Background: Leprosy is known to cause disability that leads to severe outcomes like stigma, discrimination, mental health problems and participation restriction. Furthermore, in cases of infectious leprosy, longer del...Background: Leprosy is known to cause disability that leads to severe outcomes like stigma, discrimination, mental health problems and participation restriction. Furthermore, in cases of infectious leprosy, longer delays increase the risk for the spread of the disease. Despite being preventable and curable, a significant proportion of new leprosy patients (39%) in 2019 had grade 2 (Described as Visible disability) at the time of diagnosis signifying late presentation. The aim of this study was to describe patient journeys from first symptoms suggestive of leprosy to a diagnosis and individual and community level factors associated with health seeking behavior of leprosy patients. Methods: This was a cross-sectional explorative study implemented in Kasese, Mayuge and Yumbe districts .A structured questionnaire was used to collect quantitative data. Qualitative assessment included patients, family members, health workers, voluntary health teams and the district health team. Descriptive statistics were presented in terms of percentages, frequency tables, pie Charts and graphs for easy interpretation and discussion. Results: The results indicate that 53% of the respondents identified as female. The median age of the respondents being 34 years, with a range of 1 to 76 years (Mean: 44.7, Mode: 65, Standard-Deviation: 19.6, Kurtosis: 0.6). The most common first symptom noticed by respondents was skin lesions (65%) followed by deformities (18%) (P value = 0.05%) occurring mostly in the feet (P-value = 0.48). Majority (52%) of the patients had taken more than 24 months (SD 18.72 OR 2.75) for a diagnosis to be made with a maximum delay of over 60 months. The most common cause of delay in seeking health care was lack of knowledge on leprosy (P value=Conclusions: There was a delay of 2 years in seeking health care for the majority of the patients. Key barriers to early diagnosis were lack of knowledge and infrastructure. Community sensitization and strengthening capacity building are needed to achieve early diagnosis of leprosy and proper management.展开更多
In clinical practice, it is challenging to elucidate the location of the lesion in a patient＇s nervous system that is causing the neurologic symptoms, because lesions are often microscopic and cannot be revealed by c...In clinical practice, it is challenging to elucidate the location of the lesion in a patient＇s nervous system that is causing the neurologic symptoms, because lesions are often microscopic and cannot be revealed by conventional evaluation methods.展开更多
Background: Tuberculosis (TB) remains a major global public health problem. Early detection and initiation of treatment shortens infectious period and is key to TB control. A considerable proportion of TB patients pre...Background: Tuberculosis (TB) remains a major global public health problem. Early detection and initiation of treatment shortens infectious period and is key to TB control. A considerable proportion of TB patients presenting with advanced symptoms suggests delay in seeking care. As TB control programs rely on passive case finding, TB care-seeking behavior is critical as un-diagnosed cases act as reservoirs for transmission. This study assessed patient health seeking behavior and choice of place of care among TB patients in Nigeria. Methods: This was a pro-gramme implementation, facility-based cross-sectional study in 14 states, 92 facilities across three levels of care. Interviewer-administered semi-structured questionnaires were used. Information on personal characteristics and health seeking behavior was collected from June 2020 to December 2021. The analysis was based on the various healthcare providers where the respondents first sought care. Data analysis was done using IBM SPSS and summarized using frequency and percentages. Chi square test was used for associations of characteristics of patients and choice of place of care at p Results: In all 14 states, distribution of overall first place of seeking care for TB symptoms was: 7208 (75.8%) health facilities (range 57% to 88%), while 2294 (24.2%) visited other places including community pharmacist, patent medicine vendor, traditional/home, un-specified/none. For Health facilities, the majority were at public facilities 6563 (69.1%) and private 641 (6.7%). Moreover, 6 states had >20% of respondents who first sought care at PMVs, while 3 states (Delta, Imo, and Rivers) had 10% of respondents who first sought care at Community Pharmacist. Conclusions: Nearly a quarter of people with TB first sought care outside health facilities, suggesting the need to align availability of services with their needs.展开更多
Background Persistence of slow pathway (SP) function after SP modification is not uncommon after successful rediofrequency (RF) ablation of typical AV nodal reentry tachycardia (AVNRT). Methods and results We compa...Background Persistence of slow pathway (SP) function after SP modification is not uncommon after successful rediofrequency (RF) ablation of typical AV nodal reentry tachycardia (AVNRT). Methods and results We compared two methods (maximal AH interval during decremental atrial stimlation vs occurrence of AV nodal echos or dual AV nodal physiology (DAVNP): ≥50 msec increment in AH interval with a 10 msec decrement in A1A2) for the assessment of SP function immediately and 40 minutes after successful RF modification of SP. In 31 consecutive patients (age: 51±16 years, 18 women, 13 men) with typical AVNRT, SP modification was performed using a combined anatomic and electrogram guided approach. Immediately after successful SP modification, AV nodal function was assessed. This was repeated 40 minutes later. RF modification of SP was successful in all 31 patients. There was no recurrance during a 5±3 month follow up period. There was no significant difference between the electrophysiological parameters immediately and University of Frankfurt, Germany (Li YG, Bogun F, Grnefeld G, Hohnloser SH and Goethe JW)40 min after successful SP modification. There was evidence of SP function in 14 patients (6 with DAVNP+AV nodal echoes, 8 with either DAVNP or AV nodal echos) immehiately after SP modification. These patients could be differentiated from the patients without remaining SP function by maximal AH interval (298±102 msec vs 198±72 msec, P=0.004). 40 minutes after the suucessful SP modification, 11 patients displayed SP function (4 patients with DAVNP+AV nodal echos, 7 patients with either DAVNP or AV nodal echos). These patients could also be differentiated from the remaining patients with the use of the maximal AH interval (294±89 msec vs 189±50 msec, P<0.001).[BHDFG3,WK9ZQ,WK6,WK10*2,WK5W]Befroe SP modificationImmediately after RF40 min after RF[BHDZG1*2,WK9ZQ,WK6,WK10*2,WK5W]AVNERP (msec)258±44310±116316±114AVBCL (msec)330±55384±113376±110VABCL (msec)306±67306± 66311±54Max AH (msec)337±96247±100233±86 Conclusion SP function assessed immediately and 40 minutes after a successful SP modification remains stable. SP function can be assessed reliable by maximal AH interval during decremental atrial stimulation.展开更多
Objective To investigate the effects of CXC chemokine ligand 16(CXCL16)/CXC chemokine receptor 6(CXCR6)pathway on cholesterol accumulation of atherosclerosis in the radial artery of end-stage renal disease(ESRD)patien...Objective To investigate the effects of CXC chemokine ligand 16(CXCL16)/CXC chemokine receptor 6(CXCR6)pathway on cholesterol accumulation of atherosclerosis in the radial artery of end-stage renal disease(ESRD)patients under inflammatory stress and further to investigate its potential mechanisms modulated by purinergic receptor P2X ligandgated ion channel展开更多
文摘Background: Leprosy is known to cause disability that leads to severe outcomes like stigma, discrimination, mental health problems and participation restriction. Furthermore, in cases of infectious leprosy, longer delays increase the risk for the spread of the disease. Despite being preventable and curable, a significant proportion of new leprosy patients (39%) in 2019 had grade 2 (Described as Visible disability) at the time of diagnosis signifying late presentation. The aim of this study was to describe patient journeys from first symptoms suggestive of leprosy to a diagnosis and individual and community level factors associated with health seeking behavior of leprosy patients. Methods: This was a cross-sectional explorative study implemented in Kasese, Mayuge and Yumbe districts .A structured questionnaire was used to collect quantitative data. Qualitative assessment included patients, family members, health workers, voluntary health teams and the district health team. Descriptive statistics were presented in terms of percentages, frequency tables, pie Charts and graphs for easy interpretation and discussion. Results: The results indicate that 53% of the respondents identified as female. The median age of the respondents being 34 years, with a range of 1 to 76 years (Mean: 44.7, Mode: 65, Standard-Deviation: 19.6, Kurtosis: 0.6). The most common first symptom noticed by respondents was skin lesions (65%) followed by deformities (18%) (P value = 0.05%) occurring mostly in the feet (P-value = 0.48). Majority (52%) of the patients had taken more than 24 months (SD 18.72 OR 2.75) for a diagnosis to be made with a maximum delay of over 60 months. The most common cause of delay in seeking health care was lack of knowledge on leprosy (P value=Conclusions: There was a delay of 2 years in seeking health care for the majority of the patients. Key barriers to early diagnosis were lack of knowledge and infrastructure. Community sensitization and strengthening capacity building are needed to achieve early diagnosis of leprosy and proper management.
文摘In clinical practice, it is challenging to elucidate the location of the lesion in a patient＇s nervous system that is causing the neurologic symptoms, because lesions are often microscopic and cannot be revealed by conventional evaluation methods.
文摘Background: Tuberculosis (TB) remains a major global public health problem. Early detection and initiation of treatment shortens infectious period and is key to TB control. A considerable proportion of TB patients presenting with advanced symptoms suggests delay in seeking care. As TB control programs rely on passive case finding, TB care-seeking behavior is critical as un-diagnosed cases act as reservoirs for transmission. This study assessed patient health seeking behavior and choice of place of care among TB patients in Nigeria. Methods: This was a pro-gramme implementation, facility-based cross-sectional study in 14 states, 92 facilities across three levels of care. Interviewer-administered semi-structured questionnaires were used. Information on personal characteristics and health seeking behavior was collected from June 2020 to December 2021. The analysis was based on the various healthcare providers where the respondents first sought care. Data analysis was done using IBM SPSS and summarized using frequency and percentages. Chi square test was used for associations of characteristics of patients and choice of place of care at p Results: In all 14 states, distribution of overall first place of seeking care for TB symptoms was: 7208 (75.8%) health facilities (range 57% to 88%), while 2294 (24.2%) visited other places including community pharmacist, patent medicine vendor, traditional/home, un-specified/none. For Health facilities, the majority were at public facilities 6563 (69.1%) and private 641 (6.7%). Moreover, 6 states had >20% of respondents who first sought care at PMVs, while 3 states (Delta, Imo, and Rivers) had 10% of respondents who first sought care at Community Pharmacist. Conclusions: Nearly a quarter of people with TB first sought care outside health facilities, suggesting the need to align availability of services with their needs.
文摘Background Persistence of slow pathway (SP) function after SP modification is not uncommon after successful rediofrequency (RF) ablation of typical AV nodal reentry tachycardia (AVNRT). Methods and results We compared two methods (maximal AH interval during decremental atrial stimlation vs occurrence of AV nodal echos or dual AV nodal physiology (DAVNP): ≥50 msec increment in AH interval with a 10 msec decrement in A1A2) for the assessment of SP function immediately and 40 minutes after successful RF modification of SP. In 31 consecutive patients (age: 51±16 years, 18 women, 13 men) with typical AVNRT, SP modification was performed using a combined anatomic and electrogram guided approach. Immediately after successful SP modification, AV nodal function was assessed. This was repeated 40 minutes later. RF modification of SP was successful in all 31 patients. There was no recurrance during a 5±3 month follow up period. There was no significant difference between the electrophysiological parameters immediately and University of Frankfurt, Germany (Li YG, Bogun F, Grnefeld G, Hohnloser SH and Goethe JW)40 min after successful SP modification. There was evidence of SP function in 14 patients (6 with DAVNP+AV nodal echoes, 8 with either DAVNP or AV nodal echos) immehiately after SP modification. These patients could be differentiated from the patients without remaining SP function by maximal AH interval (298±102 msec vs 198±72 msec, P=0.004). 40 minutes after the suucessful SP modification, 11 patients displayed SP function (4 patients with DAVNP+AV nodal echos, 7 patients with either DAVNP or AV nodal echos). These patients could also be differentiated from the remaining patients with the use of the maximal AH interval (294±89 msec vs 189±50 msec, P<0.001).[BHDFG3,WK9ZQ,WK6,WK10*2,WK5W]Befroe SP modificationImmediately after RF40 min after RF[BHDZG1*2,WK9ZQ,WK6,WK10*2,WK5W]AVNERP (msec)258±44310±116316±114AVBCL (msec)330±55384±113376±110VABCL (msec)306±67306± 66311±54Max AH (msec)337±96247±100233±86 Conclusion SP function assessed immediately and 40 minutes after a successful SP modification remains stable. SP function can be assessed reliable by maximal AH interval during decremental atrial stimulation.
文摘Objective To investigate the effects of CXC chemokine ligand 16(CXCL16)/CXC chemokine receptor 6(CXCR6)pathway on cholesterol accumulation of atherosclerosis in the radial artery of end-stage renal disease(ESRD)patients under inflammatory stress and further to investigate its potential mechanisms modulated by purinergic receptor P2X ligandgated ion channel
