272 research outputs found

    Depression among pregnant women and associated factors in Hawassa city, Ethiopia: an institution-based cross-sectional study.

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    BackgroundDepression is the most prevalent psychiatric disorder during pregnancy. It is not only common and chronic among women throughout the world but also principal source of disability in pregnant women. The scarce information and limited attention to the problem might aggravate the consequence of the problem and can limit the intervention to be taken. The objective of the study was to assess the prevalence and factors associated with depression among pregnant women in public health institutions, Hawassa, Ethiopia.MethodsInstitution based cross sectional study was conducted in May to July 2017. Pregnant women were selected by using systematic sampling technique. Data were collected through face-to-face interviews on socio-demographic, obstetric, psychosocial characteristics and depressive symptoms. Edinburgh Postnatal Depression Scale (EPDS) and Oslo Social Support Scale (OSS-3) were used to asses' depressive symptoms and social support respectively. Descriptive and logistic regression analyses were carried out.ResultsThe mean age of the respondents was 23.82 ± (SD = 6.65) years. The prevalence of antenatal depression was 21.5%. When we adjusted for the effect of potential confounding variables, being in age group of 20-30 years [AOR = 5.85 (95% CI: (3.70, 10.14)], current pregnancy complication [AOR = 4.98 (95% CI: (3.01, 10.37)], unplanned pregnancy [AOR = 7.12, (95% CI: (3.12, 9.63)], categories of stressors (LTE) Health risk [AOR = 1.76, (95% CI: (1.01, 3.22)], previous history of depression [AOR = 2.76 (95% CI: (1.94, 6.75)], history of abortion [AOR = 1.52, (95% CI:1.04, 5.09)], history of still birth [AOR = 1.18, (95% CI: 1.08, 2.91)], poor social support [AOR = 2.14, (95% CI: 1.49, 3.11)] and poor baby father support [AOR = 3.21 (95% CI:1.93, 6.71)] were significantly associated with antenatal depression.ConclusionFor early detection and appropriate intervention, antenatal clinics should develop screening tools for depression during the routine antenatal care

    The prevalence of depression among patients with tuberculosis: a systematic review and meta-analysis.

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    Background:Evidence has shown that the prevalence of depression is much higher among patients with tuberculosis (TB) and this, in turn, may adversely impact compliance with anti-TB medications. Therefore, this systematic review and meta-analysis aimed to quantitatively summarize epidemiologic evidence on the prevalence of depression among patients with TB and formulate a recommendation for future clinical practice as well as research. Methods:We followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to conduct this review. We searched PubMed, EMBASE, SCOPUS and Psych INFO to identify relevant studies that investigated the prevalence of depression among TB patients. We also supplemented our electronic search with manual searching to include all pertinent studies in the analysis. We used a Comprehensive Meta-Analysis software version 3.0 (CMA 3.0) to conduct a meta-analysis. We conducted a subgroup and sensitivity analysis and Cochran's Q- and the I 2-statistics were used to assess heterogeneity. The evidence for the presence of publication bias was checked by using Egger's test and visual inspection of the symmetry in funnel plots. Results:We identified a total of 25 studies that included 4903 participants across seven countries. In our analysis, the pooled estimated prevalence of depression among TB patients was found to be 45.19% (95% CI 38.04-52.55). The prevalence was higher in MDR-TB 52.34% (95% CI 38.09-66.22) than non-MDR-TB 43.47% (95% CI 35.88-51.37) patients. We also found that the pooled prevalence of depression was higher among females 51.54% (95% CI 40.34-62.60) when compared to males 45.25% (95% CI 35.19-55.71). The pooled prevalence of depression was 45.45% as measured by HRDS, and it was 55.62%, 45.52%, and 38.36% as measured by BDI, HADS and PHQ-9, respectively. Conclusion:Our finding suggested that the pooled estimated prevalence of depression among tuberculosis patients was relatively high. Screening and management of depression among TB patients were warranted to alleviate suffering. Moreover, the integration of tuberculosis program with regular psychiatry services may substantially reduce the burden

    Nutritive Value Assessment of Four Crop Residues by Proximate Composition and In Vitro Rumen Fermentation Techniques

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    This study estimated the proximate composition and in vitro gas production parameters of rice husk, bean waste, citrus pulp and maize stover, in a rumen incubation system. The incubation was for 24 h with measurement of gas production volume over incubation periods of 3, 6, 9, 12, 15, 18, 21 and 24 hours. The crude protein ranged 1.92 to 11.75% and the crude fibre ranged between 9.68 and 45.09%. The potential gas production (a+b) was rated highest in both citrus pulp and maize stover (48.33 ml), next was bean waste (42.00 ml) and lowest was rice husk (25 ml). The ranges of values of metabolizable energy (ME), organic matter digestibility (OMD) and short chain fatty acids(SCFA) were 6.33 to 9.24 MJ/kg DM, 52.70 to 64.69 % and 0.94 to 1.09 μmol respectively. The values of ME, OMD and SCFA ranked as, citrus pulp > maize stover> bean waste > rice husk. The higher values obtained for the potential gas production (a+b), ME, OMD and SCFA in citrus pulp and maize stover could imply higher nutrient availability for the rumen micro-organisms. The results revealed that citrus pulp and maize stover could be of higher nutritional value in ruminants feed than bean waste, while rice husk was lowest

    Perceived Stigma and Associated Factors among Patient with Tuberculosis, Wolaita Sodo, Ethiopia: Cross-Sectional Study.

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    BackgroundTuberculosis is a historically stigmatized disease and the stigma associated with it affects the institution, community, and interpersonal factors. Therefore, understanding tuberculosis-related perceived stigma has importance in improving quality of the patients.ObjectiveThe aim of this study was to assess prevalence and factors associated with perceived stigma among patients with tuberculosis attending Wolaita Sodo University Referral Hospital, Ethiopia.MethodsInstitution based cross-sectional study was conducted among a total of 417 tuberculosis patients who had treatment follow-up at TB clinics and were recruited for the study. Systematic random sampling technique was used to recruit study participants. A 12-item perceived TB stigma scale was used to assess tuberculosis-related perceived stigma. In addition, Oslo social support scale was used to assess social support related factors.ResultsPrevalence of tuberculosis-related perceived stigma by using perceived tuberculosis stigma scale was 42.4%. Patients who had pulmonary TB [AOR=2.49, (95% CI: 1.24, 4.87)], being intensive phase category [AOR=1.42, (95% CI: 1.19, 2.58)], TB/HIV coinfection [AOR= 3.54, (95% CI: 1.37, 9.12)], poor social support [AOR=2.45, (95% CI: 1.18, 5.09)], and using substance (alcohol, khat and cigarette) [AOR=1.78, (95% CI: 1.28, 3.17)] were more likely to have perceived TB stigma when compared to their counter parts.ConclusionHealth education programs should be conducted to reduce TB stigma and improve patients' compliance

    SOST Inhibits Prostate Cancer Invasion.

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    Inhibitors of Wnt signaling have been shown to be involved in prostate cancer (PC) metastasis; however the role of Sclerostin (Sost) has not yet been explored. Here we show that elevated Wnt signaling derived from Sost deficient osteoblasts promotes PC invasion, while rhSOST has an inhibitory effect. In contrast, rhDKK1 promotes PC elongation and filopodia formation, morphological changes characteristic of an invasive phenotype. Furthermore, rhDKK1 was found to activate canonical Wnt signaling in PC3 cells, suggesting that SOST and DKK1 have opposing roles on Wnt signaling in this context. Gene expression analysis of PC3 cells co-cultured with OBs exhibiting varying amounts of Wnt signaling identified CRIM1 as one of the transcripts upregulated under highly invasive conditions. We found CRIM1 overexpression to also promote cell-invasion. These findings suggest that bone-derived Wnt signaling may enhance PC tropism by promoting CRIM1 expression and facilitating cancer cell invasion and adhesion to bone. We concluded that SOST and DKK1 have opposing effects on PC3 cell invasion and that bone-derived Wnt signaling positively contributes to the invasive phenotypes of PC3 cells by activating CRIM1 expression and facilitating PC-OB physical interaction. As such, we investigated the effects of high concentrations of SOST in vivo. We found that PC3-cells overexpressing SOST injected via the tail vein in NSG mice did not readily metastasize, and those injected intrafemorally had significantly reduced osteolysis, suggesting that targeting the molecular bone environment may influence bone metastatic prognosis in clinical settings

    Initial experience of transumbilical laparoendoscopic single-site surgery of partial adrenalectomy in patient with aldosterone-producing adenoma

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    <p>Abstract</p> <p>Background</p> <p>Laparoscopic single-site surgery has recently emerged in the field of urology and this minimally-invasive surgery has resulted in a further reduction in morbidity compared with traditional laparoscopy. We present our initial experience with laparoendoscopic single-site surgery of partial adrenalectomy (LESS-PA) to treat aldosterone-producing adenomas.</p> <p>Case presentation</p> <p>A 60-year-old woman was diagnosed with aldosterone-producing macroadenomas in the left adrenal and aldosterone-producing microadenomas in the right adrenal. A two-step operation was planned. The first step involved transumbilical LESS-PA for the left adrenal tumors. A multichannel port was inserted through the center of the umbilicus and the left adrenal gland was approached using bent instruments according to standard traditional laparoscopic procedures. The tumors were resected using an ultrasonic scalpel, and the resected site was coagulated using a vessel sealing instrument and then sealed with fibrin glue. Operative time was 123 minutes and blood loss was minimal. The patient was discharged from hospital within 72 hours. Her right adrenal microadenomas will be treated in the next several months.</p> <p>Conclusions</p> <p>Although our experience is limited, LESS-PA appears to be safe and feasible for treating aldosterone-producing adenomas. More cases and comparisons with the multiport technique are needed before drawing any definite conclusions concerning the technique.</p

    Patients' attitudes and experiences of transition from paediatric to adult healthcare in rheumatology: a qualitative systematic review

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    Objectives. We aimed to describe patients' attitudes and experiences of transition from paediatric to adult healthcare in rheumatology to inform patient-centred transitional care programmes. Methods. We searched MEDLINE, EMBASE, PsycINFO and CINAHL to August 2019 and used thematic synthesis to analyse the findings. Results. From 26 studies involving 451 people with juvenile-onset rheumatic conditions we identified six themes: a sense of belonging (comfort in familiarity, connectedness in shared experiences, reassurance in being with others of a similar age, desire for normality and acceptance); preparedness for sudden changes (confidence through guided introductions to the adult environment, rapport from continuity of care, security in a reliable point of contact, minimizing lifestyle disruptions); abandonment and fear of the unknown (abrupt and forced independence, ill-equipped to hand over medical information, shocked by meeting adults with visible damage and disability, vulnerability in the loss of privacy); anonymous and dismissed in adult care (deprived of human focus, sterile and uninviting environment, disregard of debilitating pain and fatigue); quest for autonomy (controlled and patronized in the paediatric environment, liberated from the authority of others, freedom to communicate openly); and tensions in parental involvement (overshadowed by parental presence, guilt of excluding parents, reluctant withdrawal of parental support). Conclusion. Young people feel dismissed, abandoned, ill-prepared and out of control during transition. However, successful transition can be supported by preparing for changes, creating a sense of belonging and negotiating parental involvement and autonomy. Incorporating patient-identified priorities into transitional services may improve satisfaction and outcomes in young people with juvenile-onset rheumatic conditions.A.T. is supported by a National Health and Medical Research Council Fellowship (ID 1106716)

    Durability of Mortar Incorporating Ferronickel Slag Aggregate and Supplementary Cementitious Materials Subjected to Wet–Dry Cycles

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    This paper presents the strength and durability of cement mortars using 0–100% ferronickel slag (FNS) as replacement of natural sand and 30% fly ash or ground granulated blast furnace slag (GGBFS) as cement replacement. The maximum mortar compressive strength was achieved with 50% sand replacement by FNS. Durability was evaluated by the changes in compressive strength and mass of mortar specimens after 28 cycles of alternate wetting at 23 °C and drying at 110 °C. Strength loss increased by the increase of FNS content with marginal increases in the mass loss. Though a maximum strength loss of up to 26% was observed, the values were only 3–9% for 25–100% FNS contents in the mixtures containing 30% fly ash. The XRD data showed that the pozzolanic reaction of fly ash helped to reduce the strength loss caused by wet–dry cycles. Overall, the volume of permeable voids (VPV) and performance in wet–dry cycles for 50% FNS and 30% fly ash were better than those for 100% OPC and natural sand
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