Open Access Original Research Article

Pregnancy Outcomes in Egyptian Women on Maintenance Hemodialysis: A Multicenter Observational Study

Abir Farouk Megahed, Ghada El Kannishy, Hassan El Azawy, Hanan Farouk Megahed, Ehab Hussein Hashish, Nagy Sayed- Ahmed

Asian Journal of Medicine and Health, Page 1-17
DOI: 10.9734/ajmah/2020/v18i1030247

Background and Aims: Women in the childbearing period on hemodialysis (HD) have decreased fertility when compared with the general population. However, pregnancy in this patients’ population is still possible. The aim of the current study was to assess the conception rate in Egyptian HD females.

Methods: The study comprises 2 phases: phase one studied the frequency of conception in HD females in Egypt, while phase two studied the live birth frequency and factors affecting it in 22 hemodialysis units (HDUs) including 211 females with sexually active partner in their childbearing period comprising 33 females with HD coincidental pregnancies.

Results: 5-year conception rate was 5.2%, and was associated with higher planned dialysis dose (higher blood flow rate, larger dialyzer size, and session length), better control of blood pressure, as well as a lower level of serum ferritin. Live birth frequency was 33.3% and was statistically significantly associated with younger age of the pregnant lady, higher length of dialysis sessions, lower serum phosphorus level, and suggested better nutrition. There was no maternal mortality associated with HD coincidental pregnancies. There was a better neonatal outcome observed with the caesarian section.

Conclusion: Fertility is possible and safe in Egyptian HD female with a sexually active partner as there is no maternal mortality but not as such for the fetal outcome. Better conception potentials and the outcome are related to better-planned dialysis dosing and adequate control of phosphate and inflammation.

Open Access Original Research Article

Antibiogram Audit of Catheter-associated Uropathogenic Isolates in University of Calabar Teaching Hospital, Calabar, Nigeria: Advocating Laboratory-based Prescription Practices

G. I. Ogban, A. A. Iwuafor, U. E. Emanghe, S. N. Ushie, E. M. Bisong, S. N. Okonkwo

Asian Journal of Medicine and Health, Page 18-27
DOI: 10.9734/ajmah/2020/v18i1030248

Background: The most important risk factor to developing UTI is the presence of an indwelling urethral catheter. Eighty percent of nosocomial UTI was reported to be caused by urethral catheterization. UTIs in health care institutions and in those with frequent antibiotic exposures were frequently caused by multi- drug resistant pathogens. This study sought to determined the antibiogram of isolates from catheterized patients with UTIs with a view to establishing if there were justifications for empiric treatment of this condition in the study area in the absence of quality antibiotic formulary.

Materials and Methods: Interviewer administered questionnaires were used to collect socio-demographic data. Specimens were cultured on 5% sheep blood agar (SBA), MacConkey and sabouraud dextrose agar plates and incubated at 37°c for 24 hours in ambient air. Significant bacteriuria was determined on growths from SBA. Growths were identified using standard biochemical techniques.

Results: The study established 74.3% (52) prevalence of CAUTIs amongst catheterized patients in the study area with 29 (41.4%) female dominance. Imipenem (93.9%) recorded the highest percentage susceptibility, followed by Amikacin (91.8%) and Piperacillin/ tazobactam (88.8%). E. coli 17(32.7%) was the dominant isolate. Extended spectrum β-lctamase prevalence was 23(44.2%) and MRSA 2(3.8%). There was significant statistical relation between ESBL production and resistance to other classes of antibiotics.

Conclusion: There is high percentage prevalence of multidrug resistance (MDR) among isolates of CAUTIs in the study area. We therefore advocate laboratory based prescription practice and de-emphasized empiric treatment pending when there would be in a quality drug formulary founded on regular resistance surveillance.

Open Access Original Research Article

Health Implication of Housing Conditions on Residents in Calabar South Local Government Area, Cross River State, Nigeria

Omang, Donald Ikwun, Bisong, Jude Owan

Asian Journal of Medicine and Health, Page 28-37
DOI: 10.9734/ajmah/2020/v18i1030249

Aim: Staying healthy is a function of many factors among which housing condition of man is prime. Both intrinsic and extrinsic attributes of housing can impact on human health. This study examined the health implications of housing conditions on the residents of Calabar South Local Government Area, Cross River State, Nigeria.

Methodology: A cross sectional descriptive study design was employed using questionnaire to elicit information on the housing conditions of residents and their public health implications in Calabar South Local Government Area of Cross River State, Nigeria from February to May 2016. A sample size of 400 respondents was used for the study. Data collected were analyzed descriptively using simple percentages.

Results: Findings from this study indicate that malaria and typhoid fever were the two major health challenge among the residents. Also, domestic accident/injuries were observed to be more frequent which can be the possible effect of poor housing conditions among the residents of Calabar South Local Government Area. Results of the dwelling condition of residents in Calabar South revealed that 41.8% of the respondents rated it very poor with only 4.5% of the respondents rating their dwelling place to be excellent. Common pest/vectors perceived in housing units as highlighted by the respondents showed that mosquitoes (46.3%) and cockroaches (30.8%) were more prevalent.

Conclusion: It was recommended among others that there should be a continuous public enlightenment among the people on the health implication of their living conditions in Calabar South Local Government Area of Cross River State.

Open Access Original Research Article

Analysis of Characteristics, Technical and Perceptions on the Willingness to Use Tuberculosis (TB) Control Applications in Indonesia

Evina Widianawati, Arif Kurniadi, Ika Pantiawati

Asian Journal of Medicine and Health, Page 44-51
DOI: 10.9734/ajmah/2020/v18i1030251

Background and Objectives: Indonesia has launched the Wifi TB application that serves as a monitoring and control tuberculosis (TB) cases since September 2018. This research aims to identify characteristics, perceptions, and technicalities on the willingness to use the Wifi TB application.

Methodology: This research was conducted by collecting data from 129 doctors in Semarang city, then carried out the descriptive analysis, factor analysis & logistics as data analysis techniques.

Results: The results showed that respondents with age> 45 years, DPM agencies, length of work> 10 years, perception benefit high, perception ease high, getting training and good technical implementation will be more chance to use the Wifi TB application, while gender and technical obstacle have a low impact on the use of the Wifi TB application. The use of the Wifi TB application is influenced by dominant factors, which is the perception of benefit, perception of ease, technical implementation, and training at 69%.

Conclusions: To increase users' Wifi TB application, there needs to be retraining and technical implementation of the Wifi TB application, also strengthening the perception of benefit and ease of respondents on the Wifi TB application.

Open Access Original Research Article

Hemodialysis Status in an Egyptian Coastal City, Alexandria: An Epidemiological Study with a 3-year Prospective Mortality Observation

Abir Farouk Megahed, Reem Mohamed Farouk Saleh, Afaf Mohamed Fahmy, Nagy Sayed- Ahmed

Asian Journal of Medicine and Health, Page 52-64
DOI: 10.9734/ajmah/2020/v18i1030252

Backgrounds: Hemodialysis (HD) represents the main modality of RRT in Egypt and it constitutes a burden on the health care budget. In Alexandria province of Egypt, HD service is provided through fifty-seven HD units, which are categorized into twenty-one nonprofit units and thirty-six private for-profit HD units. Our aims were to study epidemiology and to assess the three-year survival of ESRD patients treated by HD in governmental hospitals in Alexandria province.

Methods and Design: In the year 2016; the data of the patients were collected from all the governmental hospitals in Alexandria province, which comprised seven HD units containing 687 patients. In a cross-sectional arm of the study, demographic data, vascular access, HIV, HBV and HCV serology, the possible etiology of chronic kidney disease (CKD), associated comorbidities, and the routine laboratory variables were included. Furthermore, in a prospective phase of the study, a three-year-survival rate of the studied HD patients was recorded.

Results: The total number of HD patients in Alexandria province during 2019 was totaled to be 3552 in all HD units, so the estimated HD prevalence rate would be around 710 ppm. Demographic data of the surveyed 687 patients in the governmental HD units showed their mean age; 50.78 years with more males, and their mean duration of HD; 55 months. It was also noted that there was no positive seroconversion regarding HCV, HBV nor HIV. Sixteen HCV antibody-positive patients received direct-acting antiviral drugs and were converted to HCV PCR-negative. HTN was more common etiology of CKD in males, while DM and combined DM and HTN were more common in females. The target hemoglobin level was present in around 37% of the studied HD patients. Most of the studied patients had serum calcium ranged from 8-10 mg /dl and 53% of them had serum phosphorus ranged from 3-5.5 mg /dl. Para-thyroidectomy was done for 2% of the studied patients while 4% of cases received cinacalcet. The 3-year, 5-year and 7-year survival rates were 92.5%, 87%, and 82% respectively.

Conclusion: The epidemiology of hemodialysis patients in Alexandria province is not different in many aspects from other published data about some Egyptian governorates however there is no published new epidemiology about the whole country. 11.2% of HCV Abs positive became PCR negative after antiviral management protocol.

Open Access Original Research Article

Risk Factors of Hypertension among Type 2 Diabetic Patients in Imo state, South East of Nigeria

Ugonma, Winnie Dozie, Nnenna, Vivian Okonkwo, Okwuchi, Blessed Nworuh, Somtochukwu, Mercy Orji, Chidozie Joakin Nwaokoro, Ikechukwu, Nosike Simplicius Dozie

Asian Journal of Medicine and Health, Page 65-72
DOI: 10.9734/ajmah/2020/v18i1030253

Background: Hypertension is among the important causes of non-communicable disease burden worldwide. It has raised public health concerns in both developed and developing nations. It mostly occurs in patients with diabetes and the prevalence depends on duration, type and age of the patient. The study aimed at determining the risk factors of hypertension among type 2 diabetic patients in Imo State, Nigeria.

Methods: A hospital-based descriptive survey design involving 50 patients attending hospital was used. Structured questionnaire complemented with interview schedule was used to collect data from the respondents. Data were analyzed using frequency and mean score. Hypotheses were tested using Chi-square at 5% significance level.

Results: The result showed that the majority (70.0%) of the patients was hypertensive, 54.0% of the patients used dietary control and drugs in the treatment of the diseases. Furthermore, it was found that 54.0% ate salty foods always, 58.0% of the patients added extra table salt in their meals, 54.0% ate canned foods and 82.0% took sugary drinks always. It was also found that 66.0% ate always from restaurants and 58.0% ate more of starchy foods. The result further showed that 74.0% of the patients avoided physical exercise and 70.0% indicated that doing stress works made them get anxious. Eighty percent of the patients had hypertension in their family history and the 74.0% indicated it was their brother/sister. The X2 result showed a significantly association between family history of hypertension and type 2 diabetes X2(121, N = 50) = 187, p = 0.000. It was also found that dietary pattern was significantly associated with risk of type 2 diabetes X2(121, N = 50) = 187, p = 0.000.

Conclusion: Dietary pattern and family history of hypertension were significantly associated with type 2 diabetes. It was recommended that sensitization campaigns be organized to educate women on the effect of diets on diabetes. Also, family history of hypertension should be ascertained from patients to ensure early detection and treatment of diabetes.

Open Access Original Research Article

Willingness to Participate and Pay into a Community- Based Health Insurance Scheme in Imesi-Ile, a Rural Community in Osun State, Nigeria

Oluwaseun T. Esan, Ridwan O. Opeloye, Taiwo W. Oyeniyi, Ayodele O. Joseph, Ifeoluwa B. Oluwalana, Samuel B. Babalola, Iyanuoluwa O. Adeniji

Asian Journal of Medicine and Health, Page 73-84
DOI: 10.9734/ajmah/2020/v18i1030255

Aims: Rural dwellers are forced into a vicious circle of lack of financial risk protection to accessing non-optimal care and more poverty from its complications because out-of-pocket payment is their mainstay health care financing option. A sustainable and effective Community-based health insurance scheme will offer some respite. The study aimed to determine household heads’ willingness to participate and pay into a community-based health insurance scheme and the associated factors.

Study Design: Descriptive cross-sectional.

Place and Duration of Study: Imesi-Ile, a rural community in Obokun Local government area of Osun state, Nigeria between July and September, 2015.

Methods: Study population were 147 of the 155 household heads selected via a multi-stage sampling technique. Quantitative data collection was done using a structured questionnaire. The household health status, level of trust and reciprocity in the community, their awareness of a community-based health insurance scheme and their willingness to participate and pay into it using the double contingent valuation method were assessed. Data was analysed using the IBM SPSS version 20 software and statistical significance determined at p<0.05.

Results: There was a low level of awareness (13.6%), but majority (87.1%) were willing to participate after being informed. Only 54(42.2%) were willing to pay ₦12,000 ($33.3). The maximum amount they were willing to pay was ₦6000 ($16.7). Younger household heads (p=0.009), males (p=0.032), earning ≥₦6000 ($16.7) monthly (p=0.006), and involved in cooperative schemes (p=0.002) were significantly more willing to participate in the scheme. While the sex of the household heads (p=0.006) and mean score on reciprocity (p=0.002) were significantly associated with paying ₦12,000 ($33.3) as premium for a household of 6 persons. The preferred frequency of payment was monthly (53.8%). 

Conclusion: The household heads in Imesi-Ile community were willing to participate and pay into the scheme. However, further studies on the feasibility and sustainability of implementation is advised.

Open Access Original Research Article

Socio-Demographic and Nutritional Status Correlates in Pulmonary Tuberculosis Patients in Calabar, Nigeria

Regina I. Ejemot-Nwadiaro, Glory M. Nja, Edisua H. Itam, Emmanuel N. Ezedinachi

Asian Journal of Medicine and Health, Page 85-98
DOI: 10.9734/ajmah/2020/v18i1030256

Introduction: Tuberculosis (TB) continues to rank high in contributing to the global disability adjusted life years with 10 million new cases yearly worldwide. Having effective control of TB particularly in endemic communities should be predicated on understanding factors that drive its upsurge.

Objectives: This study assessed the association between socio-demographic factors and nutritional status among adults with pulmonary TB in Calabar, Nigeria.

Methods: A descriptive analysis of a randomized controlled study that enrolled 81 clinically diagnosed pulmonary TB patients that met the eligibility criteria. Data assessed were, socio-demographic, clinical, dietary, anthropometric, haematological and serum concentration of micronutrients. Results were presented in frequencies, percentages, tables and chart. Chi-square (ꭕ2) test was used to determine existence of associations between variables at 5% level, while, Pearson Correlation test was applied to determine the correlation between variables. P-value was used to determine significance of tests.

Results: Using body mass index (BMI) as a proxy of nutritional status, results indicate that 33.4% of patients were undernourished with no discernible gender differences (p=0.254). Income level classification was observed to be statistically significantly associated with undernutrition (p=0.021), with those in the low-income category most at risk. Correlation analysis of key variables indicated that low serum ascorbate, zinc and retinol were independently associated with low BMI. These associations were statistically significant (p<0.05).Singleness was identified as a risk factor for undernutrition (p=0.060). Low functional status proxied by Karnofsky score <50% tended to align more with patients in the low income level category.

Conclusion: Results consistently indicate that patients in the low income category had higher proportion of lower ranges of haemoglobin, protein parameters, serum ascorbate, zinc and retinol concentrations considered deficient. Thus, poverty alleviation strategies should be highly prioritized in TB programming for effective control.

Open Access Original Research Article

Assessment of Patients’ Knowledge of Radiation Exposure during Medical Imaging Procedures at Private Medical Radiography Centres in Ogun State, Nigeria

Adedapo A. Adejumo, U. Enebeli, Ugo, Olaolu O. Bilewu

Asian Journal of Medicine and Health, Page 99-109
DOI: 10.9734/ajmah/2020/v18i1030257

Introduction: Radiological examinations are commonly requested for patients to aid clinical diagnosis. However, many doctors do not realize how much radiation dosage their patients are exposed to during radiological aim. The main objective of this study was to assess the level of knowledge of radiation exposure and safety practices among patients undergoing medical imaging in Ado-Odo Local Government Area, in Ogun State of Nigeria.

Methodology: A self-administered questionnaire was used for the study.

Results: More than half of the respondents 216(69.7%) were female, more than one-quarter 153(49.4) of the respondents were aged 20-29 years, More than half 186(60.0%) of the respondent are single. More than half 204(66.4%) of the respondents have heard about radiation exposure. Majority 232(74.8%) of the respondents agree that radiation hazard do come only from medical radiations. More than half 21(68.7%) of the respondents agree that they do take note of radiation warning sign, majority 236(76.1%) of the respondents agree that they know the wrong use of dose of ionizing radiation can lead to mortality, 217(70.0%) of the respondents agree that inappropriate safety measure on ionizing radiation can result into cancer

Conclusion: This study notes that majority of the literature on awareness and knowledge of the effects of ionizing radiation was carried out among health workers, whereas there is limited information from patients who undergo the procedure. This accounts for the paucity of local studies to compare our results with. In future, studies could compare the radiation awareness among patients presenting at health facilities from public and private, as well as differences in awareness levels of self-presenting and prescribed patients

Open Access Original Research Article

Progesterone Only Injectable Contraceptives: A Five Year Review of Side Effects and Discontinuation Rate in a Teaching Hospital in Niger Delta, Nigeria

Nonye-Enyidah Esther Ijeoma, Enyidah Nonyenim Solomon

Asian Journal of Medicine and Health, Page 110-117
DOI: 10.9734/ajmah/2020/v18i1030258

Background: Progesterone only injectable contraceptives (POICs) are long acting reversible method of contraception used worldwide. Menstrual abnormalities are recognized side effects that can lead to discontinuation of these highly effective and safe contraceptives.

Objectives: To determine the prevalence rate, side effects, discontinuation rate and indications for discontinuation of Norethisteroneenanthate (noristerat) and Depot Medroxyprogesterone acetate (depoprovera) at Rivers State University Teaching Hospital (RSUTH), Port Harcourt.

Methods: A five year retrospective study of 874 clients attending family planning clinic at the RSUTH from 1st of January, 2015 – 31st of December, 2019. Their records were retrieved from the clinic and reviewed. Data was extracted, coded and analyzed using the statistical package for social sciences (SPSS) IBM version 25.0 (Armonk, NY). Chi square test was used as test of significance where applicable and a p-value <0.05 was considered statistically significant.

Results: One hundred and thirty eight clients accepted and used POICs out of 874 acceptors of contraceptives within the study period giving a prevalence rate of 15.8%.

Depot Medroxyprogesterone acetate was more preferred by the women. The modal age group was 25-34 years accounting for 86 (62.3%). Age range was 19-48 years and the modal parity was para 2. Majority of the clients had formal education, 137 (99.3%), married, 128 (92.8%) and multipara 85 (61.6%).The discontinuation rate was 31.9%and the commonest reason for discontinuation was irregular vaginal bleeding accounting for 25%.

Conclusion: The prevalence rate of POICs was low and Depot Medroxyprogesterone acetate was more popular. Majority of the discontinuation was due to the side effects of the contraceptives.

Open Access Original Research Article

Gender-Related Differences and Mortality Predictors among Egyptian Hemodialysis Patients: A Multi-Center Prospective Observational Study

Abir Farouk Megahed, Mona Mohammed Tawfik Abdelhady, Ghada El Kannishy, Nagy Sayed- Ahmed

Asian Journal of Medicine and Health, Page 118-130
DOI: 10.9734/ajmah/2020/v18i1030259

Background: End-stage renal disease (ESRD) is an important cause of global morbidity and mortality affecting both sexes. Both genders may present with different symptoms and signs, respond differently to therapy and may exhibit different degrees of tolerance towards their disease. In Egypt, hemodialysis (HD) constitutes the most common modality of renal replacement therapy and the number of hemodialysis patients is increasing. The objective of the present study was to investigate gender-related differences in clinical and biochemical characteristics in HD patients. Mortality events in both genders were also recorded and predictors of mortality in the included HD population were explored.

Methods: This multicenter study adopted essentially a cross-sectional design and included 2158 patients (1241 males and 917 females) undergoing HD in 25 hemodialysis units in six governorates in Egypt. The study started at June 2016 till May 2017. Data were extracted from the patients' records. One year mortality events in the included HD patients were prospectively observed and recorded.

Results: Males on HD had a significantly lower body mass index (BMI) values and were less efficiently dialyzed. Their blood pressure measurements were significantly higher. In addition, males had significantly higher serum albumin with a significantly lower serum potassium level. The overall mortality rate was 6.9% (149 deaths) during the one year follow up period with a significant male predominance (7.9% in males vs. 5.6% in females p=0.03). The mortality rate was highest within the first 14 months after starting hemodialysis therapy. Mortality was statistically significantly higher in patients with diabetes, ischemic heart disease (IHD), anemia with low hemoglobin, and low serum albumin. The mortality risk is nearly duplicated in HD patients with IHD, while low serum albumin was associated with about 3 times an increase in mortality risk in the studied HD patients. 

Conclusion: Gender differences in clinical and laboratory characteristics and mortality do exist in Egyptian HD patients and should be considered when management guidelines are developed to suit the gender-related variations.

Open Access Original Research Article

Colorectal Cancer Risk and Prevention Knowledge among Adults Attending Public Health Facilities in Obudu, Cross River State, Nigeria

Ugbe Maurice-Joel Ugbe, Theresa Awa Mark, Okoi Faith Ubi

Asian Journal of Medicine and Health, Page 131-143
DOI: 10.9734/ajmah/2020/v18i1030260

Background: Colorectal cancer (CRC) is the 5th most frequent cause of cancer-related deaths in Nigeria. As with other cancers, CRC risk is multifactorial, including issues such as poor diet, obesity, alcohol abuse, physical inactivity, age above 50 years, history of adenomatous polyps, inflammatory bowel disease, and family history of CRCs or polyps.

Aim: The study aimed to ascertain the level of knowledge of risk factors and preventive measures against CRC among adults attending health facilities in Obudu Local Government area Cross River State, Nigeria.

Study Design: A descriptive survey research design was used.

Place and Duration of Study: Urban health facilities in Obudu Local government area, Cross River state between 2017 and 2019.

Methodology: The sample of the study comprised 310 attendees of health facilities. A structured questionnaire was the main instrument used for data collection. Face validity was employed. The split-half method was used to establish the reliability of the instrument with thirty adults in a neighboring town.

Results: Findings showed that males had better knowledge of risk factors (75.3%) than females (45.8%); and males had better knowledge of prevention of CRC (82.1%) than females (57.2%), hence showing a significant association (P=.002, P=.003) between gender with knowledge of risk factors and prevention of CRC respectively. There were also significant associations between age (P=.007, .001) and educational level (P=.002, .006) with knowledge of risk factors and prevention of CRC respectively. This showed that younger ages and higher education were associated with better knowledge of CRC.

Conclusions: Less knowledgeable women and persons with low educational level should be targeted with messages on CRC. Health educators should intensify their health education campaign on the importance of screening as the major preventive measure against CRC at the household level. Government and non-governmental organizations (NGOs) should sponsor the provision of resources and screening facilities.

Open Access Original Research Article

Awareness of Causes and Health Risks Associated with High Blood Cholesterol among Men in Awka Etiti, Anambra State, Nigeria

Anthony Somtochukwu Umezulike, Ugbe Maurice-Joel Ugbe, Okoi Faith Ubi

Asian Journal of Medicine and Health, Page 144-154
DOI: 10.9734/ajmah/2020/v18i1030261

Aim: The study aimed to determine the awareness of causes and health risks associated with high blood cholesterol (HBC) among men in Awka-Etiti, Nigeria.

Study Design: A descriptive survey research design was used.

Place and Duration: Awka-Etiti, Anambra State, Nigeria in 2019.

Methodology: The sample of the study comprised three hundred adult men aged 25 and above. A structured questionnaire was the main instrument used for data collection. Face validity was used to check for the validity of the instrument. The split-half method was used to check the reliability of the instrument and obtained a coefficient of 0.61.

Results: Generally there were low levels of awareness of causes (56%) and a moderate level of awareness for risks (65%) associated with HBC in the study area. Younger age and older age as well as higher educational attainment were identified determinants of better awareness of causes and associated risks of HBC. Significance test found associations between age and awareness of causes of HBC (P=.006); and age and awareness of associated risks of HBC (P=.001). There were no significant associations between marital status and awareness of causes of HBC (P=.221); and marital status and awareness of associated risks of HBC (P=.221).

Conclusion: There are still poor awareness levels of HBC among some minority groups in the study population. Public Health education and promotion of healthy lifestyles are recommended to reduce this burden.

Open Access Short Research Article

Knowledge and Preparedness on Corona Virus Pandemic among Healthcare Workers in Igembe South Health Facilities, Meru County, Kenya

P. K. Kubai, M. P. Ndiba, L. K. Ikiara, C. K. Karani

Asian Journal of Medicine and Health, Page 155-164
DOI: 10.9734/ajmah/2020/v18i1030262

Worldwide Corona virus outbreak has cause panic and enormous health and economic effects due to inadequate or lack of appropriate information about COVID -19.

Aims: The aim of the study was to determine the Level of knowledge and Preparedness to Corona Virus (COVID –19) Pandemic among Health Workers in Igembe South, Meru County, Kenya.

Study Design: This was cross-sectional study was conducted to determine their Knowledge and Preparedness among HCWs on COVID-19 pandemic.

Place and Duration of Study: The study was conducted in Igembe South Health Facilities between March and June 2020.

Methodology: A facility based cross-sectional study was conducted in Igembe South Sub County of Meru County from March 2020 to June 2020 among 87 Health Care Workers to determine their Knowledge and Preparedness on COVID-19 pandemic. Data was collected using structured Likert’s Scale questionnaire. Descriptive analysis was performed to obtain frequencies and distribution of the variables.

Results: The results shows that eight seven (87) health care workers with mean age of 34± 9 (SD) years with a minimum age of 19 years and maximum age of 60 years were recruited responded to the questions of the study. Among the 87 participants, 51 (58.6%) had at least a bachelor's degree, 30 (34.5%) participants had a diploma and 6 (6.9%) participants had a certificate. About 32 (36.8%) of the participants were nurses. Other professional disciplines included nutritionists, records officers, supporting staff, social workers among others. Majority of the facilities acknowledged receiving Ministry of Health guidelines and protocols on COVID-19 case management. Regarding knowledge of COVID -19 Almost half (48.3%) of the participants somewhat agreed that health care workers had knowledge of Corona Virus Pandemic, however, most of the respondents (50.6%) strongly disagreed that they are equipped with adequate Knowledge to manage severe Corona Case compared to (8%) respondents who strongly agreed that Corona Virus Incubation period is an average of 7 days and maximum of 14 days.

Conclusion: The study concludes that knowledge and preparedness level on COVID - 19 was above average, however, there is need for continuous professional development (CPD) training and support supervision for HCWs to ensure maintenance of appropriate practices during the COVID-19 pandemic. The study further concludes that those with knowledge and are conversant with their respective areas of practice are at less risk, considering that inadequate knowledge is not only a risk factor for poor delivery of WHO approved COVID -19 guidelines met to prevent the spread of COVID -19, but also increases the occupational risk to health care workers.

Open Access Case Study

Novel Association between Gemfibrozil and Dyslipidemia: A Case Report

Deena M. S. Barrouq, Tareq Irshaidat

Asian Journal of Medicine and Health, Page 38-43
DOI: 10.9734/ajmah/2020/v18i1030250

Dyslipidemia is a risk factor in many health complications, among them is hypertension.

Case: This report presents a case of a poorly controlled dyslipidemia that could not be managed by medications. A surprisingly and an unexpected factor interfered; the triglyceride-lowering medication caused a significant increase in the appetite toward fat-rich food items which opposed its intended purpose.

Methodology: A dietary intervention and an uncommon drug dose modification were necessary. Results: The personally designed protocol led to a significant overall improvement and was successful in adjusting the biochemical parameters especially the plasma triglycerides and the total cholesterol and was effective in reversing hypertension and a pre-diabetic state to safer values. Conclusion: This is the first characterized case in the literature on the involvement of gemfibrozil in poor management of dyslipidemia.