Background: With an increasing number of diabetes patients in developing countries, the burden of diabetes-related blindness is undoubtedly posing a massive challenge to the sustainable health care system due to the cost of care. Despite this fact, to date, most of the epidemiological research on diabetic retinopathy (DR) in eastern Africa, including Ethiopia, has been limited to survey studies. Thus, we determined the incidence of retinopathy and its predictors among diabetic patients in Jimma University Medical Center, Southwest Ethiopia. Methods: A retrospective follow-up study was conducted on 402 randomly selected diabetic patients of aged ≥15 years. A preliminary reviewed checklist was used to obtain information on the demographics, clinical and physiological attributes. Data were entered using EpiData version 4.6 and analyzed using Stata version 14. All variables at P-values less than 0.2 in bivariable analysis were exported to multivariable analysis. Multivariable accelerated failure time (AFT) regression analyses using Weibull distribution were used to examine the predictors of DR at a 5% level of significance. Results: Throughout a median follow-up period of 5.9 years, the cumulative incidence of DR was 20.15% (95%CI: 16.50-24.37) and the incidence rate was 36.9 per 1000 person years (PY) (95%CI: 29.7-45.9). Multivariable Weibull AFT regression analyses showed that type two diabetes mellitus (T2DM) (adjusted time ratio (ATR) 0.4095%CI: 0.20-0.78), hypertension (HTN) (ATR 0.54; 95%CI: [0.35, 0.82]), low high density lipoprotein cholesterol (HDL-C) (ATR 0.51; 95%CI: 0.36-0.73), and borderline high total cholesterol (TC) (ATR 0.63; 95%CI: 0.42-0.94) were a predictor of time to DR. Conclusion: The overall incidence of DR among patients with diabetes mellitus was estimated to be 20.15% and is becoming a public health burden in Ethiopia. Our results indicate that T2DM, HTN, low HDL-C and borderline high TC independently predicts an increased incidence/decreased survival time of retinopathy among diabetes patients. The low HDL-C, HTN, and high TC are modifiable risk factors that should be managed along with diabetes.
Diabetes foot ulcers are a leading cause of death in diabetic individuals. There are very few medicines and treatments that have received regulatory clearance for this indication, and numerous compounds from various pharmacological classes are now in various stages of clinical studies for diabetic foot ulcers treatment. Multiple risk factors contribute to diabetic foot ulcers, including neuropathy, peripheral artery disease, infection, gender, cigarette smoking, and age. The present difficulties in diabetic foot ulcers treatment are related to bacterial resistance to currently utilized antibiotics. Inhibition of the quorum sensing (QS) system and targeting matrix metallopeptidase-9 (MMP-9) are promising. This study focuses on the difficulties of existing treatment, current treatment technique, and novel pharmacological targets for diabetic foot ulcer. The electronic data base search diabetic for literature on foot ulcers treatment was carried out using Science Direct, PubMed, Google-Scholar, Springer Link, Scopus, and Wiley up to 2021. Becaplermin, a medication that targets MMP-9, glyceryl trinitrate, which inhibits the bacterial quorum sensing system, probiotic therapy, and nano technological solutions are just a few of the novel pharmaceuticals being developed for diabetic foot ulcers treatment. A combination of therapies, rather than one particular agent, will be the best option for treatment of Diabetes foot ulcer since it is multifactorial factors that render occurs of diabetic foot ulcer.
Background COVID-19 is a pandemic disease that has led to inequitable supply and shortages of essential medicines worldwide due to decreased production capacity, export bans, and national stockpiling which are affecting the global pharmaceutical supply chain. Access to essential pharmaceuticals is dependent on well-functioning supply chain systems that move medicines from the manufacturer to end users at service delivery point. Objective To assess impact of Covid-19 pandemic disease on pharmaceutical shortages and supply disruptions for non-communicable diseases among public hospitals of South West, Oromia, Ethiopia. Methods and Materials A multi-institutional cross sectional study design was employed. Quantitative and qualitative methods were utilized concurrently to gather data from four public hospital warehouses, dispensaries, patients, and local health authorities from March 1–30, 2021 in Ilu-Ababor and Buno-Bedelle Zones, Oromia, Ethiopia. Data were analyzed by using SPSS (version 23.0). A semi-structured interview guide was used to gather qualitative information from key informants from DTC members, patients, and local health authorities and finally analyzed through thematic approach. Results From six public hospitals in the two zones; cost of medicine increased more in Dedesa hospital compared to the other public hospital found in that zone and the effect of Covid-19 on essential medicines used for treatment of non-communicable diseases was less in Darimu Hospital. Stock status of PFSA and transportation were the major challenges during the procurement process due to Covid-19 pandemic disease. Among the EMs assessed at public hospitals, drugs used for cardiovascular diseases were out of stock for more than 90 days while anti-asthma drugs were out of stock for less than 40 days. Conclusion The availability of essential medicine was low and there was also poor inventory management practice in some of the public hospitals during Covid-19 pandemic in the study period.
Background: Psychometric investigations of tools used in the screening of migraine including the migraine screen questionnaire (MS-Q), using an adequate statistical approach is needed. We assessed the psychometric properties of the migraine screen questionnaire (MS-Q) using categorical data methods. Material and methods: A total of 343 students at Mizan-Tepi University, Ethiopia, age range = 18-35 years were selected by a simple random sampling method to participate in a cross-sectional study. The respondents completed the MS-Q, a semi-structured socio-demographic questionnaire, and a visual analog scale for attention (VAS-A). Results: The cumulative variance rule (> 40%), the Kaiser's criteria (Eigenvalue> 1), the Scree test and, the parallel analysis (minimum rank) identified a 1-factor model for the MS-Q with the factor loadings in the range of 0.78 to 0.84. Fit indices favored a 1-factor model of the MS-Q as indicated by comparative fit index (0.993), weighted root mean square residual (0.048), root mean square error of approximation (0.067), the goodness of fit index (1.00), and non-normed fit index (0.987). The values of the Factor Determinacy Index (0.953), marginal reliability (0.909), H-latent (0.909), H-observed (0.727), explained common variance (0.906) and the mean item residual absolute loadings (0.225) further complimented finding of the 1-Factor model. McDonald's Omega (0.903) suggested adequate internal consistency. Discriminative validity was supported by significantly higher scores for the total and all the MS-Q items except one among those with complaints of attention. Conclusion: The categorical methods support the psychometric validity of the MS-Q in the study population.
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