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The Prevalence and Pattern of Depression in Patients with Tuberculosis on Follow up at Jimma University Specialized Hospital and Jimma Health Center

Original Article

The Prevalence and Pattern of Depression in Patients with Tuberculosis on Follow up at Jimma University Specialized Hospital and Jimma Health Center

Alinur Adem, Markos Tesfaye, Mohammed Adem Mohammed

   

Abstract
Depression is an important public-health problem and is one of the leading causes of disease burden affecting 121 million people worldwide. The life time risk of depression in the general population is higher in women than men. However, the prevalence of depression in those with chronic illnesses is much higher. Depression and chronic illnesses co-exist because of physical changes from the illness trigger the depression resulting in vicious cycle. The prevalence of depression in tuberculosis patients is about 49%. It increases in prevalence with older age, duration of illness, disease severity and HIV Co infection. Aim of this study was to assess the prevalence of depression in the tuberculosis patients and its relationship with regard to socio demographic factors, disease characteristics, treatment factors and HIV infection. Institution based cross sectional survey was conducted by a face to face interview using standardized questioner, the Kessler, which has scores for classifying the patients having depression. It was conducted at Jimma University Specialized Hospital and Jimma Health Center Tuberculosis follow up clinics on 248 patients from January 1 to 29, 2010. In addition, reviewing of records of the patients was done. The study showed that 19.82% of tuberculosis patients were cases of depression from a total of 222 patients that were interviewed. Depression cases were 100% in older age group. From the total female population, depression cases were 25%. In widowed, it was 36.36%. Most of them (32.20%) were those who had attended secondary school. Farmers had higher depressive rate being 61.11%. Regarding disease characteristics, 21.86% of the depressed had pulmonary TB. Those who had illness lasting greater than 1.5 year had higher percentage being 71.43%. Majority of the depressed (26.75%) were in category I and 63.64% in initiation phase. Significant proportions (65.12%) of the depressed were HIV positive (x2=8.08, p-value = 0.001). There was significant percentage of depressed TB patients. The treatment of psychiatric co morbidities should be incorporate in the treatment of TB patients in order to achieve the goal of the Directly Observed Therapy strategy.

Key words: Depression, tuberculosis, prevalence, Ethiopia

Med-Science. 2014; 3(1): 955-68

Medicine Science Vol:3 Issue:1 Year:2014 PP:955–1139

Self-medication and Contributing Factors among Pregnant Women Attending Antenatal Care in Ethiopia: The Case of Jimma University Specialized Hospital

Original Article

Self-medication and Contributing Factors among Pregnant Women Attending Antenatal Care in Ethiopia: The Case of Jimma University Specialized Hospital

Abdi Befekadu, Nezif Hussein Dhekama, Mohammed Adem Mohammed

   

Abstract
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 a pre-tested semi-structured interview questionnaire was conducted on 315 pregnant women who are attending ANC at JUSH. Majority (54.8%, n=166) of the respondents were Oromo ethnically and 144 (47.5%) were Muslims, at least attended secondary education were 69%. The prevalence of self-medication in this study was 20.1%. The two main reasons for self-medication were easily available 35 (57.4%) and time saving 27 (44.3%). There was a significant association between self-medication and prior self-medication experience maternal education, age of the respondents, number of children and place of residence (p

Key words: Self-medication, pregnant women, antenatal care

Med-Science. 2014; 3(1): 969-81

Seroprevalence of HBsAg, Anti-HBs, anti-HDV and HDVAg in İnönü University Medical Faculty Hospital, 2012 [İnönü Üniversitesi Tıp Fakültesi Hastanesinde, 2012 Yılında, HBsAg, Anti-HBs, Anti-HDV ve HDVAg Seroprevalansı]

Original Article

Seroprevalence of HBsAg, Anti-HBs, anti-HDV and HDVAg in İnönü University Medical Faculty Hospital, 2012 [İnönü Üniversitesi Tıp Fakültesi Hastanesinde, 2012 Yılında, HBsAg, Anti-HBs, Anti-HDV ve HDVAg Seroprevalansı]

Yücel Duman, Mehmet Sait Tekerekoğlu, Selma Ay

   

Abstract
This study aimed to determine the seroprevalence of HBV and HDV in our hospital by examining the test results of HBsAg, anti-HBs, anti-HDV and HDV-Ag. Test results were evaluated retrospectively from the sera which obtained from patients admitted to hospital with suspected hepatitis in Inonu University Faculty of Medicine, 2012. The presence of HBsAg and anti-HBs in sera was investigated by using the macro ELISA Abbot – Architect i2000 system test kits, the presence of anti-HDV and HDV-Ag was investigated by micro-ELISA (Alisei, Seac Radim Comp. Rome, Italy) method. 14 522 sera were studied. 2093 (14%) of them were positive for HBsAg and 6758 (47%) were positive for anti-HBs. Among HBsAg positive sera; 316 (15%) were positive for anti-HDV and 6 (0.3%) were positive for HDV-Ag. During HBV and HDV infections considering the complications, financial aspects of cases treatment; vaccination against HBV, preventive measures and education should be given priority issues.

Key words: Hepatitis Delta Virus, Hepatitis B Virus, anti-HDV, HBsAg, Seroprevalence

Med-Science. 2014; 3(1): 982-90

A New Classification (Grading System) of Debridement in Diabetic Lower Limbs – an Improvization and Standardization in Practice of Diabetic Lower Limb Salvage Around the World

Original Article

A New Classification (Grading System) of Debridement in Diabetic Lower Limbs - an Improvization and Standardization in Practice of Diabetic Lower Limb Salvage Around the World

Amit Kumar C Jain

   

Abstract
Debridement is one of the most common and also a most underestimated surgical procedure performed by surgeons. For specialist like Podiatric surgeons and qualified wound care nurses, debridement of diabetic foot wounds has been an essential day to day common surgical practice. Inspite of being such a common procedure, there is no classification of debridement when it comes to diabetic limb salvage practice till date. The word debridement is used loosely and equally for all diabetic foot lesions without specification. The author, being one of the few handful specialist podiatric surgeons in India, proposes a new simple classification [grading system] for surgical debridement of diabetic lower limb wounds which could be used in day to day practice and which will help in standardizing the practice of diabetic lower limb salvage in developed, developing and underdeveloped countries and thus can form a language of medical communication in field of diabetic limb salvage. There is currently an urgent need for newer concepts, standardization and recent advances in diabetic foot practice in developing countries where this speciality is neglected. This new grading system is one such novel step by the author towards improvisation of diabetic foot practice.

Key words: Diabetic foot, debridement, Amit Jain’s grading, Type 1 diabetic foot complications

Med-Science. 2014; 3(1): 991-1001

The Code Blue Experiences: Gains, Problems and Troubleshooting [Hasta Güvenliğinde Mavi Kod Uygulama Sonuçlarının Değerlendirilmesi]

Original Article

The Code Blue Experiences: Gains, Problems and Troubleshooting [Hasta Güvenliğinde Mavi Kod Uygulama Sonuçlarının Değerlendirilmesi]

Emin Murat, Selime Toprak, Derya Buğur Doğan, Fatma Mordoğan

   

Abstract
The code blue, which is a professional resuscitation team organization, has an important role for the survival of patients with respiratory or/and cardiac arrest in the hospitals. This study was respectively designed to evaluate the affectivity, safety, significance, benefits and outcomes of the code blue implementation in accordance with quality policy of our hospitals. All the code blue calls were respectively reviewed over the period of d 2010 to 2012 years in the Malatya State Hospital that has 800 general ward beds. Patients demographic variables, code blue call forms, registry documents, problems reports and solutions reports for these problems, experiences of the quality management meetings and the patient safety committee meetings reports were evaluated. Total of 180 patients (103 male and 77 female) were included into the study. The mean age of the patients was 72. The mean response time of code blue teams to the patient was 2.72 minutes. The most frequent call times for code blue was between 10-11 pm. After code blue calls, 53 % of the patients were dead, 19 % of them needed to advanced life support and 28 % were improved in general status. This study showed that implementing the code blue was associated with significant improvement in outcome for hospitalized patients, and it is an accurate and irrevocable standard method in terms of hospital quality, medical ethics, legal responsibility and patients’ safety.

Key words: Code blue, patient’s safety, quality

Med-Science. 2014; 3(1): 1002-12

Neck and Wrist Circumferences Propose a Reliable Approach to Qualify Obesity and Insulin Resistance

Original Article

Neck and Wrist Circumferences Propose a Reliable Approach to Qualify Obesity and Insulin Resistance

Banu Taskiran Tatar, Canan Ersoy, Turgut Kacan, Emine Kirhan, Emre Sarandol, Deniz Sigirli, Selen Kacan, Celaleddin Demircan, Sazi İmamoglu

   

Abstract
Objective of this study is to evaluate the association of neck circumference and wrist circumference with traditional abdominal and general obesity measurement parameters, insulin resistance, insulin resistance-related factors such as blood lipids, fasting glucose, insulin concentration and adiponectin, in order to predict their values as obesity measurement parameters. Eighty six female and 20 male subjects between 18-75 years of age were included in the study. Body weight, height, waist, hip, neck and wrist circumferences were measured. Body mass index and waist-to-hip ratio were calculated. Laboratory parameters such as fasting blood glucose, total cholesterol, triglyceride, high density lipoprotein cholesterol, insulin and adiponectin were measured after 12 hours of overnight fasting. Low density lipoprotein cholesterol and the insulin resistance index (HOMA-IR) were calculated. Neck circumference showed positive correlation with age, weight, body mass index, waist and hip circumferences, waist to hip ratio, wrist circumference, insulin, HOMA-IR and negative correlation with adiponectin and high density lipoprotein cholesterol in females and positive correlation with weight, body mass index, waist and hip circumferences, waist to hip ratio and negative correlation with adiponectin in males. Wrist circumference showed positive correlation with weight, body mass index, neck, waist and hip circumferences, waist to hip ratio, insulin, HOMA-IR and negative correlation with adiponectin, high density lipoprotein cholesterol in females. No correlation was found in male subjects. Neck circumference can be a reliable obesity and insulin resistance parameter in both genders. Wrist circumference requires further investigation for the classification of its’ possible position in obesity evaluation.

Key words: Obesity, insulin resistance, adiponectin, neck circumference, wrist circumference

Med-Science. 2014; 3(1): 1013-25

Neutrophil Lymphocyte Ratio in Patients Receiving Isotretinoin for Acne Vulgaris

Original Article

Neutrophil Lymphocyte Ratio in Patients Receiving Isotretinoin for Acne Vulgaris

Arzu Ataseven, Gulcan Saylam Kurtipek, Perihan Ozturk

   

Abstract
The aim of this study is to assess the neutrophil, lymphocyte and neutrophil lymphocyte ratio in patients receiving isotretinoin for acne treatment. 110 (64 women, 46 men) patients with acnevulgaris were included in this study. Patients were treated with 0.5-1 mg/kg/day isotretinoin. The laboratory results were collected retrospectively from the patients’ records. Neutrophils, lymphocytes, and neutrophils lymphocytes ratio before treatment and at the third months after the treatment were collected retrospectively. Statistical analysis was performed using PASW Statistics 18. Paired sample T-test was used to compare pre-and post treatment parameters. The mean number of neutrophils in patients with pre-treatment and post-treatment were; 4354±1623 and 4147±1659, the mean lymphocyte counts were 2410±716 and 2384±681 and NLO values before and after treatment were 2.06 ±1.42 and 2.00 ±1.99, respectively. There is no statistically significant difference for the three values (p> 0.05). The effect of isotretinoin therapy in patients with acne vulgaris is not determined on neutrophil and lymphocyte counts and neutrophil lymphocyte ratio.

Key words: Acne, neutrophil, lymphocyte, neutrophil lymphocyte ratio

Med-Science. 2014; 3(1): 1026-31

The Incidence of Upper Gastrointestinal Complications of Non-Steroidal Anti-Inflammatory Drugs in Elderly Patients

Original Article

The Incidence of Upper Gastrointestinal Complications of Non-Steroidal Anti-Inflammatory Drugs in Elderly Patients

Ahmed H. A. Hassanein, Mohamed A.E. Abdelrahim, Amira S.A. Said, Raghda R.S. Hussein, Mohamed Abuseif

   

Abstract
The incidence of upper gastrointestinal (GI) complications of non-steroidal anti-inflammatory drugs remains the most common side effect. The objective of this study was to compare the incidence of upper gastrointestinal complications of Ibuprofen as non-selective non-steroidal anti-inflammatory drug (NSAID) to Celecoxib and Meloxicam as selective non-steroidal anti-inflammatory drugs. This study included 4 groups of subjects aging above 50 years old divided into control group including 10 healthy volunteers suffering from the symptom of dyspepsia and three test groups, each test group included 10 osteoarthritic or rheumatic patients receiving only one NSAIDs (Ibuprofen, Celecoxib or Meloxicam) from at least 1 month. There was a statistically highly significant difference between the studied groups regarding the incidence of dyspepsia (p-value=0.008) and regarding the incidence of gastritis (p-value=0.042). In group II, there was a statistically significant correlation between the duration of administration of Ibuprofen and the incidence of dyspepsia. Similarly, in group III, there was a statistically significant correlation between the duration of administration of Celecoxib and the incidence of dyspepsia. Controversial, in group IV, there was no statistically significant correlation between the duration of administration of Meloxicam and the incidence of dyspepsia or gastritis or ulcer.
Incidence of gastrointestinal side effects was lower for Celecoxib than for Meloxicam than for Ibuprofen. The study concluded that Celecoxib was safer than Meloxicam than Ibuprofen on the upper gastrointestinal tract.

Key words: Non-steroidal anti-inflammatory drugs, upper gastrointestinal tract complications, Ibuprofen, Celecoxib, Meloxicam

Med-Science. 2014; 3(1): 1032-45

Significance of Healthy Family Structure in Preventing Child Sexual Abuse: A Prospective Controlled Study

Original Article

Significance of Healthy Family Structure in Preventing Child Sexual Abuse: A Prospective Controlled Study

Mustafa Talip Sener, Yuksel Anci, Onur Burak Dursun

   

Abstract
The aim of this study was to determine the socio-demographic characteristics of victims, parents, and accused or suspected child abusers, and to evaluate the conditions that constitute the risk factors for children falling victim to sexual abuse in Eastern Anatolian Region of Turkey. Personal data files of 63 victims of child sexual abuse were analyzed and compared with 201 individuals in a control group. The children’s age, gender, educational level, number of siblings, and the nature of the event they experienced, were all examined. In addition, parents’ educational and economic levels; and parents’ relationship, were also evaluated. Of the victims 66.7% were female (n=42), while the average age of the victims was 14.2 years. A total of 52.4% (n=33) of the victims were exposed to major crime, and 47.6% (n=30) were exposed to simple sexual activity. Risk factors for children who were exposed to sexual abuse were parental conflict, low educational level of the father, non-working father, low economic level of the family, and crowded family. Domestic violence negatively affects family members, especially children, and is a main risk factor for children becoming victims of abuse.

Key words: Child abuse, sexual abuse, parental conflict

Med-Science. 2014; 3(1): 1046-53

Effects of Benzo(a)pyrene and Ethanol on Morphology and Antioxidant Status and Transaminases in Rat Liver

Original Article

Effects of Benzo(a)pyrene and Ethanol on Morphology and Antioxidant Status and Transaminases in Rat Liver

Memet Hanifi Emre, Göknur Aktay, Alaadin Polat, Feral Öztürk

   

Abstract
Ethanol and benzo(a)pyrene cause an increase in lipid peroxidation either by producing the reactive oxygen species or decreasing the level of endogenous antioxidant enzymes that leads to cellular damage and cellular dysfunction. The aim of this study was to investigate both physiological and histological changes in liver tissue after administration of benzo(a)pyrene and ethanol
Male Sprague Dawley rats were divided into four groups. Group I was control group. Group II treated with benzo(a)pyrene, group III treated with benzo(a)pyrene plus ethanol and group IV was given ethanol. Superoxide dismutase (SOD), alanin aminotransferase (ALT), aspartat aminotransferase (AST) , gamma-glutamyl transferase (GGT), glutathione (GSH), malondialdehyde (MDA) levels as well as histological examination were evaluated to demonstrate the liver response following administration of benzo(a)pyrene and ethanol separately and together. SOD activities of the liver tissue in the experimental groups were decreased when compared to the control group. Activities of ALT, AST and GGT of the liver tissue in all experimental groups were found significantly higher than that of the control group. GSH levels of the liver tissue of the experimental groups were lower than the control group especially in group IV. When we compared MDA levels among study groups, MDA levels of experimental groups were found significantly higher than the control group. Exposure to BAP resulted in hepatocellular changes in the periportal area and inflammatory cell infiltration . On the other hand, liver tissue in group III and IV, which was treated with BAP plus EtOH and EtOH alone respectively, showed seldom inflammatory cell infiltrations. BAP and EtOH administration alone or together discretely determined changes in the GSH, MDA levels and SOD ALT,AST and GGT enzyme activities in the liver tissues. Additionally, we noted BAP induced hepatocellular changes in the periportal area.

Key words: Liver, antioxidant enzymes, ethanol, benzo(a)pyrene , MDA, ALT, AST, GGT

Med-Science. 2014; 3(1): 1054-67