by Maurice Mike Ogolla, Damian Otieno Opemo and Collins Otieno Asweto
Original Research
Early mobilization in acute stroke care is highly recommended in a range of developed countries policy; however, in developing countries like Kenya, lack of evidence seems to hinder formulation and implementation of policy guideline on early mobilization in acute stroke care. Therefore, to estimate the safe optimal time for early mobilization of stroke patients in Kenya, we conducted a prospective cohort study in two purposively selected health facilities in Kisumu County, Kenya. About 100 stroke patients admitted in medical wards (mean age 59.1±2.3 years, females 61%) were recruited. Barthel Index’ tool was used to assess recovery and physical activity levels. It comprised of scoring scale ranging from 0-100. The participants were categorized as follows: Patients who score between 0 – 30 were considered as mildly recovered, 31 - 60 as moderately recovered and patients who score from 61 – 100 were regarded as fully recovered. Multiple logistic regression model was used to compute adjusted ORs (AOR) of early mobilization and Barthel Index variable, adjusting for age, gender and type of stroke. Early mobilization improves patient recovery. Participants in early mobilization group were more like to independently feed, groom, dress, use toilet, use wheel chair and climb stairs with help compared to late mobilization (p <0.05). Most (76%) participants who were exposed to high physical activity had full recovery than the (5%) bones in low physical activity (p< 0.001). This study provides evidence that early mobilization and high physical activity improves stroke patient recovery.escitalopram afbouwen
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American Journal of Public Health Research. 2016, 4(4), 154-158. DOI: 10.12691/ajphr-4-4-6
Pub. Date: July 19, 2016
16143 Views4914 Downloads1 Likes
by Mohammad U. Malik, Amibahen Gandhi, Hassan Tahir, Jhanavi Sagi, Sandhya Narukonda, Thomas Simunich, Saba Waseem and Medha Joshi
Original Research
Introduction: The transition of patient care to the resident on call during the sign-out/hand off is an integral part of residency training and is a time vulnerable to medical errors. Methods: Authors conducted the study from July 28th to December 14th 2014. Residents (n=26) were required to sign-out via the electronically via the SBAR (Situation-Background-Assessment-Recommendation) based electronic template. The quality of sign-out was assessed by night float questionnaire. The quality of the sign-out (scale 1 to 5), preventable morbidities, LOS, mortalities and readmissions were compared pre and post intervention for the admitted patients (pre= 184, post=172). Results: Improvement in the mean quality (Likert scale 1-5) of both the written sign-out, 3.0 to 3.8 (p<0.001), and verbal sign-out, 3.0 to 3.6 (p=0.002) (n=22 pre and post), was found. The preventable morbidities decreased from 10% to 5% (p=0.047). No statistically significant difference was noted for lethal morbidities, length of stay or readmissions. Conclusion: Implementation of electronic sign-out in addition to verbal sign-out improved the quality of sign-out with trend towards reduction in morbidities. The electronic sign-out may provide key information and help the on call team to make better decisions regarding the patient care.amoxicillin bivirkninger
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American Journal of Public Health Research. 2016, 4(4), 149-153. DOI: 10.12691/ajphr-4-4-5
Pub. Date: July 16, 2016
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by Bayu Begashaw, Abera Beyamo Mekiso and Tegene Legesse
Original Research
Background: prisoners are at a disproportionately high risk and neglected reservoirs and susceptible population for TB. Objective: To determine prevalence of pulmonary tuberculosis and associated factors among prisoners in Wolaita Zone, Southern Ethiopia. Methods: A cross-sectional study design was performed on 302 study participants to assess the prevalence and risk factors of pulmonary tuberculosis among prisoners in Wolaita Zone, Southern Ethiopia, from March01/2015 to April 01/2015. Prisoners with a history of cough of ⩾2 weeks were screened for PTB using direct smear microscopy. Structured questionnaire was used to collect data on risk factors of pulmonary tuberculosis. Bivariate and multivariable binary Logistic regression was used to identify predictors of pulmonary tuberculosis. Result: A total of 302 prisoners were included in the study. Among those, 15 (4.97%) prisoners were found to have TB giving a point prevalence of 966 per 100,000 populations of pulmonary TB among the study participants. Pulmonary tuberculosis was significantly associated with cigarette smoking (AOR=5.42, 95%CI= (1.21, 24.25), having history of contact with known TB patients at home (AOR=7.01, 95%CI= (1.54, 31.90), Sharing a cell with a known TB patient (AOR=7.09, 95%CI= (1.59, 31.64), stay greater than 24 months in current prison (AOR=0.09, 95%CI= (0.02,0.47). and BMI<18.5kg/m2 ((AOR=5.35,95%CI=(1.01,28.22). Conclusions and recommendation: There is high prevalence of TB among Prisoners in Wolaita Zone with possible active transmission of TB within the prison than general community. Strong cooperation between prison authorities and the national tuberculosis control programmers is urgently required to develop locally appropriate interventions to reduce transmission.
American Journal of Public Health Research. 2016, 4(4), 142-148. DOI: 10.12691/ajphr-4-4-4
Pub. Date: July 14, 2016
7187 Views3462 Downloads1 Citations
by Adeolu M.O, Akpa O.M, Adeolu A.T and Aladeniyi I.O
Original Research
Despite the global decline in under-five mortality rate from 91 deaths per 1000 live births in 1990 to 43 deaths per 1000 live births in 2015 and Nigeria’s under-five mortality reduction from 201 per 1,000 live births in 2009 to 128 per 1,000 live births in 2013 as against the Sustainable Development Goal target of 25 per 1,000 live births, child mortality rate still remain unacceptably high in Nigeria and thereby has a long way to go in achieving this target. This study explores the household’s environmental, socio-economic characteristics, maternal demographic and their effect on child mortality. Data from the Nigeria Demographic and Health Survey (NDHS) 2013 was used to investigate the predictors of child (aged 0-4 years) mortality in Nigeria. Data for the currently married women who had experienced child mortality and those who have not, totaling 20,192. Cross-tabulation and binary logistic regression techniques were employed in the statistical analysis. The result indicated that child mortality rate was highest (46.0%) among mothers with no educational and lowest (13.6%) among mothers with tertiary education and was statistically significant in reducing the child mortality rate. Children born in households with unimproved toilet experienced highest mortality rate (41.0%) compared to those who were born in households with improved toilet (30.4%) and have substantial impact on child mortality. Maternal education and provision of sanitation facilities should be advocated as a strategy to reduce child mortality.cialis coupons free
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American Journal of Public Health Research. 2016, 4(4), 134-141. DOI: 10.12691/ajphr-4-4-3
Pub. Date: July 08, 2016
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by Gad Onywere, Paul Gyles, Jeanelle Lewin, Tana Bandoo, Karhone Mundell, Dennis Bailey and Patience Bazuaye-Alonge
Original Research
Objectives: The study was to compare the efficacy of selected commercial mouthwashes and natural products against oral microorganisms. Method: Red sage (Lantana camara) and Chew stick (Gouania lupuloides) plant material were collected from Northern Caribbean University farm. Ethanolic and aqueous extracts of the plants were extracted and concentrated with a rotor vapor. The extracts were utilized for the preparation of different concentrations for antimicrobial sensitivity. Commercial mouthwashes: Crest, ACT, Ultra Care, Cari-Med and Listerine were tested against the isolates: Streptococcus mutans, Escherichia coli, Streptococcus pneumoniae and Pseudomonas aeruginosa from oral cavity. Phytochemical screening was done on the plant extracts to determine their active ingredients. Results: The results showed that Red sage and Chew stick extracts had the highest zone of inhibition against the oral microorganisms compared to the commercial mouthwashes. The microorganisms were weakly sensitive to the mouthwashes. Aqueous plant extracts tested positive for phytochemical screening. Conclusion: It is evident that the plant extracts had antimicrobial properties. The oral microorganisms were sensitive to the ethanolic and aqueous extracts. Red sage aqueous extracts was the most potent against all tested microorganisms. Thus, further work is in progress to consider Red sage and chew stick natural products as mouthwashes for treatment of oral cavity infections.
American Journal of Public Health Research. 2016, 4(4), 128-133. DOI: 10.12691/ajphr-4-4-2
Pub. Date: July 02, 2016
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by Tegene Legese, Misra Abdulahi and Anteneh Dirar
Original Research
Background: Maternal death has devastating effects on the family she leaves behind and country level. Most of the literatures in our country are reviews of maternal death which are unable to determine the predictors of maternal death and do not consider change of time since there is variation in care given and did not identify timing of death. Objective: To assess risk factors of maternal death in Jimma University specialized hospital, Southwest Ethiopia from January 2010 to December 2014. Methods: A time matched case control study was conducted on 600 charts, 120 cases and 480controls. Data was collected using checklist adapted from maternal death surveillance review of Ethiopia guide line. Data were entered into epi data 3.1 and exported to Stata 13 for analysis. Conditional logistic regression was done to identify the independent predictors of maternal death. The adjusted matched odds ratio with the 95% confidence interval was reported and statistical significance was declared at p =<0.05. To ensure confidentiality only code was written on the check list. Result: More than two third (68%) of death occurred during post-partum period. Predictors of maternal death include: age group of 20 – 34 (AMOR= 0.299, 95% CI (0.113, 0.792)), being from rural area (AMOR = 2.594, 95%CI(1.001,6.726)), prolonged labour (AMOR=37.141, 95%CI(13.296, 103.750)), comorbidities (AMOR=9.631,95%CI(3.135, 29.588), referred cases from health center (AMOR=4.011, 95% CI (1.113, 14.464) and other health institution (AMOR=6.029, 95%CI(1.565, 24.626)). Conclusion: Duration of labour, age, comorbidities, residence and referral were the major factors that affect maternal death.prescription transfer coupon
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American Journal of Public Health Research. 2016, 4(4), 120-127. DOI: 10.12691/ajphr-4-4-1
Pub. Date: June 06, 2016
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