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Plasma phenytoin and phenobarbitone levels were estimated in 123 adult Ethiopian epileptics by gas-liquid chromatography. Thirty four (38.2%) of the patients on phenytoin, and 52 (52%) of those on phenobarbitone, had plasma levels in the conventional therapeutic ranges of 10-20 micrograms/ml and 10-30 micrograms/ml respectively. Of the 89 patients who were taking phenytoin either singly or combined with phenobarbitone, motor disturbances (ataxia and nystagmus) were seen in 31 (34.8%) and dysmorphic and idiosyncratic side effects including gum hypertrophy, hirsutism, acne and skin rash in 37 (41.6%). Subnormal serum calcium levels were noted in 15 (30.6%) and high alkaline phosphatase was found in 13 (26.5%). Phenobarbitone was found to be an effective anticonvulsant (78.1% seizure control rate), with adverse effects of sedation and intellectual depression. Seizure control was achieved in 77.1% of patients on a single drug as opposed to 55.6% on combination of phenytoin and phenobarbitone (p less than 0.05). The overall seizure control rate was 66%. 相似文献
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Tigest Tamrat Subhash Chandir Kelsey Alland Alisa Pedrana Mubarak Taighoon Shah Carolyn Footitt Jennifer Snyder Natschja Ratanaprayul Danya Arif Siddiqi Numera Nazneen Inraini Fitria Syah Roger Wong Peter Lubell-Doughtie Annisa Dwi Utami Khaerul Anwar Hasmot Ali Alain B Labrique Lale Say Anuraj H Shankar Garrett Livingston Mehl 《Bulletin of the World Health Organization》2022,100(10):590
ObjectiveTo describe a systematic process of transforming paper registers into a digital system optimized to enhance service provision and fulfil reporting requirements.MethodsWe designed a formative study around primary health workers providing reproductive, maternal, newborn and child health services in three countries in Bangladesh, Indonesia and Pakistan. The study ran from November 2014 to June 2018. We developed a prototype digital application after conducting a needs assessment of health workers’ responsibilities, workflows, routine data requirements and service delivery needs. Methods included desk reviews, focus group discussions, in-depth interviews; data mapping of paper registers; observations of health workers; co-design workshops with health workers; and usability testing. Finally, we conducted an observational feasibility assessment to monitor uptake of the application.FindingsResearchers reviewed a total of 17 paper registers across the sites, which we transformed into seven modules within a digital application running on mobile devices. Modules corresponded to the services provided, including household enumeration, antenatal care, family planning, immunization, nutrition and child health. A total of 65 health workers used the modules during the feasibility assessment, and average weekly form submissions ranged from 8 to 234, depending on the health worker and their responsibilities. We also observed variability in the use of modules, requiring consistent monitoring support for health workers.ConclusionLessons learnt from this study shaped key global initiatives and resulted in a software global good. The deployment of digital systems requires well-designed applications, change management and strengthening human resources to realize and sustain health system gains. 相似文献
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BackgroundGlobally, there are about 10 million cases of deep vein thrombosis every year, and it is the third leading cardiovascular disease after myocardial infarction and stroke. The objective of the study is to assess risk factors of time to cure patients of deep vein thrombosis in southwest Ethiopia.MethodsA retrospective cohort study design was used. The study population was deep vein thrombosis patients at purposively selected hospitals in Southwest Ethiopia from January 2017 to December 2020. Cox proportional hazard model was used to identify risk factors associated with deep vein thrombosis.ResultsOut of the total 1068 registered as deep vein thrombosis patients, 263(24.6%) were cured during the study period, and 805(75.4%) were censored. Results of the Cox proportional hazard model show that; age, gender, family history of deep vein thrombosis, smoking status, immobilize and alcohol consumption were factors associated with deep vein thrombosis (p-value<0.05).ConclusionThe patients with a family history of deep vein thrombosis, prolonged immobilization, greater the 50 years, smoking cigarettes, female (non-pregnant) and alcohol users had a longer curing time of deep vein thrombosis compared to others. 相似文献
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Background
Delay in leprosy diagnosis and treatment causes disabilities due to nerve damage, immunological reactions and bacillary infiltration. Leprosy disability leads not only to physical dysfunction and activity limitation but also disrupts social interaction of affected individuals by creating stigma and discrimination. This study was aimed at assessing leprosy disability status in patients registered at All African TB and Leprosy Rehabilitation and Training Centre.Methods
Medical records of leprosy patients registered from September 11, 2010 to September 10, 2013 G.C were reviewed. Prevalence of disability calculated, bivariate and multiple logistic regressions were used to determine crude and adjusted odds ratios with 95% confidence interval.Results
The overall prevalence of disability was found to be 65.9% from all categories of patients (40.2% Grade I and 25.7% Grade II). The Prevalence among the new category was 62.8% (39.1% Grade 1 and 23.7% Grade 2). Those ageed above 30 years, with duration of symptoms 6–12 months and above 24 months, with sensory loss, nerve damage and reversal reaction were more likely to develop disability.Conclusion
In this study the prevalence of disability, both Grade I and II, is very high. Disability was associated with age, duration of symptom, sensory loss, signs of nerve damage and reversal reaction. These risk factors indicate the existence of delay in diagnosis and treatment of leprosy cases. Therefore, the national leprosy control program should investigate leprosy case detection and diagnosis system in the country and work on improving early case detection and prevention of disability. 相似文献7.
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Bark from trees obtained from sustainably managed plantations used in the production of timber, pulp and paper is an under-utilised waste in many countries across the world. However, in the context of an integrated biorefinery, they may serve as a valuable feedstock for the production of high-value products for increased revenue generation and mitigation of environmental impacts for the ailing forestry, timber, pulp and paper industry. In this study, optimum accelerated solvent extraction conditions were established for the recovery of total polyphenolic compounds (TPC) and total extractive content (TEC) from barks obtained from four Eucalyptus tree species (E.dunnii, E.grandis, E.smithii and E.nitens). Using a response surface methodology and Box-Behnken experimental design, optimum extraction conditions found were an extraction temperature of 117 °C, three extraction cycles, and a milled bark particle size class of 500–850 μm. E. smithii showed the highest TEC at 21.9% and the highest TPC at 4.7 g/100 g gallic acid equivalents (GAE). 相似文献
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Intertechnique agreement and interstudy reproducibility of strain and diastolic strain rate at 1.5 and 3 tesla: A comparison of feature‐tracking and tagging in patients with aortic stenosis 下载免费PDF全文
Anvesha Singh MBChB Christopher D. Steadman MBChB MD Jamal N. Khan MBChB BMedSci Mark A. Horsfield PhD Soliana Bekele BSc Sheraz A. Nazir MBChB Prathap Kanagala MBChB Nicholas G.D. Masca MSc Patrick Clarysse PhD Gerry P. McCann MBChB MD 《Journal of magnetic resonance imaging : JMRI》2015,41(4):1129-1137
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