traditional healer

  • 文章类型: Journal Article
    在埃塞俄比亚等发展中国家,传统治疗师处于提供精神保健服务的第一线。在埃塞俄比亚,针对传统医学的作用和社区对传统医学的看法进行了不同的研究。然而,缺乏研究,这显示了传统治疗师的心理健康素养水平。因此,本研究旨在对Jimma镇传统治疗师的心理健康素养水平,埃塞俄比亚。
    在310名参与者中采用了基于社区的横断面研究设计。要选择来自Jimma镇的参与者,2020年8月1日至9月30日采用分层随机抽样方法。心理健康素养问卷用于评估传统治疗师的心理健康素养。对收集的数据进行编码并输入EpiData版本4.6,并导出到SPSS版本25.0进行分析。采用双变量和多变量线性回归进行数据分析。
    这项研究的发现表明,在Jimma镇发现的传统治疗师样本在心理健康素养方面的总平均值为95.91±3.0025。年龄[β=-0.052(95%CI:-0.078,-0.026)],经验年份[β=0.095(95%CI:0.067,0.123)],精神病家族史[β=1.709(95%CI:0.543,2.360)],精神疾病专业求助史[β=0.501(95%CI:0.715,2.288)],在媒体上获得精神疾病信息的历史[β=0.941(95%CI:0.345,1.538)],心理健康培训[β=2.213(995%CI:1.520,2.906)],精神病治疗史[β=1.676(95%CI:0.808,2.544)],和非正式教育[β=-1.664(95%CI:-2.081,-1.247)]是与MHL显着相关的因素。
    传统治疗师的心理健康素养平均得分低于其他研究的平均得分。年龄,一年的经验,关于精神疾病的培训,家族史,寻求专业帮助的历史,治疗精神疾病的历史,关于精神疾病的信息,非正式教育与心理健康素养显著相关。因此,结构化培训对于提高其心理健康素养水平非常重要。
    UNASSIGNED: Traditional healers are in the front line to give the mental healthcare service in developing countries like Ethiopia. In Ethiopia, different studies were done focusing on the role of traditional medicine and perception of the community toward traditional medicine. However, there is paucity of studies, which shows the level of mental health literacy among traditional healers. Therefore, this study intended to mental health literacy level of traditional healers in Jimma town, Ethiopia.
    UNASSIGNED: A community-based cross-sectional study design was employed among 310 participants. To select the participants from Jimma town, a stratified random sampling method was utilized from August 1 to September 30, 2020. The Mental Health Literacy Questionnaire was used to assess mental health literacy for assessment of mental health literacy among traditional healers. The collected data were coded and entered into EpiData version 4.6 and exported to SPSS version 25.0 for analysis. Bivariate and multivariable linear regression was used for data analysis.
    UNASSIGNED: The finding of this study showed that the samples of traditional healers found in Jimma town scored a total mean of 95.91 ± 3.0025 for mental health literacy. Age [β = -0.052 (95% CI: -0.078, -0.026)], year of experience [β = 0.095 (95% CI: 0.067, 0.123)], family history of mental illness [β = 1.709 (95% CI: 0.543, 2.360)], history of professional help seeking on mental illness [β = 0.501 (95% CI: 0.715, 2.288)], history of getting information of mental illness on media [β = 0.941 (95% CI: 0.345, 1.538)], training on mental health [β = 2.213 (995% CI: 1.520, 2.906)], history of treating mental illness [β = 1.676 (95% CI: 0.808, 2.544)], and informal education [β = -1.664 (95% CI: -2.081, -1.247)] were factors significantly associated with MHL.
    UNASSIGNED: The mental health literacy of traditional healers mean score is lower than the mean score of other studies. Age, year of experience, training on mental illness, family history, history of professional help seeking, history of treating mental illness, information on mental illness, and informal education are significantly associated with mental health literacy. Therefore, structured training is very important to improve their level of mental health literacy.
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  • 文章类型: Journal Article
    基于植物的产品在医疗保健系统中的使用经历了巨大的增长,导致全球需求的大幅增长。然而,由于包括多环芳烃(PAHs)的各种污染物的污染,这种基于植物的处理的质量和有效性经常受到影响。像其他植物一样,药用植物在暴露于污染环境时也会吸收和积累PAHs。此类药用植物和/或基于植物的产品的消费对健康造成负面影响,而不是提供任何治疗优势。不幸的是,专注于药用植物中PAH积累的研究受到了非常有限的关注。这篇评论讨论了大量有关美国环境保护署(USEPA)在不同药用植物中认可的16种优先PAH污染物浓度的文献。该综述还强调了与一些药用植物有关的癌症风险评估,即苯并[a]芘(BaP)当量浓度。
    The use of plant-based products in healthcare systems has experienced a tremendous rise leading to a substantial increase in global demand. However, the quality and effectiveness of such plant-based treatments are often affected due to contamination of various pollutants including polycyclic aromatic hydrocarbons (PAHs). Like other plants, medicinal plants also uptake and accumulate PAHs when exposed to a contaminated environment. The consumption of such medicinal plants and/or plant-based products causes negative effects on health rather than providing any therapeutic advantages. Unfortunately, research focusing on PAH accumulation in medicinal plants has received very limited attention. This review discusses a sizable number of literature regarding the concentration of sixteen priority PAH pollutants as recognised by the US Environmental Protection Agency (USEPA) in different medicinal plants. The review also highlights the risk assessment of cancer associated with some medicinal plants in terms of benzo[a]pyrene (BaP) equivalent concentrations.
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  • 文章类型: Journal Article
    传统眼药(TEM)在世界范围内的应用越来越广泛。根据使用的药物,TEM的使用可以被认为是有害的或无害的。该疗法可能在已经受伤的眼睛中引起感染或不可修复的失明。该研究的目的是确定在西岸政府医院的眼科诊所就诊的成年眼科患者中传统眼药的比例和相关因素。
    一项针对300名患者的横断面研究。数据是使用结构化的,自我管理问卷。
    研究结果表明,65.7%的人使用TEM。需要使用传统眼部实践的最常见症状是眼部炎症症状(49.2%),视力模糊(15.7%),和过敏性结膜炎(10.7%)。最常见的TEM是茶(34.0%),其次是草药产品(25.4%)和蔬菜片(马铃薯,黄瓜,和洋葱)(14.7%)。最传统的眼部治疗是局部途径(92.9%)。传统眼科诊所的处方者大多数是传统治疗师(48.7%)。此外,本研究发现,在西岸部分医院眼科诊所就诊的眼科患者中,职业和收入是使用传统眼科手术的预测因素.
    在约旦河西岸的眼科患者中,传统眼科医学实践的比例很高。使用传统眼科治疗的预测因素是职业和收入。最常用的透射电镜是茶,其次是草药产品和蔬菜片(马铃薯,黄瓜,和洋葱)。
    UNASSIGNED: Traditional eye medicine (TEM) is becoming more widely used across the world. Depending on the drugs used, TEM usage can be considered harmful or innocuous. The therapy may induce infection or irreparable blindness in the already injured eye.The aim of the study was to determine the proportion of traditional eye medicine practices and associated factors among adult ophthalmic patients attending ophthalmic clinics in the governmental hospitals in the West Bank.
    UNASSIGNED: A cross-sectional study conducted on 300 patients. The data was collected using a structured, self-administered questionnaire.
    UNASSIGNED: The results of the study revealed that 65.7% of people use TEM. The most common symptoms that necessitated the use of traditional eye practice were inflammatory symptoms of the eye (49.2%), blurred vision (15.7%), and allergic conjunctivitis (10.7%). The most common TEM used was tea (34.0%), followed by herbal products (25.4%) and vegetable slices (potato, cucumber, and onion) (14.7%). The most traditional eye treatment was the topical route (92.9%). The majority of prescribers of traditional eye practice were traditional healers (48.7%). Furthermore, the current study found that occupation and the income were predictors of using traditional eye practice among ophthalmic patients attending ophthalmic clinics in selected West Bank hospitals.
    UNASSIGNED: The proportion of traditional eye medicine practice was high among ophthalmic patients in the West Bank. The predictors of using traditional eye treatment were occupation and the income. The most common TEM used was tea, followed by herbal products and vegetable slices (potato, cucumber, and onion).
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  • 文章类型: Journal Article
    了解寻求精神保健和相关因素对于计划精神保健服务至关重要。这项研究旨在评估埃塞俄比亚西北部社区样本中抑郁症状和有害饮酒的治疗寻求和护理障碍。进行了一项横断面研究,以筛查1,728名参与者的抑郁症状(n=414)和有害饮酒(n=155)。参与者被问及他们是否寻求过心理健康。我们还评估了寻求精神保健的障碍。采用Logistic回归分析确定相关因素。在有抑郁症状的人中,14.3%,15.5%,19.6%的人从医疗机构寻求治疗,非医疗机构,或任何来源,分别。宗教场所(39.5%)是最有帮助的治疗来源。内化病耻感水平较低(调整OR=3.00[1.41,6.42])和对精神疾病持积极态度(调整OR=2.84[1.33,6.07])的人寻求抑郁症治疗的可能性几乎是三倍。没有有危险饮酒的参与者从医疗机构寻求治疗,只有1.3%的人寻求家人/朋友的帮助。超过97%的患有抑郁症状和有害饮酒的参与者报告说,至少有一个从医疗机构寻求治疗的障碍。宗教和传统治疗师与寻求治疗的医疗机构一样重要。
    Understanding mental healthcare seeking and associated factors is essential for planning mental health services. This study aimed to assess treatment seeking and barriers to care for depressive symptoms and hazardous drinking in a community sample of Northwest Ethiopia. A cross-sectional study was conducted to screen 1,728 participants for depressive symptoms (n = 414) and hazardous drinking (n = 155). Participants were asked whether they had sought mental healthcare. We also assessed the barriers to seeking mental healthcare. Logistic regression was used to identify associated factors. Among people with depressive symptoms, 14.3%, 15.5%, and 19.6% sought treatment from healthcare settings, non-healthcare settings, or any sources, respectively. Religious places (39.5%) were the most helpful treatment sources. People with low levels of internalized stigma (adj OR = 3.00 [1.41, 6.42]) and positive attitudes towards mental illness (adj OR = 2.84 [1.33, 6.07]) were nearly threefold more likely to seek depression treatment. No participants with hazardous drinking sought treatment from healthcare settings, and only 1.3% had sought help from families/friends. Over 97% of participants with depressive symptoms and hazardous drinking reported at least one barrier to treatment-seeking from a healthcare setting. Religious and traditional healers were as important as healthcare settings for treatment-seeking.
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  • 文章类型: Journal Article
    传统医学和生物医学医学之间的合作可以为患有精神疾病的人带来整体护理和改善健康状况。本研究旨在探讨中西医结合医生对布兰太尔精神病患者护理的潜在合作的观点和经验,马拉维。
    采用了现象学定性研究设计。使用一对一深度访谈(IDI)和焦点小组讨论(FGD)收集数据。参与者是布兰太尔的传统治疗师和西医从业者,马拉维。我们对传统治疗师进行了10次深度访谈,4次焦点小组讨论(2次针对传统治疗师,2次针对西医从业者)和6次与两组领导人的关键线人访谈。基于数据饱和度确定样品。采用专题分析法对数据进行分析。我们使用了演绎和归纳编码的组合。
    从数据中确定了五个广泛的主题:合作经验,对合作的看法,合作模式,合作的障碍,以及可以促进合作的因素。参与者没有传统治疗师和西方医护人员在精神疾病管理方面进行正式合作的经验.然而,据报道,在安全孕产等其他卫生领域成功合作的一些经验,结核病和艾滋病毒/艾滋病。许多参与者对合作表现出积极的态度,并对此表示支持。合作的障碍包括消极态度和缺乏资源。可以促进合作的因素是对话,训练和尊重。推荐和培训是首选的合作形式。
    通过适当的结构和尊重的对话,在布兰太尔,传统和西医之间的合作是可能的,马拉维。
    UNASSIGNED: Collaboration between traditional and biomedical medicine can lead to holistic care and improved health outcomes for people with mental illnesses. The current study aimed to explore the views and experiences of traditional and western medicine practitioners on potential collaboration in the care of people living with mental illness in Blantyre, Malawi.
    UNASSIGNED: A phenomenological qualitative research design was used. Data were collected using both one-on-one in-depth interviews (IDIs) and focus group discussions (FGDs). Participants were traditional healers and western medicine practitioners in Blantyre, Malawi. We conducted 10 in-depth interviews with traditional healers, 4 focus group discussions (2 for traditional healers and 2 for western medicine practitioners) and 6 key informant interviews with leaders of the two groups. The sample was determined based on data saturation. Thematic analysis was used to analyse the data. We used a combination of deductive and inductive coding.
    UNASSIGNED: Five broad themes were identified from the data: experiences with collaboration, views on collaboration, models of collaboration, barriers to collaboration, and factors that can facilitate collaboration. participants had no experience of formal collaboration between traditional healers and western healthcare workers in the management of mental illness. However, some reported experience of successful collaborations in other health areas such as safe motherhood, tuberculosis and HIV/AIDS. Many participants showed a positive attitude toward collaboration and were in support of it. Barriers to collaboration included negative attitudes and a lack of resources. Factors that can facilitate collaboration were dialogue, training and respect. Referral and training were the preferred forms of collaboration.
    UNASSIGNED: With proper structures and respectful dialogue, a collaboration between traditional and western medicine practitioners is possible in Blantyre, Malawi.
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  • 文章类型: Journal Article
    这项研究是在Kebridehar和Shekosh地区进行的,埃塞俄比亚,对传统药用植物进行民族植物学研究。系统随机抽样技术用于数据收集。偏好排名,配对比较,线人共识因素,直接矩阵排序,和jaccard比较用于数据分析。共有34属23科的44种药用植物被记录用于治疗38人,5家畜,1人和牲畜的疾病。灌木类别是研究区的主要生长形式。研究表明,制备传统药物最常用的植物部位是根(45.45%),接着是树叶,胶水,和液体(各11.36%)。最常见的给药途径是口服(30.77%),其次是真皮(20.51%)。据报道,传统药用植物的Kebridehar和Shekosh的Jaccard相似系数为0.21,表明使用普通植物的趋势。甲醇提取物比乙醇提取物更有效。这项研究的结果提供了对芦荟提取物的抗菌特性的见解,Ephorbiarobecchi,和Oppiliacampestris。这项体外研究表明,这三种民俗药用植物具有良好的潜力。总之,研究区对药用植物的主要威胁是干旱。因此,建议在家庭花园中鼓励种植药用植物。
    This study was conducted in Kebridehar and Shekosh districts, Ethiopia, to investigate an ethnobotanical study on traditional medicinal plants. Systematic random sampling techniques were used for data collection. Preference ranking, paired comparison, informant consensus factor, direct matrix ranking, and jaccard comparison were used for data analysis. A total of 44 medicinal plant species from 34 genera and 23 families have been documented as being used to treat 38 human, 5 livestock, and 1 both human and livestock ailment. The shrub category was the dominant growth form in the study area. The study showed that the most frequently used plant parts for the preparation of traditional medicine were roots (45.45 %), followed by leaves, glue, and liquid (11.36 % each). The most common route of administration was oral (30.77 %), followed by dermal (20.51 %). Jaccard\'s Coefficient of Similarity for Kebridehar and Shekosh for the reported traditional medicinal plants were 0.21, indicating some trend towards using common plants. Methanol extracts were more effective than ethanol extracts. The results of this study provide an insight into the anti-bacterial properties of the extracts of Aloe megalacantha, Ephorbiarobecchi, and Oppiliacampestris. This in vitro study demonstrated that these three folklore medicinal plants have good potential. In conclusion, the main threat to medicinal plants in the study area was drought. Therefore, it is recommended that the cultivation of medicinal plants be encouraged in home gardens.
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  • 文章类型: Journal Article
    部落文化对医疗保健实践的看法与主流不同。不孕的部落妇女实行寻求治疗的行为,这反映了社区在文化上获得和获得治疗以及满足其医疗保健需求的习俗。在人们对不孕症的认识不断提高和众多治疗选择的环境中,这项研究旨在强调部落社区寻求不孕症治疗的行为。
    该研究采用了混合方法方法,从153对患有不孕症的部落夫妇(访谈时间表)和社区(深入访谈-14和焦点小组讨论-12)收集数据。使用Stata13.0和NVivo10分析数据。将定量数据的结果与用于书写的定性数据进行三角测量。
    在社区中对于不孕症有许多治疗选择。一般来说,传统治疗师(98.7%)优先于现代医疗从业者(35%).社区成员通常指导不育夫妇选择提供者。原发性不育妇女的治疗方法与未生育妇女的治疗方法有很大不同。由于负担不起,妇女经常停止治疗并在提供者之间切换,连通性差,距离,旅行时间,时间限制,和不支持的情况。建议这对夫妇食用草药,吃或避免吃某些食物,被给予按摩,腹部烧伤(dagani),去除黑血(phasani)和其他各种仪式来安抚精神,在提供动物祭品的同时除鬼,进行shidwa仪式。平均治疗支出为18,374卢比。如果治疗没有产生任何结果,夫妇求助于增加另一个妻子,离婚,接受无子女并抚养孩子。
    地方当局应努力促进部落社区的社会经济发展,并在其家门口提供良好的医疗服务。需要在贫困的背景下理解不孕问题,部落信仰,以及获得医疗资源的机会不平等。
    UNASSIGNED: The tribal culture views health care practices differently from the mainstream. Infertile tribal women practice treatment-seeking behaviour that reflects the community\'s cultural access to and availability of treatment as well as customs to meet their health care needs. In the environment of rising awareness of infertility and numerous treatment options, this study aims to highlight the infertility treatment-seeking behaviour of tribal communities.
    UNASSIGNED: The study employed a mix methods approach to collect data from 153 tribal couples suffering with infertility (interview schedule) and the community (in-depth interviews-14 and focus group discussions-12). The data was analyzed using Stata 13.0, and NVivo 10. Results of the quantitative data were triangulated with qualitative data for writing.
    UNASSIGNED: Many treatment options were available for infertility in the community. Generally, traditional healers (98.7%) were preferred over modern healthcare practitioners (35%). Community members usually guided infertile couples for choosing providers. Treatment practices were very different among primary infertile women than sub-fertile. Women frequently discontinued treatment and switched between providers because of unaffordability, poor connectivity, distance, travel time, time constraints, and non-supportive circumstances. The couples were advised to consume herbs, and eat or avoid certain food items, were given massage, burns on the abdomen (dagani), removed black blood (phasani) and other various rituals to appease spirits, get rid of ghosts while offering animal sacrifice, and conducting shidwa ritual. The mean expenditure on treatment was INR 18,374. If treatment did not yield any result, couple resorted to add another wife, divorce, accept childlessness and foster a child.
    UNASSIGNED: Local authorities should strive to work towards the socio-economic development of the tribal communities and provide good healthcare services at their doorstep. The infertility problem needs to be understood in the context of poverty, tribal beliefs, and unequal access to healthcare resources.
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  • 文章类型: Journal Article
    未经批准:每年有超过900万人死于精神疾病,使他们成为全球第二大死亡原因和残疾的主要原因。
    UNASSIGNED:为了探索奥罗米亚西肖区社区精神病患者对医疗保健的偏好及其决定因素,埃塞俄比亚,2022年7月11日至9月20日。
    UNASSIGNED:使用人种学研究,探索了西肖区社区精神病患者对医疗保健的偏好及其决定因素。有目的地,共有16名FGD参与者和10名非结构化访谈对象,他们有相关的经验和观点,是从城市和地区层面精心挑选出来的。利用两种方法以三角测量的方式收集数据,然后进行编码,研究结果是情境化的,并开发了主题图进行主题分析。
    未经批准:在这项研究中,在回答问题时,根据原因对三个主要发现进行了主题化,根据精神病患者的治疗偏好,在主题下划分了六个子主题。从数据中出现的主题是:1。超自然的原因,2.传统的非精神信仰和实践;和3。医疗外科问题。大多数参与者回答说,居民最喜欢宗教灵性主义者(46%),其次是传统辅导员(Wabeka)(19%),传统的灵性主义者(15%),机构护理(12%),草药(4%),心理学家(4%)。
    未经批准:在这项研究中,精神疾病最常见的原因是精神不好,恶魔般的活动,从事违反社会规范和法规的行为。宗教精神主义者是该研究的精神卫生保健的首选。这项研究为医疗保健专业人员与传统和宗教利益相关者之间的合作和共享策略提供了建议。
    UNASSIGNED: Over 9 million people die from mental diseases each year, making them the second highest cause of mortality and the primary cause of disability worldwide.
    UNASSIGNED: To explore the preferences for health care and its determinants among mentally ill patients in the West Shoa Zone Community in Oromia, Ethiopia, from July 11-September 20, 2022.
    UNASSIGNED: The preference for health care and its determinants among mentally ill patients in the West Shoa Zone community were explored using an ethnographical study. Purposefully, a total of 16 FGD participants and 10 unstructured interview subjects, who had pertinent experiences and perspectives, were carefully selected from the urban and district levels. Data was collected utilizing two approaches in a triangulated manner and then coded, findings were contextualized, and a thematic plot was developed for thematic analysis.
    UNASSIGNED: In this study, in response to the questions, three main findings were thematized according to the causes, and six sub-themes were framed under the themes according to the preferences for treatment among mentally ill patients. The themes that emerged from the data were; 1. Supernatural causes, 2. Traditional non-spiritual beliefs and practices; and 3. Medico-surgical problems. The majority of the participants responded that residents preferred religious spiritualists the most (46%), followed by traditional counselors (Wabeka) (19%), traditional spiritualists (15%), institutional care (12%), herbalists (4%), and psychologists (4%).
    UNASSIGNED: In this study, the most commonly perceived causes of mental illnesses were bad spirits, devilish activity, and engaging in actions that violated social norms and regulations. Religious spiritualists were the study\'s first choice for mental health care. This study advises collaboration and a shared strategy between health care professionals and traditional and religious stakeholders.
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  • 文章类型: Journal Article
    背景:蛇咬伤在尼泊尔是一个被忽视的公共卫生问题。我们旨在描述尼泊尔西南部住院的蛇毒患者的特征。
    方法:这是一项前瞻性队列研究,纳入了2017年5月至12月Bheri医院收治的476例蛇咬伤患者。收集了患者人口统计学数据,咬伤情况,蛇类型,寻求治疗的行为,临床效果,并发症和治疗。
    结果:有139/476(29%)的患者的临床特征的毒血症和10例死亡(8%),其中6人为院前死亡;325/476(68%)患者使用了非推荐的院前急救,包括278(58%)使用止血带的人和43(9%)咨询传统治疗师的人。到达医院的中位时间为1.5(IQR:0.8-4)h。此外,127例患者(91%)出现神经毒性和12例(9%)血液毒性,124名患者(89%)接受抗蛇毒血清,中位剂量为10(4-30)瓶。抗蛇毒血清给药后,三名患者出现过敏反应;139例中的111例(80%)被送入ICU,48例(35%)被插管。所有病例的平均住院时间为0.5(IQR:0.5-1.2)d,但感染病例为2.2(IQR:1.5-3.8)d。
    结论:大多数蛇咬伤患者使用非推荐的急救或接受传统治疗。几乎三分之一的患者出现全身毒液并需要抗蛇毒血清。病死率很高,但许多人在到达医院前死亡。
    Snakebite is a neglected public health issue in Nepal. We aimed to characterize patients with snake envenoming admitted to hospital in south-western Nepal.
    This was a prospective cohort study of 476 snakebite patients admitted to Bheri Hospital from May to December 2017. Data were collected on patient demographics, bite circumstances, snake type, treatment-seeking behavior, clinical effects, complications and treatment.
    There were 139/476 (29%) patients with clinical features of envenomation and 10 deaths (8%), of which six were prehospital deaths; 325/476 (68%) patients used non-recommended prehospital first aid, including 278 (58%) who applied a tourniquet and 43 (9%) consulting traditional healers. Median time to hospital arrival was 1.5 (IQR: 0.8-4) h. Also, 127 envenomated patients (91%) developed neurotoxicity and 12 (9%) hemotoxicity, while 124 patients (89%) received antivenom, with a median dose of 10 (4-30) vials. Three patients developed anaphylaxis following antivenom administration; 111 of 139 (80%) cases were admitted to the ICU and 48 (35%) were intubated. Median length of hospital stay for all cases was 0.5 (IQR: 0.5-1.2) d, but it was 2.2 (IQR: 1.5-3.8) d for envenomated cases.
    The majority of snakebite patients used non-recommended first aid or attended traditional healers. Almost one-third of patients developed systemic envenomation and required antivenom. The case fatality rate was high, but many died prior to arriving in hospital.
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  • 文章类型: Journal Article
    背景:大多数生殖器瘘是由于延长,难产或手术并发症。其他原因包括创伤(事故,传统治疗师,或性暴力),辐射,癌,感染,不安全堕胎,先天性畸形.
    方法:本回顾性记录综述集中在1980年后发展为瘘管并在1994年至2017年期间在坦桑尼亚寻求治疗的6,787名妇女中的罕见瘘管原因。乌干达,肯尼亚,马拉维,赞比亚,卢旺达,埃塞俄比亚,索马里,南苏丹。我们比较了各国的瘘管病因,并评估了罕见原因和失禁类型之间的关联(尿液,粪便,或两者)。
    结果:罕见瘘管占所有瘘管的1.12%(76/6,787),包括创伤事故(19/6,787,0.28%),创伤性性暴力(15/6,787,0.22%),传统治疗师造成的创伤(13/6,787,0.19%),不安全流产(10/6,791,0.15%),辐射(8/6,787,0.12%),HIV感染并发症(6/6,787,0.09%),先天性异常(5/6,787,0.07%)。传统治疗师造成的创伤是索马里妇女的一个特殊问题。
    结论:由罕见原因引起的瘘阐明了女性面临的各种风险。瘘修复培训材料应区分由传统治疗师引起的创伤作为独特的瘘病因。瘘的不同原因需要多管齐下的策略来减少瘘的发生率。
    Most genital fistulas result from prolonged, obstructed labor or surgical complications. Other causes include trauma (from accidents, traditional healers, or sexual violence), radiation, carcinoma, infection, unsafe abortion, and congenital malformation.
    This retrospective records review focuses on rare fistula causes among 6,787 women who developed fistula after 1980 and sought treatment between 1994 and 2017 in Tanzania, Uganda, Kenya, Malawi, Zambia, Rwanda, Ethiopia, Somalia, and South Sudan. We compare fistula etiologies across countries and assess associations between rare causes and type of incontinence (urine, feces, or both).
    Rare fistula accounted for 1.12% (76/6,787) of all fistulas, including traumatic accidents (19/6,787, 0.28%), traumatic sexual violence (15/6,787, 0.22%), traumatic injuries caused by traditional healers (13/6,787, 0.19%), unsafe abortion (10/6,791, 0.15%), radiation (8/6,787, 0.12%), complications of HIV infection (6/6,787, 0.09%), and congenital abnormality (5/6,787, 0.07%). Trauma caused by traditional healers was a particular problem among Somali women.
    Fistulas attributable to rare causes illuminate a variety of risks confronting women. Fistula repair training materials should distinguish trauma caused by traditional healers as a distinct fistula etiology. Diverse causes of fistula call for multi-pronged strategies to reduce fistula incidence.
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