RESUMO
BACKGROUND: Cotton dust is one of the risk factors for occupational respiratory diseases, a condition characterized by reduced pulmonary function and overwhelming respiratory symptoms. Therefore, this study aimed to determine pulmonary function parameters, respiratory symptoms, and associated factors among cotton-ginning workers at Gondar city, northwest Ethiopia. METHODS: A comparative cross-sectional study was conducted on 166 (83 cotton-ginning workers and 83 healthy controls) individuals. Simple random sampling and convenience sampling techniques were used to recruit cotton-ginning workers and controls, respectively. Pulmonary function parameters were measured using Spirometer. Data on respiratory symptoms were collected using the Modified American Thoracic Society questionnaire. We used Chi-square (χ2) and independent "t" test to compare the outcome variables between the two groups. Binary logistic regression was used to identify the associated factors of respiratory symptoms among cotton-ginning workers. The strength of association was determined using an adjusted odds ratio (AOR) with its 95% confidence interval (CI) and statistical significance was decided at P<0.05. RESULTS: Cotton-ginning workers had reduced FVC, FVC%, FEV1, FEV1/FVC%, PEFR and FEF25-75%) as compared with controls. The prevalence of overall respiratory symptom was 68.6% (95% CI: 57.8, 77.8) among cotton-ginning workers and 19.2% (95% CI: 12, 29.3) among controls. Females (AOR=5.9, 95% CI: 1.19, 29.9), those with primary and secondary education (AOR=7.9, 95% CI: 1.2, 52), working at ginning department (AOR=9.4, 95% CI 1.6, 53) and pressing department (AOR=8.0, 95% CI: 1.3, 48) and not using personal protective equipment (PPE) (AOR=9.1, 95% CI: 1.8, 45.1) had an increased odds of having respiratory symptoms. CONCLUSION: Reduced pulmonary function parameters and a higher prevalence of respiratory symptoms were observed among cotton-ginning workers than controls. This suggests the need to tailor workplace safety measures to prevent occupational respiratory diseases.
RESUMO
BACKGROUND: Intestinal obstruction is defined as a blockage or partial blockage of the passage of the intestinal contents. It is a potentially risky surgical emergency associated with high morbidity and mortality. Its pattern differs from country to country and even from place to place within a country. Therefore, this study aimed to find out the magnitude, pattern and management outcome of intestinal obstruction in Arba Minch General Hospital. METHODS: A retrospective cross-sectional study was conducted in Arba Minch General hospital from January 09, 2015, to November 09, 2018. The data collection period was from December 15, 2018, to February 09, 2019. A simple random technique was applied to select 801 study participants. Then, the required data entered into Epi Info version 7.2.1.0 and exported to the statistical package for the social sciences software package version 20 for analysis. The binary logistic regression analysis has been done to determine crude statistical associations between independent variables and dependent variables. Linearity, Multivariate normality and multicollinearity were checked between independent and dependent variables by using scatter plot and Q-Q plot respectively. Variables with a p-value of less than 0.25 in the binary logistic regression analysis were entered into multivariable logistic regression. Statistical significance factors were identified based on a p-value of < 0.05 and with a 95% confidence interval. RESULT: This study revealed that the overall magnitude of intestinal obstruction was 40.60% with 95% CI (34.95-45.95). The magnitude of unfavorable management outcomes and deaths during the study period were 22.3% with 95% CI (18.00-27.00) and 7.1% with 95% CI (4.00-10.00) respectively. Persistent tachycardia 10.3 (3.28-32.42), Dehydration 13.7 (3.34-56.56), elevated serum creatinine 10.2 (1.89-54.94), gangrenous small bowel volvulus 2.7 (1.27-5.84), ischemic bowel 3.4 (1.17-9.81) and perforated bowl 7.68 (2.96-19.93) were significantly associated with the management outcome of intestinal obstruction. CONCLUSION AND RECOMMENDATION: Intestinal obstruction was the most common among all acute abdomen cases and its management outcome highly associated with dehydration. Adequate early preoperative resuscitation and proper post-operative care with appropriate surgical techniques and wound care with sterile techniques would help to reduce further mortality. This could be achieved by increasing public awareness of health-seeking behavior. Moreover, health facilities capable of handling patients with small bowel obstruction should be available within the reach of the community.