Complete resolution of steroid-resistant organizing pneumonia associated with myelodysplastic syndrome following allogeneic hematopoietic cell transplantation

Magnitude and associated factors of chewing khat during pregnancy in Eastern Ethiopia, 2022: a mixed method cross-sectional study

Introduction

khat (Catha edulis Forsk), is an evergreen flowering tree or shrub widely produced and consumed in East Africa and the Arabian Peninsula. In Ethiopia, it is largely produced, freely marketed and consumed by almost all segments of the population. This is more pronounced in the Eastern part of the country. However, there exists little scientific information on the level and associated factors of khat use among pregnant women in Ethiopia, despite a few available evidences indicated its adverse effect on pregnancy outcomes. Moreover, the perceived reasons for chewing khat during pregnancy were not yet explored qualitatively to triangulate the quantitative findings. Hence, the aim of the present study was to determine the magnitude and associated factors of chewing khat during pregnancy in Eastern Ethiopia, 2022, in a Mixed Method study approach.

Methods

an institution-based cross-sectional study was conducted from August 1st to 14th, 2022 using both quantitative and qualitative methods. Two hundred forty-two pregnant mothers on Antenatal care (ANC) were included in the study. Moreover, 18 purposively selected pregnant mothers on ANC were also considered for qualitative data. Analysis of quantitative data was performed on Statistical Package for the Social Sciences (SPSS) version 27 and thematic framework analysis was performed for qualitative data. Univariable and multivariable logistic regression analysis was performed to identify variables which are significantly associated with khat chewing during pregnancy and to estimate the variable's crude and adjusted odds' ratio with corresponding 95% CI. The statistically significant association was declared at p-value of less than 5.

Results

the overall magnitude of chewing khat during pregnancy in the present study was 27.4% (95% CI: 22.2-33.0). Variables which significantly associated with chewing khat during pregnancy in this study were being >26 years [adjusted odds' ratio (AOR)=2.81 95% CI: 1.19-6.59], being a rural resident (AOR=2.82 95% CI: 1.19-6.69), being illiterate (AOR=4.31 95% CI: 1.02-18.20), participants having chewer husbands (AOR=3.51 95% CI: 1.33-9.24) and respondents having other chewer family members (AOR=3.05 95% CI: 1.19-7.77). In addition, the perceived reasons for chewing khat explored through in-depth interviews were for socialization, to obey tradition, to be happy with friends, husbands and families, to be free from tensioned situations, to be effective in performing daily activities, and due to lack of knowledge of its harm.

Conclusion

in the present study, a relatively higher proportion of mothers chewed khat during their current pregnancy. Being older age, living in rural areas, being illiterate, having khat chewer husbands and other family members were statistically significant variables associated with khat chewing during pregnancy. Moreover, pregnant mothers are practicing chewing of khat in the current study area due to deep-rooted sociocultural issues. Hence, creation of awareness on possible harm of chewing khat during pregnancy especially for those found to be at significantly increased risk of consumption in this study is highly recommended during their antenatal care visits. In addition, creation of awareness out of health institutions, at household and community level, is highly recommended, probably using community volunteers (health development armies) in the present study area. At last, we highly also recommend the local government and religious leaders to work on how to stop the chewing practice especially during pregnancy. For example, the local government and religious leaders can work on averting consideration of chewing by the community as culturally accepted practices.

Characteristics and Follow-Up of Organizing Pneumonia Associated with Haematological Malignancies

Background

Organizing pneumonia (OP) is a secondary process in many diseases. Due to its low incidence and indistinct symptoms, there is limited information on OP associated with haematological malignancies. Therefore, the aim of this study was to discuss the characteristics and prognosis of OP associated with haematological malignancies.

Methods

We observed and analysed pathologically confirmed OP cases associated with haematological malignancies in a hospital record database and excluded cases of OP with known causes, including chemotherapy, radiotherapy, targeted therapy, transplantation and infection.

Results

There were five patients with OP underlying only haematological malignancies, including one case each of the following: myelodysplastic syndrome, acute myelogenous leukaemia, multiple myeloma, aplastic anaemia, and T cell lymphoma. Radiological findings did not show a distinct pattern, and two cases mimicked pulmonary aspergillosis with ground-glass opacity (GGO). The diagnosis of OP was confirmed by minimal invasive biopsy. Although all patients developed severe cases, steroids yielded favourable outcomes.

Conclusion

This study demonstrates that haematological malignancies may be a cause of OP and that minimal invasive biopsy may be an effective and safe method to confirm the diagnosis. Although OP associated with haematological malignancies may more frequently develop into severe cases, the OP lesions were steroid-responsive during follow-up.

Investigating factors affecting on medical sciences students' intention to adopt mobile learning

BACKGROUND

Mobile learning (m-learning) provides a good opportunity for students' lifelong learning. The design and implementation of effective and successful mobile learning requires identification of factors that affect m-learning. The aim of this study was to investigate the factors that affect the intention of students of medical sciences to adopt mobile learning based on theory of planned behavior (TPB).

METHODS

In this cross-sectional study, 332 students of medical sciences were randomly selected. The study tool was a based a questionnaire that had been designed based on TPB model. Descriptive statistics (mean, standard deviation, frequency and percentage) were calculated. In order to determine the standardized factor loading and assess the study hypotheses, structural equation modeling was used. Composite reliability, average variance extracted, and standardized factor loading were used to determine the convergent validity.

RESULTS

The mean of mobile learning readiness was 3.59 ± 0.83. Among the TPB structures, the structures of attitude (β = 0.525) and behavioral control (β = 0.318) had positive and significant effect on the intention to adopt m-learning (P ≤ 0.01). However, the structure of subject norm did not have a significant effect on the intention to adopt m-learning. In general, attitude, behavioral control and subject norm structures were 0.675 determinants of the intention to adopt m-learning (r2 = 0.675).

CONCLUSIONS

In this study Mobile learning readiness of the students was at moderate level. Also the results indicated Positive and significant effect of attitude and behavioral control on the intention of students to accept m-learning. The TPB-based model was a suitable model for identifying psychological factors that affect the intention of students of medical sciences to adopt m-leaning. In order to increase the students' acceptance of mobile learning, we suggest that, other psychological, behavioral, social, and cultural factors that affect the acceptance of m-learning should be identified. Educational programs are also suggested to be introduced to students to familiarize them with the m-learning and its application in learning process.