Annals of Tropical Medicine and Public Health
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   2018| January-February  | Volume 11 | Issue 1  
    Online since December 10, 2019

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Prevalence and effects of sleep disorders among shift-working nurse
Mohammad Rafi Bazrafshan, Fatemeh Moravveji, Nasrin Soleymaninejad, Fatemeh Zare, Razzagh Rahimpoor, Razieh Zolghadr
January-February 2018, 11(1):13-18
Introduction: Sleep is one of the basic and physiologic needs of humans which has impressive effects on the physical and mental health of human. According to the need for the permanent presence of nurses in the hospitals, they often suffer from shift-working effects such as sleep disorders. Considering the high sensitivity of nursing jobs, the aims of this study was to evaluate the prevalence and consequence of sleep disorders in shift-working nurses. Materials and Methods: This cross-sectional study is conducted on all of the nurses employing in hospitals of Larestan City in South of Iran at 2017. After screening based on inclusion criteria, 100 nurses were selected. To evaluate of prevalence and consequence of sleep disorders in nurses, the Pittsburgh sleep quality index, Epworth sleep quality index, and insomnia severity index were used. Data were analyzed using SPSS Version 16. Results: The results showed the mean score of sleep quality index was 6.52 ± 4.23, and according to this index, 56% of studied nurses are in hazard situation. In all of the nurses, sings of insomnia during routine works was observed, so that 78.5% were sleepy, 16.5% were very sleepy, and 5% were severe sleepy. With increasing the rate of night shift-working per week, the severity of insomnia in nurses was increased too (R 2 = 0.78). Sleep disorders in surgical section nurses were higher than nurses in other section of the hospitals (P < 0.05). Conclusions: A high percentage of nurses employed in different section of hospitals have poor sleep quality and increase the rate of night shift working per week plays a major role in decreasing their sleep quality. Regarding the adverse effects due to poor sleep quality on health status and quality of job performance of nurses, it is necessary adjust the shift works of nurses to improve the sleep quality of nurses night shift-working employed in different section of hospitals.
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Perception of health-care staff's knowledge, attitudes, and practices and of potential barriers toward containing antibiotic resistance in public health-care facilities of Tumkur district (South India)
Sushma Krishna, Erica Vlieghe, NS Prashanth, Bhanu Prakash, Asm Shahabuddin, V Rukmini
January-February 2018, 11(1):23-31
Background: India faces a major public health problem of antibiotic resistance. The rational prescription practices with behavioral change of health-care staff are one of the potential interventions for containment of antibiotic resistance at the health centers level. Yet, not much is known about the perceptions of health workers. Methodology: The present study evaluated the knowledge, attitude, practices, and barriers around antibiotic usage and resistance among the government health staff by a quantitative survey of 118 health-care providers (60 physicians and 58 pharmacists) across Tumkur district of Karnataka – 53 government health facilities from all levels – 1 district hospital (DH), 4 taluk hospitals, and 48 primary health centers. Results: Antibiotic resistance was perceived as an important problem globally, nationally, and locally by 81.3% (n = 96) and 83.8% (n = 99) and 54.2% (n = 64), respectively. About 86% (n = 52) of doctors were not aware of top three resistant organisms prevalent in their center. Only 38% (n = 23) sought microbiologist's input for antibiotic recommendations. Unavailability of antibiotics was quoted a major barrier to practice (78%, n = 47), followed by unregulated over-the-counter sale (OTC) (62%, n = 37) and high work-load (56.6%, n = 34). About 87% (n = 52) of the physicians and 98% (n = 57) of pharmacists expressed their interest for a potential educational program in antibiotics and resistance. Microbiology record (July–December 2013) from DH revealed only 22 isolates from 54 processed samples and resistance data were not recorded. Conclusions: While issues around antibiotics unavailability and OTC sales are being addressed at the center, the perceptions of the public health center's staff seem to have been overlooked. The laboratory support is grossly underutilized by the staff-culture seeking behavior of the practicing physicians needs to be enhanced, and laboratory strengthening at DH is imperative. The District seems ready for the implementation of Antibiotic stewardship programs, which may be introduced by the state as an educational intervention to address the gaps in knowledge, attitude, and practices of the staff.
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Studying the effect of progressive muscle relaxation technique on fatigue in hemodialysis patients – Kermanshah- Iran
Fatemeh Hadadian, Fereshteh Jalalvandi, Saba Karimi, Alireza Abdi, Nader Salari, Akram Ghobadi
January-February 2018, 11(1):8-12
Background: Renal chronic disease is a major challenge to public health all around the world. Despite the development of sundry renal replacement therapies, the patients usually complaint about disabling symptoms and low quality of life. In fact, fatigue is one of the most annoying and disabling symptoms in dialysis patients. Therefore, the present study is an attempt to determine the effect of progressive muscle relaxation technique on fatigue in hemodialysis patients. Methods: A clinical trial study to measure the effect of progressive muscle relaxation technique on fatigue in 65 hemodialysis patients in Imam Reza Hospital (Kermanshah) was carried out in 2011. The participants were grouped in experiment and control groups. The brief fatigue inventory was used for data gathering, and the data were analyzed in SPSS-16. Results: There was no significant difference between the mean changes of fatigue before and after progressive muscle relaxation in control and experiment groups (P ≥ 0.05). However, the difference between scores of fatigue before and after the intervention in the experiment group was significant (P ≤ 0.05). Conclusion: Although progressive muscle relaxation improved fatigue in the patients in the experiment group, the difference between the control and experiment groups was not significant. Failure to control some of the effective factors might be the reason for the result.
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Hemophagocytic lymphohistiocytosis in a Nigerian child: A review of the literature
Adaobi Uzoamaka Solarin, Motunrayo Oluwabukola Adekunle, Rita Obiageli Obaze, Omodele Oluwayemisi Jagun, Daniel Ogbaro
January-February 2018, 11(1):1-7
Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening, underdiagnosed hematologic disorder that occurs from unregulated immune activation, extreme inflammation, and tissue damage. The major cause of mortality in HLH is a delay in diagnosis and prompt initiation of treatment which occurs due to the variability of the clinical manifestation of this disease entity. We present a case of a 17-year-old adolescent who presented with fever, painful facial swelling that partially resolved with the initial use of intravenous dexamethasone. Diagnosis of HLH was finally made and he had complete resolution of symptoms following appropriate treatment. With careful search, there is no report of HLH in Nigeria and the possibility of missed diagnosis and underdiagnosis cannot be ruled out. This case report of HLH is the first in Nigeria and due to the rarity of the disease the need to raise more awareness is imperative as a high index of suspicion is required for diagnosis.
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Prevalence of traumatic injuries visiting the emergency department of a regional university teaching hospital in Nigeria
Chinwe Regina Onwuchekwa, Vincent U E Adiela
January-February 2018, 11(1):19-22
Background: Traumatic injuries are important causes of death and disability among adults and children. Trauma is one of the most common causes of emergency department visits in most part of the world. Objectives: The objective of the study is to evaluate the prevalence of the traumatic injuries in the accident and emergency department of our institution, to establish the burden of traumatic injuries. Patients and Methods: The study spans over 2 years, January 2013–December 2014. Patient's biodata, type of injuries sustained, etiology of injuries, and rate of patient transfer to the wards were extracted from the emergency department attendance and transfer registers and entered into a designed questionnaire. Statistical analysis was with SPSS version 20. Results: Of the 11,393 patients who visited the emergency department during the study, 2381 (20.90%) were traumatic injury patients. The mean age was 29.25 years ± 1.57 STD. Road traffic accidents (RTA) constituted 1200 (50.40%) of all traumatic cases, followed by assaults and falls which constituted 449 (18.86%) and 174 (11.17%) respectively. The part of the body mostly affected by injury was the head 478 (20.1%) patients. A total of 757 (31.8%) cases of traumatic injury were transferred to the hospital ward after being stabilized in the emergency department. Conclusion: This study had highlighted the burden which traumatic injuries and especially RTA imposed on the health facility and the need to provide adequate resources and increase the staff strength for smooth running of the emergency department.
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Analytical and comparative evaluation of the roles and responsibilities of nurses in providing primary healthcare in selected countries: A analytical and comparative study
Mitra Mohammadzadeh, Shahram Yazdani, Fakhrolsadat Hosseini, Mohammadreza Rahbar
January-February 2018, 11(1):32-36
Background: Primary health-care system of the first level of access to healthcare is essential health system. According to the extensive need, the participation and optimal training of nurses in times of crisis and lack of clarity of roles and responsibilities of nurses in primary health-care team. Objective: This study was conducted with the aim of compare the role and responsibilities of nurses in primary health-care systems in selected countries. Materials and Methods: This study was an applied research of the type analytical-comparative. In which, the data relating to the study of selected countries were collected. The George Brady method was used to achieve the objective study. This means that in four stages (collecting and describing information, interpret, categorize, summarize, and compare) to achieve the end result conducted the research. Results: About the responsibilities of nurses in primary health-care teams, in most countries serving the nurses at the undergraduate in most of the defined tasks. In addition, majority of the nurses are responsible for the duties of supervises and guides primary care team and in some countries nursing with additional courses and obtaining certificate authorities concerned to implement the above-mentioned tasks. Conclusion: While the in our country, nurses in primary health-care teams are not present in any of the sections. The equivalent of these people in Iran country are technician, paramedical and health workers. Therefore, it is recommended necessary trainings in the educational curriculum of assistant nurses should be contained or be addressed to a review the primary health-care team.
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