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Research Article
Piecewise Linear Multiple Change Point Modelling for Under-Five Child Mortality
Sukanta Chakraborty*
,
Soma Chowdhury Biswas
Issue:
Volume 12, Issue 2, April 2024
Pages:
14-19
Received:
9 February 2024
Accepted:
23 March 2024
Published:
2 April 2024
Abstract: Using a piecewise linear multiple change-point model instead of more traditional survival techniques is more beneficial when dealing with mortality data. Utilizing this technique, the hazard model is estimated and the number of cut-point locations is found. Using various covariates, such as sociodemographic, biological, and proximate co-factors, this piecewise hazard model is fitted to the Infant Mortality Data of Bangladesh Demographic and Health Survey 2014. Finding the change point and the impact of covariates on the hazard rate is done using the maximum likelihood estimation process. The parameter's significance is subsequently supported by the Wald test statistic. It turns out that the mother's educational status, religion, mother's age in years, the number of children they have ever had, currently breastfeeding, the size of the child, desire for more children, cesarean delivery, ANC visits, and birth orders are all significant factors. It is also discovered that the detected change point of the hazard rate is extremely important for the child until they reach the age of five. Through the various time cut points, it is found that a piecewise linear multiple change-point model is very important for under-five child mortality. Public health specialists, researchers, and clinicians can all benefit from this piecewise hazard model. One of the most crucial elements in lowering child mortality is time.
Abstract: Using a piecewise linear multiple change-point model instead of more traditional survival techniques is more beneficial when dealing with mortality data. Utilizing this technique, the hazard model is estimated and the number of cut-point locations is found. Using various covariates, such as sociodemographic, biological, and proximate co-factors, th...
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Research Article
Prevalence, Antibiotics Susceptibility Profile of Listeria Monocytogenes, and Its Associated Risk Factors Among Pregnant Women Attending Millennium Health Center
Issue:
Volume 12, Issue 2, April 2024
Pages:
20-30
Received:
22 January 2024
Accepted:
2 February 2024
Published:
17 April 2024
Abstract: Background: Listeria monocytogenes is a facultative intracellular pathogen that causes serious invasive infections in pregnant women, resulting in disseminated fetal infections, abortions, and still-births. Although it causes a greater burden on pregnant women and their infants, the case in Ethiopia is overlooked, and there is a scarcity of data on L. monocytogenes, particularly in the southern parts of Ethiopia. Therefore, this study aimed to determine the prevalence and, antibiotics susceptibility of L. monocytogenes and its associated risk factors among pregnant women attending the Millennium Health Center, Hawassa, Ethiopia. Method: A cross-sectional study was conducted on 203 pregnant women between May 30 and July 30, 2022. Socio-demographic data and 5 ml venous blood samples were collected from pregnant women using structured questionnaire. Data were analyzed using SPSS version 25. Bivariate logistic regression was carried out then variables with p<0.25 were further analyzed by multivariate logistic regressions, p-values <0.05 were accepted as statistically significant. Results: The overall prevalence of L. monocytogenes among pregnant women was found to be 11/203 (5.42%; 95% CI=2.88-9.38). L. monocytogenes was resistant to benzyl penicillin (90.91%) and meropenem (81.82%), but susceptible to ampicillin (90.91%). Raw meat (AOR=6.99; 95% CI=1.39-35.14), p=0.018), uncooked vegetables (AOR=6.62; 95% CI=1.04-42.30), p=0.046), unpasteurized milk (AOR=7.56; 95% CI=1.33-42.97), p=0.023) and fever (AOR=14.65; 95% CI=3.15-68.15), p=0.001) were significantly associated with L. monocytogenes infection. Conclusion: L. monocytogenes was resistant to benzyl penicillin, meropenem, erythromycin, and sulfamethoxazole but susceptible to ampicillin. Raw meat, uncooked vegetables, unpasteurized milk, and fever were significantly associated with L. monocytogenes.
Abstract: Background: Listeria monocytogenes is a facultative intracellular pathogen that causes serious invasive infections in pregnant women, resulting in disseminated fetal infections, abortions, and still-births. Although it causes a greater burden on pregnant women and their infants, the case in Ethiopia is overlooked, and there is a scarcity of data on...
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Case Report
A Case of Placental Implantation with Exaggerated Placental Site
Zongbin Chen,
Hanlin Shuai*
Issue:
Volume 12, Issue 2, April 2024
Pages:
31-34
Received:
4 March 2024
Accepted:
1 April 2024
Published:
28 April 2024
Abstract: Objective: This study aims to investigate the clinical symptoms, diagnosis, differential diagnosis, and prognosis of exaggerated placental site (EPS), in order to reduce misdiagnosis and missed diagnosis of EPS, avoid the occurrence of serious complications such as massive hemorrhage, and provide some references for clinical doctors. Methods: Retrospective analysis of the medical history and treatment of a patient with placental implantation with exaggerated placental site. A 23-year-old female presented with persistent vaginal bleeding after medical abortion. She was diagnosed with retained products of conception and underwent hysteroscopic surgery. The preliminary postoperative pathological results indicate the possibility of EPS and placental site trophoblastic tumor (PSTT). Further immunohistochemical testing was performed, and the results suggested EPS. Results: The patient recovered well after surgery and did not require further treatment. Her serum human chorionic gonadotropin levels and transvaginal ultrasound findings were normal. Conclusion: EPS is a benign disease, and symptoms will disappear after lesion clearance, requiring no special treatment or follow-up, with a good prognosis. Due to the low incidence rate, atypical clinical symptoms, and insufficient recognition by clinical doctors, EPS are prone to misdiagnosis and missed diagnosis, leading to serious consequences such as massive hemorrhage and hysterectomy. EPS should be considered as a possible diagnosis in any woman who has irregular bleeding following medical abortion.
Abstract: Objective: This study aims to investigate the clinical symptoms, diagnosis, differential diagnosis, and prognosis of exaggerated placental site (EPS), in order to reduce misdiagnosis and missed diagnosis of EPS, avoid the occurrence of serious complications such as massive hemorrhage, and provide some references for clinical doctors. Methods: Retro...
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Research Article
Basic Characteristics and Demographic Data in Patients with Chronic Vulvar Discomfort: A Detailed Analysis of DATRIV Study
Issue:
Volume 12, Issue 2, April 2024
Pages:
35-45
Received:
26 March 2024
Accepted:
15 April 2024
Published:
28 April 2024
Abstract: This study aims to provide a descriptive analysis of the essential characteristics and demographic profiles, including age, weight, height, body mass index, marital status, and educational background in patients with chronic vulvar discomfort. The data were collected from the study DATRIV (Diagnostic Accuracy of Three Rings Vulvoscopy), which included 328 participants divided into four groups: normal vulva, impaired vulvar skin, primary vulvar distress/vulvodynia, and secondary discomfort caused by vulvar dermatoses. The clinical data collected from the study questionnaire were analyzed using statistical software such as StatSoft (Dell, Austin, TX, USA), Statistica 12 (TIBCO®, Palo Alto, CA, USA), and SPSS 20 (IBM, Armonk, NY, USA). The study was conducted with the approval of the Institutional Review Board of Polyclinic Harni, and all participants provided written informed consent. The findings from the DATRIV study shed light on several important aspects of chronic vulvar discomfort. They offered valuable insights into the demographic and reproductive characteristics of patients with chronic vulvar pain, specifically vulvar dermatosis. The study revealed that patients with vulvar dermatosis tended to be older, with a peak incidence in the 45-65 age range. They also had higher weight and BMI compared to other groups. There was a significant difference in the proportion of patients of reproductive age between the vulvar dermatosis group and other groups. Additionally, the vulvar dermatosis group had higher rates of marriage, births, and abortions and lower educational levels. The study's limitations included lacking patients younger than 16 years. Future research should aim to include a broader age range, including pediatric populations, to gain a more comprehensive understanding of vulvar dermatosis across different age groups. Further investigation is needed to uncover the underlying mechanisms and establish causal relationships, enhancing diagnosis, treatment, and support for individuals affected by vulvar dermatosis.
Abstract: This study aims to provide a descriptive analysis of the essential characteristics and demographic profiles, including age, weight, height, body mass index, marital status, and educational background in patients with chronic vulvar discomfort. The data were collected from the study DATRIV (Diagnostic Accuracy of Three Rings Vulvoscopy), which inclu...
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Case Report
Surgical Management of Giant Condyloma Acuminata Involving Vulva, Perineum and Perianal Area
Asha Misra*,
Puritan Madzhia,
Thabo Malebana,
Dakalo Muavha,
John Boshomane,
Kaiser Baloyi
Issue:
Volume 12, Issue 2, April 2024
Pages:
46-51
Received:
20 March 2024
Accepted:
9 April 2024
Published:
28 April 2024
Abstract: Condyloma acuminata (CA), also known as anogenital warts, are benign proliferative epidermal and/or mucosal lesions usually caused by Human Papilloma Virus (HPV) type 6 and 11. They initially manifest as variable sized and shaped soft papules or plaques on anogenital skin. However, they can grow as a large, bulky, lobulated growth. Lesions are commonly multiple and multifocal, affecting the vulva, perianal, vaginal and cervical regions. They represent the most common sexually transmitted disease (STD) and are highly contagious. Further, the incidence of CA is 5-7fold higher in Human Immunodeficiency virus (HIV) positive patients compared to immunocompetent patients. The HIV infection reduces the local immune control of HPV infection thus favours the proliferation of the HPV which results into large sized CA. The giant condyloma acuminata (GCA) and giant condyloma of Buschke-Löwenstein (GCBL) are uncommon variants of classical condyloma acuminata (CCA) which can reach the size of 10 to 30 cm. The treatment of CA should be individualized and based upon the extent of disease and treatment availability. The small CA which present as papules or plaques can be treated by Podophyllin, Imiquimod, electrosurgical ablation or cryotherapy. However, GCA require excision with cold knife, electrosurgery or CO2 laser. When the base of GCA is narrow, surgical excision with minimal skin loss allows primary closure of the wound, whereas when the base is broad and relatively fixed, one must keep the differential diagnoses of GCA versus GCBL which require wide excision and reconstruction of the tissue. This case report illustrates the surgical management of GCA with broad base in a 44-year-old female patient with HIV infection. She was treated by wide surgical excision followed by reconstruction of the defect with fascio-cutaneous V-Y advancement flaps. Histology confirmed the diagnosis of condyloma acuminatum. Six months following surgery, she had recurrence of a perianal wart that was cauterized. On further 12 month follow up there was no new recurrence of any condylomatous lesion.
Abstract: Condyloma acuminata (CA), also known as anogenital warts, are benign proliferative epidermal and/or mucosal lesions usually caused by Human Papilloma Virus (HPV) type 6 and 11. They initially manifest as variable sized and shaped soft papules or plaques on anogenital skin. However, they can grow as a large, bulky, lobulated growth. Lesions are comm...
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