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Background: Contrast-induced acute kidney injury (CIAKI) is the third leading cause of acute renal failure in hospitalized patients. This study was aimed to investigate whether atorvastatin could upregulate the expression of hydrogen sulfide (H2S) and hence protect against CIAKI. Methods: We treated male rats and NRK-52E cells by iopromide to establish in vivo and in vitro models of CIAKI. Pretreatment with atorvastatin was given in CIAKI rats to investigate its effect on CIAKI. We collected serum and urine samples to detect renal function. We obtained kidney tissue for histological analysis and detection of protein concentration. We tested the serum concentration of H2S and renal expression of two H2S synthetases [cystathionine γ-lyase (CSE) and cystathionine-β synthase (CBS)]. NaHS was pretreated in NRK-52E cells to testify its underlying effect on contrast-induced injury. Results: Atorvastatin significantly ameliorated renal dysfunction and morphological changes in CIAKI rats, as well as inflammation, apoptosis, and excessive oxidative stress. Atorvastatin also markedly increased the serum concentration of H2S and renal expression of CSE and CBS. Moreover, pretreatment with NaHS in NRK-52E cells considerably attenuated contrast-induced cell death and inflammation. Conclusion: Atorvastatin protects against CIAKI via upregulation of endogenous hydrogen sulfide.

The objective of this quasi-experimental study is to assess the risk factors and early cardiovascular outcomes in cancer patients treated with anthracycline-based chemotherapy in Tanzania. The study will be conducted at Ocean Road Cancer Institute in Dar es salaam, Tanzania. The study will have three phases: baseline survey, follow-up, and end-line survey. Participants will be newly diagnosed adult cancer patients who are eligible for anthracycline-based chemotherapy. A total of 427 participants will be involved. At baseline, participants will be evaluated for the cardiovascular risk factors before commencing chemotherapy. During follow-up, participants will commence their prescribed anthracycline and the cardiovascular indices monitored throughout until the patient completes the prescribed anthracycline cycles. After completing the prescribed anthracycline cycles, an end line survey will be conducted to evaluate any change in cardiovascular indices. The outcome variable in this study will be the change in biochemical data (high-density lipoprotein, low-density lipoprotein, triglyceride, and troponin I), blood pressure, and electrocardiographic information (heart rate and Bazett QT interval). Independent variables will be demographic characteristics, risk factors for cardiovascular disorders, current dietary practices, and body mass index. Descriptive statistics will be used to describe the participants. Independent and paired t-tests will be performed to make comparisons between and within groups. P-values

Background Implementation of evidence-based guidelines (EBGs) related to VAP is an effective measure for the prevention of ventilator-associated pneumonia (VAP). While low knowledge regarding the EBGs related to VAP prevention among ICU nurses is still a major concern among nurses in ICUs globally, the situation in Tanzania is scarcely known. This study aimed to assess the ICU nurses’ knowledge, compliance, and barriers toward evidence-based guidelines for the prevention of VAP in Tanzania. Methods A cross-sectional study, involving ICU nurses of major hospitals in Tanzania, was conducted. A structured questionnaire was administered among 116 ICU nurses. Data analysis included descriptive statistics and the independent sample t-test. Results The mean knowledge score was 3.86(SD = 1.56), based on ten questions (equivalent to 38.6%). Nurses with a degree or higher level of nursing education performed significantly better than the nurses with a diploma or lower level of nursing education (p = 0.004). The mean self-reported compliance score for EBGs for the prevention of VAP was 15.20 (SD = 0.93) which is equivalent to 60.8% based on 25 questions. The main barriers to the implementation of EBGs for VAP prevention were lack of skills (96.6%), lack of adequate staff (95.5%), and lack of knowledge (79.3%). Conclusion Considering the severity and impact of VAP, and the higher risks of HAIs in resource-limited countries like Tanzania, the lower level of knowledge and compliance implies the need for ongoing educational interventions and evaluation of the implementation of the EBGs for VAP prevention by considering the local context.

BackgroundUptake of deworming drugs is one of the important antenatal strategies in preventing anaemia in pregnancy. Little is known about the factors associated with uptake of the de-worming drugs. This study aimed at identifying the factors associated with the uptake of de-worming drugs during pregnancy among women of reproductive age.Method: The study used data from the 2015-16 Tanzania HIV Demographic and Health Survey and Malaria Indicators Survey (2015-16 TDHS-MIS). A total of 6924 women of active reproductive age from 15 to 49 were included in the analysis. Both univariate and multiple regression analyses were used to determine the factors associated with uptake of deworming drugs among women of reproductive age in Tanzania.Results: Majority of interviewed women 3864(60.1%) took deworming drug while a total of 2560(39.9%) did not take deworming drugs. After controlling for confounders, factors associated with uptake of deworming drugs were early antenatal booking, (AOR=1.404 at 95% CI=1.24-1.59,pConclusionFactors associated with uptake of deworming drugs were early antenatal booking, age group, rural residence, zonal residence, wealth index, level of education, and parity. Considering the outcomes of anaemia in pregnancy, clinicians should consider all the modifiable factors affecting the uptake of the deworming drugs during pregnancy to every woman of reproductive age before and after conception. Whenever possible, it should be done even beyond antenatal clinics.

Patients under anthracycline chemotherapy are at risk of cardiovascular disorders, including hypertension. Error in blood pressure measurement exceeding 5mmHg may have detrimental outcomes to the patient quality of care. Studies involving nurses reveal discrepancies in knowledge and practices, which raise questions on the reliability of their BP recordings. It is not clear whether nurses taking care of these patients have sufficient knowledge and compliance regarding accurate blood pressure measurement. This study aimed at assessing knowledge, practice and associated factors regarding accurate blood pressure measurement procedures among nurses caring for cancer patients under anthracycline chemotherapy in Tanzania, guided by the Theory of Planned Behavior and Neuman’s Prevention and Intervention Theory. Methods A cross-sectional study, with a quantitative approach was conducted among 181 nurses who were conveniently sampled from various hospitals in Tanzania. A structured questionnaire was used for data collection and analysis done by using statistical package for social sciences (SPSS) version 21. Descriptive statistics, Chi-square and Binary logistic regression analysis were applied. Results Based on the given 18 items to assess nurses’ knowledge of accurate blood pressure measurement, the mean knowledge score was 8.6 (SD=3.6), implying poor knowledge. Those with a bachelor of Nursing and above were more knowledgeable than those with a diploma and below (AOR=2.5, 95%CI=1.281-4.914, p=0.007). Out of the maximum practice score of 40, the nurses had Mean=16 (SD=2.33) implying poor practice. Three mostly reported barriers were: Feeling unempowered, Nurses’ workload, and unconducive working environment. The results conform to the theory of planned behavior and Neuman’s Prevention and Intervention Theory. Conclusion Nurses caring for patients in anthracycline chemotherapy in Tanzania have poor knowledge and poor practice regarding accurate blood pressure measurement. Institutional programs to educate nurses about accurate blood pressure measurement may have an impact on attitude and intention to practice accurate blood pressure measurement. Considering the barriers to accurate blood pressure measurement, and the impact of unstable blood pressure and hypertension on morbidity and mortality in cancer patients at risk of cardiovascular complications, efforts are needed to overcome the barriers and maximize the quality of Blood Pressure measurement by the nurses.