检索结果-南通市图书馆

Open Journal of Blood Diseases 2022年第2期12卷 11-28页

作者： Zivonishe Mwazyunga Emmanuela E. Ambrose Neema Kayange respicious bakalemwa Benson Kidenya Luke R. Smart Adolfine Hokororo Department of Paediatrics Catholic University of Health & Allied Sciences and Bugando Medical Centre Mwanza Tanzania Division of Haematology Cincinnati Children’s Hospital Cincinnati OH USA

Background: Sickle cell anaemia (SCA) is a serious, multisystem, genetic disorder affecting millions of children worldwide. The disease causes numerous complications that interfere with the health-related quality of life (HRQoL) of these children including an impact on educational, physical and psychosocial development. Few studies have described the clinical spectrum and quality of life of children with SCA living in a low-resource area. Objectives: This study aimed to determine the clinical spectrum and HRQoL among children living with sickle cell anaemia (SCA) in northwest Tanzania. Methods: This hospital-based cross-sectional study took place at Tertiary and teaching hospital, Bugando Medical Centre, Mwanza Tanzania. The study enrolled children ages 2 - 12 years old with SCA attending the Bugando Medical Centre sickle cell clinic. Health related quality of life was measured using the Pediatric Quality of Life, Brief Generic Core Scale after translating from English into a Swahili version. Important SCA complications were assessed using a structured questionnaire. Results: From October 2016 to March 2017, 204 children were enrolled. Participants presented at a median age of 6 years [IQR 4 - 9]. Among children with SCA the most common clinical signs at the time of enrolment were pale in 69.6% (142/204), jaundice in 65.9% (134/204), oxygen saturation 90% in 25% (51/204) and splenomegaly in 19% (39/204). Severe anaemia was observed in 30.9% (63/204). A majority reported vaso-occlusive crisis (166/204, 81.4%), and very few had experienced a prior stroke (5/204, 2.5%). Using a modified Likert scale, a total of 41/204 (20.1%) children had poor HRQoL indicated by low scores on PedsQLTM and 163/204 (79.9%) children had high scores, indicating good HRQoL. On multivariate analysis, age ≥ 5 years (p-value 3 hospitalizations per year (p-value = 0.008) were associated with poor HRQoL. Conclusion: SCA complicatio

关键词： Sickle Cell Anaemia Health Quality of Life Children Tanzania

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Pain Management and Factors Associated with Its Severity among Post Surgical Patients Admitted in the Intensive Care Unit at Muhimbili National Hospital, Tanzania

引用

Open Journal of Anesthesiology 2019年第2期9卷 23-33页

作者： Rebecca Samwel respicious Boniface Department of Anaesthesiology Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania Department of Anaesthesiology Muhimbili Orthopedic Institute Dar es Salaam Tanzania

Background: Pain is the common experience among post operative patients admitted to the intensive care unit. Inadequate management can lead to undesired complications which can increase risk for morbidity and mortality. Objective: The aim of this study was to assess pain management and factors associated with its severity among post surgical patients admitted in intensive care unit at MNH. Method: A prospective study was conducted from October 2017 to February 2018 involving a total of 123 post operative patients aged 18 years and above admitted to the surgical and obstetric intensive care units. Structured questionnaires were used to obtain the required perioperative information. Severity of pain was assessed by using the Numerical Rating Scale (NRS). Data was analyzed using SPSS version 23.0. Frequency, percentages, tables and charts were used to summarize the study findings. Bivariate analysis and multivariate logistic regression were done. P-value of Results: The prevalence of severe post operative pain within 24 and 72 hours was 32.1% and 41.5% respectively. Pre operative use of analgesia (OR: 2.66, CI: 1.15 - 6.12, P value = 0.02), abdominal surgery (OR: 4.12 CI: 1.12 - 15.88, P value = 0.03) and thoracic surgeries (OR;7.42, CI: 1.54 - 35.88, P value = 0.01) was significantly associated with severe pain. Age, sex, ASA class, duration of surgery, and level of education did not show significant association with pain severity. Opioids prescribed postoperatively were pethidine (70.7%), morphine (11.4%) and fentanyl (11.4%). Other analgesics used were paracetamol (60.2%) and diclofenac (22%). Conclusion: The magnitude of post operative pain was high. Pre operative uses of analgesia, abdominal and thoracic surgery were the factors associated with severe pain. Pethidine and paracetamol were the most prescribed drugs, however the prescription pattern used was inadequate to control pain.

关键词： Post Operative Pain Intensive Care Unit (ICU) Pain Severity Prescription Pattern Analgesia

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Understanding Laboratory Methods and Their Impact on Antimicrobial Resistance Surveillance, at Muhimbili National Hospital, Dar es Salaam, Tanzania

引用

Advances in Microbiology 2014年第1期4卷 33-38页

作者： Peter Nyasulu Mabula Kasubi respicious Boniface Jill Murray Department of Microbiology Central Pathology Laboratory Muhimbili National Hospital Dar es Salaam Tanzania Department of Public Health School of Health Sciences Monash University Ruimsig South Africa School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa Muhimbili Orthopaedic Institute Muhimbili National Hospital Dar es Salaam Tanzania School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa

The study sought to describe laboratory methods and blood culture procedures and their impact on antimicrobial resistance surveillance among nosocomial bacteria. We conducted a systematic audit of blood culture procedures and practices in the Department of Microbiology, Central Pathology Laboratory at Muhimbili National Hospital, between 19th and 23rd March 2012. A total of 25 -30 blood culture specimens were received each day as an indication of low volumes of blood culturing at this site. More blood culture requests came from the neonatal unit of the hospital, and were performed manually with high culture negative specimens. The laboratory performed antibiotic susceptibility testing as per the CLSI guidelines. No vancomycin resistance was ever reported at this site. All blood culture results were entered into the JEEVA laboratory information system, where results could be accessed by clinicians in the wards and data could be retrieved to assess patterns of antimicrobial resistance. Blood culture data entry system lacked quality control checks hence numerous errors and missing data were observed. Our results support the relevance of having improved laboratory procedures and good quality blood culture since surveillance of antimicrobial resistance primarily depends on good laboratory procedures, good quality and reliable blood culture data. This would essentially minimise imprecise estimates of rates of antimicrobial resistance at this hospital.

关键词： Antimicrobial Resistance Microbiology Surveillance Laboratory Tanzania

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Prevalence and Factors Associated with Mortality among Chest Injury Patients Admitted at Muhimbili National Hospital in Dar es Salaam, Tanzania

引用

International Journal of Clinical Medicine 2021年第9期12卷 364-376页

作者： Janeth Stanslaus Masuma respicious Lwezimula Boniface Edwin Rwebugisa Lugazia Muhimbili University of Health and Allied Sciences (MUHAS) Dar es Salaam Tanzania Muhimbili Orthopaedic Institute (MOI) Dar es Salaam Tanzania Injury Control Centre Tanzania (ICCT) Dar es Salaam Tanzania Jakaya Kikwete Cardiac Institute Dar es Salaam Tanzania

Introduction: Accidents represent a significant proportional of non-communicable disease in the current century, and chest injury is common. However, management and outcome of these injuries is poor in low resource setting like Tanzania. The aim of this study was to determine the prevalence and factors associated with mortality among chest injury patients at a tertiary level health facility in Tanzania. Method: A prospective Cross-Sectional study of chest injuries among trauma patients attended at Muhimbili National Hospital between September 2019 and February 2020. Results: A total of 282 trauma patients were seen, out of which 51/282 (18.1%) sustained chest injury. Road Traffic Crashes were the leading cause of chest injury 41/51 (80.4%). Majority 17/51 (33.3%) presented with lung contusion, followed by pneumohemothorax and rib fractures each 8/51 (15.7%). Most of the patients 27/51 (52.9%) were managed by tube thoracostomy and 42.1% conservatively. Mortality was 11/51 (21.6%). Independent factors associated with mortality were: Associated injuries (Odds Ratio (OR) 0.07, 95% CI 0.01 - 1.16, p = 0.02), Multimodal analgesia (Odds Ratio (OR) 0.22, 95% CI 0.05 - 0.98, p = 0.05), more than 24 hours to treatment (Odds Ratio (OR) 5.53, 95% CI 1.25 - 24.3, p = 0.02), Bilateral chest involvement (Odds Ratio (OR) 4.61, 95% CI 1.12 - 18.7, p = 0.02), and Invasive ventilation (Odds Ratio (OR) 31.5, 95% CI 4.47 - 53.8, p = 0.00). Conclusion: Chest injuries prevail significantly among trauma patients in Tanzania, mostly due to road traffic crashes. Injury preventive measures especially for road traffic crashes need to be reinforced, and establishment of chest injury management protocol in Tanzania.

关键词： Chest Injury Road Traffic Crashes Tanzania

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Prevalence and Factors Associated with Burnout Syndrome among Resident Doctors at Tertiary Teaching Hospitals in Dar es Salaam, Tanzania

引用

International Journal of Clinical Medicine 2022年第1期13卷 36-49页

作者： Edwin Rwebugisa Lugazia Happiness Charles Sway respicious Lwezimula Boniface Asha Abdullah Muhimbili University of Health and Allied Sciences (MUHAS) Dar es Salaam Tanzania Jakaya Kikwete Cardiac Institute Dar es Salaam Tanzania Muhimbili Orthopaedic Institute (MOI) Dar es Salaam Tanzania Injury Control Centre Tanzania (ICCT) Dar es Salaam Tanzania

Introduction: Burnout syndrome is prevalent to a great extent among medical residents, and this can interfere with their training and patient management. However, the extent of the problem is still unknown in our setting. This study therefore aimed at determining prevalence and factors associated with burnout syndrome among resident doctors at tertiary teaching hospitals in Dar es Salaam, Tanzania. Method: A cross-sectional study of resident doctors was carried out in four teaching hospitals of Muhimbili University of Health and Allied Sciences between January 2021 and March 2021. Participants were interviewed using a structured questionnaire and Maslach Burnout Inventory. Results: The study had 398 participants with a mean age of 35 ± 3.5 years. Overall burnout prevalence was 33.7%, as for the burnout dimensions, 205 (51.5%) respondents reported burnout in the dimension of emotional exhaustion (EE), 177 (44.5%) in the dimension of depersonalization (D), and 144 (36.2%) in the dimension of reduced personal accomplishment (RPA). Independent factors associated with burnout syndrome were: inadequate support from residency program supervisors (Odds Ratio (OR) 1.97, 95% CI: 1.23 - 3.14, p = 0.005), work-related family conflicts (Odds Ratio (OR) 3.2, 95% CI: 1.35 - 7.71, p = 0.008), stressful call perception (Odds Ratio (OR) 3.31, 95% CI: 1.90 - 5.76, p = 0.001) and each added year of study (Odds Ratio (OR) 3.46, 95% CI: 1.08 - 6.73, p = 0.009). Conclusion: Burnout is a problem among resident doctors in Tanzania. This could be addressed by directing preventive and intervention measures in the residency training program. Periodic assessment is also needed to mitigate factors associated with burnout among resident doctors.

关键词： Burnout Resident Doctors Emotional Exhaustion (EE) Depersonalization (DP) Reduced Personal Accomplishment (RPA)

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：