Lyhnesummers2323

Background HIV diagnosis comes with a lot of worry and distress. Ability to objectively estimate this distress by non-psychiatrist will enhance early detection of psychological distress for intervention. Objectives To investigate the validity of the Distress Thermometer (DT) and its problem checklist in achieving early detection of mental distress among ART-naïve HIV infected patient. Materials and Methods A total of 90 ART-naïve HIV infected patients completed the DT and its problem check list, Hospital Anxiety Depression Scale (HADS), Oslo Social Support Scale and the 14-item Resilience Scale. Results The DT was positively correlated with all the measures of distress and reversely correlated with all the positive wellness in this study. The correlations were only significant for the negative measures of psychological wellness. The internal consistency of the DT's problem list overall and sub-categories were within acceptable range (i.e. α > 0.50). The Receiver Operating Characteristic (ROC) curves and Area Under the Curves (AUC) analysis were significant and found the DT and Problem List to respectively differentiate between cases of distress, anxiety and depression. The DT's cut-off was >5.0 with AUC range (0.754 - 0.709); sensitivity range (81.0% - 70.4%); specificity range (68.3% - 65.2%) for distress, anxiety and depression as determined by HADS. And the Problem List cut-off was >6.0 with AUC range (0.854 - 0.821); sensitivity range (90.5% - 85.7%); specificity range (68.3% - 65.2%) for distress, anxiety and depression as measured by HADS. Conclusion The DT and Problem List were found to be valid measures of distress in ART-naïve HIV infected patients. © 2019 Obiajulu et al.Background Self-esteem is a major psychological health issue. People living with HIV and AIDS have been found to be victims of discrimination and stigmatization which affect their self-esteem. Objectives The study investigated the influence of stigma and discrimination on self-esteem of people living with HIV and AIDS (PLHIV). Methods The design was a cross-sectional study carried out in four teaching hospitals in south-eastern Nigeria between 13th July 2016 - 11th May 2017. Four hundred and eighty-four (174 males and 310 females) PLHIV participated in the study. Quantitative study supplemented by qualitative in-depth interviews were used to collect data regarding discrimination, stigma and self-esteem of PLHIV whilst a structured questionnaire was used to elicit information about the socio-demographic variables. Results Stigmatization and discrimination were found to have significant influence on self-esteem of PLHIV. The results indicate that stigmatization and discrimination, together with income, work status, AIDS diagnosis status, and medication use status significantly influence self-esteem of PLHIV. These results imply that stigmatization and discrimination influences on self-esteem among PLHIV. Conclusion Conclusively, intervention programmes should evolve enlightenment through television, movies, and educational programs that incorporate the ill effects of discrimination and stigma so as to boost self-esteem of PLHIV. © 2019 Adimora et al.Background Cemento-osseous dysplasia (COD) is a fibro-osseous jaw bone lesion. The affected bone in COD progressively becomes sclerotic, poorly vascularized and susceptible to secondary osteomyelitis. Objective To provide a clinico-pathologic appraisal of COD in a South African patient population. Methods Archived records of 133 patients diagnosed with COD were reviewed for patient demographics, COD location, COD type, osteomyelitis or simple bone cyst secondary to COD. Results The mean age was 53.4 ± 13.5 years with a 94.7% female predilection. COD mainly affected the mandible (57.1%), followed by involvement of both jaws (38.3%) and maxilla (4.5%). Florid COD was the most prevalent (69.9%), followed by focal COD (18%) and periapical COD (12%). Florid COD showed a clear trend of increasing with age, peaking in the sixth decade and decreasing thereafter. Osteomyelitis and simple bone cyst presented as complications of COD in 74.4% and 5.3% of cases respectively, while 21.8% of all cases of jaw osteomyelitis during the study period were secondary to COD. Conclusion A higher frequency of jaw osteomyelitis secondary to COD was found compared to previous studies. No significant association was shown between any of the COD types and secondary osteomyelitis. © 2019 Benaessa et al.Background The aims of this study were to estimate the self-rated oral health status and its associated factors in a national community dwelling population in Kenya. Methods A cross-sectional study based on a stratified cluster random sampling was conducted in 2015. The total sample included 4,459 individuals 18-69 years (M=40.4 years, SD=13.9). Questionnaire interview, blood pressure and anthropometric measurements, and biochemistry tests were conducted, including questions on the oral health status, general health status, oral health behaviour and socio-demographic information. Results Overall, 13.7% of participants reported poor self-rated oral health. In adjusted logistic regression analysis, older age (Odds Ratio-OR 1.70, Confidence Interval-CI 1.07, 2.69), having a lower number lover number of teeth (OR 0.19, CI 0.06, 0.62), having dentures (OR 1.92, CI 1.22, 3.03), having pain in the mouth or teeth (OR 5.62, CI 3.58, 8.90), impaired Oral Health Related Quality of Life (OR 3.01, CI 2.03, 4.47) and frequent soft drink consumption (OR 3.62, CI 1.89, 6.97) were associated with poor self-rated oral health. Conclusion High unsatisfied self-rated oral health status was found and several risk factors for poor self-rated oral health were identified that can help in guiding oral health care programming in Kenya. © 2019 Pengpid et al.Background Propofol is administered as intermittent boluses to achieve deep sedation to facilitate oesophagogastroduodenoscopy. Target controlled infusion (TCI) can be employed for this purpose. Methods 176 adults were randomly allocated into two groups of 88 patients. Control group Received an initial bolus of propofol 1mg/kg, with repeat boluses of 0.25mg/kg. Intervention group Received an initial target effect-site concentration of 4mcg/ml, followed by maintenance target effect-site concentration of 2.5mcg/ml, titrated by 0.5mcg/ml from baseline infusion rate as needed. Oxygen saturation, blood pressure and heart rate were evaluated immediately before administering the sedative and at 2.50, 5.00, 7.50 and 10.00 minutes. Oxygen desaturation below 90% in both study groups was recorded. Sedation starting time, stopping time, waking up time and overall duration of time to recovery of participants in each study arm was recorded. Results More hypoxic episodes were observed in the intermittent bolus group with statistically significant association between control and the incidence of hypoxia Chi square test, p=0.037. There were more hypotensive episodes in the TCI group but not achieving statistical significance Chi square test for association X2(1) = 0.962, p=0.327.The time to recovery between the two groups was comparable, with 18.84 ± 10.76 minutes in the bolus group and 19.72 ± 9.27 minutes in the TCI group; no statistically significant difference was shown Student's t-test, p=0.0564. Conclusion TCI of propofol was associated with fewer episodes of hypoxia compared to intermittent bolus administration. Similar hemodynamic profiles and comparable time to recovery were demonstrated by these two sedation techniques. © 2019 Ndosi et al.Background In developing countries, post-operative pain remains underestimated and undertreated due to economic constraints, lack of awareness and limited resources. In contrast, ketamine is an effective, readily available, easy to use and inexpensive drug frequently used in poor settings. Objectives The aim of this study was to explore the overall reduction in the medication treatment cost of acute post-operative pain by adding intra-operative low-dose ketamine to traditional intravenous morphine for surgery in a low-income country. Methods A double blind randomized controlled trial with placebo-controlled parallel group was performed in Mulago National Hospital (Uganda). Selleck ICI-182780 Consenting adults scheduled for elective surgery were randomized into two study arms Group K received ketamine 0.15mg/kg bolus at induction and a continuous infusion of 0.12 mg/kg/hour till start of skin closure; Group C (control) received normal saline. Both groups received Morphine 0.1 mg/kg IV at debulking. The total medication cost was registered. NRS pain scores and other measurements such vital signs and incidence of major and minor side effects were also recorded. Results A total of 46 patients were included. Patients' baseline characteristics were comparable in both groups. No statistically significant difference was found between the groups concerning the overall medication cost of post-operative pain management. Pain scores, patients' satisfaction in the first 24 hours after surgery and hospital length of stay were similar in both groups. Conclusion Our results do not support the utilization of intra-operative low dose ketamine as a cost-saving post-operative pain treatment strategy for all types of surgery in low-resource settings. © 2019 Ragazzoni et al.Introduction Certain real life applications of scientific and social science ideas that knowingly reject accumulated empirical biomedical evidence have been termed 'pseudoscience,' or empirical rejectionism. An uncritical acceptance of empiricism, or even of evidence-based medicine, however, can also be problematic. Objectives With reference to a specific type of medical denialism associated with moral failure, justified by dissident AIDS and anti-vaccine scientific publications, this paper seeks to make the argument that this type of denialism meets certain longstanding definitions for classification as pseudoscience. Methods This paper uses a conceptual framework to make certain arguments and to juxtapose arguments for evidence-based approaches to medicine against literature that highlights certain limitations of an unquestioning approach to empiricism. Results Discussions of certain real life examples are used to derive the important insight that, under certain conditions, moral failure can result in the violation both Type I and Type II scientific error types, with catastrophic consequences. Conclusion It is argued that the validity of all theory should not be assumed before sufficient empirical evidence has accumulated to support its validity across contexts. link2 However, caution is required, to avoid the consequences of an unquestioning approach to empiricism. © 2019 Callaghan C.Background Patient safety is a fundamental component of health care quality and medical errors continue to occur, placing patients at risk. Medical error reporting systems could help reduce the errors. Purpose This study assessed "Medical error reporting among Physicians and Nurses in Uganda". The objectives were; (1) identify the existing medical error reporting systems. (2) Assess the types of medical errors that occurred. (3) Establish factors influencing error reporting. Methods A cross-sectional, descriptive study in Kisubi and Entebbe hospitals between March to August 2013, with quantitative methods. Results Medical errors occurred in the two hospitals (53.2%), with overdoses (42.9%) leading. Neither hospital had a medical error reporting system. More than two thirds, 42(64.6%), would not report. link3 Almost half, 29(44.6%) believe reporting a medical error is a medical obligation. Majority, 50(76.9%), believed the law does not protect medical error reporting. Not punishing health workers who report medical errors, (53.