HEALTH SCIENCES QUARTERLY

Chronic kidney disease and risk factors among Type 2 Diabetic patients in selected hospitals in Dhaka, Bangladesh

Md Rasel Mahbub — 2024-10-12

Chronic kidney disease (CKD) may be defined as abnormalities of kidney function or structure present for more than 3 months. Around 10% of people worldwide have CKD. The data about chronic kidney disease among diabetics in Bangladesh is inadequate, and very few studies have been done on specific populations, i.e., male or female. Thus, the study aims to determine the prevalence of CKD and its risk factors among diabetic patients in selected hospitals in Dhaka city. The specific objectives of the study were to assess the participants through physical and laboratory evaluations, categorize them into the different stages of CKD, analyze their socio-demographic characteristics, and determine the association between CKD and various risk factors. This is a cross-sectional study. The study population consisted of different outpatient diagnostic centers and outpatient and indoor patients of Shaheed Suhrawardy Medical College and Hospital. The sample size of the study is 369. The Modification of Diet in Renal Disease equation was used to calculate eGFR. This study revealed that in Dhaka, 18.2% of Type 2 Diabetic patients had CKD. Most of the participants were between 46 and 65years old. Most of the CKD patients had a low education level and a lower family income. Having diabetes for more than 3 years and hypertension for more than 5 years were associated with a higher risk of developing CKD, especially among individuals who consumed added salt in their diet.

The effect of viral anxiety experienced by nurses working in pediatric service on psychological factors during Covid-19 period

Çiğdem Müge Haylı — 2024-10-12

During the Covid-19 period, nurses, as healthcare professionals, have been under a great workload, and their anxiety levels have also increased their psychological effects. Therefore, this study was conducted to examine the effect of viral anxiety experienced by nurses working in the pediatric ward during the Covid-19 period on psychological factors. This is a descriptive study. Permission was obtained from Hakkari University Scientific Research and Publication Ethics Committee for research permission. Sociodemographic data were collected online from 1200 nurses working in the pediatric service who voluntarily participated in the study between October 13, 2023 and December 25, 2023 using the sociodemographic data collection form and the stress and anxiety scale for health workers due to virus epidemic-9 items (SAVE-9), Patient health questionnaire-9 (PHQ-9), Obsession with Covid-19 Scale (OCS), Reassurance-seeking behavior scale against coronavirus (CRBS). In order to compare SAVE, PHQ, OCS and CRBS scale scores according to sociodemographic information and vaccination status variables, independent groups t test one-way variance analysis Levene's F test was applied and data were analyzed using a statistical package program. It is understood that 59.9% of the participants are male and 40.1% are female. The proportion of married participants was 95.4%. The results of the scores obtained from the SAVE and PHQ scales show that the stress and anxiety related to the virus epidemic are above the middle level, the result of the OCS scale score shows that the dysfunctional thoughts associated with the coronavirus, and the scores obtained from the CRBS Total scale show that the assurance-seeking behavior is exhibited according to the results. The effect of viral anxiety on the psychological factor according to sociodemographic characteristics (gender, age, marital status, socioeconomic status, educational status, working area in pediatric service, vaccination status) showed significant and different results according to scale scores. It was concluded that the viral anxiety experienced by the nurses working in the pediatric service during the Covid-19 period showed different characteristics in terms of psychological factors and sociodemographic characteristics, and the nurses were not very effective due to the decrease in the effect of Covid-19.

The effect of environmental stressors perceived by surgical intensive care unit patients on hopelessness level

Dilek Güneş — 2024-10-12

The aim of the research was to determine the effects of environmental stressors perceived by patients hospitalized in the surgical intensive care unit on hopelessness level. This descriptive research was performed between September 2023 and February 2024. The population of the study included all adult patients hospitalized in the Surgical Intensive Care Clinic of a City Hospital in Eastern Türkiye. The sample of the study includes 230 patients selected by random sampling method from this population. We used Personal Information Form, Intensive Care Unit Environmental Stressors Scale (ICUESS) and Beck Hopelessness Scale (BHS) to collect the data. Descriptive statistics, t-test, ANOVA, and correlation analysis tests were used to evaluate the data. The ICUESS mean score of the patients participated in the study was found to be at a high level with 102.13±15.95. Beck hopelessness scale score mean was found to be at a mild level with 6.36±5.78. It was found that the patients' gender, age, educational status, chronic disease status and previous intensive care experience affected the level of hopelessness. The relationship between ICUESS and BHS scores of the patients included in the study was examined and it was found that there was a low level of positive significant relationship between them (r: 0.162, p: 0.014). The hopelessness level of patients in surgical intensive care units was found to increase as the level of exposure to environmental stressors increased. It may be recommended to identify environmental stressors affecting the hopelessness level of patients and to implement interventions to reduce them.

The relationship between uropathogens and clinical characteristics of children with urinary tract infection

Emre Leventoğlu — 2024-10-12

Urinary tract infections (UTI) are common bacterial infections in children. This study aimed to examine the relationships between different microorganisms and both clinical and laboratory findings in pediatric patients with UTIs. We conducted a retrospective evaluation of children with UTI between 2019 and 2024. Patients were divided into four main groups as normal anatomy, vesicoureteral reflux (VUR), ureteropelvic junction obstruction (UPJO), and neurogenic bladder (NB). Information on clean intermittent catheterization (CIC) and prophylactic antibiotic use was recorded. Laboratory results were compared across these patient groups. The study included 266 patients, with a female predominance (female/male ratio: 7.33). NB was the most common urinary tract condition (43.3%), followed by VUR (10.9%) and UPJO (9%). Prophylactic antibiotics were used by 9% of the patients. Acute phase reactants in patients with CIC were significantly higher (p=0.023 for white blood cell (WBC) and p=0.002 for C-reactive protein (CRP) levels). They were also higher in patients with prophylactic antibiotics compared to those without (p=0.001 for both). The most frequently detected bacteria in urine cultures were E. coli (65%), followed by Klebsiella spp. (18.8%), Pseudomonas spp. (7.5%), and Proteus spp. (4.9%). Klebsiella spp., Enterococcus spp., and Morganella spp. were not isolated from patients receiving prophylaxis (p=0.022). Risk factors for UTIs need to be carefully assessed for every patient, and treatment should be customized according to clinical and laboratory results. Individual patient factors should guide drug selection, and treatment plans should account for potential resistance patterns.

University student suicides in Türkiye: Insights from two decades of media reports

Mahmut Şerif Yıldırım — 2024-10-12

University student suicides have emerged as a significant societal concern, reflecting challenges inherent in the transition to adulthood and academic pressures. This study aims to analyze two decades of national media coverage on university student suicides in Türkiye, examining demographic trends, suicide methods, and social factors implicated in these tragic incidents. A comprehensive scan of Turkish national media archives from January 1, 2004, to December 31, 2023, identified 213 unique reports of university student suicides. Data extracted included age, sex, year of incident, prior suicide attempts, geographic distribution, housing status, academic major, psychiatric history, social background, suicide method, and presence of suicide notes or social media posts. Statistical analyses utilized Fisher's Exact Test and Pearson's Chi-square to examine categorical data. Male students accounted for 61.6% (n=125) of reported suicides, with a mean age of 22.2 years (SD=3.05). The most common suicide method was jumping from height, differing by sex, with hanging prevalent among males and jumping more frequent among females. Mobbing emerged as a predominant social stressor implicated in suicide incidents, surpassing other factors reported in the literature. The findings highlight an alarming increase in media-reported university student suicides, predominantly affecting males and characterized by distinct suicide methods. The pervasive impact of mobbing underscores the urgent need for targeted interventions addressing social stressors, alongside comprehensive medical, psychological, social, and economic support systems within academic settings. Efforts should prioritize proactive mental health initiatives, policy reforms, and community-based interventions to mitigate suicide risks among university students.

The association of vaccine hesitancy with other public health practices in well child care: a cross-sectional study

İzzet Erdal — 2024-10-12

Vaccination is one of the most successful public health initiatives in human history. Despite all the benefits of vaccination, it is noteworthy that the number of vaccine hesitant parents has increased in recent years. Individuals with vaccine hesitancy are known to have similar attitudes towards other scientific initiatives. In this study, we investigated the relationship between the attitudes of vaccine hesitant parents and other practices and interventions in well child care. The “Parental Attitudes Towards Childhood Vaccinations (PACV) scale was applied to parents of children aged 2-6 without chronic diseases. A PACV score of 50 or above was considered as vaccine hesitancy. Sociodemographic characteristics, economic status and practices in well child care were questioned. Parents' vaccine hesitancy and their approaches to other practices in well child follow-up were compared. A total of 329 parents were included in the study. The rate of parents with vaccine hesitancy was 22.8% (n=75). In both groups, most participants had an undergraduate/graduate level of education. Those with vaccine hesitancy were less likely to have received vitamin K at birth (81.3% vs. 97.6%, p<0.01), and use of prophylactic vitamin D (72% vs. 88.2%, p<0.01) and iron supplements in the first year of life (66.7% vs 78.3%, p=0.038) were lower. No difference was found for developmental hip dysplasia and hearing screening. The current attitudes of vaccine hesitant parents are not limited to vaccination, but also affect other health initiatives. In our study, we have shown that vaccine hesitant individuals are also opposed and/or reluctant to child health initiatives. Taking this into account when developing strategies to overcome vaccine hesitancy may lead to more effective results.

Combination of oral anticoagulant and antiplatelet therapy does not change the 1-year prognosis compared to oral anticoagulant alone in stroke patients with atherosclerosis and atrial fibrillation

Gökçe Zeytin Demiral — 2024-10-12

This study aims to evaluate the effectiveness of combined antiplatelet and oral anticoagulant (OAC) therapy versus OAC therapy alone on one-year post-stroke outcomes in patients with non-valvular atrial fibrillation (NVAF) and systemic atherosclerosis. A retrospective study was conducted using the recorded data of patients diagnosed with ischemic cerebrovascular disease between January 1, 2022, and January 1, 2023, at the Neurology Clinic, Afyonkarahisar Health Sciences University. Patients with non-valvular atrial fibrillation (NVAF) and systemic atherosclerosis were included in the study. Collected data included demographic information, medical history. Patients were divided into two groups based on the treatment regimen used at discharge: those receiving OAC alone and those receiving a combination of OAC and antiplatelet therapy. Clinical outcomes were evaluated within one year following the stroke. A total of 671 stroke patients were screened, and 565 (84.2%) had ischemic stroke. Among these, 113 (20%) had NVAF, and 53 had both NVAF and systemic atherosclerosis. Data from these 53 patients were analyzed. The mean age was 71.81±11.90 years, with a female gender ratio of 52.8%. Logistic regression analysis showed no statistically significant differences between the two treatment groups in terms of all-cause mortality, bleeding, recurrent stroke, and hemorrhagic stroke (p>0.05 for all comparisons). The combination of antiplatelet and OAC therapy did not demonstrate superiority over OAC therapy alone in reducing the risks of recurrent ischemic stroke, hemorrhagic stroke, myocardial infarction, and mortality in patients with NVAF and systemic atherosclerosis. These findings suggest that OAC therapy alone may provide sufficient protection in this patient population. Prospective studies with larger samples are needed to confirm these results.