In this paper,we present a comprehensive system model for Industrial Internet of Things(IIoT)networks empowered by Non-Orthogonal Multiple Access(NOMA)and Mobile Edge Computing(MEC)technologies.The network comprises e...In this paper,we present a comprehensive system model for Industrial Internet of Things(IIoT)networks empowered by Non-Orthogonal Multiple Access(NOMA)and Mobile Edge Computing(MEC)technologies.The network comprises essential components such as base stations,edge servers,and numerous IIoT devices characterized by limited energy and computing capacities.The central challenge addressed is the optimization of resource allocation and task distribution while adhering to stringent queueing delay constraints and minimizing overall energy consumption.The system operates in discrete time slots and employs a quasi-static approach,with a specific focus on the complexities of task partitioning and the management of constrained resources within the IIoT context.This study makes valuable contributions to the field by enhancing the understanding of resourceefficient management and task allocation,particularly relevant in real-time industrial applications.Experimental results indicate that our proposed algorithmsignificantly outperforms existing approaches,reducing queue backlog by 45.32% and 17.25% compared to SMRA and ACRA while achieving a 27.31% and 74.12% improvement in Qn O.Moreover,the algorithmeffectively balances complexity and network performance,as demonstratedwhen reducing the number of devices in each group(Ng)from 200 to 50,resulting in a 97.21% reduction in complexity with only a 7.35% increase in energy consumption.This research offers a practical solution for optimizing IIoT networks in real-time industrial settings.展开更多
Digital health innovations such as online webinars,websites,blogs,and health apps have been associated with increased sexual and reproductive health(SRH)among the general population.Many studies have been conducted in...Digital health innovations such as online webinars,websites,blogs,and health apps have been associated with increased sexual and reproductive health(SRH)among the general population.Many studies have been conducted in developed countries in the West;however,little research has been conducted in low-income countries,especially in Pakistan.The socioeconomic instability and the government's lack of awareness and knowledge have resulted in no regulations being placed to incorporate telehealth in medicine.The healthcare departments must take into consideration the lifechanging impact of telehealth and the barriers that prevent it in becoming known,to reduce the incidence of unsafe abortions and sexual health practices that prove to be a stigma in society.展开更多
Background: Maternal and neonatal mortality remains a public health problem in Benin. Each year, approximately 1500 maternal deaths and more than 12,000 newborn deaths are recorded there. In order to correct the situa...Background: Maternal and neonatal mortality remains a public health problem in Benin. Each year, approximately 1500 maternal deaths and more than 12,000 newborn deaths are recorded there. In order to correct the situation, strategies such as the implementation of Emergency Obstetric and Neonatal Care (EmONC) were initiated. Objective: Determine the rates of maternal deaths in EmONC centers in the Collines department from 2018 to 2022. Framework and Methods: The study took place in Benin precisely in the Collines department. This was a descriptive cross-sectional study. Data collection was carried out during the first two weeks of January 2023 and covered data from the 09 Basic Emergency Obstetric and Neonatal Care centers (BEMONC) and the Obstetric and Neonatal Care centers of Complete Emergency (CEmONC) of the Collines department from 2018 to 2022. An estimate of the ratios of maternal deaths occurring at the level of the EmONC centers of the Collines department from 2018-2022 was carried out followed by constructive suggestions. Results: During the five years (2018 to 2022), the Collines department recorded 42,582 live births with 148 maternal deaths, i.e. a ratio of 348 maternal deaths per 100,000 live births. Between 2018 and 2022, the highest maternal death ratio was recorded in 2019, i.e. 425 maternal deaths per 100,000 live births for all EmONC centers and 607 maternal deaths per 100,000 live births in EmONC centers. The highest maternal death ratio at the BEmONC center level was recorded in 2020, i.e. 129 maternal deaths per 100,000 births. Conclusion: These results suggest that despite the implementation of EmONC in the Collines department, maternal deaths have not decreased. To improve these outcomes for a reduction in maternal deaths, urgent action must be taken.展开更多
The Dimbokro health district has one of the highest incidences of malaria in Côte d’Ivoire, despite numerous campaigns to distribute Long-Acting Impregnated Mosquito Nets (LLINs). Given this observation, what ar...The Dimbokro health district has one of the highest incidences of malaria in Côte d’Ivoire, despite numerous campaigns to distribute Long-Acting Impregnated Mosquito Nets (LLINs). Given this observation, what are the population’s attitudes towards LLINs that could explain the high endemicity of malaria in Dimbokro? The aim of this study is to assess the knowledge, attitudes and practices of people in the health area of Nofou, one of the villages in the Dimbokro health district where malaria is most prevalent, with a view to strengthening malaria control strategies. A collection of historical health data (malaria cases and LLIN usage rates) and a cross-sectional questionnaire survey was carried out from July 20 to August 03, 2022 in 400 households selected by systematic random sampling. Data were entered using Epi Info 7 and multivariate statistical analyses were performed using IBM SPSS 22 software. In the Dimbokro health district, the rate of LLIN use was negatively correlated (r = -0.771) with malaria incidence over the six years of historical data collection. Households had an average of 53% good knowledge, 68.6% good practices and 28.4% good attitudes towards LLINs. The study also revealed that the main factors explaining LLIN use in the Nofou health area are mosquito bite (ORa = 5.29 (1.12 - 25.04)), age of household members (ORa = 1.07 (1.01 - 1.14)) and marital status (ORa = 8.45 (1.70 - 45.02)). Awareness-raising on the use of LLINs should be intensified in the Dimbokro health district. Other control strategies, such as vector control and environmental sanitation, should be considered to combat malaria.展开更多
Purpose: The purpose of this study was to clarify the relationship and experiences of occupational health nurses (OHNs) and related departments in project development of mental health care for primary treatment in the...Purpose: The purpose of this study was to clarify the relationship and experiences of occupational health nurses (OHNs) and related departments in project development of mental health care for primary treatment in the Japanese occupational health setting. Method: A total of 235 OHNs who are members of the Japan Academy of Occupational Health Nursing were sent an anonymous self-administered questionnaire survey. The questionnaire included items on the following: the OHN’s background, whether the OHN had experience in project development, the communication between the associated departments, the Japanese version of the Work Engagement Scale (UWES-J), occupational assessments, workplace assessments, and the Transtheoretical Model (TTM) for health promotion in companies and the OHN’s working environment. We performed logistic regression analysis to examine the relationship between experience and these harmonious relationships with other associated departments. Result: Responses from 61 OHNs (valid response rate: 25.9%) were analyzed. The mean number of years of service as an OHN was 18.9, and 82% of respondents had experience in project development. The logistic analysis further revealed that OHNs who had experience in project development of mental health care usually had a harmonious relationship with other associated departments. Conclusion: To promote mental health care for workers, OHNs have the capability to create individual and workplace assessments, enhance their work engagement, and make further improvements to their working environment. .展开更多
Objective: To study the public health Emergency Operations Centers(EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Co...Objective: To study the public health Emergency Operations Centers(EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Command Center in Chinese National Health and Family Planning Commission. Methods: Literature review was conducted to explore the EOCs of selected countries. Results: The study focused on EOC function, organizational structure, human resources and information management. The selected EOCs had the basic EOC functions of coordinating and commanding as well as the public health related functions such as monitoring the situation, risk assessment, and epidemiological briefings. The organizational structures of the EOCs were standardized, scalable and flexible. Incident Command System was the widely applied organizational structure with a strong preference. The EOCs were managed by a unit of emergency management during routine time and surge staff were engaged upon emergencies. The selected EOCs had clear information management framework including information collection, assessment and dissemination. Conclusions: The performance of National Health Emergency Response Command Center can be improved by learning from the good practice of the selected EOCs, including setting clear functions, standardizing the organizational structure, enhancing the human resource capacity and strengthening information management.展开更多
Objective:To explore health-improving behaviors during COVID-19 pandemic and to reveal the impact of the risk perception of COVID-19 on these behaviors.Methods:We recruited a total of 510 participants for this cross-s...Objective:To explore health-improving behaviors during COVID-19 pandemic and to reveal the impact of the risk perception of COVID-19 on these behaviors.Methods:We recruited a total of 510 participants for this cross-sectional study.The data were collected online using a questionnaire booklet covering a form inquiring about the participants’demographic,physical,and mental characteristics,the Generalized Anxiety Disorder-7 Scale,and the COVID-19 Perceived Risk Scale.Results:The mean age of the participants was(28.7±10.1)years,and 76.1%were females.Of the participants,31.8%were overweight and obese.While 35.1%experienced negative alterations in their dietary patterns,23.9%reported positive changes to their diet during the pandemic.Besides,47.8%reported their sleep to be negatively affected during the pandemic.While the rate of those with extended screen time was 72.5%,it was 44.3%for the participants engaging in regular exercise.More than one-third of the participants(35.9%)had high and severe anxiety.We also found increased risk perception of COVID-19 among females,obese,those with disturbed eating and sleep quality,healthcare workers,and those with severe anxiety.Conclusions:Overall,the pandemic has appeared to have brought both positive and negative impacts on maintaining and improving eating,sleep,physical activity,and mental health.展开更多
Objective:To investigate the stress perceptions of nurses serving in home healthcare services during COVID-19.Methods:This study was qualitative research with a phenomenological design.Data were collected and recorded...Objective:To investigate the stress perceptions of nurses serving in home healthcare services during COVID-19.Methods:This study was qualitative research with a phenomenological design.Data were collected and recorded through in-depth interviews with 6 nurses working in MuşState Hospital,Home Healthcare Services Unit using a form consisting of 12 questions on an online platform between May 2021 and July 2021.The audio recordings were transcribed by the researcher and content analysis was performed by creating codes,categories,and themes.Results:The interviews yielded 10 categories and 59 sub-codes.These codes were addressed under the theme of"COVID-19 pandemic".Under this main theme,nurses expressed the problems they experienced in issues such as stress,support mechanisms,and family and social problems during COVID-19.They mentioned that they experienced high stress in this process,as well as social isolation and negative thoughts of society about them and that they could not spare time for themselves and their families.Conclusions:Nurses working in home healthcare services frequently express negativities such as high stress,isolation from society,and increased workload.Therefore,actions should be taken to raise awareness of society on these issues,increase the number of personnel,conduct more research,and share the results with the public.展开更多
Objectives:This study was to longitudinally investigate the association between occupational change trajectories and mental health in the Korean population aged 45 years and older from the Korean Longitudinal Study of...Objectives:This study was to longitudinally investigate the association between occupational change trajectories and mental health in the Korean population aged 45 years and older from the Korean Longitudinal Study of Aging(KLo-SA).Methods:After excluding missing values,the data of 6,224 participants from thefirst to eighth waves of the KLo-SA were analyzed using t-test,Analysis of variance(ANOVA),Group-based Trajectory Model(GBTM)from 1–5th KLoSA and Time-Lagged Generalized estimating equation(GEE)model from 5–8th KLoSA to analyze the association between occupational change trajectories and mental health in the Korean population aged 45 years and older.Results:An analysis of the association between occupational change trajectories and mental health demonstrated that,among all age group,the“sustained in unemployment”group had a worse MMSE and CESD score compared to“sustained WC”group.unlike the under-54 age group,those aged≥55 years demonstrated reductions in the MMSE and CESD scores in the sustained unemployment and the changed working condition from Standard BC to Unemployment groups,whereas those who underwent a change from the Standard WC to unemployment group only demonstrated a reduction in MMSE scores.Conclusions:There was a close relationship between occupational change trajectories and mental health.Therefore,this study can serve as the foundation for policies and institutional measures to manage the deteriorate mental health in the late middle-aged and older population.展开更多
Globally,there have been multiple public health emergencies in recent decades.High rates of morbidity,occasionally mortality,and economic instability are usually associated with pandemics.One of the epidemics that has...Globally,there have been multiple public health emergencies in recent decades.High rates of morbidity,occasionally mortality,and economic instability are usually associated with pandemics.One of the epidemics that has significantly increased morbidity and mortality worldwide is the human immunodeficiency virus(HIV)and acquired immune deficiency syndrome(AIDS)pandemic.HIV has a disproportionately negative impact on key populations.Strong leadership,effective communication,and sound science are necessary for public health emergency(PHE)responses to be successful.These three PHE response pllars are also essential for bridging the HIV response gap among key populations in the setting of restrictive laws.In this review,we explored the importance of these three pillars of successful PHEs responses,and how they are essential to closing the gap in the HIV response among key populations.Leaders must make decisions and instil a sense of authority in the populace during PHEs to foster trust and confidence.Leaders should base their choices on scientific evidence.Effective communication during PHEs should be proactive,polite,imaginative,innovative,and constructive.To address gaps in the HIV response among key populations,leaders must create a supportive environment for effective communication and scientific research,communication should be used to raise awareness of HIV and to dispel stigma and discrimination,while science should provide evidence of efficacy and effectiveness of interventions amongkey populations.展开更多
Background: Recent studies suggested that vitamin D deficiency among children is widespread worldwide. Most of the Asian countries are suffering from high prevalence of vitamin D deficiency, especially in children. Ho...Background: Recent studies suggested that vitamin D deficiency among children is widespread worldwide. Most of the Asian countries are suffering from high prevalence of vitamin D deficiency, especially in children. However, the vitamin D deficiency of Bangladeshi children has not been investigated yet. The objective of the study was to assess the prevalence of vitamin D deficiency among children in Dhaka city, Bangladesh. Methods: A cross-sectional study was designed. Children aged 0 month to 16 years attended Pediatrics’ clinics with minor illness were conveniently recruited. After obtaining informed written consent, venous blood was taken and serum 25(OH)D levels were determined by direct enzyme-linked immunosorbent assay. Descriptive statistics were performed for age, sex, biochemical parameters. Socio-economic status (SES) was estimated using a wealth index, producing a weighted score. Scores were categorized into quintiles, with category 1 representing the poorest and category 5 the richest. Serum 25(OH)D was categorized: deficient as Results: 31.88% children of 0 - 1 year had deficient serum 25(OH)D level and 52.17% children had insufficient level. Among 2 - 5 years’ group, 38.16% were deficient and 50% were insufficient. Among the 6 - 11 years group, 41.02% were deficient and 52.56% were insufficient. Among 12 - 16 years group, 46.75% were deficient and 51.95% were insufficient. That means, serum 25-hydroxyvitamin D deficiency and insufficiency rate is found very high among Bangladeshi children. Conclusions: The prevalence of vitamin D deficiency and insufficiency among children in Bangladesh is high. The study recommended that vitamin D supplementation in Bangladeshi children should be formally launched from first day of birth up to adolescence.展开更多
Background: Breast cancer is a genetically and clinically heterogeneous disease with multiple subtypes. The classification of these subtypes has evolved over the years. The most common and widely accepted classificati...Background: Breast cancer is a genetically and clinically heterogeneous disease with multiple subtypes. The classification of these subtypes has evolved over the years. The most common and widely accepted classification of breast cancer is from an immunohistochemical perspective, based on the expression of the following hormone receptors: Estrogen Receptor (ER), Progesterone Receptor (PR) and Human Epidermal Growth Factor (HER2). Accordingly, the following four subtypes of breast cancer are widely recognized—Luminal A, Luminal B, HER2 Enriched and Triple Negative. Breast cancer management approaches include surgery, chemotherapy, radiotherapy and targeted hormone therapy necessitated by molecular subtyping. Aims: This study aimed to determine the level of adherence to breast cancer molecular subtyping among women with breast cancer attending tertiary health facilities in Imo State. Methodology: Immunohistochemistry reports of women with breast cancer attending tertiary health facilities in Imo State were retrieved from patient’s case files. Tissue blocks were also retrieved from tissue block archives of both hospitals for women who did not take up immunohistochemistry services after their initial diagnosis and also those whose immunohistochemistry reports were not found in their case files. Results: Among the 121 women that participated in the study, there were in all 74 (61.2%) had molecular subtyping of their tumour blocks. Up to 45 (37.2%) did not go for molecular subtyping of their tumour blocks while 2 (1.7%) were not sure whether they had or not. Conclusion: It, therefore, depicts that the rate of uptake was found as 61.2% among the participants and there is a need to create more awareness of the importance of molecular subtyping, which necessitates the use of targeted hormone therapy.展开更多
Background: Breast cancer is the leading cause of death from cancer in women worldwide. It can be stratified by histological and immunopathological analysis as well as by molecular subtypes. Socioeconomic and cultural...Background: Breast cancer is the leading cause of death from cancer in women worldwide. It can be stratified by histological and immunopathological analysis as well as by molecular subtypes. Socioeconomic and cultural-mediated factors contribute to breast cancer heterogeneity and overall survivability. Objective: The aim of this study was to determine the influence of socioeconomic profile on the uptake of immunohistochemistry (IHC) services among women with breast cancer attending tertiary health facilities in Imo State. Methodology: This descriptive cross-sectional study was carried out among women with breast cancer in Imo State. The instrument for data collection used was a structured questionnaire constructed in line with the objectives of the study. A total of 121 respondents were selected randomly from a target study population of 891 using a systematic sampling technique. The software Statistical Package for Social Sciences (SPSS) version 21 was used for data analysis. Results: The mean age of the 121 respondents in this study was 45.2 ± 0.7 years. Age and education levels of the respondents were found to significantly influence the utilization of IHC services (P Conclusion: In our study, the consumption of IHC services was influenced significantly by the respondents’ age and level of education. Consequently, public health awareness programmes centred on the importance of IHC services in the management of breast cancer should be encouraged, so as to reach the less educationally endowed and older women in order to save more lives.展开更多
Purpose: Malaria continues to be a public health threat, especially in sub-Saharan Africa, including Uganda. While Batwa Indigenous People (IPs) face a higher burden of malaria, there is limited understanding of their...Purpose: Malaria continues to be a public health threat, especially in sub-Saharan Africa, including Uganda. While Batwa Indigenous People (IPs) face a higher burden of malaria, there is limited understanding of their malaria-lived experiences. We assessed and characterized malaria illness and accessing healthcare lived experiences of the Batwa in Kanungu district to inform contextually and culturally appropriate public health interventions. Methods: An exploratory qualitative study was conducted in 5 Batwa settlements where 5 Focus Group Discussions (n = 36) and 13 Key Informant Interviews (n = 13) were held. Data were collected using printed guides and voice recorders in April 2018. Transcripts from the data that captured the lived experiences of the symptoms, prevention, treatment and barriers to accessing formal healthcare services were applied to Atlas.ti a qualitative data analysis software and condensed into codes, categories, and themes. Results: Many Batwa have experienced malaria in their households, and they know its causes and risk factors, like not sleeping under insecticide-treated mosquito nets (ITNs), living near water bodies, prevention measures like the use of ITNs, and vector management. The lived experiences demonstrate malaria management by an Indigenous population in a rural setting and comprised detecting malaria symptoms, use of herbs as first line of treatment, buying medicines from drug shops, and village health teams (VHTs) treatment. For many Batwa accessing formal healthcare is normally a second option. Barriers for malaria treatment included: long distances to health facilities, geographically difficult terrain, economic constraints, irregular health outreaches, and stockouts of malaria medicines at health facilities. Conclusion: This study characterized Batwa’s malaria illness lived experiences and access to healthcare in rural remote settings. These experiences are essential in appreciating the ways in which Indigenous populations understand and manage common illnesses and how appropriate policies and interventions can be developed.展开更多
Introduction: Maternal mortality, which is estimated at 614 deaths per 100,000 births in Côte d’Ivoire, is associated with a low national contraceptive prevalence rate of 13.9%. In this study, we are interes...Introduction: Maternal mortality, which is estimated at 614 deaths per 100,000 births in Côte d’Ivoire, is associated with a low national contraceptive prevalence rate of 13.9%. In this study, we are interested in the contraceptive experiences of women who attend health centers to estimate their rate of contraceptive use and to assess the factors involved in the use of modern contraceptive methods among women of childbearing age who are exposed to the risk of pregnancy. Method: A descriptive cross-sectional study was conducted from December 2018 to September 2019 among 423 women, who attended two health centers in Abidjan. A bivariate analysis identified factors associated with contraceptive use by these women. A descriptive analysis determined the means for the quantitative variables and the frequencies and percentages of qualitative variables. Interpretation of results was based on significance (α = 5%, 95% CI). Results: Contraceptive prevalence was 37%. There was a significant relationship between contraceptive use and the socio-demographic and reproductive characteristics of women (p Conclusion: Women who were over 35 years age, uneducated, primary school graduates, housewives, unemployed, in the informal sector, Muslims, nulliparous, and lacking information and decision-making power were less likely to use modern contraceptive methods. They are the target population for strategic interventions to improve contraceptive prevalence.展开更多
Background: Breast cancer is the most frequently diagnosed cancer among women, making it a significant global public health issue. Although developed countries have a higher incidence of breast cancer, developing coun...Background: Breast cancer is the most frequently diagnosed cancer among women, making it a significant global public health issue. Although developed countries have a higher incidence of breast cancer, developing countries like Nigeria have a low incidence rate but higher rates of morbidity and mortality from the disease. Objective: This study explored how cues to action influenced the use of immunohistochemistry by women in Imo State and how many of them used immunohistochemistry (IHC) to diagnose their condition. Methodology: We used a descriptive study methodology for the investigation, and 121 participants were chosen at random from the 891 total population. The respondents were chosen through a systematic sampling procedure. Structured questionnaire was used as the data collection tool, and the statistical software for social science (SPSS) was used to analyze the data. Results: The mean age of the 121 participants in the study was 45.2 ± 0.7 years. The study found that awareness of IHC services is a significant influencing factor for the uptake and health personnel is the major source of awareness of IHC services. Cues to action particularly from health workers, as well as knowledge of any victim of breast cancer and user of IHC services, also significantly influenced uptake of the IHC services (P Conclusion: In our study, utilization of IHC services was also impacted by cues to action, particularly from healthcare professionals, as well as awareness of any breast cancer victims and those who used IHC services thus cues to action is a major predicator of immunohistochemistry uptake among women with breast cancer.展开更多
Introduction: In spite of significant progress towards eliminating mother-to-child transmission (MCT) of HIV by 2025, trends in vertical mother-to-child transmission are still worrying in sub-Saharan African countries...Introduction: In spite of significant progress towards eliminating mother-to-child transmission (MCT) of HIV by 2025, trends in vertical mother-to-child transmission are still worrying in sub-Saharan African countries. This study aims to take stock of the factors associated with HIV MCT at the level of peripheral health training. Patients and Methods: This was a descriptive and analytical retrospective study, over a five-year period from January 1<sup>st</sup>, 2017 to December 31<sup>st</sup>, 2021. The study population was represented by HIV-positive women and their cared infants in the Parent-Child Transmission Prevention Unit (PCTP) of the Castors Urban Health Center (CUHC). Results: 288 medical records were selected out of a total of 347 HIV-positive mothers followed. HIV seroprevalence in the population of women who received PreNatal Consultation (PNC) during the study period was 8.2%. The HIV MCT rate was 3.7%. HIV+ mothers followed were mostly young (average age of 28), not living in a couple (96.9%), poorly educated (58.7%) and not engaged in income-generating activity (58.4%). They had all received triple therapy and the period of initiation of antiretroviral (ARV) therapy was in the majority of cases during the first trimester. Factors associated with MCT were: primiparity (OR = 18.4 [5.55 - 61.05];Khi<sup>2</sup> = 32.61;p < 0.001), late discovery of infection during large or after childbirth (OR = 0.03 [0.007 - 0.10];Khi<sup>2</sup> = 55.22;p < 0.001), WHO Clinical Stage 2 and 3 (OR = 0.007 [0.001 - 0.03];Khi<sup>2</sup> = 108.73;p < 0.001), CD4 count 200/mm<sup>3</sup> (OR = 14.12 [4.03 - 57.20];Khi<sup>2</sup> = 21.68;p < 0.001), viral load > 1000 copies/mm<sup>3</sup> (OR = 8.85 [2.33 - 43.20];Khi<sup>2</sup> = 10.46;p = 0.001), prolonged labor (OR = 12.33 [3.45 - 57.25];Khi<sup>2</sup> = 18.47;p < 0.001), premature rupture of membranes (OR = 24.03 [6.97 - 96.01];Khi<sup>2</sup> = 40.60;p <sup>2</sup> = 5.96;p = 0.014), and artificial or mixed breastfeeding (OR = 0.01 [0.002 - 0.043];Khi<sup>2</sup> = 97.65;p Conclusion: Taking into account the risk factors for PCTP is essential if we want to achieve the goal of “Zero New Infections in Children by the year 2025”.展开更多
Background: This study, it was aimed to determine the level of knowledge, attitudes, and behaviors of patients who applied to a family health center about the rational use of drugs. Irrational use of drugs is a major ...Background: This study, it was aimed to determine the level of knowledge, attitudes, and behaviors of patients who applied to a family health center about the rational use of drugs. Irrational use of drugs is a major problem worldwide. WHO reports that half of the patients do not use their drugs correctly. Methods: This cross-sectional study was conducted between 1 October 2017 and 30 November 2018 at Istanbul Fatih Family Health Center No 7. The sample size was determined as 301 people selected by systematic sampling method from patients aged 18 and older. Results: The mean age of the participants was 53.8% ± 16.8%, 59.8% were female, 62.5% were married, and 52.5% were primary school graduates. 63.9% of the participants knew the names of the drugs they used, and 79.9% of them knew the indication for use. 89% of individuals check the expiry date of the drugs before using them, and 83.1% read the drug prospectus. 84% of the participants support the prohibition of using over-the-counter drugs. Conclusion: The level of knowledge of the participants about the rational use of drugs is above the societal average. However, some issues need more awareness. The high level of rational use of drugs awareness of physicians and pharmacists will also strengthen the rational use of drugs and indirectly increase the awareness of the public.展开更多
Introduction: Cardio-renal syndrome (CRS) is a complex pathophysiological entity affecting the heart and kidneys in which acute or chronic dysfunction of one organ can induce acute or chronic dysfunction of the other ...Introduction: Cardio-renal syndrome (CRS) is a complex pathophysiological entity affecting the heart and kidneys in which acute or chronic dysfunction of one organ can induce acute or chronic dysfunction of the other organ. Five types of CRS have been described. Methods: The study explored the prevalence and types of Cardiorenal Syndrome (CRS) at CHU Ibn Sina in Rabat. Over a year, 120 CRS patients were assessed, excluding those with end-stage chronic renal failure. We analyzed the epidemiological, clinical, therapeutic and evolutionary profile of these patients. Results: The average age of our patients is 67.8 ± 12 years, with extremes ranging from 39 years to 92 years. The sex ratio is 1.35. The different types of CRS types (1, 2, 4 and 5) were noted respectively in 28.4%, 20.8%, 5%, 45.8%, however, we did not note patients having CRS type 3. On the renal level, we noted acute renal failure (ARF) in 51.6% of patients, of whom 61.3% had functional ARF and 38.7% presented with acute tubular necrosis. Chronic renal failure (CRF) is found in 48.4% of cases, of which 39% are at stage III and 61% are at stage IV. The etiology of CKD is dominated by hypertensive nephropathy (72.4%) followed by diabetic nephropathy (60.3%). Therapeutically diuretics are administered in 51% of our patients. We used hemodialysis in 9.1% of patients who are resistant to diuretics. Vasoactive drugs are used in 9.5% of our patients. Mortality risk factors for patients with CRS are significantly related to advanced age, long hospital stay, type 1 CRS, re-hospitalization, acute pulmonary edema (APE), use of hemodialysis, right heart failure (RHF), valvulopathy and hemodynamic instability (OR = 1.15, p = 0.01;OR = 4.5, p = 0.03;OR = 5.2, p = 0.019;p Conclusion: CRS type 5 was most common, with hypertension and diabetes being primary causes of Chronic Kidney Disease. Mortality factors were linked to acute pulmonary edema, hemodialysis, right heart failure, valvulopathy, and re-hospitalization.展开更多
Introduction: Painful proctological conditions that are far less pleasant can mar pregnancy and childbirth. In Mali, few studies have been carried out on proctological pathologies in pregnant women and in the postpart...Introduction: Painful proctological conditions that are far less pleasant can mar pregnancy and childbirth. In Mali, few studies have been carried out on proctological pathologies in pregnant women and in the postpartum period. Objective: To determine the frequency and identify the risk factors of anal pathologies during pregnancy and in the postpartum period in the obstetric gynecology department of the Centre de Santé de Référence de la comme IV du District de Bamako. Mali. Methods and Materials: Our observational study, a cross-sectional cohort survey over a period of nine (09) months from January 1, 2020 to September 30, 2020, was conducted in the obstetrics and gynecology department of the Health Center of Reference of Type IV of the District of Bamako. Results: The frequency of anal pathologies during pregnancy and in the post partum period was 24% (36/150). The different anal pathologies found were anal fissures, hemorrhoidal disease, anal incontinence and multiple anal pathologies with respectively 10%;6.67%;5.33%;2%. Chronic constipation (p = 0.003), a newborn weight > 3500 g (p = 0.000) to the occurrence of hemorrhoidal disease. For anal fissures, risk factors were noted such as (weight of the newborn > 3500 g (p = 0.002) and duration of fetal expulsion > 20 minutes (p = 0.000). Finally, a newborn weight > 3500 g (p = 0.000) and a maternal age of up to 30 years (p = 0.001) were associated with the occurrence of anal incontinence. Conclusion: Our study shows that anal pathologies affecting women's intimacy are frequent during pregnancy and in the postpartum period and are part of the many taboos difficult to address in our society.展开更多
基金the Deanship of Scientific Research at King Khalid University for funding this work through large group research project under Grant Number RGP2/474/44.
文摘In this paper,we present a comprehensive system model for Industrial Internet of Things(IIoT)networks empowered by Non-Orthogonal Multiple Access(NOMA)and Mobile Edge Computing(MEC)technologies.The network comprises essential components such as base stations,edge servers,and numerous IIoT devices characterized by limited energy and computing capacities.The central challenge addressed is the optimization of resource allocation and task distribution while adhering to stringent queueing delay constraints and minimizing overall energy consumption.The system operates in discrete time slots and employs a quasi-static approach,with a specific focus on the complexities of task partitioning and the management of constrained resources within the IIoT context.This study makes valuable contributions to the field by enhancing the understanding of resourceefficient management and task allocation,particularly relevant in real-time industrial applications.Experimental results indicate that our proposed algorithmsignificantly outperforms existing approaches,reducing queue backlog by 45.32% and 17.25% compared to SMRA and ACRA while achieving a 27.31% and 74.12% improvement in Qn O.Moreover,the algorithmeffectively balances complexity and network performance,as demonstratedwhen reducing the number of devices in each group(Ng)from 200 to 50,resulting in a 97.21% reduction in complexity with only a 7.35% increase in energy consumption.This research offers a practical solution for optimizing IIoT networks in real-time industrial settings.
文摘Digital health innovations such as online webinars,websites,blogs,and health apps have been associated with increased sexual and reproductive health(SRH)among the general population.Many studies have been conducted in developed countries in the West;however,little research has been conducted in low-income countries,especially in Pakistan.The socioeconomic instability and the government's lack of awareness and knowledge have resulted in no regulations being placed to incorporate telehealth in medicine.The healthcare departments must take into consideration the lifechanging impact of telehealth and the barriers that prevent it in becoming known,to reduce the incidence of unsafe abortions and sexual health practices that prove to be a stigma in society.
文摘Background: Maternal and neonatal mortality remains a public health problem in Benin. Each year, approximately 1500 maternal deaths and more than 12,000 newborn deaths are recorded there. In order to correct the situation, strategies such as the implementation of Emergency Obstetric and Neonatal Care (EmONC) were initiated. Objective: Determine the rates of maternal deaths in EmONC centers in the Collines department from 2018 to 2022. Framework and Methods: The study took place in Benin precisely in the Collines department. This was a descriptive cross-sectional study. Data collection was carried out during the first two weeks of January 2023 and covered data from the 09 Basic Emergency Obstetric and Neonatal Care centers (BEMONC) and the Obstetric and Neonatal Care centers of Complete Emergency (CEmONC) of the Collines department from 2018 to 2022. An estimate of the ratios of maternal deaths occurring at the level of the EmONC centers of the Collines department from 2018-2022 was carried out followed by constructive suggestions. Results: During the five years (2018 to 2022), the Collines department recorded 42,582 live births with 148 maternal deaths, i.e. a ratio of 348 maternal deaths per 100,000 live births. Between 2018 and 2022, the highest maternal death ratio was recorded in 2019, i.e. 425 maternal deaths per 100,000 live births for all EmONC centers and 607 maternal deaths per 100,000 live births in EmONC centers. The highest maternal death ratio at the BEmONC center level was recorded in 2020, i.e. 129 maternal deaths per 100,000 births. Conclusion: These results suggest that despite the implementation of EmONC in the Collines department, maternal deaths have not decreased. To improve these outcomes for a reduction in maternal deaths, urgent action must be taken.
文摘The Dimbokro health district has one of the highest incidences of malaria in Côte d’Ivoire, despite numerous campaigns to distribute Long-Acting Impregnated Mosquito Nets (LLINs). Given this observation, what are the population’s attitudes towards LLINs that could explain the high endemicity of malaria in Dimbokro? The aim of this study is to assess the knowledge, attitudes and practices of people in the health area of Nofou, one of the villages in the Dimbokro health district where malaria is most prevalent, with a view to strengthening malaria control strategies. A collection of historical health data (malaria cases and LLIN usage rates) and a cross-sectional questionnaire survey was carried out from July 20 to August 03, 2022 in 400 households selected by systematic random sampling. Data were entered using Epi Info 7 and multivariate statistical analyses were performed using IBM SPSS 22 software. In the Dimbokro health district, the rate of LLIN use was negatively correlated (r = -0.771) with malaria incidence over the six years of historical data collection. Households had an average of 53% good knowledge, 68.6% good practices and 28.4% good attitudes towards LLINs. The study also revealed that the main factors explaining LLIN use in the Nofou health area are mosquito bite (ORa = 5.29 (1.12 - 25.04)), age of household members (ORa = 1.07 (1.01 - 1.14)) and marital status (ORa = 8.45 (1.70 - 45.02)). Awareness-raising on the use of LLINs should be intensified in the Dimbokro health district. Other control strategies, such as vector control and environmental sanitation, should be considered to combat malaria.
文摘Purpose: The purpose of this study was to clarify the relationship and experiences of occupational health nurses (OHNs) and related departments in project development of mental health care for primary treatment in the Japanese occupational health setting. Method: A total of 235 OHNs who are members of the Japan Academy of Occupational Health Nursing were sent an anonymous self-administered questionnaire survey. The questionnaire included items on the following: the OHN’s background, whether the OHN had experience in project development, the communication between the associated departments, the Japanese version of the Work Engagement Scale (UWES-J), occupational assessments, workplace assessments, and the Transtheoretical Model (TTM) for health promotion in companies and the OHN’s working environment. We performed logistic regression analysis to examine the relationship between experience and these harmonious relationships with other associated departments. Result: Responses from 61 OHNs (valid response rate: 25.9%) were analyzed. The mean number of years of service as an OHN was 18.9, and 82% of respondents had experience in project development. The logistic analysis further revealed that OHNs who had experience in project development of mental health care usually had a harmonious relationship with other associated departments. Conclusion: To promote mental health care for workers, OHNs have the capability to create individual and workplace assessments, enhance their work engagement, and make further improvements to their working environment. .
文摘Objective: To study the public health Emergency Operations Centers(EOCs)in the US, the European Union, the UK and Australia, and summarize the good practice for the improvement of National Health Emergency Response Command Center in Chinese National Health and Family Planning Commission. Methods: Literature review was conducted to explore the EOCs of selected countries. Results: The study focused on EOC function, organizational structure, human resources and information management. The selected EOCs had the basic EOC functions of coordinating and commanding as well as the public health related functions such as monitoring the situation, risk assessment, and epidemiological briefings. The organizational structures of the EOCs were standardized, scalable and flexible. Incident Command System was the widely applied organizational structure with a strong preference. The EOCs were managed by a unit of emergency management during routine time and surge staff were engaged upon emergencies. The selected EOCs had clear information management framework including information collection, assessment and dissemination. Conclusions: The performance of National Health Emergency Response Command Center can be improved by learning from the good practice of the selected EOCs, including setting clear functions, standardizing the organizational structure, enhancing the human resource capacity and strengthening information management.
文摘Objective:To explore health-improving behaviors during COVID-19 pandemic and to reveal the impact of the risk perception of COVID-19 on these behaviors.Methods:We recruited a total of 510 participants for this cross-sectional study.The data were collected online using a questionnaire booklet covering a form inquiring about the participants’demographic,physical,and mental characteristics,the Generalized Anxiety Disorder-7 Scale,and the COVID-19 Perceived Risk Scale.Results:The mean age of the participants was(28.7±10.1)years,and 76.1%were females.Of the participants,31.8%were overweight and obese.While 35.1%experienced negative alterations in their dietary patterns,23.9%reported positive changes to their diet during the pandemic.Besides,47.8%reported their sleep to be negatively affected during the pandemic.While the rate of those with extended screen time was 72.5%,it was 44.3%for the participants engaging in regular exercise.More than one-third of the participants(35.9%)had high and severe anxiety.We also found increased risk perception of COVID-19 among females,obese,those with disturbed eating and sleep quality,healthcare workers,and those with severe anxiety.Conclusions:Overall,the pandemic has appeared to have brought both positive and negative impacts on maintaining and improving eating,sleep,physical activity,and mental health.
文摘Objective:To investigate the stress perceptions of nurses serving in home healthcare services during COVID-19.Methods:This study was qualitative research with a phenomenological design.Data were collected and recorded through in-depth interviews with 6 nurses working in MuşState Hospital,Home Healthcare Services Unit using a form consisting of 12 questions on an online platform between May 2021 and July 2021.The audio recordings were transcribed by the researcher and content analysis was performed by creating codes,categories,and themes.Results:The interviews yielded 10 categories and 59 sub-codes.These codes were addressed under the theme of"COVID-19 pandemic".Under this main theme,nurses expressed the problems they experienced in issues such as stress,support mechanisms,and family and social problems during COVID-19.They mentioned that they experienced high stress in this process,as well as social isolation and negative thoughts of society about them and that they could not spare time for themselves and their families.Conclusions:Nurses working in home healthcare services frequently express negativities such as high stress,isolation from society,and increased workload.Therefore,actions should be taken to raise awareness of society on these issues,increase the number of personnel,conduct more research,and share the results with the public.
文摘Objectives:This study was to longitudinally investigate the association between occupational change trajectories and mental health in the Korean population aged 45 years and older from the Korean Longitudinal Study of Aging(KLo-SA).Methods:After excluding missing values,the data of 6,224 participants from thefirst to eighth waves of the KLo-SA were analyzed using t-test,Analysis of variance(ANOVA),Group-based Trajectory Model(GBTM)from 1–5th KLoSA and Time-Lagged Generalized estimating equation(GEE)model from 5–8th KLoSA to analyze the association between occupational change trajectories and mental health in the Korean population aged 45 years and older.Results:An analysis of the association between occupational change trajectories and mental health demonstrated that,among all age group,the“sustained in unemployment”group had a worse MMSE and CESD score compared to“sustained WC”group.unlike the under-54 age group,those aged≥55 years demonstrated reductions in the MMSE and CESD scores in the sustained unemployment and the changed working condition from Standard BC to Unemployment groups,whereas those who underwent a change from the Standard WC to unemployment group only demonstrated a reduction in MMSE scores.Conclusions:There was a close relationship between occupational change trajectories and mental health.Therefore,this study can serve as the foundation for policies and institutional measures to manage the deteriorate mental health in the late middle-aged and older population.
文摘Globally,there have been multiple public health emergencies in recent decades.High rates of morbidity,occasionally mortality,and economic instability are usually associated with pandemics.One of the epidemics that has significantly increased morbidity and mortality worldwide is the human immunodeficiency virus(HIV)and acquired immune deficiency syndrome(AIDS)pandemic.HIV has a disproportionately negative impact on key populations.Strong leadership,effective communication,and sound science are necessary for public health emergency(PHE)responses to be successful.These three PHE response pllars are also essential for bridging the HIV response gap among key populations in the setting of restrictive laws.In this review,we explored the importance of these three pillars of successful PHEs responses,and how they are essential to closing the gap in the HIV response among key populations.Leaders must make decisions and instil a sense of authority in the populace during PHEs to foster trust and confidence.Leaders should base their choices on scientific evidence.Effective communication during PHEs should be proactive,polite,imaginative,innovative,and constructive.To address gaps in the HIV response among key populations,leaders must create a supportive environment for effective communication and scientific research,communication should be used to raise awareness of HIV and to dispel stigma and discrimination,while science should provide evidence of efficacy and effectiveness of interventions amongkey populations.
文摘Background: Recent studies suggested that vitamin D deficiency among children is widespread worldwide. Most of the Asian countries are suffering from high prevalence of vitamin D deficiency, especially in children. However, the vitamin D deficiency of Bangladeshi children has not been investigated yet. The objective of the study was to assess the prevalence of vitamin D deficiency among children in Dhaka city, Bangladesh. Methods: A cross-sectional study was designed. Children aged 0 month to 16 years attended Pediatrics’ clinics with minor illness were conveniently recruited. After obtaining informed written consent, venous blood was taken and serum 25(OH)D levels were determined by direct enzyme-linked immunosorbent assay. Descriptive statistics were performed for age, sex, biochemical parameters. Socio-economic status (SES) was estimated using a wealth index, producing a weighted score. Scores were categorized into quintiles, with category 1 representing the poorest and category 5 the richest. Serum 25(OH)D was categorized: deficient as Results: 31.88% children of 0 - 1 year had deficient serum 25(OH)D level and 52.17% children had insufficient level. Among 2 - 5 years’ group, 38.16% were deficient and 50% were insufficient. Among the 6 - 11 years group, 41.02% were deficient and 52.56% were insufficient. Among 12 - 16 years group, 46.75% were deficient and 51.95% were insufficient. That means, serum 25-hydroxyvitamin D deficiency and insufficiency rate is found very high among Bangladeshi children. Conclusions: The prevalence of vitamin D deficiency and insufficiency among children in Bangladesh is high. The study recommended that vitamin D supplementation in Bangladeshi children should be formally launched from first day of birth up to adolescence.
文摘Background: Breast cancer is a genetically and clinically heterogeneous disease with multiple subtypes. The classification of these subtypes has evolved over the years. The most common and widely accepted classification of breast cancer is from an immunohistochemical perspective, based on the expression of the following hormone receptors: Estrogen Receptor (ER), Progesterone Receptor (PR) and Human Epidermal Growth Factor (HER2). Accordingly, the following four subtypes of breast cancer are widely recognized—Luminal A, Luminal B, HER2 Enriched and Triple Negative. Breast cancer management approaches include surgery, chemotherapy, radiotherapy and targeted hormone therapy necessitated by molecular subtyping. Aims: This study aimed to determine the level of adherence to breast cancer molecular subtyping among women with breast cancer attending tertiary health facilities in Imo State. Methodology: Immunohistochemistry reports of women with breast cancer attending tertiary health facilities in Imo State were retrieved from patient’s case files. Tissue blocks were also retrieved from tissue block archives of both hospitals for women who did not take up immunohistochemistry services after their initial diagnosis and also those whose immunohistochemistry reports were not found in their case files. Results: Among the 121 women that participated in the study, there were in all 74 (61.2%) had molecular subtyping of their tumour blocks. Up to 45 (37.2%) did not go for molecular subtyping of their tumour blocks while 2 (1.7%) were not sure whether they had or not. Conclusion: It, therefore, depicts that the rate of uptake was found as 61.2% among the participants and there is a need to create more awareness of the importance of molecular subtyping, which necessitates the use of targeted hormone therapy.
文摘Background: Breast cancer is the leading cause of death from cancer in women worldwide. It can be stratified by histological and immunopathological analysis as well as by molecular subtypes. Socioeconomic and cultural-mediated factors contribute to breast cancer heterogeneity and overall survivability. Objective: The aim of this study was to determine the influence of socioeconomic profile on the uptake of immunohistochemistry (IHC) services among women with breast cancer attending tertiary health facilities in Imo State. Methodology: This descriptive cross-sectional study was carried out among women with breast cancer in Imo State. The instrument for data collection used was a structured questionnaire constructed in line with the objectives of the study. A total of 121 respondents were selected randomly from a target study population of 891 using a systematic sampling technique. The software Statistical Package for Social Sciences (SPSS) version 21 was used for data analysis. Results: The mean age of the 121 respondents in this study was 45.2 ± 0.7 years. Age and education levels of the respondents were found to significantly influence the utilization of IHC services (P Conclusion: In our study, the consumption of IHC services was influenced significantly by the respondents’ age and level of education. Consequently, public health awareness programmes centred on the importance of IHC services in the management of breast cancer should be encouraged, so as to reach the less educationally endowed and older women in order to save more lives.
文摘Purpose: Malaria continues to be a public health threat, especially in sub-Saharan Africa, including Uganda. While Batwa Indigenous People (IPs) face a higher burden of malaria, there is limited understanding of their malaria-lived experiences. We assessed and characterized malaria illness and accessing healthcare lived experiences of the Batwa in Kanungu district to inform contextually and culturally appropriate public health interventions. Methods: An exploratory qualitative study was conducted in 5 Batwa settlements where 5 Focus Group Discussions (n = 36) and 13 Key Informant Interviews (n = 13) were held. Data were collected using printed guides and voice recorders in April 2018. Transcripts from the data that captured the lived experiences of the symptoms, prevention, treatment and barriers to accessing formal healthcare services were applied to Atlas.ti a qualitative data analysis software and condensed into codes, categories, and themes. Results: Many Batwa have experienced malaria in their households, and they know its causes and risk factors, like not sleeping under insecticide-treated mosquito nets (ITNs), living near water bodies, prevention measures like the use of ITNs, and vector management. The lived experiences demonstrate malaria management by an Indigenous population in a rural setting and comprised detecting malaria symptoms, use of herbs as first line of treatment, buying medicines from drug shops, and village health teams (VHTs) treatment. For many Batwa accessing formal healthcare is normally a second option. Barriers for malaria treatment included: long distances to health facilities, geographically difficult terrain, economic constraints, irregular health outreaches, and stockouts of malaria medicines at health facilities. Conclusion: This study characterized Batwa’s malaria illness lived experiences and access to healthcare in rural remote settings. These experiences are essential in appreciating the ways in which Indigenous populations understand and manage common illnesses and how appropriate policies and interventions can be developed.
文摘Introduction: Maternal mortality, which is estimated at 614 deaths per 100,000 births in Côte d’Ivoire, is associated with a low national contraceptive prevalence rate of 13.9%. In this study, we are interested in the contraceptive experiences of women who attend health centers to estimate their rate of contraceptive use and to assess the factors involved in the use of modern contraceptive methods among women of childbearing age who are exposed to the risk of pregnancy. Method: A descriptive cross-sectional study was conducted from December 2018 to September 2019 among 423 women, who attended two health centers in Abidjan. A bivariate analysis identified factors associated with contraceptive use by these women. A descriptive analysis determined the means for the quantitative variables and the frequencies and percentages of qualitative variables. Interpretation of results was based on significance (α = 5%, 95% CI). Results: Contraceptive prevalence was 37%. There was a significant relationship between contraceptive use and the socio-demographic and reproductive characteristics of women (p Conclusion: Women who were over 35 years age, uneducated, primary school graduates, housewives, unemployed, in the informal sector, Muslims, nulliparous, and lacking information and decision-making power were less likely to use modern contraceptive methods. They are the target population for strategic interventions to improve contraceptive prevalence.
文摘Background: Breast cancer is the most frequently diagnosed cancer among women, making it a significant global public health issue. Although developed countries have a higher incidence of breast cancer, developing countries like Nigeria have a low incidence rate but higher rates of morbidity and mortality from the disease. Objective: This study explored how cues to action influenced the use of immunohistochemistry by women in Imo State and how many of them used immunohistochemistry (IHC) to diagnose their condition. Methodology: We used a descriptive study methodology for the investigation, and 121 participants were chosen at random from the 891 total population. The respondents were chosen through a systematic sampling procedure. Structured questionnaire was used as the data collection tool, and the statistical software for social science (SPSS) was used to analyze the data. Results: The mean age of the 121 participants in the study was 45.2 ± 0.7 years. The study found that awareness of IHC services is a significant influencing factor for the uptake and health personnel is the major source of awareness of IHC services. Cues to action particularly from health workers, as well as knowledge of any victim of breast cancer and user of IHC services, also significantly influenced uptake of the IHC services (P Conclusion: In our study, utilization of IHC services was also impacted by cues to action, particularly from healthcare professionals, as well as awareness of any breast cancer victims and those who used IHC services thus cues to action is a major predicator of immunohistochemistry uptake among women with breast cancer.
文摘Introduction: In spite of significant progress towards eliminating mother-to-child transmission (MCT) of HIV by 2025, trends in vertical mother-to-child transmission are still worrying in sub-Saharan African countries. This study aims to take stock of the factors associated with HIV MCT at the level of peripheral health training. Patients and Methods: This was a descriptive and analytical retrospective study, over a five-year period from January 1<sup>st</sup>, 2017 to December 31<sup>st</sup>, 2021. The study population was represented by HIV-positive women and their cared infants in the Parent-Child Transmission Prevention Unit (PCTP) of the Castors Urban Health Center (CUHC). Results: 288 medical records were selected out of a total of 347 HIV-positive mothers followed. HIV seroprevalence in the population of women who received PreNatal Consultation (PNC) during the study period was 8.2%. The HIV MCT rate was 3.7%. HIV+ mothers followed were mostly young (average age of 28), not living in a couple (96.9%), poorly educated (58.7%) and not engaged in income-generating activity (58.4%). They had all received triple therapy and the period of initiation of antiretroviral (ARV) therapy was in the majority of cases during the first trimester. Factors associated with MCT were: primiparity (OR = 18.4 [5.55 - 61.05];Khi<sup>2</sup> = 32.61;p < 0.001), late discovery of infection during large or after childbirth (OR = 0.03 [0.007 - 0.10];Khi<sup>2</sup> = 55.22;p < 0.001), WHO Clinical Stage 2 and 3 (OR = 0.007 [0.001 - 0.03];Khi<sup>2</sup> = 108.73;p < 0.001), CD4 count 200/mm<sup>3</sup> (OR = 14.12 [4.03 - 57.20];Khi<sup>2</sup> = 21.68;p < 0.001), viral load > 1000 copies/mm<sup>3</sup> (OR = 8.85 [2.33 - 43.20];Khi<sup>2</sup> = 10.46;p = 0.001), prolonged labor (OR = 12.33 [3.45 - 57.25];Khi<sup>2</sup> = 18.47;p < 0.001), premature rupture of membranes (OR = 24.03 [6.97 - 96.01];Khi<sup>2</sup> = 40.60;p <sup>2</sup> = 5.96;p = 0.014), and artificial or mixed breastfeeding (OR = 0.01 [0.002 - 0.043];Khi<sup>2</sup> = 97.65;p Conclusion: Taking into account the risk factors for PCTP is essential if we want to achieve the goal of “Zero New Infections in Children by the year 2025”.
文摘Background: This study, it was aimed to determine the level of knowledge, attitudes, and behaviors of patients who applied to a family health center about the rational use of drugs. Irrational use of drugs is a major problem worldwide. WHO reports that half of the patients do not use their drugs correctly. Methods: This cross-sectional study was conducted between 1 October 2017 and 30 November 2018 at Istanbul Fatih Family Health Center No 7. The sample size was determined as 301 people selected by systematic sampling method from patients aged 18 and older. Results: The mean age of the participants was 53.8% ± 16.8%, 59.8% were female, 62.5% were married, and 52.5% were primary school graduates. 63.9% of the participants knew the names of the drugs they used, and 79.9% of them knew the indication for use. 89% of individuals check the expiry date of the drugs before using them, and 83.1% read the drug prospectus. 84% of the participants support the prohibition of using over-the-counter drugs. Conclusion: The level of knowledge of the participants about the rational use of drugs is above the societal average. However, some issues need more awareness. The high level of rational use of drugs awareness of physicians and pharmacists will also strengthen the rational use of drugs and indirectly increase the awareness of the public.
文摘Introduction: Cardio-renal syndrome (CRS) is a complex pathophysiological entity affecting the heart and kidneys in which acute or chronic dysfunction of one organ can induce acute or chronic dysfunction of the other organ. Five types of CRS have been described. Methods: The study explored the prevalence and types of Cardiorenal Syndrome (CRS) at CHU Ibn Sina in Rabat. Over a year, 120 CRS patients were assessed, excluding those with end-stage chronic renal failure. We analyzed the epidemiological, clinical, therapeutic and evolutionary profile of these patients. Results: The average age of our patients is 67.8 ± 12 years, with extremes ranging from 39 years to 92 years. The sex ratio is 1.35. The different types of CRS types (1, 2, 4 and 5) were noted respectively in 28.4%, 20.8%, 5%, 45.8%, however, we did not note patients having CRS type 3. On the renal level, we noted acute renal failure (ARF) in 51.6% of patients, of whom 61.3% had functional ARF and 38.7% presented with acute tubular necrosis. Chronic renal failure (CRF) is found in 48.4% of cases, of which 39% are at stage III and 61% are at stage IV. The etiology of CKD is dominated by hypertensive nephropathy (72.4%) followed by diabetic nephropathy (60.3%). Therapeutically diuretics are administered in 51% of our patients. We used hemodialysis in 9.1% of patients who are resistant to diuretics. Vasoactive drugs are used in 9.5% of our patients. Mortality risk factors for patients with CRS are significantly related to advanced age, long hospital stay, type 1 CRS, re-hospitalization, acute pulmonary edema (APE), use of hemodialysis, right heart failure (RHF), valvulopathy and hemodynamic instability (OR = 1.15, p = 0.01;OR = 4.5, p = 0.03;OR = 5.2, p = 0.019;p Conclusion: CRS type 5 was most common, with hypertension and diabetes being primary causes of Chronic Kidney Disease. Mortality factors were linked to acute pulmonary edema, hemodialysis, right heart failure, valvulopathy, and re-hospitalization.
文摘Introduction: Painful proctological conditions that are far less pleasant can mar pregnancy and childbirth. In Mali, few studies have been carried out on proctological pathologies in pregnant women and in the postpartum period. Objective: To determine the frequency and identify the risk factors of anal pathologies during pregnancy and in the postpartum period in the obstetric gynecology department of the Centre de Santé de Référence de la comme IV du District de Bamako. Mali. Methods and Materials: Our observational study, a cross-sectional cohort survey over a period of nine (09) months from January 1, 2020 to September 30, 2020, was conducted in the obstetrics and gynecology department of the Health Center of Reference of Type IV of the District of Bamako. Results: The frequency of anal pathologies during pregnancy and in the post partum period was 24% (36/150). The different anal pathologies found were anal fissures, hemorrhoidal disease, anal incontinence and multiple anal pathologies with respectively 10%;6.67%;5.33%;2%. Chronic constipation (p = 0.003), a newborn weight > 3500 g (p = 0.000) to the occurrence of hemorrhoidal disease. For anal fissures, risk factors were noted such as (weight of the newborn > 3500 g (p = 0.002) and duration of fetal expulsion > 20 minutes (p = 0.000). Finally, a newborn weight > 3500 g (p = 0.000) and a maternal age of up to 30 years (p = 0.001) were associated with the occurrence of anal incontinence. Conclusion: Our study shows that anal pathologies affecting women's intimacy are frequent during pregnancy and in the postpartum period and are part of the many taboos difficult to address in our society.
