Category: Nevin Manimala

Pan Afr Med J. 2021 Nov 3;40:133. doi: 10.11604/pamj.2021.40.133.30350. eCollection 2021.

ABSTRACT

INTRODUCTION: non-invasive ventilation is widely used in the respiratory management of severe bronchiolitis.

METHODS: a randomized controlled trial was carried out in a tertiary pediatric university hospital´s PICU over 3 years to compare between continuous positive airway pressure/nasal positive pressure ventilation (CPAP/NPPV) and high flow nasal cannula (HFNC) devices for severe bronchiolitis. The trial was recorded in the national library of medicine registry (NCT04650230). Patients aged from 7 days to 6 months, admitted for severe bronchiolitis were enrolled. Eligible patients were randomly chosen to receive either HFNC or CPAP/NPPV. If HFNC failed, the switch to CPAP/NPPV was allowed. Mechanical ventilation was the last resort in case of CPAP/NPPV device failure. The primary outcome was the success of the treatment defined by no need of care escalation. The secondary outcomes were failure predictors, intubation rate, stay length, serious adverse events, and mortality.

RESULTS: a total of 268 patients were enrolled. The data of 255 participants were analyzed. The mean age was 51.13 ± 34.43 days. Participants were randomized into two groups; HFNC group (n=130) and CPAP/NPPV group (n=125). The success of the treatment was significantly higher in the CPAP/NPPV group (70.4% [61.6%- 78.2%) comparing to HFNC group (50.7% [41.9%- 59.6%])- (p=0.001). For secondary outcomes, lower baseline pH was the only significant failure predictor in the CPAP/NPPV group (p=0.035). There were no differences in intubation rate or serious adverse events between the groups.

CONCLUSION: high flow nasal cannula was safe and efficient, but CPAP/ NPPV was better in preventing treatment failure. The switch to CPAP/NPPV if HFNC failed, avoided intubation in 54% of the cases.

PMID:34909101 | PMC:PMC8641623 | DOI:10.11604/pamj.2021.40.133.30350

Pan Afr Med J. 2021 Nov 5;40:139. doi: 10.11604/pamj.2021.40.139.30358. eCollection 2021.

ABSTRACT

INTRODUCTION: few research studies about mental health problems in medical staff during the first wave of the COVID-19 pandemic have been reported. The Aim of the study is to assess the prevalence of anxiety and insomnia, affecting the professional quality of life of physicians during COVID-19 pandemic.

METHODS: doctors answered an online questionnaire regarding their perception of insomnia, anxiety and professional quality of life during COVID-19 pandemic with psychological parameters including the Generalized Anxiety Disorder (GAD-7), Insomnia Severity Index (ISI) and Professional quality of life version 5 (ProQOL5).

RESULTS: anxiety was found in 64.8% of the participants. This disorder was respectively moderate and severe in 12.4% and 6.7% of cases. Insomnia was found in 51.4% of respondents, 29.5% of whom worked in the COVID circuit (p=0.17). Insomnia was assessed as mild, moderate and severe in respectively 38.1%, 11.4% and 1.9% of cases. Compassion satisfaction was moderate in 72.4 of cases and high in 24.8% of cases. The entire population with low CS belonged to the 20-29 age group (p=0.019). Compassion satisfaction was statistically higher in married people (32.7%) (p=0.004). This entity varied significantly with occupational grade (p=0.003), seniority in grade (p=0.011) and working in the private health sector (p=0.046). Burnout was moderate in 73.3% and low in 26.7% of cases. Burnout was significantly higher among single people (p=0.03) and statistically altered in the staff working in the COVID unit (p=0.028). Secondary traumatic disorder was above moderate in 69.6%.

CONCLUSION: a high prevalence of psychological symptoms was found among doctors during COVID-19. Medical health workers are in need of health protection and adequate working conditions.

PMID:34909107 | PMC:PMC8641639 | DOI:10.11604/pamj.2021.40.139.30358

Pan Afr Med J. 2021 Nov 2;40:128. doi: 10.11604/pamj.2021.40.128.19757. eCollection 2021.

ABSTRACT

INTRODUCTION: foodborne disease (FBD) is a major public health problem globally. Inadequate food workers’ knowledge, attitude, and low level of food handling practices (FHPs) may all contribute to the possibility of FBD outbreaks in public food service establishments. This study aimed to assess FHPs and associated factors among food handlers working in public food and drink service establishments in Woldia town, Northeast Ethiopia.

METHODS: an institutional-based cross-sectional study was conducted from 01 to 29, January 2017. A total of 288 food handlers were recruited through a simple random selection method. A structured interviewer-administered questionnaire and observation checklists were used to collect the respondents’ socio-demographic characteristics, knowledge status on FHPs, and food handling working practices data. Descriptive statistics, bivariate and multivariate logistic regression analysis were employed using SPSS version 20 software. Those variables with a p< 0.05 were considered statistically significant.

RESULTS: out of 288 participants, 91.7% were female, and 82.3% were single, while 69.8% were literate. One hundred eighty-four (63.9%) of them were under 15-25 years of age, with a median age of 23.3 years. The proportion of good FHP was (n=134, 46.5%) (95% CI: 41.00-52.4%). Advanced age (adjusted odds ratio (AOR) =12.01, 95% CI: 1.96-73.52), education (participants who attend grades 7-12 (AOR=2.33, 95% CI: 1.14-4.79), and above secondary education (AOR=2.29, 95% CI: 1.05-4.61), work experience above six years (AOR=2.43, 95% CI: 2.08-3.17), received formal training (AOR=1.79, 95% CI: 1.68-4.71), and inspection visits by a concerned body (AOR=2.24, 95% CI: 1.05-3.09) were factors positively associated with handling practices.

CONCLUSION: the study revealed that FHP in the study area was low. Age, education, service year, training received and sanitary inspection visits by the regulatory personnel were factors significantly associated with FHPs. This finding highlights the importance of employing regular sanitary inspection visits to public food service establishments by the concerned authority to ensure that all food handlers have the knowledge and the skill to provide safe food.

PMID:34909096 | PMC:PMC8641629 | DOI:10.11604/pamj.2021.40.128.19757

Pan Afr Med J. 2021 Nov 3;40:131. doi: 10.11604/pamj.2021.40.131.28217. eCollection 2021.

ABSTRACT

INTRODUCTION: globally about 5.4 million people are affected by snakebite annually leading to 2.7 million cases of snakebite envenoming and 81,000-138,000 deaths. In sub-Saharan Africa, the burden of disease caused by snakebite is often underestimated despite its status as a category A neglected tropical disease. We reviewed snakebite data to determine the magnitude of snakebite by person, place, and time in the Volta and Oti Regions of Ghana.

METHODS: we conducted a descriptive secondary data analysis using snakebite data from 2014-2018 extracted from the District Health Information and Management Systems (DHIMS 2) database. Data were analyzed descriptively by person, place, and time using summary statistics and results were presented in proportions and graphs. Missed outbreaks were determined through calculation of cumulative sum (CUSUM 2).

RESULTS: a total of 2,973 cases of snakebites were reported over the 5 years of which 1675 (56.3%) were males. Majority 867 (29.2%) of snakebite victims were between 20-34 years of age with recorded 5-year average incidence of 24 snakebite cases per 100,000. Nkwanta North District recorded the highest cases 499 (16.8%) with most of the snakebite cases 2,411 (81%) recorded in the rainy season. Overall, there was a decreasing trend of snakebites and four missed snakebite outbreaks occurred during the period. No snakebite death was recorded.

CONCLUSION: a 5-year average snakebite incidence of 24 cases per 100,000 persons was recorded and Nkwanta North District recorded the highest cases with peaks occurring in rainy and harvesting seasons. Four outbreaks were missed. There is a need to conduct periodic data analysis for effective intervention programs.

PMID:34909099 | PMC:PMC8641636 | DOI:10.11604/pamj.2021.40.131.28217

Pan Afr Med J. 2021 Oct 13;40:96. doi: 10.11604/pamj.2021.40.96.26708. eCollection 2021.

ABSTRACT

INTRODUCTION: urogenital schistosomiasis affects school-aged children with impacts on health, growth, and cognitive development. Basic schools along active water bodies have a possibility of a high infection among the children.

METHODS: we performed a school-based cross-sectional assessment of urogenital schistosomiasis among children in four selected rural communities along major rivers in the central region of Ghana. Three hundred and nine (309) basic school children class 1 to junior high school (JHS) 3 were recruited. Sociodemographic data and information on behavioral influences were collected with a structured written questionnaire. Laboratory examinations were conducted on fresh urine samples. Descriptive statistics and cross-tabulations with measures of association between variables, adjusted and unadjusted logistic regression analysis were performed on measured variables.

RESULTS: we recorded a 10.4% prevalence of urogenital schistosomiasis. Schools in communities along the Kakum river recorded the highest disease burden (65.6%). The odds of infection among pupils who engage in irrigation activities were 4 folds more than those who do not engage in irrigation activities (adjusted odds ratio (aOR) (95%CI): 4.3 (1.6-12.1), P-value=0.005). Pupils of caregivers who resort to self-medication using local herbal concoctions had 14-fold more odds of infection compared to those who visit the health facility (aOR (95%CI): 14.4 (1.4-143.1), P-value=0.006).

CONCLUSION: poor health-seeking behaviors and lack of access to health facilities influenced the disease proportion among the children in these endemic communities.

PMID:34909084 | PMC:PMC8607954 | DOI:10.11604/pamj.2021.40.96.26708

Pan Afr Med J. 2021 Oct 4;40:74. doi: 10.11604/pamj.2021.40.74.26379. eCollection 2021.

ABSTRACT

INTRODUCTION: this is the first study assessing the psychological impact on Tunisian general population during the first peak of the COVID-19 pandemic. We aimed to assess the prevalence of anxiety, depressive symptoms and insomnia, as well as associated factors.

METHODS: a cross-sectional study was conducted through an online survey of 1615 people during March 23^rd to May 5^th, 2020. We used the hospital anxiety and depression scale for anxiety and depression screening, and the insomnia severity index to assess sleep disturbances.

RESULTS: our study revealed a high prevalence of anxiety and depressive symptoms, and insomnia (70.9%, 71.1% and 60.6% respectively). Multivariable statistics showed that anxiety symptoms were correlated to female gender (adjusted odds ratio [aOR] 1.784, 95% confidence interval (CI 1.252-2.542; p=10^-3), history of mental illness (aOR: 1.680, 95% CI: 1.329-2.125; p<10^-3), frequently social media exposure (aOR: 1.578, 95%CI: 1.250-1.992; p<10^-3), times to focus on COVID-19 ≥ 3hours (aOR: 1.840, 95% CI: 1.433-2.362; p<10^-3), consultation with doctor in the clinic in the past 14 days (aOR: 1.821, 95%CI : 1.220-2.718; p=0.003) and recent traumatic event in the past 14 days (aOR: 1.641,95% CI: 1.331-2.024; p<10^-3). Principal factors associated with depressive symptoms included female gender (aOR: 1.637, 95% CI: 1.150-2.331; p=0.006), history of mental illness (aOR: 1.498, 95% CI: 1.189-1.888; p=10^-3), times to focus on COVID-19 ≥ 3hours (aOR: 1.956, 95% CI: 1.555-2.461; p<10^-3), and recent traumatic event in the past 14 days (aOR: 1.558, 95% CI: 1.265-1.919; p<10^-3). The main factors correlated to insomnia were younger (age <35years) (aOR: 1.592, 95% CI: 1.17 -2.152; p=0.003), female gender (aOR: 1.864, 95% CI: 1.252-2.775; p=0.002), having organic diseases (aOR: 1.527, 95% CI: 1.131-2.061; p=0.006), history of mental illness (aOR: 1.777, 95% CI: 1.396-2.263; p<10^-3), students (aOR: 1.931, 95% CI: 1.495-2.495; p<10^-3), times to focus on COVID-19 ≥3hours (aOR: 1.877, 95% CI: 1.467-2.400; p<10^-3) and recent traumatic event (aOR: 1.431, 95% CI: 1.144-1.789; p=0.002).

CONCLUSION: our study revealed a major mental health burden in Tunisia during COVID-19 pandemic. Many factors were correlated to anxiety, depressive symptoms and insomnia, suggesting the need for greater psychological support in general and in certain vulnerable groups.

PMID:34909069 | PMC:PMC8637751 | DOI:10.11604/pamj.2021.40.74.26379

Pan Afr Med J. 2021 Oct 7;40:82. doi: 10.11604/pamj.2021.40.82.28157. eCollection 2021.

ABSTRACT

INTRODUCTION: domestic abuse against women is very common globally and has far-reaching consequences on the society. Therefore, it is essential to deeply study the seriousness of this public health issue among our pregnant women. The objectives were to determine the prevalence, pattern, and predictors of domestic abuse among pregnant women in Enugu, Nigeria.

METHODS: a cross-sectional study of 400 consenting pregnant women at the antenatal clinics of the University of Nigeria Teaching Hospital Ituku-Ozalla, Nigeria. Each woman completed a modified abuse assessment screen structured questionnaire. Data analysis was descriptive and inferential with Chi-square and multivariate binary logistic regression using SPSS version 21. A p-value of <0.05 was considered statistically significant.

RESULTS: a total of 172 out of 400 respondents (43.0%) had ever experienced domestic abuse in their pregnancies. One hundred and ten (37.2%; 110/296) of the multigravid women were abused in previous pregnancies while 137 (34.3%; 137/400) of all respondents were being abused in the current pregnancy. For all pregnancies, the most common type of abuse experienced by the respondents was verbal abuse (85.5%; 147/172), while the commonest perpetrators of abuse were the respondents´ spouses for both the index pregnancy (82.5%; 113/137) and previous pregnancies (84.5%; 93/110). The most common women perceived cause of abuse was financial constraints (68.6%; 118/172). Age less than 25 years (AOR=1.9, 95% CI=1.01-3.76, p=0.048), not having tertiary education (AOR=2.0, 95% CI=1.17 – 3.25, p=0.01), having at least a male child (AOR=3.3, 95% CI=1.71 – 6.40, p=<0.001), and maternal unemployed status (AOR=2.0, 95% CI=1.27 – 3.19, p=0.003) were the identified predictors among women abused in pregnancy.

CONCLUSION: the prevalence of domestic abuse was high among pregnant women in the University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu, Nigeria. The predominant women perceived cause of domestic abuse was financial constraints while age less than 25 years, not having tertiary education, having at least a male child, and maternal unemployed status were the predictors in abused women. Domestic abuse poses a great threat to women´s reproductive health, and so, its screening should be incorporated into antenatal care in our environment.

PMID:34909071 | PMC:PMC8607940 | DOI:10.11604/pamj.2021.40.82.28157

Clin Neuropsychiatry. 2021 Aug;18(4):188-195. doi: 10.36131/cnfioritieditore20210402.

ABSTRACT

OBJECTIVE: Affecting more than 264 million people, depression is a systemic and multifactorial disorder that represents one of the leading causes of illness and disability worldwide. Several studies showed an inflammatory response in depressed patients, including the involvement of both chronic low-grade inflammatory response and activation of cell-mediated immunity. The present study aimed to verify the efficacy of a structured functional therapy program for patients with depressed mood, and to determine whether this program can significantly reduce levels of C-reactive protein.

METHOD: 28 outpatients with depressed mood received 20 individual sessions of Functional therapy. Data about socio-demographic variables, depression, self-esteem, and quality of life were collected; moreover, blood specimens were collected before and after treatment, and CRP measurement was performed by immunoenzymatic method. All measures were administered at baseline, at the end of treatment (i.e., 3 months after baseline), and at follow-up (i.e., 6 months after baseline).

RESULTS: A repeated measures ANOVA showed a significant difference after treatment on depression levels, levels of self-esteem, and all dimensions of quality of life, such as physical, psychological, social relationships, and environment. Furthermore, a statistically significant difference on levels of CRP was found. Moreover, at follow-up, improvements were maintained.

CONCLUSIONS: The study revealed initial evidence of the efficacy of a functional therapy program on treating depression and its psychological and inflammation-related markers.

PMID:34909034 | PMC:PMC8650180 | DOI:10.36131/cnfioritieditore20210402

Arabian journal of chemistry. 2022 Feb;15(2):103595. doi: 10.1016/j.arabjc.2021.103595. Epub 2021 Nov 28.

ABSTRACT

This study reports the synthesis, characterization and importance of a novel diethyl 2-(2-(2-(3-methyl-2-oxoquinoxalin-1(2H)-yl)acetyl)hydrazono)malonate (MQOAHM). Two independent molecular structures of the disordered MQOAHM have been established by XRD‑single‑crystal analysis in a ratio of 0.596(3)/0.404(3), MQOAHM (a) and MQOAHM (b), respectively. MQOAHM was characterized by means of various spectroscopic tools ESI-MS, IR, ¹H &¹³C NMR analyses. Density Functional Theory (DFT) method, B3LYP, 6-311++G(d,p) basis set was used to optimize MQOAHM molecule. The obtained theoretical structure and experimental structure were superimposed on each other, and the correlation between them was calculated. The Highest Occupied Molecular Orbital (HOMO) and Lowest Unoccupied Molecular Orbital (LUMO) were created, and the energy gap between these orbitals was calculated. For analyzing intermolecular interactions, Molecular Electrostatic Potential (MEP) and Hirshfeld Surface Analysis were studied. For a fair comparative study, the two forms of the title compound were docked together with 18 approved drugs and N3 under precisely the same conditions. The disordered molecule structure’s binding scores against 7BQY were -7.0 and -6.9 kcal/mol^-1 for MQOAHM (a) and MQOAHM (b), respectively. Both the forms show almost identical superimposed structures and scores indicating that the disorder of the molecule, in this study, has no obvious effect. The high binding score of the molecule was attributed to the multi-hydrogen bond and hydrophobic interactions between the ligand and the receptor’s active amino acid residues. Worth pointing out here that the aim of using the free energy in Silico molecular docking approach is to rank the title molecule compared to the wide range of approved drugs and a well-established ligand N3. The binding scores of all the molecules used in this study are ranged from -9.9 to -4.5 kcal/mol^-1. These results and the supporting statistical analyses suggest that this malonate-based ligand merits further research in the context of possible therapeutic agents for COVID-19. Cheap computational techniques, PASS, Way2drug and ADMET, online software tools, were used in this study to uncover the title compound’s potential biological activities and cytotoxicity.

PMID:34909067 | PMC:PMC8627592 | DOI:10.1016/j.arabjc.2021.103595

Clin Neuropsychiatry. 2020 Dec;17(6):339-348. doi: 10.36131/cnfioritieditore20200603.

ABSTRACT

OBJECTIVE: Psychiatric morbidity, impulsive behaviour and use of dysfunctional and maladaptive defences are core features of personality disorder (PD). This study aims to evaluate the significance of the strength of the association between these three core dimensions and PD.

METHOD: Using a cross-sectional design, a sample of co-morbid Axis-I & -II disorders, and a sample of Axis-I disorders with no co-morbid PD were recruited at three general psychiatric mental health resource centres and then compared.PD as dependent variable was analysed both as a categorical and as a dimensional entity using the Structured Clinical Interview for DSM-IV. The Symptoms Checklist 90-R general severity index (GSI), the Barratt Impulsivity Scale (BIS) and the Defense Style Questionnaire (DSQ) were used to measure severity of psychiatric morbidity, impulsivity and defensive style, respectively.

RESULTS: BIS was a highly significant predictor of categorical PD (β = .13, SE = .03, p < .001), but not GSI and DSQ. BIS and GSI significantly predicted PD as a dimensional construct (β = 0.32, SE = .08, t = 4.05, p < 0.001; and β = 5.04, SE = 1.54, t = 3.28, p = 0.002, respectively). The diagnostic efficiency statistics found that BIS had greater sensitivity (.82) and specificity (.79), and overall predictive power (.87) of correctly identifying true positive and true negative PD diagnosis compared to the other two measures.

CONCLUSIONS: BIS may be used in routine clinical practice as a screening measure to identify the presence of PD in complex presentations.

PMID:34909012 | PMC:PMC8629056 | DOI:10.36131/cnfioritieditore20200603