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Olanzapine/samidorphan precipitated opioid withdrawal in a patient taking transdermal fentanyl [Letter]

Warstadt, Nicholus M; Schmitz, Zachary P; Soghoian, Samara E
PMID: 35323081
ISSN: 1556-9519
CID: 5200582

Home-Based Remedies to Prevent COVID-19-Associated Risk of Infection, Admission, Severe Disease, and Death: A Nested Case-Control Study

Nuertey, Benjamin Demah; Addai, Joyce; Kyei-Bafour, Priscilla; Bimpong, Kingsley Appiah; Adongo, Victor; Boateng, Laud; Mumuni, Kareem; Dam, Kenneth Mibut; Udofia, Emilia Asuquo; Seneadza, Nana Ayegua Hagan; Calys-Tagoe, Benedict Nl; Tette, Edem M A; Yawson, Alfred Edwin; Soghoian, Sari; Helegbe, Gideon K; Vedanthan, Rajesh
Objective/UNASSIGNED:This study aimed at determining the various types of home-based remedies, mode of administration, prevalence of use, and their relevance in reducing the risk of infection, hospital admission, severe disease, and death. Methods/UNASSIGNED:The study design is an open cohort of all participants who presented for testing for COVID-19 at the Infectious Disease Treatment Centre (Tamale) and were followed up for a period of six weeks. A nested case-control study was designed. Numerical data were analysed using STATA version 14, and qualitative data were thematically analysed. Results/UNASSIGNED: = 2)). Participants who practiced any form of home-based therapy were protected from SARS-CoV-2 infection (OR = 0.28 (0.20-0.39)), severe/critical COVID-19 (OR = 0.15 (0.05-0.48)), hospital admission (OR = 0.15 (0.06-0.38)), and death (OR = 0.31 (0.07-1.38)). Analysis of the various subgroups of the home-based therapies, however, demonstrated that not all the home-based remedies were effective. Steam inhalation and herbal baths were associated with 26.6 (95% CI = 6.10-116.24) and 2.7 (95% CI = 0.49-14.78) times increased risk of infection, respectively. However, change in diet (AOR = 0.01 (0.00-0.13)) and physical exercise (AOR = 0.02 (0.00-0.26)) remained significantly associated with a reduced risk of infection. We described results of thematic content analysis regarding the common ingredients in the drinks, diets, and other home-based methods administered. Conclusion/UNASSIGNED:Almost a third of persons presenting for COVID-19 test were involved in some form of home-based remedy to prevent COVID-19. Steam inhalation and herbal baths increased risk of COVID-19 infection, while physical exercise and dietary changes were protective against COVID-19 infection and hospital admission. Future protocols might consider inclusion of physical activity and dietary changes based on demonstrated health gains.
PMID: 35310036
ISSN: 1741-427x
CID: 5220302


Chapter by: Fernandez, Denise; Soghoian, Sari
in: Goldfrank's toxicologic emergencies by Nelson, Lewis; et al (Ed)
New York : McGraw-Hill Education, [2019]
pp. ?-?
ISBN: 1259859614
CID: 3700152


Chapter by: Hines, Elizabeth Q; Soghoian, Sari
in: Goldfrank's toxicologic emergencies by Nelson, Lewis; et al (Ed)
New York : McGraw-Hill Education, [2019]
pp. ?-?
ISBN: 1259859614
CID: 3700252

International perspecgtives on medical toxicology

Chapter by: Soghoian, Sari
in: Goldfrank's toxicologic emergencies by Nelson, Lewis; et al (Ed)
New York : McGraw-Hill Education, [2019]
pp. ?-?
ISBN: 1259859614
CID: 3700472

Community leader support for adults with hypertension in ACCRA ghana [Meeting Abstract]

Birkemeier, J; Appleton, N; Ojo, T; Ampomah, I; Soghoian, S; Boden-Albala, B
Recently, Ghana's hypertension burden has significantly increased, with an accompanying rise in incidence of stroke and cardiovascular disease (CVD). Community leaders (CLs) in Ghana are looked upon for information and resource linkages, and their support could be leveraged to improve blood pressure (BP) control. As part of a pilot intervention, CLs were trained to provide support and resources to individuals with elevated BP. Sixty participants with BP readings>=140/90 were recruited from a screening event in the La Dade Kotopon community of Accra. CLs were assigned to follow 10- 15 participants each, providing medication and appointment reminders and tracking BP over the phone and through home visits. After three months, two separate focus groups were conducted with five community leaders and eight program participants to collect feedback about intervention implementation and acceptability, which will inform a larger intervention study. Detailed notes were taken by the facilitator and major themes described below. Both CLs and participants felt the intervention helped to improve adherence practices, including refilling and taking medications and attending medical appointments. Patients preferred receiving support from CLs over nurses and health workers; they also preferred home visits to calls. Barriers identified by both groups included medication costs and difficulties connecting over the phone. Both groups requested more education about CVD prevention. Community leaders are trusted and influential figures in Ghana, whose support may positively impact health behaviors for managing hypertension. This novel approach may be relevant in tailoring stroke and CVD prevention interventions in low and middle income countries
ISSN: 1747-4949
CID: 3489152

Mapping the process of emergency care at a teaching hospital in Ghana

Aaronson, Emily; Mort, Elizabeth; Soghoian, Samara
Emergency Department (ED) overcrowding has become a global concern as the number of countries with formalized emergency care systems has expanded, and the burden of trauma and non-communicable diseases in low and middle-income countries increased. In light of this, the international Emergency Medicine literature has outlined the need for operational projects in low and middle income countries which focus on the process of care. Despite this, there is limited published literature describing these types of projects. We share our experience mapping emergency care processes at a teaching hospital in Ghana as a case study of Lean's application in a relatively resource limited setting. From this work, we conclude that process mapping, a critical first step in further process re-design, is a cost effective, low tech activity which can be feasibly used in low resource environments to initiate quality improvement.
PMID: 28065392
ISSN: 2213-0772
CID: 2911002

Identifying priorities for quality improvement at an emergency Department in Ghana

DeWulf, Annelies; Otchi, Elom H; Soghoian, Sari
BACKGROUND: Healthcare quality improvement (QI) is a global priority, and understanding the perspectives of frontline healthcare workers can help guide sustainable and meaningful change. We report a qualitative investigation of emergency department (ED) staff priorities for QI at a tertiary care hospital in Ghana. The aims of the study were to educate staff about the World Health Organization's (WHO) definition of quality in healthcare, and to identify an initial focus for building a departmental QI program. METHODS: Semi-structured interviews were conducted with ED staff using open-ended questions to probe their understanding and valuation of the six dimensions of quality defined by the WHO. Participants were then asked to rank the dimensions in order of importance for QI. Qualitative responses were thematically analyzed, and ordinal rank-order was determined for quantitative data regarding QI priorities. RESULTS: Twenty (20) members of staff of different cadres participated, including ED physicians, nurses, orderlies, a security officer, and an accountant. A majority of participants (61%) ranked access to emergency healthcare as high priority for QI. Two recurrent themes - financial accessibility and hospital bed availability - accounted for the majority of discussions, each linked to all the dimensions of healthcare quality. CONCLUSIONS: ED staff related all of the WHO quality dimensions to their work, and prioritized access to emergency care as the most important area for improvement. Participants expressed a high degree of motivation to improve healthcare quality, and the study helped with the development of a departmental QI program focused on the broad topic of access to ED services.
PMID: 28854879
ISSN: 1471-227x
CID: 2678972

Kumawu polyclinic: A needs assessment of a district facility in Ghana [Meeting Abstract]

Soiefer, L R; Hein, P N; Soghoian, S E; Hultgren, A L
Background: Many district hospitals and medical centers in Ghana are limited with regard to the number of employed medical staff, hospital resources, and services available. Our team went to Kumawu Polyclinic to learn about the detailed operations of the hospital, resources, and to determine the challenges faced by the facility. A needs assessment was developed that can be used as a model for how to briefly and efficiently evaluate a district facility in Sub Saharan Africa. Methods: A team consisting of an emergency physician working at a tertiary referral hospital in Ghana and medical students from the United States developed a needs assessment and conducted a visit to Kumawu Polyclinic (Sekyere Afram Plains District, Ashanti Region, Ghana) over three consecutive days in July 2015. The team surveyed the facility, observed rounds with the medical staff, and conducted informal interviews with the polyclinic director and staff. Findings: Kumawu Polyclinic is a district health facility with 23 inpatient beds, split between three wards. There is only one medical officer (physician) at the hospital, along with one physician's assistant and a physician assistant in training. 25 nurses work at the hospital but only 8 are formally trained. The most common patient presentations are fever in children under five, pregnancy and delivery, and complications of noncommunicable diseases such as stroke and hypertensive crisis. The clinic faces several challenges, one being an unreliable supply of essential consumables from the Ghana Health Service. The polyclinic also has limited capability to run laboratory tests and has to send patients 45 minutes away to a larger facility for any imaging. Electric supply is intermittent and requires the use of a backup generator during periods of electrical failure. Interpretation: Our team recommended establishing a triage system for patient intake to increase the efficiency of the clinic. In addition, the needs assessment addressed the clinic's limited range of drugs it can prescribe, moving forward on a 25-bed extension, and the challenges of intermittent electricity. This method of assessing the needs of a district facility can be employed at other polyclinics in Ghana and in developing countries in Africa
ISSN: 2214-9996
CID: 2415762

Impact of Mandatory Carbon Monoxide Alarms: An Investigation of the Effects on Detection and Poisoning Rates in New York City

Wheeler-Martin, Katherine; Soghoian, Sari; Prosser, Jane M; Manini, Alex F; Marker, Elizabeth; Stajic, Marina; Prezant, David; Nelson, Lewis S; Hoffman, Robert S
OBJECTIVES: We sought to evaluate the impact of New York City's (NYC's) 2004 carbon monoxide (CO) alarm legislation on CO incident detection and poisoning rates. METHODS: We compared CO poisoning deaths, hospitalizations, exposures reported to Poison Control, and fire department investigations, before and after the law for 2000 to 2010. Use of CO alarms was assessed in the 2009 NYC Community Health Survey. RESULTS: Investigations that found indoor CO levels greater than 9 parts per million increased nearly 7-fold after the law (P < .001). There were nonsignificant decreases in unintentional, nonfire-related CO poisoning hospitalization rates (P = .114) and death rates (P = .216). After we controlled for ambient temperature, the law's effect on hospitalizations remained nonsignificantly protective (incidence rate ratio = 0.747; 95% confidence interval = 0.520, 1.074). By 2009, 83% of NYC residents reported having CO alarms; only 54% also recently tested or replaced their batteries. CONCLUSIONS: Mandating CO alarms significantly increased the detection of potentially hazardous CO levels in NYC homes. Small numbers and detection bias might have limited the discovery of significant decreases in poisoning outcomes. Investigation of individual poisoning circumstances since the law might elucidate remaining gaps in awareness and proper use of CO alarms. (Am J Public Health. Published online ahead of print June 11, 2015: e1-e7. doi:10.2105/AJPH.2015.302577).
PMID: 26066948
ISSN: 1541-0048
CID: 1626602