Background: Respectful and compassionate care is a holistic, non-judgmental, empathetic, respectful and empowering concept of quality of healthcare. In Ethiopia, a significant proportion of health professionals see patients as just ‘cases’ and do not show compassion. This study assessed respectful and compassionate healthcare service and associated factors in public Hospitals in East Hararghe Zone in Ethiopia. Methods: Hospital-based cross-sectional study was conducted on 423 clients visiting maternity care units in three public hospitals at East Hararghe Zone in Eastern Ethiopia from February 23 April 24, 2020. Pretested structured questionnaire was used to collect data from participants through face to face interview. Data were entered into EpiData version 3.1 and analyzed by SPSS version 24. Descriptive statistics were used to determine the level of compassionate health care and the characteristics of participants. Bivariable and multivariable logistic regression analyses were used to identify factors associated with the outcome variable. Adjusted Odds Ratio (AOR) and 95% CI were used to report association and significance was declared at P < 0.05. Results: A total of 417 (98.6%) participants were involved in the study. Two hundred ninety-nine (71.7%) participants received disrespect and abusive maternity care (95% CI: 66.9%, 76.0%). Age ≥ 45 years (AOR = 1.89, 95% CI: 0.37, 3.86), formal education (AOR = 1.75, 95% CI: 1.10, 2.81), Abnormal delivery (AOR = 0.54, 95% CI: 0.34, 0.87) and Staying in facility (AOR = 2.86, 95% CI: 1.76, 4.63) significantly associated with disrespect and abusive care. Conclusion and Recommendation: Overall level of disrespect and abuse was common. Family monthly income, number of ANC visit, length of stay and type of health facility were some of factors associated with disrespect and abuse. High prevalence of disrespect and abuse in maternity care at health facilities calls for strengthened action to provide quality of maternity care for all childbearing mothers. Further facility based research in both urban and rural area will be needed.
Objective: To assess the utility of a chemoresponse assay (ChemoFx®) in planning for gynecologic malignancies. Study Design: A retrospective chart review from November 2008 July 2012 identified patients at 3 institutions with a tissue specimen sent to Precision Therapeutics for in-vitro chemosensitivity testing via ChemoFx®. Chemosensitivity testing was performed on tumors from 71 Patients with Uterine, Cervical, Ovarian and nonGynecologic primary cancers. Tumors were classified as responsive (RR), intermediately responsive (IR), and nonresponsive (NR) to multiple chemotherapeutic regimens. Overall survival based on treatment concordance and chemotherapy used was assessed using descriptive statistics and Kaplan Meier survival plots. Results: There was a mean survival benefit for patients treated with RR (39.6 months) over IR (21.3 months) or NR (18 months) (p = 0.03). There was a trend towards significance (p = 0.068) of prolonged overall survival when C/T was RR when compared to those when C/T was IR or NR. Conclusion: When prescribed accordingly, a responsive chemotherapy regimen on ChemoFx® is associated with an improved overall survival in patients with a gynecologic malignancy regardless of stage of disease, disease type, or residual disease.
Backgrounds and Aim: Recurrent pregnancy loss is a very distressing condition. Lots of couple with H/O RPL consult at infertility OPD. Proper evaluation and treatment as well as psychological supports can help to overcome the situation for these couples. My aim was to evaluation of causes of RPL. Material and Method: This descriptive cross sectional study was conducted at BRB Hospitals Limited, a tertiary level hospital of Dhaka, Bangladesh from March 2019 to February 2021. Couple who came to Obs-Gyn department of this hospital with the complaints of two or more clinically proven pregnancy loss were included in the study. Total 84 patients were evaluated. Results: Total 84 patients were included in the study. Highest percent of RPL was found among age group of 30 34 years (50%). Maximum patients came with 2 previous miscarriages 58.3% and lowest number was in more than 3 miscarriages 14.3%. Regarding causes of RPL, unexplained and APLS were same in percent, 25%. After proper evaluation and treatment, 29 patients conceived, 12 healthy baby delivered and 17 pregnancy is ongoing. Conclusion: Recurrent pregnancy loss may end at a born of a healthy baby if proper evaluation and treatment is applied. Tremendous psychological support is essential part of treatment for these couples. But, unfortunately about 50% cases, cause remain unknown. If there is no treatment available, health care provider should provide at least tender loving care, which will improve the mental strength of these couples.
Background: More than a decade has passed since the publication of landmark randomized controlled trials on primary prevention of sudden cardiac death, which have served until the present as the basis for implantable cardiac defibrillator use in patients with left ventricle systolic dysfunction and heart failure. Recent studies have shown that patients with reduced ejection fraction may improve over time and some of these patients will receive a defibrillator without a clear need. We hypothesized that patients with ischemic heart disease are being better managed, faster and with newer medical therapies and thus, resulting in a reduction of mortality and need for implantable cardiac device therapy. Methods: Retrospective cohort study of 655 patients with acute coronary syndrome. Primary outcome: 1-year mortality rate and unplanned revascularization. Secondary outcome: incidence of cardiac device implantation for primary prevention of sudden cardiac death. Follow-up period of 633 days. Results: Median age 65 years, male 68,7%. 403 (61.3%) with non-ST elevation myocardial infarction and 252 (38.5%) with ST elevation myocardial infarction, underwent invasive coronary angiography. One-year mortality occurred in 3.8%, and unplanned revascularization in 8,2%. 98 patients received device therapy for primary prevention of sudden cardiac death. Conclusion: There is trend towards reduction in mortality and cardiac device therapy implantation in patients with ischemic cardiomyopathy.
