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Abnormal Umbilical Doppler: Incidence and Neonatal Outcomes among Hypertensive Disorders in Pregnancy at KCMC: A Hospital-Based Prospective Cohort Study

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Open Journal of Obstetrics and Gynecology 2024年第8期14卷 1253-1266页

作者： Yusuph Mwidibo Pendo Mlay Adnan Sadiq Gosbert George Bariki Mchome Nasra Batchu Glory Mangi Raziya Gaffur Rafiki Mjema Eusebius Maro Tom Kakumbi Doris Rwenyagila Gileard Masenga Patricia Swai Department of Obstetrics and Gynecology Kilimanjaro Christian Medical Center (KCMC) Moshi Tanzania Department of Obstetrics and Gynecology Kilimanjaro Christian Medical University College (KCMUCo) Moshi Tanzania Department of Radiology Kilimanjaro Christian Medical Center (KCMC) Moshi Tanzania

Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9% from 1990 to 2019. Umbilical Doppler study in hypertensive disorders of pregnancy helps to predict neonatal outcomes and prevent neonatal and maternal morbidity and mortality. Objective: This study aims to determine the incidence of abnormal umbilical Doppler among hypertensive pregnant women, to identify the adverse neonatal outcomes associated with abnormal umbilical Doppler, and also to detect the diagnostic predictive values of umbilical Doppler to neonatal outcomes at KCMC. Material and methods: A hospital-based prospective cohort study included women with hypertensive disorders of pregnancy from the gestational age of 28 weeks and above, followed up to delivery during the study period from August 2022 to March 2023. Multivariate logistic regression analysis was used to determine the association between AUD and neonatal outcomes. Results: Out of 112 women with HDP, the incidence of abnormal umbilical Doppler was 38 (33.93%). Abnormal umbilical Doppler was associated with neonates with low birth weight aOR (95% of CI) of 4.52 (1.59 - 12.83) p = 0.005 and neonatal ICU admission 9.71 (2.90 - 32.43) p Conclusion: The incidence of abnormal umbilical Doppler is high in hypertensive disorders of pregnancy which is associated with an increase in neonatal low birth weight and neonatal ICU admissions, the sensitivity of abnormal umbilical Doppler in prediction of low birth weight and neonatal ICU admission is significant hence the routine use of umbilical Doppler assessment among hypertensive pregnant women is crucial.

关键词： Hypertensive Disorders in Pregnancy Umbilical Doppler Neonatal Outcomes KCMC

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D-Dimer: Predictor of Postpartum Hemorrhage among Pre-Eclampsia at kilimanjaro christian medical Centre

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Open Journal of Obstetrics and Gynecology 2024年第6期14卷 923-937页

作者： Husna Silim Ally Nyasatu G. Chamba Raziya Gaffur Nasra Batchu Glory Mangi Pendo S. Mlay Bariki Mchome Mtoro J. Mtoro Thomas J. Kakumbi Rafiki N. Mjema Doris Rwenyagila Eusebius Maro Fredrick Mbise Gilleard Masenga Patricia S. Swai Department of Obstetrics and Gynaecology KCMC Hospital Moshi Tanzania Department of Obstetrics and Gynaecology Kilimanjaro Christian Medical University College (KCMUCo) Moshi Tanzania

Background: Postpartum hemorrhage (PPH) is the major contributor to maternal mortality and morbidity worldwide as well as in Tanzania. Studies have shown Pre-eclampsia as a risk indicator for Postpartum hemorrhage and D-dimer tends to rise in women with pre-eclampsia. Few studies that have shown the association between D-dimer and PPH have been controversial and differ according to ethnicity and lifestyle. Hence there is no suitable reference interval for D-dimer in predicting Postpartum hemorrhage among women with pre-eclampsia. Broad Objective: This study aimed to assess the association, sensitivity, and specificity of D-dimer as a laboratory predictor of postpartum hemorrhage among women with pre-eclampsia at KCMC hospital. Methodology: This was a hospital-based analytical cross-sectional study conducted at KCMC Hospital in Northern Tanzania from September 2022 to March 2023. A total of 195 women with pre-eclampsia were included in this study. Plasma D-dimer levels were taken from women with pre-eclampsia pre-delivery. Haematocrit was compared before and after delivery, and a fall of 10% was considered as Postpartum hemorrhage together with clinical assessment of the patient. Participants were divided among those who had severe features and those who did not have severe features and were further categorized into those who had PPH and those who did not have PPH. Logistic regression was used to determine the association between D-dimer and PPH adjusting for other factors. The Receiver Operating Curve (ROC) was used to evaluate the predictive value. Results: Higher median D-dimer levels were seen among women who had PPH compared to those who had no PPH. D-dimer was seen to be associated with PPH, thus for every unit increase of µg/ml of D-dimer among women who had pre-eclampsia without severe features there was a 14% significant increase in the odds of having postpartum hemorrhage and a 45% significant increase of having postpartum hemorrhage among those who had pre

关键词： D-Dimer Preeclampsia Postpartum Hemorrhage Tanzania

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Pain Efficacy of a Home-Based Low-Intensity Continuous Ultrasound Stimulator for Knee Arthritis: A Single-Arm, Open-Label, Prospective Clinical Trial

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Health 2024年第7期16卷 703-716页

作者： Md. Habibur Rahman Yeon-Gyu Jang Johny Bajgai Subham Sharma Kchorng Vira Abdul-Nasir Sofian Seong Hoon Goh Yundeok Kim Cheol-Su Kim Doo-Sup Kim Kyu-Jae Lee Department of Convergence Medicine Wonju College of Medicine Yonsei University Wonju Republic of Korea Department of Neurosurgery Wonju Severance Christian Hospital Wonju College of Medicine Yonsei University Wonju Republic of Korea Department of Global medical Science Wonju College of Medicine Yonsei University Wonju Republic of Korea Department of Internal Medicine Division of Hematology-Oncology Wonju Severance Christian Hospital Wonju Republic of Korea Department of Orthopaedic Surgery Wonju College of Medicine Yonsei University Wonju Republic of Korea

1) Background: Osteoarthritis (OA) is defined as a degenerative joint disease that mainly affects the bone. This study aims to evaluate the effect of low-intensity continuous ultrasound (LICUS) treatment on the knee of osteoarthritis patients through home-based intervention using the LICUS medical device. 2) Methods: The clinical trials were designed in a single-arm, open-label, and intervention study. Thirty-five participants, including those who dropped out (12%), were screened and enrolled. The patients received LICUS (1.1 MHz, 1.5 W/cm2, collimated beams) on the knee by the instructions of the investigator at home (5 min/session, 3 times/day, for four-weeks). Outcome measures were assessed using the Visual Analog Scale (VAS) as a primary endpoint and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) as a secondary endpoint to evaluate pain relief and functional recovery of the knee between pre-treatment (baseline) and post-treatment (four-weeks). 3) Results: Knee pain scores measured using the VAS and WOMAC indices were significantly reduced after a four-week treatment with LICUS compared to baseline. Knee stiffness and functional capacity were significantly reduced after the LICUS application. In addition, there were no reports of adverse effects during the study period. 4) Conclusion: Long-term and home-based application of LICUS can be recommended as an alternative option for the treatment of OA patients, as evidenced by the effect of pain relief and knee function recovery.

关键词： Knee Osteoarthritis Low-Intensity Continuous Ultrasound Stimulator Clinical Trial Visual Analogue Scale Western Ontario and McMaster Universities Osteoarthritis Index

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Prevalence and Associated Factors of Hepatitis B Surface Antigen (HBsAg) among People Living with HIV (PLWHIV) Attending at CTC Mawenzi Regional Hospital kilimanjaro, Northern Tanzania

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Advances in Infectious Diseases 2021年第2期11卷 216-231页

作者： Benedicto Shimula Nyalika kilimanjaro christian medical university college Kilimanjaro Tanzania

Background: Human immunodeficiency virus (HIV) and hepatitis virus (HBV) coinfection are common due to shared modes of transmission between these viruses. Also studies have shown that HIV appears to be a risk factor for reactivation of hepatitis B in patients who have developed hepatitis B surface antibodies HBsAg which is considered as a marker of chronic HBV infection. The magnitude of HIV/HBV coinfection among people living with HIV in Tanzania is not well known. Objective: The aim of this study was to determine the prevalence and associated factors of HBsAg among HIV Positive Clients at CTC at Mawenzi Regional Hospital. Methods: It was a cross sectional study that included 100 HIV Positive CTC clients at Mawenzi Regional Hospital. Ethical clearance was obtained at KCMUCo ethical committee, structured questionnaires with closed-ended question were used to collect the information needed done by interviewing the person, blood sample was collected from median cubital vein and HBsAg Rapid Test Strips were used. Data processing and analysis were done using SPSS version 20. Results: Of 100 HIV patients, only 8 (8%) tested positively for HBsAg. There was a significant association between residence and HBV infection. People from rural areas had high prevalence compared to urban areas (OR 8.71, 95% CI: 1.029 - 73.66). Other social demographic and clinical characteristics in this study had no significant association with HBsAg positivity. Conclusion: Significant numbers of 8% HIV patients are HBsAg positive. HIV patients from rural residency are more likely to acquire HBV than Urban residents that showed significant association.

关键词： HIV HBV HBsAg Care and Treatment Center (CTC)

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Proximate analyses,in vitro antioxidant activity and GC-MS analyses of fermented Pentaclethra macrophylla seeds

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Life Research 2024年第3期7卷 2-8页

作者： Ikechukwu Okoro Parker Joshua Innocent Okagu christian Amah Nnamani Ikenna Nene Chiaka-Onyemeze Emeka Anaduaka David Obasi Prince Okoroh Daniel Orieke Victor Ogugua Department of medical Biochemistry College of Health SciencesDavid Umahi Federal University of Health SciencesUburuNigeria Department of Biochemistry University of NigeriaNsukkaNigeria Department of Biochemistry State University of Medical and Applied SciencesIgbo-EnoNigeria Department of medical Laboratory Sciences State University of Medical and Applied SciencesIgbo-EnoNigeria

The present study assessed the proximate composition,in vitro antioxidant activity and GC-MS analyses of fermented Pentaclethra macrophylla seeds extract(FPMSE).The in vitro antioxidant activity was assessed using 2,2-diphenyl-1-picrylhydrazl(DPPH)while Gas Chromatography-Mass Spectrophotometry(GC-MS)technique was used to identify the volatile compounds in *** revealed a dose dependent percentage inhibition of the extract on DPPH *** composition of FPMSE constitutes respectively;ash(0.33±0.12%),protein(2.19±0.08%),fats and oil(80.60±0.00%),carbohydrate(16.88±0.00%)while moisture and fibre were not ***,the pulverised sample constitute respectively;ash(1.27±0.58%),protein(10.51±0.60%),moisture(8.27±0.12%),fats and oil(32.33±0.12%),fibre(7.27±0.12%)and carbohydrate(40.35±0.00%).GC-MS analyses revealed fourteen(14)fatty acids including Octadecanoic acid(1.95%),Benzyloxymethylimine(43.89%),2-Allylpent-4-enoic acid benzyl ester(26.25%),Hexadecanoic acid,methyl ester(1.09%),Oleic Acid(0.25%),9,12-Octadecadienoic acid,methyl ester(Omega-6-fatty acid)(1.52%).The bioactive compounds identified in FPMSE could contribute to the pharmacological properties of *** seeds and hence,could be of considerable interest for the development of new drugs.

关键词： Pentaclethra macrophylla in vitro antioxidant GC-MS fatty acids

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Evaluation of Mobile Electronic Devices in Detecting Optic Disc and Visual Field Parameters in Patients with Glaucoma at a Tertiary Hospital in Northeastern Tanzania

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Open Journal of Ophthalmology 2020年第3期10卷 230-238页

作者： Francisco Alcides Mulobuana Tolbert Sonda Martin M. Rwabilimbo William Makupa kilimanjaro christian medical university college Moshi Tanzania kilimanjaro Clinical Research Institute Moshi Tanzania Department of Epidemiology and Applied Biostatistics Kilimanjaro Christian Medical College University Moshi Tanzania kilimanjaro christian medical Centre Moshi Tanzania

Background: Glaucoma is a serious public health problem since it causes visual impairment impacting social, mental and physical health of an individual. Diagnosis and management of glaucoma continue to be a challenge due to few qualified personnel and high cost of the equipment. The use of portable Eye Examination Kit such as Smartphone and tablets can be used in glaucoma screening for taking high-resolution fundus photos for optic disc and visual field parameters, respectively. This study was conducted to evaluate the applicability of mobile electronic device to detect optic disc and visual field parameters for glaucoma in a resource limited setting. Objective: To evaluate the applicability of mobile electronic devices to detect optic disc and visual field parameters for glaucoma. Methodology: Across-sectional study was conducted at KCMC Eye department from October 2018 to June 2019. Study included 140 participants attending eye clinic of which 67 had glaucoma and 73 without glaucoma. Clinical and socio-demographic data were collected using a structured questionnaire and analysed using Stata 15. Glaucoma examination was made on the right eye and photo comparison made between those with and without glaucoma. PEEK Smartphone fundus photo examination was compared with the gold standard machine (Slit Lamp Biomicroscopy), Amsler grid chart installed on a tablet (Microsoft surface, internal storage 256 GB, 2013) and contrast sensitivity compared with Humphrey field analyser (i series, model 740117434, Carl Zeiss Meditec). Results: The kappa (k) agreement between Slit lump biomicroscopy fundus view image and PEEK Smartphone concerning the optic disc measurement was 0.92 with sensitivity and specificity of 90.32% (95% CI: 80.12 - 96.37) and 93.59% (95% CI: 85.67 - 97.89) with a p < 0.001 respectively. An agreement between Amsler grid and Humphrey Field Analyser was 0.67 with sensitivity of 33.33% (95% CI:

关键词： Glaucoma PEEK Smartphone Contrast Sensitivity Amsler Grid kilimanjaro

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Visual Outcome and Predictors of Poor Visual Outcome among Uveitis Patients Attended at KCMC Eye Department, Moshi—Northern Tanzania

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Open Journal of Ophthalmology 2020年第2期10卷 123-132页

作者： Abrahamo Arao Nhutene Matova William Makupa kilimanjaro christian medical university college (KCMUCo) Moshi Tanzania kilimanjaro christian medical Center Hospital Moshi Tanzania

Background: Uveitis, an inflammatory disease of the middle layer of the human eye is a potentially blinding disease, carrying social, economic and individual consequence. Though not being a leading blinding disease, it causes visual impairment and blindness with its complications like cataract and glaucoma. Few studies have addressed the visual outcome after diagnoses and follow-up of patients with uveitis;and at our setting, few is known about the visual outcome, factors predicting poor outcome. Methodology and Materials: This was a hospital-based cohort study conducted at the kilimanjaro christian medical Center (KCMC), Eye Department. Files of patients attended from January 2010 to December 2017 were assessed. Measures of Central Tendency and their corresponding dispersion were used to summarize continuous variables and proportions for categorical variables. One sample paired t-test was used to assess differences in mean Best Corrected Visual Acuity (BCVA) and Wilcoxon Signed Rank test for differences in median BCVA between the first visit and at one year respectively. Association between predictors and poor outcome was analyzed by using Chi square test. Multivariate regression was used to control for potential confounders and a p value less than 0.05 was considered as statistical significant. Results: A total of 291 patients were assessed, majority of them being female (54.6%), with median age being 53 years. The proportion of visual impairment reduced from the initial 57.7% at presentation to 28.2% at one year. The mean BCVA improved from the initial 0.96 log MAR to 0.70 log MAR at one year. The main factors associated with poor presenting vision were: Cataract (p value Conclusions: at one year of follow-up of patients with uveitis, the proportion of visual impairment reduces significantly, with improvement also being observed on mean visual acuity. The most common predictors of poor visual outcome were Cataract, Glaucoma CME, abnormal IOP and Maculopathy.

关键词： Visual Outcomes Predictors Uveitis

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Awareness and Factors Associated with Postpartum Modern Contraceptives Use among Women of Reproductive Age in Bukombe District, Geita Region

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Advances in Sexual Medicine 2020年第3期10卷 71-85页

作者： Immanuel Shayo Sia E. Msuya Caroline Amour Michael J. Mahande kilimanjaro christian medical university college Moshi Tanzania Department of Epidemiology & Biostatistics Institute of Public Health Kilimanjaro Christian Medical University College Moshi Tanzania Department of Community Health Institute of Public Health Kilimanjaro Christian Medical Centre Moshi Tanzania

Introduction: Pregnancies that occur during the first year postpartum are more likely to be unplanned. This leads to an increased risk of adverse maternal and perinatal outcomes. However, modern contraceptive use during this period helps to reduce unplanned pregnancies and its associated adverse outcomes. There is scant data on postpartum contraceptives in pastoral communities in Tanzania. This study aimed to assess awareness and factors associated with postpartum modern contraceptives use among women of reproductive age in Bukombe District, Geita Region. Method: A community based cross-sectional study was conducted in a predominant pastoral community of Bukombe district in Geita region in north-western Tanzania from May-June 2018. A total of 511 postpartum women who were in their first year after child birth were studied. A multistage sampling technique was used to select study participants. Data analysis was performed using SPSS version 21. Multivariable logistic regression analysis was used to determine independent predictors of postpartum modern contraceptive use. Results: Most (97.3%) of the participants were aware about modern contraceptives. The prevalence of postpartum modern contraceptive use was 11.9%. The most frequent used contraceptive method was Implant 6.5%. Majority (75%) of women started to use the contraceptive at the first three months after delivery. Living in urban (AOR = 1.84, 95% CI: 1.20 - 3.79), business women’s (AOR = 2.34, 95% CI: 1.31 - 2.28), having last born aged 3 - 4 months (AOR = 3.30, 95% CI: 1.11 - 9.85) and menses resumption (AOR = 9.23, 95% CI: 3.60 - 23.72) were associated with postpartum modern contraceptive use. Fear of side effects, poor knowledge about contraceptives, husband restrictions, distance to health facility and availability of contraceptive were the barriers for use of contraceptive use. Conclusion: We found low uptake of postpartum modern contraceptive use in this population. Numerous f

关键词： Awareness Postpartum Modern Contraceptives Use Tanzania

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Prevalence and Determinants of Modern Contraceptive Methods Use among Women of Reproductive Age (15 - 49 Years) in Rural Setting: A Case of Kishapu District, Shinyanga Region

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Advances in Sexual Medicine 2019年第4期9卷 53-66页

作者： Veronica Martin Sia E. Msuya Ntuli Kapologwe Damian J. Damian Beatrice John Michael J. Mahande Department of Epidemiology and Biostatistics Institute of Public Health Kilimanjaro Christian Medical University College Moshi Tanzania kilimanjaro christian medical Centre Moshi Tanzania Community Health Department Kilimanjaro Christian Medical University College Moshi Tanzania Shinyanga Regional medical Office Shinyanga Tanzania

Background: Modern contraceptive use among women of reproductive age (15 - 49 years) is a public health priority in Tanzania. The national prevalence remains unacceptably low as 32%. Shinyanga region is one among the regions with lowest contraceptive prevalence rate (21%) and high unmet need for family planning (23%). Understanding factors contributing to its use may help to improve maternal and child health. This study aimed to assess the prevalence and determinants of modern contraceptive use among women of reproductive age. Methods: A community-based cross-sectional study was conducted in Kishapu district of Shinyanga region: A total of 602 women aged 15 - 49 years were interviewed using a standardized questionnaire. Data were analysed using SPSS version 20.0. Odds ratios with 95% confidence intervals for factors associated with use of modern contraceptives were estimated in multivariable logistic regression models. Results: The prevalence of modern contraceptive use was 42.7%. Being employed (OR 2.42, 95% CI: 1.13 - 5.18), formal educational level (OR 2.45, 95% CI: 1.38 - 4.35), couples communication (OR 2.44, 95% CI: 1.74 - 3.42) and availability of modern contraceptives (OR 1.94, 95% CI: 1.17 - 3.20) were significantly associated with current use of modern contraceptives. Husband disapproval was frequently reported as barrier for modern contraceptives in the study area. Conclusions: Numerous factors were associated with use of modern contraceptives. Husband disapproval was frequently reported as barrier for contraceptive use. Strategies to promote the importance of modern contraceptives use in the study area are warranted. District health office and concerned stakeholders should encourage male involvement for family planning.

关键词： Family Planning Modern Contraceptive Use Prevalence Determinants

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Rare Case of Surviving Infant with Strawberry Yoghurt like Blood Diagnosed to Be Infantile Hypertriglyceridemia at 1 Month Old: A Case Report

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Open Journal of Pediatrics 2021年第4期11卷 777-785页

作者： Matei Mselle Aisa Shayo Ronald Mbwasi Faith Mosha Jeremia Pyuza Philip Mrindoko Nyemo Peter Elton Meleki Elise Kimambo Arnold Likiliwike Lucy Frisch Magreth Swai Zaituni Hatibu Ally Iman Beatrice Maringo Linda Kissila Ikupa Minga Deborah Mchaile Department of Paediatrics and Child Health Kilimanjaro Christian Medical University College Moshi Tanzania Department of Paediatrics and Child Health Kilimanjaro Christian Medical Centre Moshi Tanzania Department of Clinical Laboratory Kilimanjaro Christian Medical Centre Moshi Tanzania

Background: Hypertriglyceridemia in children means increased plasma fasting Triglyceride levels above the 95th percentile for age and sex. For children aged 0 to 9 years, a triglyceride level greater than or equal to 100 mg/dl is considered above the 95th percentile. Hypertriglyceridemia can be mild to borderline high, moderate to high, very high, severe and very severe (>2000 mg/dl). We present the case of a 1 month and 3 weeks old baby who presented with difficulty in breathing. It was accidentally found to have strawberry yoghurt like blood during phlebotomy, of which upon investigation had very high triglyceride levels of >2000 mg/dl. Case Presentation: 1 month and 3 weeks old female baby, admitted as referral from nearby health centre presenting with difficulty in breath, her blood sample was incidentally found to appear as strawberry yoghurt like. Clinically the infant had features suggestive of respiratory distress, with no other systemic abnormalities noted. Chest X-ray that was don

关键词： Strawberry Yoghurt Like Blood Hypertriglyceridemia Tanzania

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