above. There were no significant differences in mean STAI
GU Jin(谷进); ZENG Zhirong(曾志荣); CHEN Rongzhang(陈荣章); ZHU Huilan(朱慧兰); QIU Xiaoshan(邱晓珊)
Objectives: To investigate the etiology of genital ulcerdisease (GUD) among patients attending sexuallytransmitted disease (STD) clinics in Guangzhou, China.Methods: Between September 8, 1998, and August 9,2001, 267 patients with a genital ulcer were clinicallyassessed. Clinical etiology of GUD was dependent onphysical appearance and microbiologic examination,including the following: dark field microscopy and serologyfor Treponema pallidum (TP), swabs of genital ulcer forHerpes simplex virus (HSV), processed quantitativefluorescent polymerase chain reaction (QF-PCR) forsimultaneous detection of HSV, TP, Haemophilus ducreyi(HD), Human papillomavirus (HPV), and serology for HIVinfection.Results: Two hundred thirty men and thirty-sevenwomen with a median age of 33.4 (range 16-74 years) wereanalyzed. The etiology of GUD was syphilis (26.59%)(71/267), genital herpes (17.60%) (47/267), condylomataacuminata (4.87%) (13/267), candidiasis (3.37%) (9/267),bacterial infection (3.75%) (10/267), and multiple infection(6.74%) (18/267). The seroprevalence of HIV was 0.75%(2/267). No etiology was identified in 50.56% (135/267).Conclusion: The etiology of GUD among STD patients inour area was multifactorial with a predominance of syphilisand genital herpes. Based on this limited data obtained atSTD clinics, HIV infection was not common.
Purpose: To develop a predictive model for survival from the time of presentation in an outpatient palliative radiotherapy clinic. Methods and Materials: Sixteen factors were analyzed prospectively in 395 patients seen in a dedicated palliative radiotherapy clinic in a large tertiary cancer center using Cox's proportional hazards regression model. Results: Six prognostic factors had a statistically significant impact on survival, as follows: primary cancer site, site of metastases, Karnofsky performance score (KPS), and fatigue, appetite, and shortness of breath scores from the modified Edmonton Symptom Assessment Scale. Risk group stratification was performed (1) by assigning weights to the prognostic factors based on their levels of significance, and (2) by the number of risk factors present. The weighting method provided a Survival Prediction Score (SPS), ranging from 0 to 32. The survival probability at 3, 6, and 12 months was 83%, 70%, and 51%, respectively, for patients with SPS ≤13 (n=133); 67%, 41%, and 20% for patients with SPS 14-19 (n=129); and 36%, 18%, and 4% for patients with SPS ≥20 (n=133) (p<0.0001). Corresponding survival probabilities based on number of risk factors were as follows: 85%, 72%, and 52% (≤3 risk factors) (n=98); 68%, 47%, and 24% (4 risk factors) (n=117); and 46%, 24%, and 11% (≥5 factors) (n=180) (p<0.0001). Conclusion: Clinical prognostic factors can be used to predict prognosis among patients attending a palliative radiotherapy clinic. If validated in an independent series of patients, the model can be used to guide clinical decisions, plan supportive services, and allocate resource use
Nguyen Thi Thuy, Hanh; Gammeltoft, Tine; Rasch, Vibeke
.3-3.4), living in a remote rural area (aOR 7.8, 95% CI 3.4-17.8), late antenatal care attendance (aOR 3.6, 95% CI 1.3-10.1) and not being informed about PMTCT at their first antenatal care visits (aOR 7.4, 95% CI 2.6-21.1). Among women who had multiple tests, 80% had the second test after 36 weeks of gestation......ABSTRACT: BACKGROUND: HIV testing for pregnant women is an important component for the success of prevention of mother-to-child transmission of HIV (PMTCT). A lack of antenatal HIV testing results in loss of benefits for HIV-infected mothers and their children. However, the provision of unnecessary...... repeat tests at a very late stage of pregnancy will reduce the beneficial effects of PMTCT and impose unnecessary costs for the individual woman as well as the health system. This study aims to assess the number and timing of antenatal HIV testing in a low-income setting where PMTCT programmes have been...
Mamata Sharma Neupane
Full Text Available Urinary tract infection (UTI is the most common bacterial infection in young and elderly women. Despite the higher incidence of bacteriuria in elderly women, most UTI research has been conducted in young women. Hence, the present paper investigates the assessment of UTI in postmenopausal women attending OPD Clinic of Chitwan Medical College, Bharatpur, Chitwan, Nepal. A cross-sectional study was conducted in OPD clinic of Chitwan Medical College Teaching Hospital from December, 2012 to April, 2013. Total 400 patients suspected with UTI were reviewed, out of which 173 (43.3 % of the suspected samples showed presence of potential pathogens causing UTI in postmenopausal women. Escherichia coli (E. coli was the predominant (65.1% bacterial pathogen. Amikacin was found to be most sensitive antimicrobial followed by Nitrofurantoin and Gentamcin. Ampicillin showed the higher percentage of resistant, compared to other antimicrobials. In conclusion, drug resistance among bacterial pathogens is an evolving process, regular surveillance and monitoring is necessary to provide effective treatment of UTIs.
Full Text Available Background: Assessing individual’s readiness to change and targeting the intervention to the level of readiness may improve successful weight loss rates. This study aimed to assess readiness for weight loss in obese women using the trans theoretical model. Methods: A cross-sectional study was conducted on 90 volunteer apparently healthy obese women, in Ardabil, Iran. Participants completed the translated and validated University of Rhode Island Change Assessment questionnaire in their first visit. Subjects were categorized into one of the stages of change based on the highest of four z-transformed scale scores. The readiness to change score was calculated. Results: More than half of the participants were in early stages of weight loss and 24.5% were in the action stage. The readiness score in the precontemplation stage was significantly lower than the other stages, but no significant difference was observed among the contemplation, action and maintenance stages. The significant correlation was observed between the stages of change and waist-to-hip ratio (r=0.33, P<0.05. Conclusion: Obese women attending the nutrition clinic are in different stages to change for weight loss. Understanding person specific stages of change orientates the dietitian to use the most appropriate counseling strategies. Hence the stages and readiness to change should be considered before implementing any intervention in clinical settings for optimal outcomes.
Om Prakash Giri
Full Text Available Background: Substance misuse is an increasing problem in urban and rural India. The utility of community-based interventions and preventive strategies are increasingly emphasized in this context. The drug de-addiction and treatment center, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, has been running a drug de-addiction and treatment clinic at Kharar Civil Hospital, Kharar, District Mohali, Punjab, since 1998. As part of an effort to enhance this community outreach program, community-based drug awareness and treatment camps have been organized since March 2004 in villages in and around Tehsil Kharar of Mohali. Aim: To study the impact of the drug awareness and treatment camps on the attendance of patients at the community outreach drug de-addiction and treatment clinic at Kharar Civil Hospital. Methods: Sociodemographic and clinical variables, including treatment outcome-related variables, of patients attending the clinic at Kharar Civil Hospital, before and after the camps were compared. Discussion and Conclusion: The study showed a positive impact on drug awareness and treatment camps held in the community on outpatient attendance at a community outreach clinic, with attendance increasing more than 1.8 times.
Mushi Adiel K
Full Text Available Abstract Background Although antenatal care coverage in Tanzania is high, worrying gaps exist in terms of its quality and ability to prevent, diagnose or treat complications. Moreover, much less is known about the utilisation of postnatal care, by which we mean the care of mother and baby that begins one hour after the delivery until six weeks after childbirth. We describe the perspectives and experiences of women and health care providers on the use of antenatal and postnatal services. Methods From March 2007 to January 2008, we conducted in-depth interviews with health care providers and village based informants in 8 villages of Lindi Rural and Tandahimba districts in southern Tanzania. Eight focus group discussions were also conducted with women who had babies younger than one year and pregnant women. The discussion guide included information about timing of antenatal and postnatal services, perceptions of the rationale and importance of antenatal and postnatal care, barriers to utilisation and suggestions for improvement. Results Women were generally positive about both antenatal and postnatal care. Among common reasons mentioned for late initiation of antenatal care was to avoid having to make several visits to the clinic. Other concerns included fear of encountering wild animals on the way to the clinic as well as lack of money. Fear of caesarean section was reported as a factor hindering intrapartum care-seeking from hospitals. Despite the perceived benefits of postnatal care for children, there was a total lack of postnatal care for the mothers. Shortages of staff, equipment and supplies were common complaints in the community. Conclusion Efforts to improve antenatal and postnatal care should focus on addressing geographical and economic access while striving to make services more culturally sensitive. Antenatal and postnatal care can offer important opportunities for linking the health system and the community by encouraging women to
Full Text Available Objectives: Epilepsy is a common neurological disorder with a median lifetime prevalence of 14 per 1000 subjects. Sleep disorders could influence epileptic seizure. The most common sleep disorder is obstructive sleep apnea syndrome (OSAS which occurs in 2% of adult women and 4% of adult men in the general population. The aim of this study is to estimate the frequency of OSAS among patients with epilepsy and to study the seizure characteristics among those patients with co-morbid OSAS. Methods: Patients with a confirmed diagnosis of epilepsy who attended the Sultan Qaboos University Hospital neurology clinic were recruited for the study between June 2011 and April 2012. Patients were screened for OSAS by direct interview using the validated Arabic version of the Berlin questionnaire. Patients identified as high-risk underwent polysomnography. Results: A total of 100 patients with epilepsy (55 men and 45 women were screened for OSAS. Generalized and focal seizure was found in 67% of male and 27% of female patients. Six percent of the participants had epilepsy of undetermined type. Only 9% of the sample was found to have high risk of OSAS based on the Berlin questionnaire. No significant correlation was found between risk of OSAS, type of epilepsy, and anti-epileptic drugs. Conclusion: The risk of OSAS was marginally greater in patients with epilepsy compared to the general population with the overall prevalence of 9%.
Costa, Eleonora C V; Oliveira, Rosa; Ferreira, Domingos; Pereira, M Graça
Women account for 30% of all AIDS cases reported to the Health Ministry in Portugal and most infections are acquired through unprotected heterosexual sex with infected partners. This study analyzed socio-demographic and psychosocial predictors of consistent condom use and the role of education as a moderator variable among Portuguese women attending family planning clinics. A cross-sectional study using interviewer-administered fully structured questionnaires was conducted among 767 sexually active women (ages 18-65). Logistic regression analyses were used to explore the association between consistent condom use and the predictor variables. Overall, 78.7% of the women were inconsistent condom users. The results showed that consistent condom use was predicted by marital status (being not married), having greater perceptions of condom negotiation self-efficacy, having preparatory safer sexual behaviors, and not using condoms only when practicing abstinence. Living with a partner and having lack of risk perception significantly predicted inconsistent condom use. Less educated women were less likely to use condoms even when they perceive being at risk. The full model explained 53% of the variance in consistent condom use. This study emphasizes the need for implementing effective prevention interventions in this population showing the importance of taking education into consideration. PMID:26277905
Mikl, J.; Sudar, Z.; Smith, P. F.; Bruckova, M.; Jedlicka, J.; Kastankova, V.; Tryzna, R.; Dehovitz, J.
OBJECTIVE: This survey was conducted to determine the prevalence of HIV infection and associated risk behaviour in a high risk population of clients attending an STD clinic in Prague, Czech Republic. METHODS: Between September 1994 and January 1995, clients entering the Apolinar STD clinic in Prague, Czech Republic, were enrolled in a blinded, unlinked HIV antibody seroprevalence study. Non-identifying demographic characteristics, STD diagnoses, HIV risk exposures, and voluntary HIV tes...
Full Text Available Richard Crosby1–3, Richard J Charnigo1, Lydia A Shrier41College of Public Health, University of Kentucky, Lexington, KY, USA; 2Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA; 3The Kinsey Institute for Research in Sex, Gender, and Reproduction, Bloomington, IN, USA; 4Children's Hospital Boston, Boston, MA, USAObjectives: To compare the frequency of condom-use errors and problems between teens (15–19 years of age and young adults (20–24 years of age attending clinics. Also, to assess whether the odds of experiencing condom failure were influenced by age group, gender, and motives for condom use.Methods: As part of a larger study of condom effectiveness, youth (15–24 years of age from five clinics, in three US cities, were recruited (N = 263. Data were prospectively collected using daily electronic diaries. For each episode of condom use with penile–vaginal sex, youths were asked to respond to questions assessing seven errors and five problems in condom use. Data analyses entailed statistical modeling with generalized estimating equations.Results: Teens did not significantly differ from their older counterparts on any of the seven condom-use errors or any of the five condom-use problems. Of all condom-use events, teens reported that 20% did not involve condom use from start-to-finish of sex, 14.7% involved a condom that had dried out, 8.1% involved rushed application, 6.7% did not involve adequate lubrication, and other errors and problems occurred less often. Further, condom failure was not predicted by age group, gender, or motive for using condoms. Significant interaction effects were not observed.Conclusions: Several forms of condom-use errors/problems occurred with similar frequency when comparing teens and young adults, suggesting a need to intervene to improve condom-use behavior regardless of age.Keywords: condoms, teens, sexually transmitted diseases, sexual behavior
Gunasekera Henadira Appuhamilage Kamani Mangalika
Full Text Available Background: In Sri Lanka little is known about the prevalence of Chlamydia trachomatis (CT infection. Objective was to determine the prevalence of CT in female patients attending sexually transmitted disease (STD clinics in the Colombo district. Materials and Methods: A descriptive cross-sectional study was carried out for the prevalence of CT in all female patients (n = 168 more than 18 years of age, attending two STD clinics in the Colombo district from January to May 2012. Endocervical swabs were collected and tested for CT using the Amplicor CT/NG polymerase chain reaction assay. Results: Prevalence of CT in females attending the STD clinics in the Colombo district was 8.3%. Mean age of those infected with CT was 32.9 years (SD ± 8.2. Majority of females with CT infections were Sinhalese and married. There was no significant association with age, ethnicity or being married or not. Females who did not attend school, or had their education only up to Grade 5 were significantly found to have six times the risk of having CT infection (95% CI = 1.8-22.6. A significant association was found with number of sexual partners but not with commercial sex work or past history of STD. Conclusions: Prevalence of CT was moderately high in this population.
Sidhu, Meena; Bala, Renu; Akhtar, Naveen; Sawhney, Vijay
Screening and detection of clinically significant antibodies among antenatal women plays an important role in transfusion safety and preventing hemolytic disease of fetus and newborn. Routine screening of antenatal women for antibodies is not done in all blood centres of our country and so immunization rates are not known in pregnant women. We studied the prevalence of alloantibodies and titration of Anti D among antenatal multiparous women in Jammu region. In present prospective study, 750 antenatal multiparous women attending antenatal clinics were typed for ABO and D antigens. Alloantibody screening was done, if positive, specificity of alloantibody was ascertained by using commercially available red cell panel by tube method. Rate of alloimmunization was correlated with Rh D status, gravida, previous transfusion history and bad obstetric history. Titration of alloantibody D was done in first and third trimester of pregnancy. In present study most common blood group detected was B positive (38.4 %). Rh D negative cases constituted 7.6 % of total cases. Rate of alloimmunization was 2 %. A significant correlation was seen between Rh D-negative and alloimmunization (21 % in D-negative and 0.45 % in D-positive). There is significant increasing degree of alloimmunization with increase in Gravida. Alloimmunization in females with bad obstetric history was high (4.41 %) as compared to females with no bad obstetric history showing only 1.76 %. Alloantibodies detected were Anti-D, Anti-E, Anti-C and Anti-K. Anti-D constituted 80 % of all alloantibodies detected. Six women in their third trimester had raised titers of anti-D. Most common alloantibody detected was anti-D (80 %). Alloantibodies to other Rh antigens and Kell blood group systems were also identified. To minimize alloimmunization in Rh D negative women, proper Anti D immunoprophylaxis should be implemented. PMID:27429523
Mohammed Al-Azri; Iman Al-Lawati; Raya Al-Kamyani; Maisa Al-Kiyumi; Aisha Al-Rawahi; Robin Davidson; Abdullah Al-Maniri
Objectives: This study aimed to identify the prevalence of antenatal depression and the risk factors associated with its development among Omani women. No previous studies on antenatal depression have been conducted in Oman. Methods: This descriptive cross-sectional study was carried out between January and November 2014 in Muscat, Oman. Pregnant Omani women ≥32 gestational weeks who were attending one of 12 local primary care health centres in Muscat for routine antenatal care we...
Colón-López, Vivian; Ortiz, Ana Patricia; Del Toro-Mejías, Lizbeth; Clatts, Michael Craig; Palefsky, Joel M.
Purpose Recent studies in Puerto Rico have reported an increasing incidence of anal cancer in Puerto Rican men. The objective of this study was to determine the prevalence, genotype distribution and risk factors associated with anal HPV infection among men attending an STI clinic in Puerto Rico. Methods We conducted a cross-sectional study among 205 men 18 years and older. A comprehensive survey was administered that included a demographic and a behavioral assessment. Separate logistic regres...
Yu, Xiaoyan; Lu, Roujian; Wang, Zhong; Zhu, Na; Wang, Wen; Julian, Druce; Chris, Birch; Lv, Jianxin; Tan, Wenjie
Background Acute respiratory tract infections (ARTIs) represent a serious global health burden. To date, few reports have addressed the prevalence of respiratory viruses (RVs) in adults with ARTIs attending an emergency department (ED). Therefore, the potential impact of respiratory virus infections on such patients remains unknown. Methodology/Principal Findings To determine the epidemiological and clinical profiles of common and recently discovered respiratory viruses in adults with ARTIs a...
Kerkadi, Abdelhamid; Al-Thani, Asma; Al-Boainain, Amina; al Janahi, Ibrahim; Singh, Rajiv
The prevalence of allergic diseases such as asthma, allergic rhinitis and atopic dermatitis have risen at an alarming rate throughout the world in the past 50 years. Sensitization to food (FA) and inhalant allergens (IA) have been associated with an increase of allergic diseases. The objective of this study was to estimate the prevalence of sensitization to FA and IA among children attending Allergy and Asthma Pediatric Clinic in Doha, Qatar. A total of 134 children with age between 1 mont...
C. C. Lim; Armstrong, D.K.; Dinsmore, W W; Maw, R. D.
This study documents the use of prostitutes (commercial sex workers) by new male patients attending a genito urinary medicine clinic. 541 consecutive male patients completed an anonymous self-administered questionnaire. 48 (8.9%) gave a history of previous purchase of sexual services in Northern Ireland and/or elsewhere; 69% of these encounters occurred outside Northern Ireland. The largest group were single men aged 20-29 years. 87% of those who purchased services in Northern Ireland were as...
Full Text Available Mervat M El-Rafie,1 Ghada M Khafagy,2 Marwa G Gamal31Department of Public Health, 2Department of Family Medicine, Faculty of Medicine, Cairo University, Giza, Egypt; 3Family Health Unit, Ministry of Health, Cairo, EgyptBackground: Antenatal depression is not uncommon and is associated with a greater risk of negative pregnancy outcomes.Aim: Exploring the effect of exercise in preventing and treating antenatal depression.Methods: This was a prospective interventional controlled study carried out in 100 pregnant women treated at the Ain-Shams Family Medicine Center and Maadi Outpatient Clinic, Cairo, Egypt. The participants were divided into two groups (n=50 in the exercise group and n=50 in the control group. The exercise group regularly attended supervised sessions for 12 weeks. The activities in each session included walking, aerobic exercise, stretching, and relaxation. The control group completed their usual antenatal care. The Center for Epidemiological Studies Depression Scale (CES-D was used to assess depression symptoms at the first interview and immediately after the 12-week intervention.Results: Compared to the control group, the exercise group showed significantly improved depressive symptoms as measured with the CES-D after the 12-week intervention on the CES-D (P=0.001. Within groups, the exercise group demonstrated a significant improvement of depressive symptoms from baseline to intervention completion, while the control group demonstrated no significant changes over time.Conclusion: Exercise during pregnancy was positively associated with reduced depressive symptoms.Keywords: antenatal depression, pregnant women, exercise
Daniyan S. Y.; M. E. Abalaka
Objective: To evaluate the occurrences of asymptomatic bacteriuria among healthy pregnant women attending ante-natal clinic of General Hospital Minna, Nigeria. To test for sensitivity to commonly used treatments. Methodology: Two hundred mid- stream urine samples were collected in a sterile universal bottle. The cultured plates were examined. The morphological and biochemical characteristics were determined. Results: The bacteria isolates recovered from urine samples includes E. coli 32 (51.6...
Wendel, K; Erbelding, E; Gaydos, C.; Rompalo, A.
Methods: Men attending a public STD clinic in Baltimore, Maryland, were evaluated between March and July 2000. Clinicians recorded a standardised history and clinical examination. Urethral swab specimens were collected for Gram stain and Neisseria gonorrhoeae culture. First fraction urine samples were evaluated with TV culture and chlamydia and TV polymerase chain reaction (PCR). True positive TV was defined as a positive TV culture or a positive TV PCR confirmed with a second primer set.
Imad, Hassan; Yasir, Ged
Introduction This study aims at describing the epidemiological and clinical characteristics, severity, reversibility testing and response to treatment using simple spirometry in asthmatic patients attending a model specialized Asthma Care Center. Methods Eligible subjects must have a suggestive clinical picture and confirmed by spirometry to have a 12% plus 200ml absolute increase in FEV1 either by reversibility testing or after a therapeutic trial with inhaled and/or oral steroid therapy. Bu...
Full Text Available BACKGROUND Congenital anomalies are a global problem, but data on congenital anomalies from developing countries like India are limited. We have tried to study antenatal ultrasound detection of anomalous pregnancies, as it can have an effect not only on patient counselling but also on patient’s decision for or against continuation of pregnancy, if it is diagnosed prior to 20 completed weeks and subsequent management options. AIMS AND OBJECTIVES 1. To study various congenital anomalies in singleton pregnancies detected antenatally by ultrasound examination. 2. To study the incidence of stillbirth in those diagnosed to have congenital anomalies on ultrasound examination. METHODS This was a hospital-based cross-sectional study conducted at a tertiary care hospital over a period of six months from January 2015 to June 2015. All women attending Antenatal Clinic were screened by ultrasound examination. Anomalies included in the study were classified by the organ system affected. All women who were diagnosed with major anomaly before 20 weeks of gestation were given a choice of medical termination of pregnancy. Women diagnosed later were observed closely throughout pregnancy and delivery. OBSERVATIONS AND RESULTS Out of a total of 2535 singleton pregnancies screened, 67 women were sonologically diagnosed to have congenital anomalies. The mean maternal age was 24.7 years. Mean gestational age at the time of diagnosis was 28.5 weeks. Majority women had an abnormal amount of Amniotic Fluid Index (AFI. The mean AFI was 13.7 cm. Central Nervous System affection was the commonest followed by Renal and Cardiovascular System affection. All 9 women who were diagnosed prior to 20 weeks of gestation opted for medical termination of pregnancy. According to our study, the odds that a foetus having a congenital anomaly on Ultrasound examination will die in utero are 4.16 (1.72-10.01. Hence, the association between Congenital Anomaly and Stillbirth was found to be
Full Text Available INTRODUCTION: Antenatal care is a comprehensive antepartum programme which involves a coordinated approach to medical care , continuous risk assessment , and psychological support that optimally begins before conception and extends throughout the postpartum period and int erconceptional period .  One of major responsibility of obstetrician providing antenatal care is to identify high risk factors based on past history, examination and investigation results. The objective of antenatal care therefore is to assure that every wanted pregnancy results in the delivery of a healthy baby without impairing the mothers health .  In a 1914 study by Williams antenatal care reduced fetal mortality by 40%
We have studied retrospectively a total of 650 cases of myopia among 35 00 refractions done in Katuri medical college, Guntur and S anjeevani hospital, Guntur, Andhra Pradesh . 10.1% of the patients of the patients attending Ophthalmic department of K aturi medical college and Sanjeevani hospital Guntur have refractory errors. Mal es are more affected than females. There is family incidence of ...
El-Rafie, Mervat M; Khafagy, Ghada M; Gamal, Marwa G
Background Antenatal depression is not uncommon and is associated with a greater risk of negative pregnancy outcomes. Aim Exploring the effect of exercise in preventing and treating antenatal depression. Methods This was a prospective interventional controlled study carried out in 100 pregnant women treated at the Ain-Shams Family Medicine Center and Maadi Outpatient Clinic, Cairo, Egypt. The participants were divided into two groups (n=50 in the exercise group and n=50 in the control group)....
Mphonda, Steve M; Rosenberg, Nora E; Kamanga, Esmie; Mofolo, Innocent; Mwale, Gertrude; Boa, Edson; Mwale, Mwawi; Martinson, Francis; Hoffman, Irving; Hosseinipour, Mina C
In sub-Saharan Africa, although male involvement in antenatal care is associated with positive outcomes for HIV-infected women and their infants, men rarely accompany female partners. We implemented a project to increase the number of male partners attending an antenatal clinic at Bwaila Hospital in Lilongwe, Malawi. We evaluated changes in the proportion of women who came with a partner over three periods. During period 1 (January 2007 - June 2008) there was didactic peer education. During period 2 (July 2008 - September 2009) a peer-led male-involvement drama was introduced into patient waiting areas. During period 3 (October 2009 - December 2009) changes to clinical infrastructure were introduced to make the clinic more male-friendly. The proportion of women attending ANC with a male partner increased from 0.7% to 5.7%, to 10.7% over the three periods. Peer education through drama and male-friendly hospital infrastructure coincided with substantially greater male participation, although further gains are necessary. PMID:25022146
Seema Kalpesh Patel
Methods: This is a retrospective study. Total 8224 antenatal patients, who attended for first time at antenatal OPD at GMERS Medical College, Sola between April 2012 to March 2014, were included in the study. HIV testing was done by RAPID method after taking informed consent and pre-test counselling as per NACO guideline. Results: Out of total 8224 antenatal patients 7921 (96% patient opted for HIV testing. Seroprevalence of HIV is found to be 15/7921 (0.19%. 7044/7921 (88.93% women attended post-test counselling. 12/15 (80% HIV positive women accepted post-test counselling.12/15 (80% spouses accepted testing for HIV. 8/12 (66.66% spouses of HIV positive women were also found to be HIV positive. Conclusions: The seroprevalence of HIV infection in antenatal women is low. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 662-665
Full Text Available We have studied retrospectively a total of 650 cases of myopia among 35 00 refractions done in Katuri medical college, Guntur and S anjeevani hospital, Guntur, Andhra Pradesh . 10.1% of the patients of the patients attending Ophthalmic department of K aturi medical college and Sanjeevani hospital Guntur have refractory errors. Mal es are more affected than females. There is family incidence of myopia in 15% . About 86% of cases come with difficulty in seeing distant objects, and 12% with head ache. Highest diaptoric power of myopia recorded is - 22D. Only a single case of retinal deta chment was noted in our study
Brixval, Carina Sjöberg; Thygesen, Lau Caspar; Axelsen, Solveig Forberg;
reduce fear during birth which in turn may decrease use of pain relief. Few randomised trials have examined the effect of attending antenatal education in small groups on use of epidural analgesia and among these conclusions are conflicting. The objective of this study was therefore to examine the effect...... of an antenatal education program in small classes on use of epidural analgesia. Methods: Data from the NEWBORN trial were used. A total of 1766 women from the Copenhagen area, Denmark were randomized to participate in either antenatal education in small groups or standard care. Data were analysed...
Full Text Available Abstract Background Over the last 30 years the number of people who drink alcohol at harmful levels has increased in many countries. There have also been large increases in rates of sexually transmitted infections. Available evidence suggests that excessive alcohol consumption and poor sexual health may be linked. The prevalence of harmful alcohol use is higher among people attending sexual health clinics than in the general population, and a third of those attending clinics state that alcohol use affects whether they have unprotected sex. Previous research has demonstrated that brief intervention for alcohol misuse in other medical settings can lead to behavioral change, but the clinical- and cost-effectiveness of this intervention on sexual behavior have not been examined. Methods We will conduct a two parallel-arm, randomized trial. A consecutive sample of people attending three sexual health clinics in London and willing to participate in the study will be screened for excessive alcohol consumption. Participants identified as drinking excessively will then be allocated to either active treatment (Brief Advice and referral for Brief Intervention or control treatment (a leaflet on healthy living. Randomization will be via an independent and remote telephone randomization service and will be stratified by study clinic. Brief Advice will comprise feedback on the possible health consequences of excessive alcohol consumption, written information about alcohol and the offer of an appointment for further assessment and Brief Intervention. Follow-up data on alcohol use, sexual behavior, health related quality of life and service use will be collected by a researcher masked to allocation status six months later. The primary outcome for the study is mean weekly alcohol consumption during the previous three months, and the main secondary outcome is the proportion of participants who report unprotected sex during this period. Discussion Opportunistic
Heredia-Pi, Ileana; Darney, Blair G; Reyes-Morales, Hortensia; Lozano, Rafael
Abstract Objective To propose an antenatal care classification for measuring the continuum of health care based on the concept of adequacy: timeliness of entry into antenatal care, number of antenatal care visits and key processes of care. Methods In a cross-sectional, retrospective study we used data from the Mexican National Health and Nutrition Survey (ENSANUT) in 2012. This contained self-reported information about antenatal care use by 6494 women during their last pregnancy ending in live birth. Antenatal care was considered to be adequate if a woman attended her first visit during the first trimester of pregnancy, made a minimum of four antenatal care visits and underwent at least seven of the eight recommended procedures during visits. We used multivariate ordinal logistic regression to identify correlates of adequate antenatal care and predicted coverage. Findings Based on a population-weighted sample of 9 052 044, 98.4% of women received antenatal care during their last pregnancy, but only 71.5% (95% confidence interval, CI: 69.7 to 73.2) received maternal health care classified as adequate. Significant geographic differences in coverage of care were identified among states. The probability of receiving adequate antenatal care was higher among women of higher socioeconomic status, with more years of schooling and with health insurance. Conclusion While basic antenatal care coverage is high in Mexico, adequate care remains low. Efforts by health systems, governments and researchers to measure and improve antenatal care should adopt a more rigorous definition of care to include important elements of quality such as continuity and processes of care. PMID:27274597
Y. Ramesh Bhat
Full Text Available Antenatal Bartter syndrome (ABS is a rare autosomal recessive renal tubular disorder. The defective chloride transport in the loop of Henle leads to fetal polyuria resulting in severe hydramnios and premature delivery. Early onset, unexplained maternal polyhydramnios often challenges the treating obstetrician. Increasing polyhydramnios without apparent fetal or placental abnormalities should lead to the suspicion of this entity. Biochemical analysis of amniotic fluid is suggested as elevated chloride level is usually diagnostic. Awareness, early recognition, maternal treatment with indomethacin, and amniocentesis allow the pregnancy to continue. Affected neonates are usually born premature, have postnatal polyuria, vomiting, failure to thrive, hypercalciuria, and subsequently nephrocalcinosis. Hypokalemia, metabolic alkalosis, secondary hyperaldosteronism and hyperreninaemia are other characteristic features. Volume depletion due to excessive salt and water loss on long term stimulates renin-angiotensin-aldosterone system resulting in juxtaglomerular hyperplasia. Clinical features and electrolyte abnormalities may also depend on the subtype of the syndrome. Prenatal diagnosis and timely indomethacin administration prevent electrolyte imbalance, restitute normal growth, and improve activity. In this paper, authors present classification, pathophysiology, clinical manifestations, laboratory findings, complications, and prognosis of ABS.
Full Text Available Background: Physiotherapy plays an essential role in obstetrics, both in the antenatal and postnatal periods. Antenatal exercises are recommended for the health benefits and safe delivery that they secure of pregnant mothers. However, studies on the efficacy of this approach in developing countries like India are limited in literature.The objective of this study was to determine knowledge, perception, and attitude of pregnant women towards the role of physical therapy in antenatal care. Methods: A descriptive survey research design was used for this cross-sectional study. A total of 106 pregnant women attending regular antenatal checkups in tertiary care centers in Mangalore, Karnataka, India were recruited. Data were obtained on maternal characteristics, knowledge, perception, and attitude towards the role of physiotherapy in antenatal care. Results: 46% of subjects knew about antenatal exercises. The majority of them were not aware or not sure about the different type of antenatal exercises avaliable.60% of the respondents had a positive attitude to physiotherapy during antenatal care. However, only 30% of the participants had adequate knowledge of the benefits of antenatal exercise and this was not influenced by maternal sociodemographic characteristics. Conclusion: A majority of Indian pregnant women demonstrate inadequate knowledge but have positive attitude towards role of physiotherapy in antenatal care.
Ikeoluwapo O. Ajayi
Full Text Available A cross sectional study was conducted in Primary Health Centers among pregnant women to elucidate adequacy of antenatal care across different socio demographic variables. Four hundred respondents were proportionately selected from 18 primary health centers using simple random sampling. Exit interviews were conducted using the adapted antenatal care exit interview form of the Safe Motherhood Needs Assessment package. Data was analyzed using descriptive statistics and Chi square test. Adequacy of antenatal care in this study was measured by the single adequacy indicators which are duration of pregnancy at entry into antenatal care and number of antenatal visits; which are particularly suitable for developing countries. Age of respondents, means of transportation to the PHCs, occupation, location and level of education of the respondents were found to be determinants of whether the pregnant women attended their first antenatal visit in the first trimester, similarly, age of the respondents was a predictor of whether the women made up to four antenatal visits by their third trimester. Occupation and level of education were determinants of whether or not the pregnant women made their first antenatal visits at the first trimester. More respondents who were not working and those who were unskilled workers made their first antenatal visit at the first trimester compared to those who were skilled workers; work place policies and the fact that antenatal booking are made on weekdays and at work hours may hinder or be discouraging to the working class mothers.
Gayle, Krystal A.T.; Tulloch-Reid, Marshall K.; Younger, Novie O; Francis, Damian K.; Shelly R. McFarlane; Wright-Pascoe, Rosemarie A.; Boyne, Michael S.; Wilks, Rainford J; Ferguson, Trevor S
This study aimed to estimate the proportion of patients at the University Hospital of the West Indies (UHWI) Diabetes Clinic who engage in recommended foot care and footwear practices. Seventy-two participants from the UHWI Diabetes Clinic completed an interviewer-administered questionnaire on foot care practices and types of footwear worn. Participants were a subset of a sex-stratified random sample of clinic attendees and were interviewed in 2010. Data analysis included frequency estimates ...
Wilkinson Shelley A
Full Text Available Abstract Background Pregnancy is an ideal time to encourage healthy lifestyles as most women access health services and are more receptive to health messages; however few effective interventions exist. The aim of this research was to deliver a low-intensity, dietitian-led behavior change workshop at a Maternity Hospital to influence behaviors with demonstrated health outcomes. Methods Workshop effectiveness was evaluated using an RCT; ‘usual care’ women (n = 182 received a nutrition resource at their first antenatal visit and 'intervention' women also attended a one-hour ‘Healthy Start to Pregnancy’ workshop (n = 178. Dietary intake, physical activity levels, gestational weight gain knowledge, smoking cessation, and intention to breastfeed were assessed at service-entry and 12 weeks later. Intention-to-treat (ITT and per-protocol (PP analyses examined change over time between groups. Results Approximately half (48.3% the intervention women attended the workshop and overall response rate at time 2 was 67.2%. Significantly more women in the intervention met pregnancy fruit guidelines at time 2 (+4.3%, p = 0.011 and had a clinically-relevant increase in physical activity (+27 minutes/week compared with women who only received the resource (ITT. Women who attended the workshop increased their consumption of serves of fruit (+0.4 serves/day, p = 0.004, vegetables (+0.4 serves/day, p = 0.006, met fruit guidelines (+11.9%, p , had a higher diet quality score (p = 0.027 and clinically-relevant increases in physical activity (+21.3 minutes/week compared with those who only received the resource (PP. Conclusions The Healthy Start to Pregnancy workshop attendance facilitates improvements in important health behaviors. Service changes and accessibility issues are required to assist women's workshop attendance to allow more women to benefit from the workshop’s effects. Trial registration Australian New Zealand Clinical Trials Registry ACTRN
for other risk factors. Conclusion Risk factor profiles for antenatal depression, postnatal depression and parenting stress differ but are interrelated. Antenatal depression was the strongest predictor of postnatal depression, and in turn postnatal depression was the strongest predictor for parenting stress. These results provide clinical direction suggesting that early identification and treatment of perinatal depression is important.
Jeppesen, Maja Haunstrup; Ainsworth, Mark Andrew
in a gastroenterology outpatient clinic like ours. METHODS: This was a comparative intervention study with a historical control group in a gastroenterology outpatient clinic. The study lasted six months. Patients with a scheduled appointment in the first three-month period received no reminder...
E A Etukumana
Full Text Available Background: Obstetrics risk and practices can lead to the spread of HIV/AIDS. Identification of such obstetrics risk of HIV infection is a useful step in the prevention of transmission of the virus. Objective: We sought to determine obstetrics risk of HIV infection in pregnant women attending antenatal clinic in a rural Northern Nigerian hospital. Methods: We conducted a cross-sectional descriptive study of pregnant women attending antenatal clinic of a rural mission hospital in northern Nigeria between June and October 2005. Data were collected using structured questionnaire. HIV screening and confirmation was carried out on pregnant women after voluntary counseling. Results: 350 pregnant women were enrolled with a mean age (±SD of 26.8± 6.4years. The highest number of HIV infected women was observed in those who had their first coitus between 16 and 20 years. The age at first coitus was not significantly related to the HIV infection (P=0.41. Neither parity (P=0.13 nor past history of abortion (P=0.42 was associated with HIV infection. None of the 41 women who had their last delivery at home had HIV infection compared with 9.8% of the 194 women who delivered in the hospital or clinic (P=0.008. Forty percent of those who had their last delivery in primary health centre had HIV infection while 22.2% of those who delivered under the care of traditional birth had HIV infection. Conclusion: Obstetrics practices may encourage transmission of HIV infection. This calls for re-examination of the obstetrics practices especially in our primary health centers in order to prevent transmission of HIV infection.
Amar D Bavle
Full Text Available Context: Antenatal depression is not easily visible, though the prevalence is high. The idea of conducting this study was conceived from this fact. Aims and Objectives: The aim of this study was to estimate the prevalence of antenatal depression and identify the risk factors, for early diagnosis and intervention. Settings and Design: The study conducted in a Tertiary Care Hospital was prospective and cross-sectional. Materials and Methods: Pregnant women between 18 and 40 years of age were studied. The sample size comprised 318 women. They were assessed using Edinburgh Postnatal Depression Scale (EPDS score, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders, Life Event Stress Scale (LESS, and Life Distress Inventory (LDI. Statistical Analysis Used: The Statistical Package for Social Sciences (SPSS Version 15 software was used to measure percentages, mean, correlation, and P < 0.05 were considered significant. Results: Prevalence of antenatal depression in the study was 12.3%. Correlation of the sociodemographic factors, obstetric factors, LDI, and LESS with EPDS scores showed statistical significance for unplanned pregnancy, distress associated with relationships, physical health, financial situation, social life, presence of personality disorder, being a homemaker, and higher educational status. Conclusion: The study showed a high prevalence rate of depression and identified risk factors.
Ebuehi OM; Akintujoye IA
Olufunke M Ebuehi, IA AkintujoyeReproductive and International Health Unit, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, NigeriaBackground: In developing countries, most childbirth occurs at home and is not assisted by skilled attendants. This situation increases the risk of death for both mother and child and has severe maternal and neonatal health complications. The purpose of this study was to explore pregnant women’s perceptio...
Tunde Joshua Ogunrinde
Full Text Available Background: Good denture care practice by individuals using Removable Partial Denture (RPD is an important component of oral health measures. An assessment of denture care practice of such individuals by dental care practitioners is necessary. Objective : To evaluate the denture care practice among prosthetics patients attending a tertiary Hospital Dental Centre in Nigeria. Materials and Methods: An interviewer administered questionnaire was used to obtain information from RPD wearers that were willing to participate. The questionnaire assessed among other things, patients′ bio-data, frequency, techniques and device used for cleaning their dentures. Data was analyzed using Chi-square test (P < 0.05. Results: One hundred and ninety eight denture wearers consisting of 100 (50.5% males and 98 (49.5% females participated in the study. Majority 110 (55.6% cleaned their dentures once daily and toothbrush and pastes were used by 105 (53% of the participants. More than 70% of the respondents removed their dentures at night. One hundred and sixty-six (83.8% visited the dentist only when they needed treatment. There was a statistical significant relationship between frequency and technique of cleaning denture, and denture cleanliness (P < 0.05. Conclusion: This study shows that once daily cleaning of dentures and cleaning the denture with rest of the teeth are ineffective in prevention of plaque accumulation.
Full Text Available The aim of this study was to determine nutrition knowledge and dietary practices of hypertensive adults attending hypertensive clinics at Day Hospitals in the Cape Metropole. Ten Day Hospitals were randomly selected from a total of 31 Day Hospitals and the first participants attending the hypertension clinics per day were recruited. A total of 85 participants were evaluated. The weight, height, waist and hip circumference of each participant was measured, as well as their blood pressure. Knowledge of dietary intake was obtained by completing a questionnaire, during an interview with the patient. Knowledge regarding salt usage indicated that a large percentage (34.1 % of participants believed that flavour enhancers like Aromat or Fondor could safely be used instead of table salt. Furthermore, 23.5% reported that tinned and smoked meat or fish have a low sodium (salt content. Fruit and vegetables were perceived as having a positive effect on hypertension by 74.1 % of participants. However, only 15% of the group knew that the recommendation for their usage was five or more servings per day. Only 12.9% of participants in this study had a normal weight (body mass index (BMI < 25, 25.9% were overweight (BMI 25 - 29.9 and 61.2% were obese (BMI ≥ 30; 84.7% recognized the association between obesity and hypertension. A large waist circumference (> 88cm in women; 102cm in men was found in 61.2% of participants, however, only 18.2% of black men had such a measurement. Uncontrolled blood pressure readings (> 140/90mm Hg were found in 61.2% of these patients at the hypertension clinics.
Yu. V. Semenova; N.P. Kutishenko; S.Yu. Martsevich
The aim of this review was to study a problem of outpatient non-attendance by the analysis of relevant literature data. Pubmed and Cyberlenica articles and abstracts, published in 1966-2015, concerning the problem of non-attendance at outpatient clinics and cardiac rehabilitation programs, were used as data sources. The search included articles that reviewed the prevalence of outpatient non-attendance, reasons for it, it’s effect on disease outcomes and search for possible ways of its correct...
Marcano-Belisario, José S; Gupta, Ajay K; O'Donoghue, John; Morrison, Cecily; Car, Josip
Introduction Depression is one of the most common mental health disorders that may affect women during pregnancy. The prompt identification of this disorder, and the provision of treatment, may help to reduce the likelihood of post-partum depression, prevent severe forms of the disease, and reduce its intergenerational impact. Despite women's repeated encounters with health services throughout their antenatal care, depression often goes undiagnosed. This is one area where mobile health could prove useful. We will assess the feasibility of using tablets to incorporate depression screening into antenatal pathways. We will also assess if survey layout could affect the quality of the data collected through these devices. Methods and analysis We will test the feasibility of using iPad Airs for the administration of the Whooley questions and the Edinburgh Postnatal Depression Scale (EPDS) to pregnant women attending antenatal clinics in England. We will assess the impact of survey layout on the quality of the responses given to these screening scales using a parallel, randomised controlled study design. We will calculate the positive predictive value, the negative predictive value and the false omission rate of the Whooley questions in comparison with the EPDS. We will calculate differences in data equivalence, time needed to complete the surveys, break-off rates, data completeness and requests for help between the 2 experimental groups: using all questions in one screen and navigation by vertical scrolling, or a single question per screen and navigation by multiple pages. Ethics and dissemination This study has been approved by the National Research Ethics Service Committee South East Coast—Surrey. Our findings will be disseminated through academic peer-reviewed publications, conferences and discussion with peers. PMID:26801468
de la Torre, J; Coll, C; Coloma, M; Martín, J I; Padrón, E; González González, N L
The phenomenon of immigration has had an impact on the health care of the population. The immigrant population in Spain today represents approximately 8% of the total population. The majority of this population proceeds from countries with low income, and its origin and distribution is diverse. The immigrant population is characterised by its being young and healthy, and with a capacity to adapt to changes, but its social, economic and labour conditions are frequently insecure and favour vulnerability to disease. In spite of the number of immigrants of the male sex being globally higher than that of women, the percentage of immigrants of the female sex is growing. This increase of the female immigrant population has resulted in the appearance of specific health care needs, especially with respect to sexual and reproductive health. To which we must add a substantial increase in pathologies prevalent in the countries of origin, such as anaemia, tuberculosis, malnutrition, haemoglobinopathies, consanguinity, hypocalcaemia, hepatitis B and/or C, sexually transmitted infections, infectious diseases transmitted by arthropods, such as Chagas disease and other parasitoses, as well as genital mutilations. The aim of this article is to analyse the factors that make it difficult to control gestation in the immigrant population, as well as to establish guidelines for acting in antenatal care consultations. Insistence is placed on health education and prevention during pregnancy, and consideration is given to the appearance of rare diseases related to some of these groups. PMID:16721417
Wilcox, Gabrielle; Schroeder, Meadow
Psychoeducational assessment involves collecting, organizing, and interpreting a large amount of data from various sources. Drawing upon psychological and medical literature, we review two main approaches to clinical reasoning (deductive and inductive) and how they synergistically guide diagnostic decision-making. In addition, we discuss how the…
Handy, Pauline; Sankar, K. Nathan
Objective: To elicit the level of knowledge, training and preferences of men in relation to Testicular Self Examination (TSE). Setting: The Genito Urinary Medicine (GUM) department of a large teaching hospital in the North East of England. The open access clinic serves patients from Newcastle upon Tyne, Northumberland, Gateshead and surrounding…
Sonal A. Bhuyar
Full Text Available Background: Objective was to study the seroprevalence of human immunodeficiency virus (HIV in antenatal patients and to find out the incidence of mother to child transmission (MTCT using single dose nevirapine (sdNVP to mother- baby pairs in labour. Methods: This prospective study was conducted in the department of Obstetrics and Gynecology, Dr. PDMMC, Amravati, Maharashtra from February 2010 to May 2015. All pregnant women attending the antenatal clinic were subjected to pretest counseling and HIV testing after informed consent. The HIV +ve pregnant patients who opted for delivery at our hospital were included in the study. sdNVP was administered to mother- baby pairs according to NACO guidelines. Babies of these patients were followed up to 18 months of age for HIV testing. Results: 12077 antenatal patients underwent pretest counseling. 11957 antenatal patients were tested for HIV of which 28 were detected positive. Therefore, the seroprevalence in this study was found to be 0.23%. 23 patients delivered at our hospital during the study period and babies of 2 patients tested positive for HIV. Hence the incidence of MTCT was found to be 9.5% in our study. Conclusions: Universal screening of pregnant patients for HIV and judicious use of PPTCT regimens can significantly reduce MTCT of HIV and prevalence of pediatric HIV infection. Single dose nevirapine use over last few years has successfully reduced MTCT, but our aim should be to reduce it further with more effective ART regimens for the seropositive antenatal patients and their babies. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1436-1441
Full Text Available Background: In the past few years, the interest in STDs and their management has increased tremendously because of their proven role in facilitation of HIV infection, which, in turn, also increases the risk of acquiring STIs. Sexually transmitted diseases (STDs are a major health problem affecting mostly young people, not only in developing, but also in developed countries Male circumcision is being considered as strategy to reduce the burden of HIV/AIDS. Aims: (i To screen the new patients attending the STI clinic for bacterial causes of STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Gardnerella vaginalis and (ii to evaluate the role of various risk factors in the prevalence of STIs. Materials and Methods: The present study was conducted on 200 patients attending the STI clinic. They were evaluated for the prevalence of HIV and bacterial STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum and Gardnerella vaginalis along with the role of risk factors particularly circumcision. Results: The prevalence of HIV was 7% and prevalence of other STI was 20%. The causative agents were Chlamydia 8%, Gonorrhea 7.5%, Bacterial Vaginosis 2.7% and Syphilis 2%. Conclusion: The factors found to be significantly associated with the prevalence of STI were circumcision, positive HIV status, education, religion, multiple sexual partners, contact with Commercial sex workers (CSW, non use of contraception, profession involving long stay away from home, and past history of STI. The present study suggests that circumcision is a protective factor for acquisition of STIs but other factors like sexual behavior, use of barrier contraceptives, drug abuse etc., also play a role.
Full Text Available Objective: To determine the extent of disclosure and factors associated with disclosure of HIV status to sexual partners, we interviewed HIV infected adults attending the centralized HIV clinics seeking medical care for HIV. Methods: The subjects were patients who attended the LRU for primary care and treatment of their HIV infection during the three months period of this study enrolment. Patients were asked to participate in this study after initial clinical care was performed, in a 30-minute standardized interview concerning behavioral, medical, and social history. Results: The study patients had the following characteristics: female, 42.7%; male, 57.3%; singles, 84.5%; married, 11.8%. The median age of respondents was 35 years, and 66.4% were employed. Seventy nine percent were sexually active, and of these 72% had a steady sex partner and 61% had one or more casual partners. Over all 64 (58.2% of those interviewed, had disclosed their HIV status to significant others. Of the sixty three persons who had a steady partner 71.4% had self disclosed their HIV status to one or more steady partners. Of the fifty three persons who had one or more casual partners, 26.4% had self-disclosed their status to one or more casual partners. The most common reasons listed for nondisclosure to spouse or significant other were stigma/discrimination, fear of spread of information, rejection. Conclusion: Our findings suggest that both the knowing and unknowing sexual partners of HIV-infected persons continue to be at risk for HIV transmission.
Chan, S C
The practice of breast self-examination (BSE) amongst 1,303 women registered with the Well Person's Clinic, Outpatient Department, Hospital Ipoh between April 1995 and March 1997 were assessed through a questionnaire. Majority (98.2%) were never taught and did not practise BSE, 17(1.3%) practised BSE while 6 (0.5%) were taught BSE but failed to put it into practice. Only 5.8% of 52 women with past/family history of breast cancer/lump and 2.9% of 207 women with past/family history of other cancers were practising BSE regularly. Three out of 64 women with breast lumps found on clinical breast examination discovered the lumps themselves. Five of the 64 women were subsequently confirmed to have breast carcinoma. PMID:11072459
Meynard, Anne; Genequand, Lydia Markham; Jeannot, Emilien; Wyler-Lazarevic, Claire-Anne; Cerutti, Bernard; Narring, Françoise
Adolescent vaccination coverage is very variable in European countries and data are scarce. The aim of this study was to assess immunization status and analyze potential variations according to sociodemographic variables in a youth clinic in Geneva, Switzerland. Immunization status was assessed retrospectively: Tetanus (number of doses or in absence of data tetanus antibodies) and measles as indicators of childhood coverage as well as hepatitis B and human papillomavirus. All new patients (N = 390) of Geneva University Hospital's youth clinic were included between January 2010 and June 2011. Vaccine coverage was low for all vaccines regardless of sex or origin. 89 % of young people tested (mostly recent immigrants with no available data) had tetanus antibodies indicating adequate childhood immunization but hepatitis B and HPV coverage was low especially in recent immigrants. Systematic assessment allows better adolescent vaccine coverage and can improve safety by avoiding unnecessary dosis. PMID:25774037
Russell, Sushila; Subramanian, Balakrishnan; Russell, Paul Swamidhas Sudhakar
Background In developing countries, primary health care facilities, such as adolescent health clinics, are frequently the first contact for an adolescent with a health professional for a myriad of health problems including mental health issues. Psychopathology is prevalent among adolescents, and causes significant educational, occupational and social impairment. The presence of psychopathology with impairment requires the development of treatment models to address both of these components. We...
Birtchnell, S.; Lacey, J H
Women presenting for breast augmentation and breast reduction to a National Health Service plastic surgery/psychiatry liaison clinic appear to differ beyond the anatomical. Those requesting breast reduction tend to be younger, unmarried and not to have been pregnant and may be uncomfortable with adult sexuality. Those requesting breast augmentation are presenting for surgery in their mid-thirties although many have always had small breasts. This is at a time of fading attractiveness, marital ...
Gayle, Krystal A T; Tulloch Reid, Marshall K; Younger, Novie O; Francis, Damian K; McFarlane, Shelly R; Wright-Pascoe, Rosemarie A; Boyne, Michael S; Wilks, Rainford J; Ferguson, Trevor S
This study aimed to estimate the proportion of patients at the University Hospital of the West Indies (UHWI) Diabetes Clinic who engage in recommended foot care and footwear practices. Seventy-two participants from the UHWI Diabetes Clinic completed an interviewer-administered questionnaire on foot care practices and types of footwear worn. Participants were a subset of a sex-stratified random sample of clinic attendees and were interviewed in 2010. Data analysis included frequency estimates of the various foot care practices and types of footwear worn. Participants had a mean age of 57.0±14.3 years and mean duration of diabetes of 17.0±10.3 years. Fifty-three percent of participants reported being taught how to care for their feet, while daily foot inspection was performed by approximately 60% of participants. Most participants (90%) reported daily use of moisturizing lotion on the feet but almost 50% used lotion between the toes. Approximately 85% of participants reported wearing shoes or slippers both indoors and outdoors but over 40% reported walking barefoot at some time. Thirteen percent wore special shoes for diabetes while over 80% wore shoes without socks at some time. Although much larger proportions reported wearing broad round toe shoes (82%) or leather shoes (64%), fairly high proportions reported wearing pointed toe shoes (39%), and 43% of women wore high heel shoes. In conclusion, approximately 60% of patients at the UHWI diabetic clinic engage in daily foot inspection and other recommended practices, but fairly high proportions reported foot care or footwear choices that should be avoided. PMID:24765484
Krystal A.T. Gayle
Full Text Available This study aimed to estimate the proportion of patients at the University Hospital of the West Indies (UHWI Diabetes Clinic who engage in recommended foot care and footwear practices. Seventy-two participants from the UHWI Diabetes Clinic completed an interviewer-administered questionnaire on foot care practices and types of footwear worn. Participants were a subset of a sex-stratified random sample of clinic attendees and were interviewed in 2010. Data analysis included frequency estimates of the various foot care practices and types of footwear worn. Participants had a mean age of 57.0±14.3 years and mean duration of diabetes of 17.0±10.3 years. Fifty-three percent of participants reported being taught how to care for their feet, while daily foot inspection was performed by approximately 60% of participants. Most participants (90% reported daily use of moisturizing lotion on the feet but almost 50% used lotion between the toes. In conclusion, approximately 85% of participants reported wearing shoes or slippers both indoors and outdoors but over 40% reported walking barefoot at some time. Thirteen percent wore special shoes for diabetes while over 80% wore shoes without socks at some time. Although much larger proportions reported wearing broad round toe shoes (82% or leather shoes (64%, fairly high proportions reported wearing pointed toe shoes (39%, and 43% of women wore high heel shoes. Approximately 60% of patients at the UHWI diabetic clinic engage in daily foot inspection and other recommended practices, but fairly high proportions reported foot care or footwear choices that should be avoided.
Full Text Available Abstract Background To reduce the intolerable burden of malaria in pregnancy, the Ministry of Health in Uganda improved the antenatal care package by including a strong commitment to increase distribution of insecticide-treated nets (ITNs and introduction of intermittent preventive treatment with sulphadoxine-pyrimethamine for pregnant women (IPTp-SP as a national policy in 2000. This study assessed uptake of both ITNs and IPTp-SP by pregnant women as well as antenatal and maternity care use with the aim of optimizing their delivery. Methods 769 post-partum women were recruited from a rural area of central Uganda with perennial malaria transmission through a cross-sectional, community-based household survey in May 2005. Results Of the 769 women interviewed, antenatal clinic (ANC attendance was high (94.4%; 417 (57.7% visiting initially during the 2nd trimester, 242 (33.5% during the 3rd trimester and 266 (37.1% reporting ≥ 4 ANC visits. About 537 (71% and 272 (35.8% received one or ≥ 2 IPTp-SP doses respectively. Only 85 (15.8% received the first dose of IPTp-SP in the 3rd trimester. ITNs were used by 239 (31.3% of women during pregnancy and 314 (40.8% delivered their most recent pregnancy outside a health facility. Post-partum women who lacked post-primary education were more likely not to have attended four or more ANC visits (odds ratio [OR] 3.3, 95% confidence interval [CI] 1.2–9.3. Conclusion These findings illustrate the need to strengthen capacity of the district to further improve antenatal care and maternity services utilization and IPTp-SP uptake. More specific and effective community health strategies to improve effective ANC, maternity services utilization and IPTp-SP uptake in rural communities should be undertaken.
Full Text Available Abstract Background Nearly half the world’s babies are born at home. We sought to evaluate the training, knowledge, skills, and access to medical equipment and testing for home birth attendants across 7 international sites. Methods Face-to-face interviews were done by trained interviewers to assess level of training, knowledge and practices regarding care during the antenatal, intrapartum and postpartum periods. The survey was administered to a sample of birth attendants conducting home or out-of-facility deliveries in 7 sites in 6 countries (India, Pakistan, Guatemala, Democratic Republic of the Congo, Kenya and Zambia. Results A total of 1226 home birth attendants were surveyed. Less than half the birth attendants were literate. Eighty percent had one month or less of formal training. Most home birth attendants did not have basic equipment (e.g., blood pressure apparatus, stethoscope, infant bag and mask manual resuscitator. Reporting of births and maternal and neonatal deaths to government agencies was low. Indian auxilliary nurse midwives, who perform some home but mainly clinic births, were far better trained and differed in many characteristics from the birth attendants who only performed deliveries at home. Conclusions Home birth attendants in low-income countries were often illiterate, could not read numbers and had little formal training. Most had few of the skills or access to tests, medications and equipment that are necessary to reduce maternal, fetal or neonatal mortality.
Xia, Wei; Chiu, Yu-Han; Afeiche, Myriam C; Williams, Paige L; Ford, Jennifer B; Tanrikut, Cigdem; Souter, Irene; Hauser, Russ; Chavarro, Jorge E
Intake of full-fat dairy has been linked to lower semen quality but whether this leads to decreased fertility is unknown. To address this question, we prospectively evaluated the association of men's dairy intake with treatment outcomes of subfertile couples undergoing assisted reproductive technology (ART). We followed 142 men from couples undergoing infertility treatment with ART at an academic fertility centre between 2007 and 2014. Couples completed dietary assessments prior to treatment, and the female partners underwent a total of 248 ART cycles. Multivariable generalized linear mixed models were used to examine the association of dairy intake with fertilization, implantation, clinical pregnancy and live birth rates adjusting for age, body mass index, smoking status, total exercise time, dietary patterns, alcohol, caffeine, total energy intake, and female dairy intake. Intake of dairy foods, regardless of their fat content, was not associated with fertilization, implantation, clinical pregnancy or live birth rates. The adjusted live birth rates (95% confidence interval) for couples in increasing quartiles of men's dairy intake were 0.42 (0.25, 0.60), 0.25 (0.13, 0.42), 0.26 (0.15, 0.41), and 0.44 (0.27, 0.63) (p linear trend = 0.73). Results remained similar after adjustment for female partner intake of dairy foods. Overall, men's dairy intake was not associated with treatment outcomes of couples undergoing ART. PMID:26825777
Full Text Available Background and Objectives: Studying gender differences among suicide attempters is important for identifying gender-specific risk factors and for planning management and prevention. Our objective was to delineate gender differences among a well-defined group of suicide attempters. Materials and Methods: This record-based study was conducted among patients presenting to a Crisis Intervention Clinic in a Tertiary Care Hospital in South India. Information was gathered regarding sociodemographic and clinical characteristics. Hopelessness was measured using Beck Hopelessness Scale (BHS, and stress was evaluated using Presumptive Stressful Life Events Scale (PSLES. Results: The sample comprised of 162 males and 137 females. Males were significantly older and were more likely to be employed as compared to females. Alcohol use was significantly more in males and number of men who attempted suicide under intoxication was significantly higher. Females had a greater proportion of attempts with the use of plant poisons and medication overdose. There was no significant difference between two genders on BHS though differences were noted on types of stresses reported on PSLES. Conclusion: Gender-specific differences were noted with regard to substance use, mode of attempt and types of stressors experienced. Identifying these factors might help us to design targeted interventions to prevent further attempts.
Hassan A Elechi
Full Text Available Background: Malaria has remained an important public health problem in Nigeria with children under 5 years of age bearing the greatest burden. Accurate and prompt diagnosis of malaria is an important element in the fight against the scourge. Due to the several limitations of microscopy, diagnosis of malaria has continued to be made based on clinical ground against several World Health Organization (WHO recommendations. Thus, we aim to assess the performance of empirical clinical diagnosis among febrile children under 5 years of age in a busy pediatric outpatient clinic. Materials and Methods: The study was a cross-sectional study. Children aged <5 years with fever or 72 h history of fever were recruited. Children on antimalarial prophylaxis or on treatment for malaria were excluded. Relevant information was obtained from the caregiver and clinical note of the child using interviewer administered questionnaire. Two thick and two thin films were made, stained, and read for each recruited child. Data was analysed using SPSS version 16. Results: Of the 433 children studied, 98 (22.6% were empirically diagnosed as having malaria and antimalarial drug prescribed. Twenty-three (23.5% of these children were confirmed by microscopy to have malaria parasitemia, while 75 (76.5% were negative for malaria parasitemia. Empirical clinical diagnosis show poor predictive indices with sensitivity of 19.2%, specificity of 76.0%, positive predictive value of 23.5% and negative predictive value of 71%. Conclusion and Recommendations: Empirical clinical diagnosis of malaria among the under-five children with symptoms suggestive of acute malaria is highly not reliable and hence the need to strengthen parasitological diagnosis.
Full Text Available Danai Tavonga Zhou,1,2 Vitaris Kodogo,1 Kudzai Fortunate Vongai Chokuona,1 Exnevia Gomo,1 Olav Oektedalen,3 Babill Stray-Pedersen21Department of Medical Laboratory Sciences, College of Health Sciences, University of Zimbabwe, Avondale, Zimbabwe; 2Institute of Clinical Medicine, University in Oslo, Oslo University Hospital, Oslo, Norway; 3Department of Infectious Diseases, Oslo University Hospital, Oslo, NorwayAbstract: The chronic inflammation induced by human immunodeficiency virus (HIV contributes to increased risk of coronary heart disease (CHD in HIV-infected individuals. HIV-infected patients generally benefit from being treated with antiretroviral drugs, but some antiretroviral agents have side effects, such as dyslipidemia and hyperglycemia. There is general consensus that antiretroviral drugs induce a long-term risk of CHD, although the levels of that risk are somewhat controversial. The intention of this cross-sectional study was to describe the lipid profile and the long-term risk of CHD among HIV-positive outpatients at an HIV treatment clinic in Harare, Zimbabwe. Two hundred and fifteen patients were investigated (females n=165, mean age 39.8 years; males n=50; mean age 42.0 years. Thirty of the individuals were antiretroviral-naïve and 185 had been on antiretroviral therapy (ART for a mean 3.9±3.4 years. All participants had average lipid and glucose values within normal ranges, but there was a small difference between the ART and ART- for total cholesterol (TC and high-density lipoprotein (HDL.Those on a combination of D4T or ZDV/NVP/3TC and PI-based ART were on average oldest and had the highest TC levels. Framingham risk showed 1.4% prevalence of high CHD risk within the next ten years. After univariate analysis age, sex, TC/HDL ratio, HDL, economic earnings and systolic BP were associated with medium to high risk of CHD. After multivariate regression analysis and adjusting for age or sex only age, sex and economic earnings
Joseph, Nitin; Nagaraj, Kondagunta; Saralaya, Vittal; Nelliyanil, Maria; Rao, PP Jagadish
Introduction: Menopausal symptoms experienced by women are known to affect their quality-of-life. The symptoms experienced at menopause are quite variable and their etiology is found to be multifactorial. This study was hence done to assess the pattern and severity of menopausal symptoms and to find out the factors associated with these symptoms. Materials and Methods: This cross-sectional study was conducted in various outreach clinics of Kasturba Medical College, Mangalore. Women in the age group of 40-65 years were included in the study by convenient sampling method. Data regarding menopausal symptom was obtained by interviewing each participant using the menopause rating scale questionnaire. Results: Mean age of the participants were 54.2 ± 7.2 years and mean age of attainment of menopause was 48.4 ± 4.5 years. Mean duration of menopause was found to be 7.5 ± 5.3 years. Commonest symptom reported was joint and muscular discomfort and physical and mental exhaustion seen in 94 (85.4%) participants. The mean number of symptoms reported by participants was 7.6 ± 2.8. Educated women reported significantly more symptoms (F = 2.218, P = 0.047). Somatic and urogenital symptoms were more among perimenopausal women and somatic symptoms were more among postmenopausal women. Fifty-eight (52.7%) participants had one or more severe symptoms. Severe symptoms were most among premenopausal women. Conclusion: The high proportion and severity of menopausal symptoms observed in this study group proves that menopausal symptoms are common and cannot be ignored. More of menopausal clinics are needed for awareness generation, early recognition and treatment of related morbidities. PMID:24970987
A M Ogunbode
Full Text Available BACKGROUND: The morbidity and mortality caused by breast cancer can be decreased by early detection with breast self-examination (BSE. The objective of this study was to determine the prevalence and the factors determining the practice of BSE. MATERIALS AND METHODS: The study was conducted on 140 women aged above 18 years who presented consecutively in a General Outpatient's clinic in a tertiary hospital in Nigeria. This was the baseline study from an intervention study which looked at the effect of demonstration of BSE on improving Clinical Breast Examination (CBE among two groups of respondents. Structured questionnaires were validated and administered by an interviewer and the data were analyzed using Statistical Package for Social Sciences (SPSS version 12. RESULTS: The overall self-reported prevalence of BSE practice was 62.1% among the respondents. Older women (16, 76.2%, married women (63, 65.6% and women with tertiary education (51, 68.9% had the highest prevalence of BSE practice. Prevalence rate was highest for civil servant (25, 78.1%, P = 0.04. The practice of BSE was higher among women with a previous history of breast disease (15, 68.2% and in respondents with a family history of breast disease (7, 63.6%, Only 11 (12.6% performed BSE as per guidelines, which was once in a month. CONCLUSION: The prevalence of BSE was found to be high, especially in those with tertiary education and in those with a past personal or family history of breast disease. In resource-constrained countries, BSE is a screening tool that can be employed to help reduce the breast cancer burden because routine mammography screening is not yet feasible. Women need to be informed about the when and how to perform BSE.
Paquissi, Feliciano Chanana; Cuvinje, Arminda Bimbi Paquissi; Cuvinje, Almeida Bailundo
Background. Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis, whose prevalence is increasing worldwide, and is associated with all-cause mortality. However, no study has assessed this disease in Huambo. The aim of this study was to evaluate the prevalence of PAD in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. Methods. A cross-sectional study, including 115 patients aged 40 years and older attending an outpatient service. The evaluation included a basic questionnaire for lifestyle and medical history and ankle-brachial index (ABI) measurement using hand-held Doppler. PAD was defined as an ABI ≤0.9 in either lower limb. Results. Of 115 patients, 62.60% were women with a median age of 52.5 (range of 40 to 91) years. The prevalence of PAD was 42.6% (95% confidence intervals [CI]: 95%: 33.91-52.17%). Among patients with PAD, 95.92% had mild disease and 4.08% moderate to severe disease. The main risk factor for PAD was age (≥60 years) (χ (2) = 3.917, P ≤ 0.05). The prevalence was slightly higher in men and hypertensive subjects, but without statistical significance with ORs of 1.5 (95% CI: 0.69-3.21) and 1.42 (95% CI: 0.64-3.17), respectively. Hypertension was also high in the group (66.95%). Conclusion. The prevalence of PAD was 42.6%, higher in those aged 60 years and older. More studies, with representative samples, are necessary to clarify PAD prevalence and associated risk factors. PMID:27293966
Feliciano Chanana Paquissi
Full Text Available Background. Peripheral arterial disease (PAD is a common manifestation of atherosclerosis, whose prevalence is increasing worldwide, and is associated with all-cause mortality. However, no study has assessed this disease in Huambo. The aim of this study was to evaluate the prevalence of PAD in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. Methods. A cross-sectional study, including 115 patients aged 40 years and older attending an outpatient service. The evaluation included a basic questionnaire for lifestyle and medical history and ankle-brachial index (ABI measurement using hand-held Doppler. PAD was defined as an ABI ≤0.9 in either lower limb. Results. Of 115 patients, 62.60% were women with a median age of 52.5 (range of 40 to 91 years. The prevalence of PAD was 42.6% (95% confidence intervals [CI]: 95%: 33.91–52.17%. Among patients with PAD, 95.92% had mild disease and 4.08% moderate to severe disease. The main risk factor for PAD was age (≥60 years (χ2=3.917, P≤0.05. The prevalence was slightly higher in men and hypertensive subjects, but without statistical significance with ORs of 1.5 (95% CI: 0.69–3.21 and 1.42 (95% CI: 0.64–3.17, respectively. Hypertension was also high in the group (66.95%. Conclusion. The prevalence of PAD was 42.6%, higher in those aged 60 years and older. More studies, with representative samples, are necessary to clarify PAD prevalence and associated risk factors.
Paquissi, Feliciano Chanana; Cuvinje, Arminda Bimbi Paquissi; Cuvinje, Almeida Bailundo
Background. Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis, whose prevalence is increasing worldwide, and is associated with all-cause mortality. However, no study has assessed this disease in Huambo. The aim of this study was to evaluate the prevalence of PAD in patients attending an outpatient clinic at a general hospital in Huambo, South Angola. Methods. A cross-sectional study, including 115 patients aged 40 years and older attending an outpatient service. The evaluation included a basic questionnaire for lifestyle and medical history and ankle-brachial index (ABI) measurement using hand-held Doppler. PAD was defined as an ABI ≤0.9 in either lower limb. Results. Of 115 patients, 62.60% were women with a median age of 52.5 (range of 40 to 91) years. The prevalence of PAD was 42.6% (95% confidence intervals [CI]: 95%: 33.91–52.17%). Among patients with PAD, 95.92% had mild disease and 4.08% moderate to severe disease. The main risk factor for PAD was age (≥60 years) (χ2 = 3.917, P ≤ 0.05). The prevalence was slightly higher in men and hypertensive subjects, but without statistical significance with ORs of 1.5 (95% CI: 0.69–3.21) and 1.42 (95% CI: 0.64–3.17), respectively. Hypertension was also high in the group (66.95%). Conclusion. The prevalence of PAD was 42.6%, higher in those aged 60 years and older. More studies, with representative samples, are necessary to clarify PAD prevalence and associated risk factors. PMID:27293966
Shivaraj B Mallappa
Full Text Available "Introduction: Depression is the most common psychiatric disorder among the elderly. Diabetes will add additional burden on occurrence of depression. The study was conducted to study the prevalence of the depression among elderly diabetics who are seeking care at a tertiary care centre. Methods: A cross sectional study held at a diabetes clinic of a tertiary care institute with the purposive sample of 100 subjects during the month of March 2013. The diabetic patients who were above the age of 60 years are surveyed.. WHO Geriatric Depression Scale (GDS short form was used to collect the data. Results: Prevalence of Depression among studied population 41%. Mean age of the study population 67.8 (+6.2 years with females constituting 72%. 39 % of the study population was illiterate and 33 % of them did primary schooling. There were significant association of depression with female gender, widows, illiterates, financially dependent and persons with multiple co-morbid conditions. Conclusion: This study has shown that geriatric depression is highly prevalent. The results of this study emphasize the need of intervention studies which can promote the physical, mental and social health of the patient attending the diabetes clinic." [Natl J Community Med 2016; 7(3.000: 198-200
Full Text Available INTRODUCTION: Breast feeding and contraception are important determinants of child mortality and morbidity. These practices vary in different communities due to different socio-cultural factors. Breast feeding practices influences health of the child and incidence of infections. OBJECTIVES: 1. To determine the socio demographic characteristics among mothers attending under 5 clinic. 2. To determine the breast feeding practices among mothers. 3. To determine the association between ARI and ADD with breastfeeding. 4. To determine the contraceptive practices among the mother. METHODOLOGY: This Cross-sectional study was conducted at a government tertiary care teaching hospital, Karnataka for a period of 6 months. The data was collected from the mothers by using a pre-tested, semi-structured questionnaire in the local language (Kannada. RESULTS: Of the total 2932 mothers, 46.1% mothers had breast-fed their babies within one hour of delivery, 9.2% had given pre-lacteal feeds and colostrum was not fed to 7.9% of the babies. The difference in the incidence of ARI and ADD between the children who were exclusively breastfeed and the children who were not exclusively breastfed was significant. Contraception was practices by 10.8% of the mothers. CONCLUSION: The immunization clinic offers an opportunity to enquire the mother about the breast feeding practices and advise about the importance of exclusive breast feeding. It also provides an opportunity for questioning and offering advice about contraception.
HN Harsha Kumar
Full Text Available Introduction: Osteoarthritis (OA of the knee is the most common type of arthritis of the elderly among Asians. Reports suggest that it affects the quality of life. Hence, this study was undertaken with the objective to know the impact of OA of the knee on 8 domains of health related quality of life (HRQoL which include: (1 Physical functioning (PF, (2 role limitation due to physical health (RP. (3 Emotional well-being/mental health (MH, (4 role limitation due to emotional problems (RE, (5 energy/vitality, (6 social well-being (short form [SF], (7 body pain, (8 general health. Materials and Methods: This cross-sectional study was conducted in primary care rural clinics situated on peripheral areas of Mangalore city. Total sample size was calculated to be 77. Patients who met the criteria of modified American Rheumatologic Association Classification for OA of knee were administered a SF-36 questionnaire to measure the HRQoL in the local language version. Mean scores (with its standard deviation across each domain was calculated. Results: Of 80 patients, 38 were males. OA affected HRQoL. Four out 8 factors had more impact on HRQoL (they are PF, RP, MH, RE. Duration of OA is an important determinant on HRQoL. Patients with newer onset of OA (4 years of OA (Domain, Mean, the emotional impact (MH, 44.67; RE, 45.67 reduced but the physical impact (PF, 47.83; RP, 19.75 persisted/got worse. Conclusion: Osteoarthritis had impact on HRQoL. Duration of OA determines the kind of impact. With the onset of OA emotional/mental support would be needed in addition to the medical treatment. As the disease progresses, they tend to cope with emotional/mental problems even as the physical problems persist/increase.
Full Text Available Introduction & Objectives: Substance abuse and opioid dependency refers to hazardous use of psychoactive substance .Prevention and treatment of opiate dependence has not been success-ful. Most effective drug in agonist treatment of opiates is methadone maintenance therapy (MMT.But the lack of cooperation of addicts in methadone maintenance therapy has always been a big problem to continue. The purpose of this study is to investigate the retention in the MMT. Materials & Methods: This historical cohort study analyzed the medical records of patients of Baharan hospital in Zahedan. All 912 cases of methadone maintenance clinic of Baharan hos-pital in Zahedan 2011-2012 were studied and the data were analyzed using SPSS. Tables and indexes were analyzed by the Chi-square test and survival curves were plotted using Kaplan–Meier method and analyzed by Log-Rank test. Results: This study reviewed records from 912 patients with a mean age of 34.67% and stan-dard deviation of 10.88 and the range of 15-86 years. 735 were male and 177 ware female. 1-moth retention rate was 71%, 3 months was 59%, 6 months was 47%, 1 year was 30% and 2 years was 17%. Kaplan-Meier median survival time of 8 months was estimated by relation-ship. Doses higher than 60 mg/d of methadone was associated with increased survival on MMT. Conclusion: Age increase, increase of employment time, increasing of the duration of drug abuse, increasing the daily dose of methadone, oral substance abuse increased retention rate and heroin abuse and smoking were associated with decrease retention rate of methadone maintenance therapy. So, with an emphasis on each of these factors effective steps can be taken to improve the cooperation of patients in MMT. (Sci J Hamadan Univ Med Sci 2015; 22 (1:30-36
Full Text Available Background: Being a mother is considered by many women as their most important role in life. Women’s perceptions of their abilities to manage the demands of parenting and the parenting skills they posses are reflected by perceived maternal role competence. The present study was carried out to assess the perceived maternal role competence and its associated factors among mothers. Methods: A descriptive cross-sectional research study was carried out on 290 mothers of infant in four immunization clinics of Dharan, Nepal. Data were collected using a standardized predesigned, pretested questionnaire (Parent sense of competence scale, Rosenberg’s self esteem scale, Maternity social support scale. The data were analyzed using descriptive and inferential statistics and multiple regression analysis at 0.05 level of significance. Results: The mean score of the perceived maternal role competence obtained by mothers was 64.34±7.90 and those of knowledge/skill and valuing/comfort subscale were 31±6.01 and 33±3.75, respectively. There was a significant association between perceived maternal role competence and factors as the age of the mother (P<0.001, educational status (P=0.015, occupation (P=0.001 and readiness for pregnancy (P=0.022. The study findings revealed a positive correlation between perceived maternal role competence and age at marriage (r=0.132, P=0.024, per capita income (r=0.118, P=0.045, self esteem (r=0.379, P<0.001, social support (r=0.272, P<0.001, and number of support persons (r=0.119, P=0.043. The results of the step wise multiple regression analysis revealed that the major predictor of perceived maternal role competence was self esteem. Conclusion: The factors associated with perceived maternal role competence were age, education, occupation, per capita income, self esteem, social support, and the number of support persons.
Besera, Ghenet; Moskosky, Susan; Pazol, Karen; Fowler, Christina; Warner, Lee; Johnson, David M; Barfield, Wanda D
Although both men and women have reproductive health care needs, family planning providers traditionally focus services toward women (1,2). Challenges in providing family planning services to men, including preconception health, infertility, contraceptive, and sexually transmitted disease (STD) care (3,4), include their infrequent use of preventive health services, a perceived lack of need for these services (1,5), and the lack of provider guidance regarding men's reproductive health care needs (4). Since 1970, the National Title X Family Planning Program has provided cost-effective and confidential family planning and related preventive health services with priority for services to low-income women and men. To examine men's use of services at Title X service sites, CDC and the U.S. Department of Health and Human Services' Office of Population Affairs (OPA) analyzed data from the 2003-2014 Family Planning Annual Reports (FPAR), annual data that are required of all Title X-funded agencies. During 2003-2014, 3.8 million males visited Title X service sites in the United States and the percentage of family planning users who were male nearly doubled from 4.5% (221,425 males) in 2003 to 8.8% (362,531 males) in 2014. In 2014, the percentage of family planning users who were male varied widely by state, ranging from ≤1% in Mississippi, Tennessee, and Alabama to 27.2% in the District of Columbia (DC). Title X service sites are increasingly providing services for males. Health care settings might want to adopt the framework employed by Title X clinics to better provide family planning and related preventative services to men (3). PMID:27309884
Shrooti, Shah; Mangala, Shrestha; Nirmala, Pokharel; Devkumari, Shrestha; Dharanidhar, Baral
Background: Being a mother is considered by many women as their most important role in life. Women’s perceptions of their abilities to manage the demands of parenting and the parenting skills they posses are reflected by perceived maternal role competence. The present study was carried out to assess the perceived maternal role competence and its associated factors among mothers. Methods: A descriptive cross-sectional research study was carried out on 290 mothers of infant in four immunization clinics of Dharan, Nepal. Data were collected using a standardized predesigned, pretested questionnaire (Parent sense of competence scale, Rosenberg’s self esteem scale, Maternity social support scale). The data were analyzed using descriptive and inferential statistics and multiple regression analysis at 0.05 level of significance. Results: The mean score of the perceived maternal role competence obtained by mothers was 64.34±7.90 and those of knowledge/skill and valuing/comfort subscale were 31±6.01 and 33±3.75, respectively. There was a significant association between perceived maternal role competence and factors as the age of the mother (P<0.001), educational status (P=0.015), occupation (P=0.001) and readiness for pregnancy (P=0.022). The study findings revealed a positive correlation between perceived maternal role competence and age at marriage (r=0.132, P=0.024), per capita income (r=0.118, P=0.045), self esteem (r=0.379, P<0.001), social support (r=0.272, P<0.001), and number of support persons (r=0.119, P=0.043). The results of the step wise multiple regression analysis revealed that the major predictor of perceived maternal role competence was self esteem. Conclusion: The factors associated with perceived maternal role competence were age, education, occupation, per capita income, self esteem, social support, and the number of support persons.
Full Text Available : INTRODUCTION: Rabies is an acute viral disease that causes fatal encephalitis in virtually all the warm blooded animals including man. In India it is estimated that annually 17.4 million animal bite cases occur and 20, 000 deaths occur due to human rabies. Dogs are responsible for about 97%of the human rabies, followed by cats (2%, jackals, mongoose and others (1%. There is scarcity of literature regarding human rabies due to wild animals. OBJECTIVES: To describe the socio- demographic characteristics of wild animal bite victims attending Anti Rabies Clinic (ARC, Mandya Institute of Medical Sciences (MIMS, Mandya and to describe the circumstances, characteristics of bite and post exposure prophylactic measures taken to prevent rabies. METHODOLOGY: This hospital based case record analysis was done for a period of 3 years from January 2011 to December 2013 at Anti Rabies Clinic (ARC, Mandya Institute of Medical Sciences, Mandya. The details regarding the socio demographic characteristics of bite victims, characteristics of the bite wound and post exposure prophylactic measures taken to prevent rabies were collected using case records of wild animal bite victims. RESULTS: A total of 12, 798 animal bite victims had attended ARC during the study period, of which 67 (0.52% cases were exposed to wild animals. Of these 67 cases, 45 (67.2% of the victims were exposed to monkey and 13 (19.4% were exposed to wild boar. 45 (67.2% of the wild animal bite victims were in the age group of 15 to 60 years, 49 (73.1% were males and 22 (32.8% belonging to class IV socio economic status. Many of the monkey bites happened when the monkey was trying to snatch food from the victims and while other wild animal bites happened when the farmers were guarding their field. 40 (59.7% had bites on upper limb. 51 (76.1% had washed the wound with soap and water before coming to ARC. RIG was advised to all victims but was taken by 49 (73.1% of the bite victims. All four doses
Full Text Available Background: Tobacco-attributable mortality in India is estimated to be at least 10%. Tobacco cessation is more likely to avert millions of deaths before 2050 than prevention of tobacco use initiation. Objective: To describe the clinico-epidemiological profile of attendees of a tobacco cessation clinic in a teaching hospital in Bangalore city. Materials and Methods: A descriptive study of 189 attendees seen over 2 years in the Tobacco Cessation Clinic of a tertiary-care teaching hospital in Bangalore, with information on socio demographic characteristics, tobacco-use details, nicotine dependence, family/medical history, past quit attempts, baseline stage-of-change, and treatment initiated. Results: Only 5% were ′walk-in′ patients; 98% of attendees were smokers; 97% were males. The mean (±SD age of attendees was 48.0 (±14.0 years. Most participants were married (88%, and predominantly urban (69%. About 62% had completed at least 8 years of schooling. Two-thirds of smokers reported high levels of nicotine dependence (Fagerström score >5/10. About 43% of patients had attempted quitting earlier. Four-fifths (79% of tobacco-users reported a family member using tobacco. Commonly documented comorbidities included: Chronic respiratory disease (44%, hypertension (23%, diabetes (12%, tuberculosis (9%, myocardial infarction (2%, stroke (1%, sexual dysfunction (1% and cancer (0.5%. About 52% reported concomitant alcohol use. At baseline, patients′ motivational stage was: Precontemplation (14%, contemplation (48%, preparation/action (37% and maintenance (1%. Treatment modalities started were: Counseling alone (41%, nicotine replacement therapy alone (NRT (34%, medication alone (13%, and NRT+medication (12%. Conclusions: This is the first study of the baseline profile of patients attending a tobacco cessation clinic located within a chest medicine department in India. Important determinants of outcome have been captured for follow-up and prospective
Rahman, Md. Mosfequr; Rahman, Md. Mizanur; Tareque, Md. Ismail; Ferdos, Jannatul; Jesmin, Syeda S.
Objective To investigate the association between maternal pregnancy intention and professional antenatal and delivery care utilization. Methods Our data were derived from the 2011 nationally representative Bangladesh Demographic Health Survey. We included antenatal and delivery care utilization data of the most recent live births for women for the previous three years (n = 4672). We used multilevel logistic regression models to assess the relationship between pregnancy intention and use of professional antenatal and delivery care, with adjustment for potential confounding variables. Results Approximately 13% and 16% of children were reported by their mothers as unwanted and mistimed at the time of conception, respectively. Among the women, 55% received at least one professional antenatal care service; 21% received four or more professional antenatal services, while 32% were attended by professionals during deliveries. Mothers of children whose pregnancies had been unwanted had a greater risk for not seeking professional antenatal and professional delivery care than those whose pregnancies had been wanted [1≥ ANC from professionals: AOR: 0.66; 95% CI:0.51–0.93; 4≥ ANC from professionals: AOR:0.56; 95% CI:0.37–0.84; and delivery care from professionals: AOR: 0.70; 95% CI:0.50–0.97]. Women who were married after age 18, had secondary or higher level of education, and were from the wealthiest households were more likely to utilize antenatal and delivery care. Conclusion Unwanted pregnancy is significantly associated with lower utilization of professional antenatal and delivery care services in Bangladesh. Reducing unwanted births and promoting access to professional antenatal and delivery care are crucial for achieving the Sustainable Development Goals (SDGs) 3 in Bangladesh. PMID:27309727
Ganta, Shravani; Nagaraj, Anup; Pareek, Sonia; Atri, Mansi; Singh, Kushpal; Sidiq, Mohsin
Background: Noise is a source of pervasive occupational hazard for practicing dentists and the patients. The sources of dental sounds by various dental equipments can pose as a potential hazard to hearing system and add to the annoyance levels of the patients. The aim of the study was to analyze the noise levels from various equipments and evaluate the effect of acoustic noise stimulus on dental fear and annoyance levels among patients attending different dental clinic setups in Jaipur, India. Methodology: The sampling frame comprised of 180 patients, which included 90 patients attending 10 different private clinics and 90 patients attending a Dental College in Jaipur. The levels of Acoustic Noise Stimulus originating from different equipments were determined using a precision sound level meter/decibulometer. Dental fear among patients was measured using Dental Fear Scale (DFS). Results: Statistical analysis was performed using chi square test and unpaired t-test. The mean background noise levels were found to be maximum in the pre-clinical setup/ laboratory areas (69.23+2.20). Females and the patients attending dental college setup encountered more fear on seeing the drill as compared to the patients attending private clinics (p<0.001). Conclusion: The sources of dental sounds can pose as a potential hazard to hearing system. It was analyzed that the environment in the clinics can directly have an effect on the fear and annoyance levels of patients. Hence it is necessary control the noise from various dental equipments to reduce the fear of patients from visiting a dental clinic. PMID:24959512
Sadia; Khan; Godfred; Antony; Menezes; Rahul; Dhodapkar; Belgode; Narasimha; Harish
Objective:To report our experience with two tests,anti-cardiolipin antibody test[venereal disease reasearch laboratory(VDRL) test]and specific treponemal test(Treponema pallidum hemagglutination assay),used for screening antenatal,high risk cases and cases from sexually transmitted infection in a tertiary care hospital from January 2006 till December 2008.Methods:A total of 14639 samples received from various patient groups including antenatal cases,patients attending sexually transmitted disease(STD) clinic,blood donors and HIV positive patients were screened.Results:Among the 14639 samples collected,103 were positive by VDRL test.Of these 89 cases were confirmed by quantitative VDRL test and Treponema pallidum hemagglutination assay.The cumulative seroprevalence over two years was found to be 0.61%in this study.The syphilis seroprevalence reduced from 0.88%in 2006 to 0.40%in 2008.Among the various sub-populations studied,patients attending the sexually transmitted infection clinic showed a seroprevalence of 2.62%.The seroprevalence decreased significantly from 4.00%in 2006 to1.39%in 2008.Conclusions:Our study showed a statistically significant declining rate of syphilis in STD clinics as well as the overall seroprevalence.These findings could be interpreted as indicators of improved programmes for prevention and management of STDs.
Sadia Khan; GodfredAntony Menezes; Rahul Dhodapkar; Belgode Narasimha Harish
To report our experience with two tests, anti-cardiolipin antibody test [venereal disease reasearch laboratory (VDRL) test] and specific treponemal test (Treponema pallidum hemagglutination assay), used for screening antenatal, high risk cases and cases from sexually transmitted infection in a tertiary care hospital from January 2006 till December 2008. Methods: A total of 14639 samples received from various patient groups including antenatal cases, patients attending sexually transmitted disease (STD) clinic, blood donors and HIV positive patients were screened. Results: Among the 14639 samples collected, 103 were positive by VDRL test. Of these 89 cases were confirmed by quantitative VDRL test and Treponema pallidum hemagglutination assay. The cumulative seroprevalence over two years was found to be 0.61% in this study. The syphilis seroprevalence reduced from 0.88% in 2006 to 0.40% in 2008. Among the various sub-populations studied, patients attending the sexually transmitted infection clinic showed a seroprevalence of 2.62%. The seroprevalence decreased significantly from 4.00% in 2006 to 1.39% in 2008. Conclusions: Our study showed a statistically significant declining rate of syphilis in STD clinics as well as the overall seroprevalence. These findings could be interpreted as indicators of improved programmes for prevention and management of STDs.
Mirkuzie Alemnesh H; Sisay Mitike M; Moland Karen; Åstrøm Anne N
Abstract Background To facilitate access to the prevention of mother-to-child HIV transmission (PMTCT) services, HIV counselling and testing are offered routinely in antenatal care settings. Focusing a cohort of pregnant women attending public and private antenatal care facilities, this study applied an extended version of the Theory of Planned Behaviour (TPB) to explain intended- and actual HIV testing. Methods A sequential exploratory mixed methods study was conducted in Addis Ababa in 2009...
Wilkinson, D.; Gouws, E.; Sach, M.; Karim, S. S.
User fees are used to recover costs and discourage unnecessary attendance at primary care clinics in many developing countries. In South Africa, user fees for children aged under 6 years and pregnant women were removed in 1994, and in 1997 all user fees at all primary health care clinics were abolished. The intention of these policy changes was to improve access to health services for previously disadvantaged communities. We investigated the impact of these changes on clinic attendance patterns in Hlabisa health district. Average quarterly new registrations and total attendances for preventive services (antenatal care, immunization, growth monitoring) and curative services (treatment of ailments) at a mobile primary health care unit were studied from 1992 to 1998. Regression analysis was undertaken to assess whether trends were statistically significant. There was a sustained increase in new registrations (P = 0.0001) and total attendances (P = 0.0001) for curative services, and a fall in new registrations (P = 0.01) and total attendances for immunization and growth monitoring (P = 0.0002) over the study period. The upturn in demand for curative services started at the time of the first policy change. The decreases in antenatal registrations (P = 0.07) and attendances (P = 0.09) were not statistically significant. The number of new registrations for immunization and growth monitoring increased following the first policy change but declined thereafter. We found no evidence that the second policy change influenced underlying trends. The removal of user fees improved access to curative services but this may have happened at the expense of some preventive services. Governments should remain vigilant about the effects of new health policies in order to ensure that objectives are being met. PMID:11477970
Full Text Available Background: The implementation of new technology can interrupt established workflows in health care settings. The Quality of Maternal Care (QUALMAT project has introduced an (eCDSS for antenatal care (ANC and delivery in rural primary health care facilities in Africa. Objective: This study was carried out to investigate the influence of the QUALMAT eCDSS on the workflow of health care workers in rural primary health care facilities in Ghana and Tanzania. Design: A direct observation, time-and-motion study on ANC processes was conducted using a structured data sheet with predefined major task categories. The duration and sequence of tasks performed during ANC visits were observed, and changes after the implementation of the eCDSS were analyzed. Results: In 24 QUALMAT study sites, 214 observations of ANC visits (144 in Ghana, 70 in Tanzania were carried out at baseline and 148 observations (104 in Ghana, 44 in Tanzania after the software was implemented in 12 of those sites. The median time spent combined for all centers in both countries to provide ANC at baseline was 6.5 min [interquartile range (IQR =4.0–10.6]. Although the time spent on ANC increased in Tanzania and Ghana after the eCDSS implementation as compared to baseline, overall there was no significant increase in time used for ANC activities (0.51 min, p=0.06 in Ghana; and 0.54 min, p=0.26 in Tanzania as compared to the control sites without the eCDSS. The percentage of medical history taking in women who had subsequent examinations increased after eCDSS implementation from 58.2% (39/67 to 95.3% (61/64 p<0.001 in Ghana but not in Tanzania [from 65.4% (17/26 to 71.4% (15/21 p=0.70]. Conclusions: The QUALMAT eCDSS does not increase the time needed for ANC but partly streamlined workflow at sites in Ghana, showing the potential of such a system to influence quality of care positively.
Miller, Joyce; Beharie, Monica Christine; Taylor, Alison M; Simmenes, Elisabeth Berg; Way, Susan
This service evaluation investigated an interdisciplinary allied professional health care strategy to address the problem of suboptimal breastfeeding. A clinic of midwives and chiropractors was developed in a university-affiliated clinic in the United Kingdom to care for suboptimal feeding through a multidisciplinary approach. No studies have previously investigated the effect of such an approach. The aim was to assess any impact to the breastfeeding dyad and maternal satisfaction after attending the multidisciplinary clinic through a service evaluation. Eighty-five initial questionnaires were completed and 72 (85%) follow-up questionnaires were returned. On follow-up, 93% of mothers reported an improvement in feeding as well as satisfaction with the care provided. Prior to treatment, 26% of the infants were exclusively breastfed. At the follow-up survey, 86% of mothers reported exclusive breastfeeding. The relative risk ratio for exclusive breastfeeding after attending the multidisciplinary clinic was 3.6 (95% confidence interval = 2.4-5.4). PMID:26763046
Norhayati Moktar; Nor Liyana Ismail; Phoy Cheng Chun; Mohamad Asyrab Sapie; Nor Farahin Abdul Kahar; Yusof Suboh; Noraina Abdul Rahim; Nor Azlin Mohamed Ismail; Tengku Shahrul Anuar
Objective: To investigate the presence of trichomoniasis among women attending the Obstetrics and Gynaecology Clinic, Universiti Kebangsaan Malaysia Medical Centre. Methods: A total of 139 high vaginal swabs were taken from the subjects and sent to the laboratory in Amies gel transport media. The specimens were examined for the presence of Trichomonas vaginalis using wet mount, Giemsa staining and cultured in Diamond's medium. Sociodemographic characteristics and gynaecological complaints were obtained in private using structured questionnaire applied by one investigator. Results: The median age was 32 years, with an interquartile interval of 9.96. Most of the subjects were Malays (76.9%) and the remaining were Chinese (15.1%), Indians (2.2%) and other ethnic groups (5.8%). One hundred and thirty eight (99.3%) of the women were married and 98.6%had less than 6 children. More than half (75.5%) of the women's last child birth was less than 6 years ago. Forty seven percent of them were involved in supporting administrative work and 64.7% of the women gave a history of previous or current vaginal discharge. Conclusions: The present study reported zero incidence rate of trichomoniasis. The low incidence rate was postulated due to all women who participated in this study were categorized into a low-risk group.
Shaeer, K Z M; Osegbe, D N; Siddiqui, S H; Razzaque, A; Glasser, D B; Jaguste, V
The prevalence and correlates of erectile dysfunction (ED) in developing countries are largely unknown. Our objectives were to determine the prevalence and associated factors of ED in three countries (Pakistan, Egypt, Nigeria) that represent very different cultures. Men 35-70y of age seeking primary medical care answered a structured questionnaire adapted to reflect local cultures. Degree of ED was categorized as 'none,' 'mild,' 'moderate,' or 'complete.' The age-adjusted prevalence rates of ED among men attending primary care clinics was 57.4% in Nigeria, 63.6% in Egypt, and 80.8% in Pakistan. Older age, diabetes, peptic ulcers, prostate disease, depression-related symptoms, and caffeine consumption were independently associated with increased prevalence of ED, whereas being moderately active to very active at work (hard physical labor) and during leisure time (strenuous exercise) was associated with half the prevalence of moderate-to-complete ED. Our multicultural study demonstrates that in every country studied, high proportions of men older than age 35 have some degree of ED (57-81%). Both severity and prevalence increase consistently with age. Factors associated with ED are similar, but their distribution differs across countries. PMID:12825103
Lymphoedema is a chronic, incurable, debilitating condition, usually affecting a limb and causes discomfort, pain, heaviness, limited motion, unsatisfactory appearance and impacts on quality of life. However, there is a paucity of prevalence data on this condition. This study aimed to determine the prevalence of lymphoedema among persons attending wound management and vascular clinics in an acute tertiary referral hospital. Four hundred and eighteen patients meeting the inclusion criteria were assessed. A prevalence rate of 2.63% (n = 11) was recorded. Thirty-six percent (n = 4) had history of cellulitis and broken skin, 64% (n = 7) had history of broken skin and 36% (n = 4) had undergone treatment for venous leg ulcers. The most common co-morbidities were hypertension 55% (n = 6), deep vein thrombosis (DVT) 27% (n = 3), hypercholesterolemia 36% (n = 4) and type 2 diabetes 27% (n = 3). Quality of life scores identified that physical functioning was the domain most affected among this group. This study has identified the need to raise awareness of this condition among clinicians working in the area of wound management.
Grau, Lauretta E; Krasnoselskikh, Tatiana V; Shaboltas, Alla V; Skochilov, Roman V; Kozlov, Andrei P; Abdala, Nadia
Cultural adaptation is an important step in the process of implementing health promotion interventions that, having been proven to be effective in one culture, are being applied in another. This study describes the results of a formative investigation to culturally adapt a STI/HIV risk reduction intervention for use in St. Petersburg, Russia. Analyses of data from brief elicitation interviews, focus groups, community experts, and a pilot test of the adapted intervention identified environmental, cognitive-information processing, and affect-motivation factors that needed to be addressed during the adaptation process. The participant/counselor relationship was adapted to reflect a hierarchical (cf. collaborative) relationship in order to accommodate Russian expectations about patient interactions with healthcare experts. Key skills building activities (e.g., identification of personal risk behaviors, role-playing) were approached gradually or indirectly in order to maintain participants' engagement in the intervention, and close-ended questions were added to assist participants in understanding unfamiliar concepts such as "triggers" and self-efficacy. Information about the prevalence of HIV/STI infections and alcohol use included data specific to St. Petersburg to increase the personal relevance of these materials and messages. Intervention components were tailored to participants' risk reduction and informational needs. No gender differences that would have justified adaptation of the intervention approach or content were noted. Examples of specific adaptations and the key issues to attend to when adapting behavioral interventions for use in Russian clinical settings are discussed. PMID:23322231
Purpose: To validate a predictive model for survival of patients attending a palliative radiotherapy clinic. Methods and Materials: We described previously a model that had good predictive value for survival of patients referred during 1999 (1). The six prognostic factors (primary cancer site, site of metastases, Karnofsky performance score, and the fatigue, appetite and shortness-of-breath items from the Edmonton Symptom Assessment Scale) identified in this training set were extracted from the prospective database for the year 2000. We generated a partial score whereby each prognostic factor was assigned a value proportional to its prognostic weight. The sum of the partial scores for each patient was used to construct a survival prediction score (SPS). Patients were also grouped according to the number of these risk factors (NRF) that they possessed. The probability of survival at 3, 6, and 12 months was generated. The models were evaluated for their ability to predict survival in this validation set with appropriate statistical tests. Results: The median survival and survival probabilities of the training and validation sets were similar when separated into three groups using both SPS and NRF methods. There was no statistical difference in the performance of the SPS and NRF methods in survival prediction. Conclusion: Both the SPS and NRF models for predicting survival in patients referred for palliative radiotherapy have been validated. The NRF model is preferred because it is simpler and avoids the need to remember the weightings among the prognostic factors
Senn, Theresa E; Walsh, Jennifer L; Carey, Michael P
Prior research shows that violence is associated with sexual risk behavior, but little is known about the relation between community violence (i.e., violence that is witnessed or experienced in one's neighborhood) and sexual risk behavior. To better understand contextual influences on HIV risk behavior, we asked 508 adult patients attending a publicly funded STI clinic in the U.S. (54 % male, M age = 27.93, 68 % African American) who were participating in a larger trial to complete a survey assessing exposure to community violence, sexual risk behavior, and potential mediators of the community violence-sexual risk behavior relation (i.e., mental health, substance use, and experiencing intimate partner violence). A separate sample of participants from the same trial completed measures of sexual behavior norms, which were aggregated to create measures of census tract sexual behavior norms. Data analyses controlling for socioeconomic status revealed that higher levels of community violence were associated with more sexual partners for men and with more episodes of unprotected sex with non-steady partners for women. For both men and women, substance use and mental health mediated the community violence-sexual risk behavior relation; in addition, for men only, experiencing intimate partner violence also mediated this relation. These results confirm that, for individuals living in communities with high levels of violence, sexual risk reduction interventions need to address intimate partner violence, substance use, and mental health to be optimally effective. PMID:27000155
Percudani, Mauro; Barbui, Corrado; Beecham, Jennifer; Knapp, Martin
BACKGROUND : There is a paucity of economic studies carried out in the routine clinical practice of psychiatric services. This study estimated service and non-service costs in a random sample of patients attending a community psychiatric mental health centre in Italy. Costs of different diagnostic subgroups and variables associated with service and non-service costs were calculated. METHODS : A randomly selected sample of patients identified during one week of routine clinical activity was en...
OBJECTIVES: To study the obstetric outcome in pregnancies with oligohydramnios and polyhydramnios. To determine the perinatal outcome in pregnancies complicated with oligohydramnios and polyhydramnios. METHODS: This study is conducted on pregnant woman with abnormal liquor volume who attended the antenatal clinic at Institute of obstetrics and gynecology , Bowring and Lady curzon Hospital attached to BMCRI Bengaluru Ja...
Full Text Available Background: Treatment-seeking is limited in women substance abusers. Studying the sociodemographic and clinical profile of treatment-seeking substance-dependent women can help us to understand the problem better and respond appropriately in terms of primary and secondary prevention strategies. Aim: To study the sociodemographic and clinical profile of women attending a de-addiction centre in North India. Design and Methodology: Retrospective structured chart review of 35 women substance abusers. Results: The results indicated that a typical subject was urban (86%, married (63%, nuclear family (60%, based housewife (57%, educated up to school completion (54%, and having poor social support (57%. The common substances were opioids (60%, followed by alcohol (17%, and tobacco and benzodiazepines (11.5% each. The mean age at onset of substance use was 30.5 years, the mean duration of use was 9 years and mean duration to develop dependence was 5.5 years. The common reasons for initiating use were medical (63% and curiosity (34%. Comorbidity profile was: physical illness (34%, psychiatric illness (23% and dependence on another substance (14%. Only 20% had a family history of substance dependence. The social impairment ranged from 77% for social to 40% for financial and none for legal aspects. A typical subject had followed up 4.2 times in 8.4 months, while 54% were abstaining, 40% were continuing their substance dependence at the last follow up. Conclusions: The results suggest that the development of substance dependence in women is a combination of genetic, personal, and social vulnerability factors, including the drug culture of the social milieu and the poor social support. Comorbidity and impairment are common features.