Time to death and its predictors among adult patients on mechanical ventilation admitted to intensive care units in West Amhara comprehensive specialized hospitals, Ethiopia: a retrospective follow-up study.

INTRODUCTION: Mechanical ventilation is the most common intervention for patients with respiratory failure in the intensive care unit. There is limited data from African countries, including Ethiopia on time to death and its predictors among patients on mechanical ventilators. Therefore, this study aimed to assess time to death and its predictors among adult patients on mechanical ventilation admitted in comprehensive specialized hospitals in West Amhara, Ethiopia. METHODS: An institutional-based retrospective follow-up study was conducted from January 1, 2020, to December 31, 2022. A simple random sampling was used to select a total of 391 patients' charts. Data were collected using data the extraction tool, entered into Epi-data version 4.6.0, and exported to STATA version 14 for analysis. Kaplan-Meier failure curve and the log-rank test were fitted to explore the survival difference among groups. The Cox regression model was fitted, and variables with a p-value < 0.25 in the bivariable Cox regression were candidates for the multivariable analysis. In the multivariable Cox proportional hazard regression, an adjusted hazard ratio with 95% confidence intervals were reported to declare the strength of association between mortality and predictors when a p value is < 0.05. RESULTS: A total of 391 mechanically ventilated patients were followed for 4098 days at risk. The overall mortality of patients on mechanical ventilation admitted to the intensive care units was 62.2%, with a median time to death of 16 days (95% CI: 11, 22). Those patients who underwent tracheostomy procedure (AHR = 0.40, 95% CI: 0.20, 0.80), received cardio-pulmonary resuscitation (AHR = 8.78, 95% CI: 5.38, 14.35), being hypotensive (AHR = 2.96, 95% CI: 1.11, 7.87), and had a respiratory rate less than 12 (AHR = 2.74, 95% CI: 1.48, 5.07) were statistically significant predictors of time to death among mechanically ventilated patients. CONCLUSION: The mortality rate of patients on mechanical ventilation was found to be high and the time to death was short. Being cardiopulmonary resuscitated, hypotensive, and had lower respiratory rate were significant predictors of time to death, whereas patients who underwent tracheostomy was negatively associated with time to death. Tracheostomy is needed for patients who received longer mechanical ventilation, and healthcare providers should give a special attention for patients who are cardiopulmonary resuscitated, hypotensive, and have lower respiratory rate.

Extracorporeal shock wave therapy on pain and foot functions in subjects with chronic plantar fasciitis: systematic review of randomized controlled trials.

PURPOSE: The aim of this review was to synthesize current evidence on the efficacy of extracorporeal shock wave therapy on pain, and foot function in subjects with plantar fasciitis. MATERIALS AND METHODS: A comprehensive search of PubMed/Medline, CINAHL, AMED, PEDro, Cochrane Library, and Scopus were done to identify randomized controlled trials of extracorporeal shock wave therapy in subjects with plantar fasciitis. PEDro scale was used to evaluate the methodological quality of included trials. Visual Analogue Scale and Foot Function Index were the primary outcome measures of this review. Due to varying of entailed trials, meta-analysis was not carried out. RESULTS: Eleven randomized controlled trials with 658 patients were included. Extracorporeal shock wave therapy exhibited a moderate confirmation to better pain, and foot function of individuals with chronic plantar fasciitis. CONCLUSION: Extracorporeal shock wave therapy could be a promising rehabilitation intervention and might support to improve pain, and foot function of subjects with chronic plantar fasciitis.IMPLICATIONS FOR REHABILITATIONExtracorporeal shock wave therapy (ESWT) exerted beneficial effects on pain and functional outcomes for chronic plantar fasciitis.ESWT could be effectively performed with no side effects.ESWT could be an alternative to the conventional management of chronic plantar fasciitis.

Patients Satisfaction and Associated Factors Towards Physiotherapy Services in North West Ethiopia.

BACKGROUND: Patient satisfaction is a critical patient-focused indicator of the general quality of patient care and health care. There was only one previous study conducted to assess patient satisfaction with physiotherapy services in Ethiopia. OBJECTIVE: This study aimed to assess patients' satisfaction and associated factors towards physiotherapy services in North West Ethiopia. METHODS: An institution-based cross-sectional study was conducted. Using consecutive sampling method, 393 samples were collected. The collected data were cleaned, coded, entered into Epi-Data version 4.2 and exported to SPSS version 25 for analysis. The binary logistic regression model was fitted and p-value less than 0.25 was used to select significant variables for multivariate analysis. Results were presented in frequency distribution tables and graphs. RESULTS: Overall 201 (51.1%) of the respondents were satisfied. The odds of physiotherapy service satisfaction at age greater than 55 years old were OR 1.78 (95% CI: 1.02-3.09) times higher than the age less than or equal to 55 years old. The odds of physiotherapy service satisfaction of married respondents were OR 1.75 (95% CI: 1.05-2.90) times higher than for single patients and the odds of satisfaction of having a good feeling about physiotherapy service was OR 3.76 (95% CI: 1.46-9.70) times higher than their counterparts. CONCLUSION: Almost half of the respondents were satisfied with the physiotherapy service. Age, marital status, history of having information about physiotherapy and feelings about the physiotherapy service were significant variables affecting patient's satisfaction in the physiotherapy service.

Survival and Predictors of Mortality Among Adult HIV/AIDS Patients Initiating Highly Active Antiretroviral Therapy in Debre-Berhan Referral Hospital, Amhara, Ethiopia: A Retrospective Study.

BACKGROUND: Acquired immune deficiency syndrome is one of the most destructive epidemics the world has ever witnessed. An estimated 36.9 million people were living with HIV in 2017. HIV/AIDS is the major contributing factor for morbidity and mortality in low- and middle-income countries. Although different studies on survival and predictors of mortality among HIV/AIDS patients after initiation of antiretroviral therapy were conducted, there are inconsistencies in the findings of those studies. Furthermore, to the authors' knowledge, there was a dearth of studies conducted in this study area. PURPOSE: The purpose of this study was to assess the survival and predictors of mortality among adult patients starting highly active antiretroviral therapy at Debre Berhan Referral Hospital, North Showa, Amhara, Ethiopia. PATIENTS AND METHODS: An institution-based retrospective study was conducted among the medical records of 447 study subjects' selected using simple random sampling from January 1t, 2013 to December 30, 2018. The data was collected using a structured data abstraction checklist and analyzed using Kaplan-Meier statistics and Cox regression models. RESULTS: Among 447 adult patients, 54 patients (12.1%) had died, giving a crude death rate of 4.18 per 100 person years (95% CI=3.20-5.45). The overall estimated survival rate after initiation of antiretroviral therapy was 81.7% (95% CI=75.36-86.54%) at 72 months of follow-up. The independent predictors of mortality were clinical stage IV (HR=15.6, 95% CI=6.609-36.948), baseline opportunistic infections (HR=1.86, 95% CI=1.048-3.330), baseline Hgb<10 mg/dL (HR=4.655, 95% CI=2.253-9.619), baseline CD4<200 cells/µL (HR=4.71, 95% CI=2.275-9.751), the presence of comorbidity (HR=2.56 95% CI=1.391-4.740), being widowed (HR=3.475, 95% CI=1.412-8.550), and bedridden functional status (HR=3.069, 95% CI=1.111-8.480). CONCLUSION: Patients with opportunistic infections, advanced clinical stage disease, bedridden functional status, baseline Hgb<10 mg/dL, baseline CD4<200 cells/µL, and comorbidity should be given special care.

Effectiveness of Neuromuscular Electrical Stimulation on Post-Stroke Dysphagia: A Systematic Review of Randomized Controlled Trials.

The purpose of this review was to summarize the latest best scientific evidence on the efficacy of neuromuscular electrical stimulation on swallowing function in dysphagic stroke patients. A comprehensive systematic search of literature published between November 2014 and May 2020 was performed using the following electronic databases: PubMed/Medline, CINAHL, PEDro, Science Direct, Google Scholar, EMBASE, and Scopus. Only randomized controlled trials (RCT) evaluating the effect of neuromuscular electrical stimulation on swallowing function in dysphagic stroke patients were included. Physiotherapy Evidence Database (PEDro) has been used to evaluate the risk of bias of included trials. This review was reported in accordance with PRISMA statement guideline. The methodological quality of the studies was determined using PEDro scale and GRADE approach. Evidence of overall quality was graded from moderate to high. Eleven RCTs involving 784 patients were analyzed. The primary outcome measures of this review were functional dysphagia scale (FDS) and standard swallowing assessment. This review found neuromuscular electrical stimulation (NMES) coupled with traditional swallowing therapy could be an optional intervention to improve swallowing function after stroke in rehabilitation department.

Effectiveness of Kinesio Taping on the Management of Knee Osteoarthritis: A Systematic Review of Randomized Controlled Trials.

The purpose of this review was to summarize the current best evidence for the effectiveness of Kinesio Taping in reducing pain and increasing knee function for patients with knee osteoarthritis. A comprehensive search of literature published between 2014 and 2019 was conducted using the following electronic databases: PubMed, Google Scholar, Physiotherapy Evidence Database (PEDro), Science Direct, and Scopus. Only randomized controlled trials evaluating the effect of Kinesio Taping on knee osteoarthritis were included. PEDro was used to assess the risk of bias of included trials. This study was reported according to the guideline of the PRISMA statement. The methodological quality of the studies was done using the PEDro scale and GRADE approach. The overall quality of evidence was rated from moderate to high. Eighteen randomized trials involving 876 patients were included. The present systematic review demonstrated that there were significant differences between Kinesio Taping groups and control groups in terms of visual analog scale (VAS), Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC) scale and flexion range of motion. Kinesio Taping is effective in improving pain and joint function in patients with knee OA.