Student's Journal of Health Research Africa

HISTOPATHOLOGICAL AND IMMUNOHISTOCHEMICAL ANALYSIS OF PERIPHERAL NERVE SHEATH TUMORS: A PROSPECTIVE COHORT STUDY.

2024-07-23T06:08:25+00:00

Background

Peripheral nerve sheath tumors (PNSTs) are rare, heterogeneous soft tissue neoplasms arising from Schwann cells, fibroblasts, and histiocytic or macrophage-like cells. They include benign tumors like schwannomas and neurofibromas and the highly aggressive malignant peripheral nerve sheath tumors (MPNSTs).

Objective

To evaluate the histopathological features and immunohistochemical (IHC) profiles of different PNSTs using S-100, SOX10, and CD56 markers.

Methods

This prospective observational study was conducted from June 2022 to July 2023 at a tertiary care teaching hospital in India. Thirty patients under 65 years with benign or malignant PNSTs were included. Histological features were assessed using light microscopy, and IHC staining was performed with S100, SOX10, and CD56. Data were analyzed using SPSS software, with a significance level set at p<0.05.

Results

Out of 30 cases, 17 (56.7%) were neurofibromas, 12 (40%) were schwannomas, and 1 (3.3%) was an MPNST. The mean age was 38.7 years, with a male-to-female ratio of 16:14. Tumor size varied significantly between types, with MPNST and schwannomas being larger than neurofibromas (P=0.07). Schwannomas frequently exhibited Antoni A and B patterns, Verocay bodies, and hyalinized blood vessels, while neurofibromas showed spindle cells and shredded carrot-type collagen. Immunohistochemistry revealed S100 positivity in 70% of tumors, SOX10 in 86.7%, and CD56 in 43.3%. Schwannomas showed higher S100 and CD56 expression compared to neurofibromas (p<0.05).

Conclusions

The study highlights distinct histological and immunohistochemical features of PNST subtypes, with significant differences in marker expression aiding in differential diagnosis. Larger-scale studies are needed to further validate these findings in diverse populations.

Recommendations
The study recommends using histopathological and immunohistochemical analysis with markers (S100, SOX10, CD56) for accurate PNST diagnosis and emphasizes the need for larger-scale, follow-up studies. It also highlights the importance of routine analysis, multidisciplinary collaboration, comprehensive patient care, and enhanced training for pathologists.

PREPONDERANCE OF EOSINOPHILIA AT TERTIARY CARE CENTRE IN THE SOUTHWEST REGION OF PATNA: A RETROSPECTIVE CROSS-SECTIONAL STUDY

2024-09-27T11:37:09+00:00

Background

Eosinophils are synthesized in response to inflammation in the body. The underlying disease can vary to a large extent. The data regarding the underlying causes is scarce.

Objectives

To determine the eosinophilia cases at the tertiary care center of the Southwest Region of Patna.

Materials and Methods

The present retrospective, observational, and hospital-based study was conducted. The blood samples of the patients participating in the study were tested for complete blood count on a hematology analyzer. The manual identification of the WBC and determination of the AEC was carried out on the blood samples. The demographic and clinical details of the patients were recorded and statistically analyzed.

Results

A total of 301 patients were reported to have eosinophilia. Of these, 203 (67.4%) were male, and 98 (32.6%) were female. The present study showed higher cases of eosinophilia in male patients. 13.6% of the participants with eosinophilia were within the age group of 21-30 years. 91.4% of the cases were under the moderate eosinophilia category. The majority of the patients had agriculture as their occupation.

Conclusion

In conclusion, the present study has detected that eosinophilia is frequent in the West Region of Patna. A thorough search for the etiological factors and other relevant investigations is essential for appropriate management.

Recommendation

Eosinophilia can be associated with various etiological factors. It is essential to determine the underlying cause to treat eosinophilia.

A Prospective Observational Study on Ocular Manifestations of Sickle Cell Hemoglobinopathies

2024-09-30T15:55:18+00:00

Background: Sickle cell disease (SCD) is a genetic hemoglobinopathy described by abnormal hemoglobin S, leading to systemic complications due to vaso-occlusion and hemolysis. Ocular manifestations, particularly proliferative sickle retinopathy (PSR), can result in significant visual impairment if not detected and treated early. The study assessed the prevalence, types, and risk factors associated with ocular manifestations in individuals with SCD and to explore the relationship between disease severity and ocular complications.

Methods: Included were 205 individuals with SCD diagnoses, of which 74 showed signs and symptoms related to the eyes. Patients received thorough evaluations by ophthalmologists, which included fundus examinations, slit-lamp biomicroscopy, and fluorescein angiography. SPSS version 23.0 was used for the statistical analysis. P-values less than 0.05 were regarded as significant.

Results: Ocular manifestations were observed in 36.1% of patients (n=74). The most common findings were proliferative sickle retinopathy (43.2%) and non-proliferative sickle retinopathy (28.4%). Patients with severe SCD were significantly more likely to have ocular manifestations (51.4%) compared to those with mild disease (16.2%) (p = 0.002). The mean duration of SCD was longer in patients with ocular involvement (14.4 vs. 10.8 years, p = 0.032). Visual impairment was present in 27.0% of patients with ocular manifestations.

Conclusion: A substantial proportion of patients with SCD develop ocular complications, with proliferative sickle retinopathy being the most common. The severity and duration of SCD are associated with an increased risk of ocular manifestations, emphasizing the need for regular ophthalmological evaluations.

Recommendations: Routine ophthalmological screening should be integrated into the management of patients with SCD, particularly for those with severe disease or longer disease duration. Early detection and treatment of ocular manifestations may help prevent vision loss.

COMPARISON OF AUTOLOGOUS BLOOD AND FIBRIN GLUE IN PTERYGIUM EXCISION WITH CONJUNCTIVAL AUTOGRAFT SURGERY: A RANDOMIZED TRIAL.

2024-09-21T13:57:35+00:00

Background

Because it can affect vision, pterygium is a common ocular surface condition that frequently requires surgical intervention. Conventional surgical methods, such as suture-based conjunctival autograft (CAG), are associated with discomfort after surgery and have a high recurrence risk. To examine the safety and effectiveness of fibrin glue vs autologous blood for pterygium excision during CAG surgery, this study was conducted.

Methods

There were 150 patients in the study, and they were assigned randomly to one of two groups: group 1: autologous blood (75 eyes), or group 2: fibrin glue (75 eyes). Preoperative evaluations of the patients included slit-lamp biomicroscopy and documentation of their visual acuity. The recurrence rate at a 1-year follow-up was the main result. Improvement in visual acuity, intraoperative and postoperative complications, and graft stability were among the secondary outcomes. Chi-square and t-tests were used to analyze the data, with a significance threshold of p<0.05.

Results

The recurrence rate at 1-year follow-up was significantly lower in the group 2 (6.7%) compared to the group 1 (16%) (p=0.02). Graft stability was better in group 2, with 96% of grafts intact on postoperative day 1, compared to 86.7% in group 1 (p=0.04). The prevalence of complications was similar between the groups, with no significant differences. Both groups showed significant improvements in visual acuity postoperatively (p<0.01), with no difference between the groups.

Conclusion

For CAG fixation in pterygium surgery, fibrin glue works better than autologous blood, providing improved graft stability and a decreased recurrence rate. Both techniques are equally safe and efficient at raising visual acuity.

Recommendations

Fibrin glue should be considered the preferred method for CAG fixation in pterygium surgery due to its superior outcomes in terms of recurrence and graft stability. Further studies could explore long-term outcomes and cost-effectiveness.

Comparing 0.5% Bupivacaine versus 0.5% Levobupivacaine for peribulbar anaesthesia in cataract surgery

2024-09-30T16:02:15+00:00

Background: The choice of drug used in the anaesthesia affects the overall outcome of cataract surgery, regarding patient satisfaction and adverse effects.

Objectives: This study aimed to compare the efficacy and tolerability of levobupivacaine and bupivacaine in anaesthesia for cataract surgery.

Materials and Methods: This was a double-blinded randomized study conducted in the operation theatre of Zoram Medical College for a year. The patients who were to undergo cataract surgery were considered for this study. They were divided randomly and were evaluated for the efficacy and safety of the drugs under study. The data obtained was compared statistically.

Results: The akinesia score of the bupivacaine group at 10 minutes was 0.24±0.14 and for the levobupivacaine group it was 0.25±0.34. The patient’s satisfaction score in the bupivacaine group was 8.2±0.34 and in the levobupivacaine group, it was 8.4±0.21. The surgeons rated the quality of the motor block, the bupivacaine group had an average of 7.23±0.42 and for levobupivacaine, the average was 7.88±0.32. The results of both groups are comparable.

Conclusion: The motor and sensory blockade for cataract surgery can be achieved with bupivacaine and levobupivacaine with similar efficacy and tolerance.z

Recommendation: Levobupivacaine should be used as a local anaesthetic in patients with systemic disease to improve the outcome of the surgery.

A RETROSPECTIVE COHORT STUDY OF 200 PATIENTS: CLINICAL MANIFESTATIONS AND AETIOLOGY OF RECURRENT CORNEAL EROSION SYNDROME.

2024-09-30T12:45:31+00:00

Objective

To investigate the clinical characteristics and causes of recurrent corneal erosion syndrome (RCES).

Methods

A study was conducted on 200 patients (185 eyes) diagnosed with Recurrent Corneal Erosion Syndrome (RCES) at the institution, Netaji Subhas Medical College and Hospital, Bihta, Patna. The analyzed data encompassed information on demographics, causes, position on the cornea, and the relationship with meibomian gland dysfunction (MGD).

Findings

The average age of participants was 44.5 years, with a range of 14-80 years. The identified causes of Recurrent Corneal Erosion Syndrome (RCES) were as follows: prior minor trauma (73 eyes, 39.45%), photorefractive keratectomy (31 eyes, 16.75%), epithelial basement membrane corneal dystrophy (EBMD) (31 eyes, 16.75%), laser-assisted in situ keratomileusis (14 eyes, 7.56%), and unknown origin (36 eyes, 18.91%). The inferior paracentral cornea was the most common area for recurrent corneal erosions (RCES), accounting for 68.4% of cases. The upper cornea and other locations were less frequently affected, with each accounting for 21.3% of cases. MGD was present in 59% of patients.

Summary

Recurrent corneal erosion syndrome (RCES) can be caused by many factors, which account for the diverse range of symptoms observed in individuals with the condition. Notably, a considerable proportion of patients with Recurrent Corneal Erosion disease (RCES) start experiencing the disease after undergoing keratorefractive surgery, a significant proportion of individuals also exhibit Meibomian Gland Dysfunction (MGD).

Recommendations

The study suggests treating MGD, which is often connected to RCES. It also suggests treating RCES with PRK and LASIK and preventing it in patients. Study MGD's role in RCES and treatment options including phototherapeutic keratectomy (PTK), which has shown promise in managing reoccurring cases.

THE ASSOCIATION BETWEEN CAFFEINE CONSUMPTION AND DRY EYE DISEASE: A RETROSPECTIVE CROSS-SECTIONAL STUDY

2024-09-21T14:08:58+00:00

Background

Multifactorial dry eye disease (DED) results in ocular surface deterioration and instability of the tear film, which can lead to pain and problems in vision. Research on DED has contested coffee's effects on tear production and ocular surface health. The study investigated the connection between caffeine consumption and DED.

Methods

The Women's Health Research (WHS) dry eye questionnaire and data on caffeine consumption were completed by 500 research participants. After controlling for variables such as age, education level, sex, family income, body mass index (BMI), alcohol intake, smoking status, and medical comorbidities, multivariable logistic regression models were utilized to examine the relationship between caffeine intake and DED outcomes.

Results

30% of people had DED as defined by the WHS, with females having a higher incidence (36.3%) than males (19.4%). Caffeine use was found to have a significant positive correlation with DED, with an increase in the odds of developing DED of 10% for every 100 mg/day of caffeine consumed (OR = 1.10, 95% CI = 1.02–1.18, p = 0.01). Females had a higher correlation with this (OR = 1.12, 95% CI = 1.03–1.21, p = 0.005). The risk of DED was further enhanced by inadequate sleep, high levels of work-related stress, and increased caffeine use. The main source of caffeine that was shown to be contributing to this risk was tea.

Conclusion

Higher caffeine intake is associated with an increased risk of DED, particularly among females and individuals with poor sleep quality or high work stress. Tea emerged as a significant contributor to this association.

Recommendations

The mechanisms underlying the link between caffeine use and DED require more investigation. Caffeine use should be moderated by public health standards to lower the risk of DED, particularly in more susceptible populations.

Risks of Glaucoma Treatment in Patients with Cataracts

2024-09-30T10:06:57+00:00

Background: Glaucoma and cataract frequently coexist in older adults, with glaucoma being a leading cause of irreversible blindness and cataracts contributing to reversible vision loss. Medical therapy for glaucoma primarily targets intraocular pressure (IOP) reduction, but its potential effects on cataract progression are not fully understood. This study assessed the risks associated with medical glaucoma therapy in patients with cataracts.

Methods: A total of 100 patients diagnosed with both glaucoma and cataracts were recruited. Baseline data included age, cataract severity, and IOP measurements. Patients were followed at 1, 3, and 6 months to assess cataract progression, visual acuity changes, and any side effects related to glaucoma treatment. Statistical analysis involved paired t-tests for intraocular pressure changes and Chi-square tests for cataract progression.

Results: Thirty-five percent of participants experienced significant cataract progression, with those having more advanced baseline cataracts being at higher risk (p = 0.01). Mean IOP decreased significantly from 24.1 mmHg to 16.8 mmHg (p < 0.001) over the study period, indicating effective glaucoma control. Visual acuity worsened from 0.4 LogMAR to 0.6 LogMAR in patients with cataract progression (p = 0.02). Ocular side effects, such as dry eye and hyperemia, were reported in 25% of the cohort.

Conclusion: While medical therapy effectively controls IOP in glaucoma patients, it is correlated with an increased risk of cataract progression, particularly in those with severe cataracts at baseline. The decline in visual acuity highlights the need for careful monitoring of cataract status during glaucoma treatment.

Recommendations: For patients with coexisting glaucoma and cataracts, regular monitoring of cataract progression and adjustments to glaucoma therapy may be necessary. Consideration of alternative treatments, such as combined cataract and minimally invasive glaucoma surgeries, may optimize outcomes.

OUTCOME PREDICTION IN INDIVIDUALS WITH ORGANOPHOSPHORUS AND CARBAMATE POISONING: A PROSPECTIVE COHORT STUDY.

2024-09-06T12:27:06+00:00

Objective

The study evaluated the predictive utility of Erythrocyte Acetylcholinesterase (E-AChE) and Butyrylcholinesterase (BChE) levels in individuals presenting with OP and carbamate poisoning.

Methods

Of the 60 patients, 42 had Organophosphorus (OP) poisoning, and 18 had Carbamate poisoning in the ER. Vital signs, symptoms, and POP Severity Scale scores were recorded. E-AChE levels were measured using the Rapid ChE Check Mobile, and BChE levels were assessed through standard lab techniques. SPSS was used for statistical analysis, examining correlations between E-AChE levels and outcomes like ICU stay, mechanical ventilation, and mortality.

Results

The study involved 60 patients (mean age 32.5 years, ± 10.7), 66.7% male and 33.3% female. Of these, 60% consumed OP chemicals and 40% carbamate. Severe poisoning was associated with significantly lower E-AChE levels (mean = 2.1 U/g Hb) compared to moderate (3.5 U/g Hb) and mild cases (5.1 U/g Hb) (p < 0.001), showing a strong negative correlation with POP Severity scores (rho = -0.76, p < 0.001). Butyrylcholinesterase (BChE) levels also showed a significant decrease in severe poisoning cases, aligning with clinical outcomes, although the correlation was less robust than with E-AChE. Delays in care led to severe consequences in 80% of low-income patients. Lower E-AChE levels correlated with prolonged ICU stays (r = -0.68, p < 0.001), increased ventilation needs (r = -0.62, p < 0.01), and higher mortality (r = -0.74, p < 0.001). Rural patients faced worse outcomes due to inadequate healthcare access.

Conclusion

Although BChE levels were also measured, their correlation with outcomes was less pronounced but still valuable. Incorporating early measurements of both E-AChE and BChE could enhance clinical decision-making in OP and carbamate poisoning cases.

Recommendations

Incorporating rapid diagnostic tools for cholinesterase measurement in emergency settings could improve clinical decision-making and patient outcomes.

UTILIZATION OF PRE- AND POST-COMPARATIVE ANALYSIS OF INTRA-LESIONAL DEXAMETHASONE COMBINED WITH HYALURONIDASE IN THE TREATMENT OF PATIENTS WITH ORAL SUBMUCOUS FIBROSIS: A CROSS-SECTIONAL STUDY

2024-10-01T15:19:26+00:00

Background

Oral Submucous Fibrosis (OSMF) is a chronic and potentially malignant disorder characterized by collagen deposition in the oral mucosa, primarily affecting the South Asian population. Despite its high prevalence and association with oral cancer, the pathophysiology of OSMF remains poorly understood, complicating effective treatment options.

Aim

To examine the efficacy of intra-lesional corticosteroid injections in alleviating symptoms and improving oral functionality in patients diagnosed with OSMF.

Methods

This clinic-observational study included patients diagnosed with OSMF. A total of 120 participants, aged 18 to 50 years, were administered intra-lesional injections of dexamethasone and hyaluronidase twice weekly for eight weeks. Clinical assessments, including mouth opening and burning sensation measured on a Visual Analogue Scale (VAS), were conducted tri-monthly. Statistical analysis was performed using SPSS to evaluate treatment efficacy.

Results

The study included 120 patients with OSMF, 68% (N = 82) were male, and 32% (N = 38) were female. The study revealed a significant improvement in mouth opening from 23.75 ± 2.54 mm pre-treatment to 27.50 ± 3.15 mm post-treatment (p = 0.001). Additionally, the VAS score for burning sensation decreased from 5.80 ± 1.30 to 2.90 ± 1.95 (p = 0.001), indicating effective symptom relief. These findings suggest that intra-lesional corticosteroid therapy significantly enhances oral mobility and reduces discomfort in patients with OSMF.

Conclusion

Intra-lesional corticosteroid therapy is an effective treatment for improving mouth opening and alleviating burning sensations in patients with OSMF. These results underscore the potential of corticosteroids in managing this precancerous condition and improving patients' quality of life.

Recommendations

The study recommends incorporating intra-lesional corticosteroid therapy as a primary treatment for OSMF due to its effectiveness in improving oral mobility and reducing discomfort. Additionally, further research is suggested to explore long-term outcomes and the benefits of combining this therapy with other treatment modalities.

OTORHINOLARYNGOLOGICAL SYMPTOMS IN COVID-19 PATIENTS: A COHORT STUDY

2024-08-27T06:41:00+00:00

Background

The COVID-19 pandemic, caused by SARS-CoV-2, has led to widespread infection with a range of clinical presentations, including otorhinolaryngological (ENT) symptoms alongside the more common respiratory manifestations. This study aims to explore the prevalence, types, and clinical significance of ENT symptoms in COVID-19 patients, providing insights into their potential impact on illness severity and patient outcomes.

Methods

A retrospective observational study was conducted at a tertiary care center, involving 200 COVID-19 patients confirmed via RT-PCR. Patients aged 18 or older without pre-existing chronic ENT conditions were included. Data on demographics, ENT symptoms, other COVID-19 symptoms, and treatment outcomes were collected through patient interviews, medical record reviews, and diagnostic tests. The prevalence of ENT symptoms was calculated, and their association with COVID-19 outcomes was analyzed using descriptive statistics and multivariable logistic regression.

Results

Among the 200 participants, 56% were male, and 44% were female, with a median age of 45 years. Anosmia and ageusia were linked to a reduced likelihood of severe COVID-19 (OR = 0.5, 95% CI = 0.3-0.7, p < 0.05), while nasal congestion and sore throat were associated with increased severity (OR = 1.7, 95% CI = 1.2-2.4, p < 0.05).

Conclusion

ENT symptoms, particularly anosmia and ageusia, may serve as clinical indicators of less severe COVID-19, whereas nasal congestion and sore throat may indicate a higher risk of severe outcomes.

Recommendations

Early recognition of ENT symptoms in COVID-19 can aid in identifying patients at risk of severe disease, guiding treatment strategies, and informing public health interventions to improve patient outcomes. Further research is recommended to elucidate the underlying mechanisms of these associations.

RETINOPATHY IN A CASE OF FAMILIAL HYPERCHOLESTEROLEMIA WITH DIABETES- A RARE CASE REPORT.

2024-07-04T05:27:29+00:00

Background

Familial hyperlipidemia is a genetic disorder characterized by high levels of LDL cholesterol and is associated with an increased risk of sudden cardiac death. However, the majority of cases of familial hypercholesterolemia remain undiagnosed or diagnosed at a later stage. Hyperlipidemia per se plays a major role in the pathophysiology of diabetes and its complications. Lipid-lowering agents have a protective effect on the progression of diabetic retinopathy and reduce the risk of diabetic macular oedema. Hence in cases of familial hypercholesterolemia with diabetic retinopathy a combined and aggressive approach is vital for better visual outcome.

Case presentation

In this report, an unusual case of 54 years old male presented to the ophthalmology OPD of Kalinga Institute of Medical Sciences, Bhubaneswar with diabetic retinopathy which was unresponsive to conventional treatment. Upon thorough evaluation, he was diagnosed with a case of familial hypercholesterolemia, and lipid-lowering therapy was initiated along with intravitreal anti-VEGF injections to which he responded better and there was a significant improvement in visual acuity.

Conclusion

This case report emphasizes that all cases of diabetic retinopathy unresponsive to treatment should be thoroughly evaluated. Familial hypercholesterolemia is a grave disease with serious implications. Early diagnosis and timely intervention play a crucial role in improving visual prognosis and life expectancy in such patients.

HYDROPS FETALIS SECONDARY TO TOXOPLASMA GONDII AND TREPONEMA PALLIDUM COINFECTION: CASE REPORT AND BRIEF LITERATURE REVIEW

2024-09-14T23:00:23+00:00

Background

Hydrops fetalis is a pathological condition in which fluid accumulates in the fetus in an extracellular environment, leading to subcutaneous edema and possible accumulation in the fetal body and abdominal cavity. The most common causes in this region are infectious, making systematic monitoring during pregnancy essential. However, it is difficult to apply this guideline in urban areas, and even more so in rural areas with few resources for investigation, as in this patient's case, monitoring was ineffective.

The aim was to carry out infection studies in maternal blood samples taken after giving birth to a newborn in hydrops.

Case presentation

A 36-year-old rural woman in her 6th pregnancy presented with uterine contractions in what was thought to be a full-term pregnancy. The progress of this pregnancy had not been monitored throughout the antenatal period for unknown reasons despite a clinical presentation characterized by breathlessness and generalized edema. The obstetric gynecology clinical examination revealed a mattress-like appearance suggestive of placenta previa, and a cesarean section was indicated with the extraction of a newborn with hydrops fetalis who died despite resuscitation efforts. An infectious disease investigation after delivery revealed the presence of both Treponema pallidum and Toxoplasma gondii in the maternal blood sample.

Conclusion

This state of hydrops fetalis was secondary to this co-infection, which is very difficult to manage in such conditions, facilitated by the lack of systematic biological monitoring for pathogens that could harm both the fetus and the mother.

Recommendation

Facilitate prenatal visits to women, especially in rural areas where access to services is limited, through home visits from health workers and community relays.

During the monthly antenatal visit, pregnant women should be subjected to compulsory infectious screening to provide suitable conditions for the fetus.

POSTOPERATIVE COMPLICATIONS RATE IN EARLY AND LATE PRESENTING CASES OF GASTROINTESTINAL TRACT PERFORATION IN BIHAR: A COHORT STUDY.

2024-08-27T06:27:43+00:00

Background

Gastrointestinal (GI) tract perforation is a life-threatening surgical emergency requiring immediate intervention. This study aims to evaluate the postoperative complication rates in early versus late presenting cases of gastrointestinal tract perforations in Northern India.

Methods

A prospective cohort study included 182 individuals with confirmed GI tract perforations, who presented to the emergency department and outpatient clinic. The patients were allotted into 2 groups: Group A (presentation within 48 hours) and Group B (presentation between 48 and 144 hours). Both groups underwent exploratory laparotomy followed by standard postoperative care. Data on postoperative complications, hospital stay, and mortality were collected and analyzed using SPSS version 23.0.

Results

The study included 182 patients, with 48 in Group A and 134 in Group B. The mean age was 42.5 ± 10.6 years, with a male predominance (70% male, 30% female). Group B experienced significantly higher rates of postoperative complications compared to Group A. Local complications, such as surgical site infection, were observed in 25.4% of Group B patients versus 10.4% in Group A (p=0.028). Systemic complications, including septicemia and respiratory complications, were more common in Group B (55.2%) compared to Group A (27.1%) (p=0.001). The mortality rate was significantly higher in Group B (17.9%) compared to Group A (6.2%) (p=0.047). The mean hospital stay was longer for Group B, averaging 12.6 ± 4.3 days, compared to 8.9 ± 3.1 days for Group A (p<0.001).

Conclusion

Delayed presentation of GI tract perforations is correlated with notably higher postoperative complications, longer hospital stays, and increased mortality. Early intervention is crucial to improving patient outcomes.

Recommendations

There is an urgent need to enhance healthcare accessibility and education in rural areas to encourage early presentation. Strengthening healthcare infrastructure and implementing community outreach programs can help reduce delays in seeking medical care for GI emergencies.

A COMPARATIVE STUDY ON THE EFFECTS OF 0.5% EPIDURAL LEVOBUPIVACAINE AND 0.75% ROPIVACAINE IN LOWER LIMB SURGERY: A CROSS-SECTIONAL STUDY

2024-09-30T16:22:00+00:00

Background

Levobupivacaine and ropivacaine are widely used local anesthetics in lower limb surgeries. Both agents offer favorable safety profiles, but their comparative effects on anesthesia quality and duration remain a subject of interest. This study compared the clinical efficacy, onset, duration, and safety of 0.5% levobupivacaine and 0.75% ropivacaine in lower limb surgeries.

Methods

Eighty patients were randomly randomized into two groups: Group R (ropivacaine 0.75%, 20 ml) and Group L (levobupivacaine 0.5%, 20 ml). Onset times, duration of sensory and motor block, anesthetic quality, and hemodynamic parameters were recorded and analyzed using SPSS version 20.0.

Results

The mean age of participants was comparable between groups (Group R: 42.5 ± 12.1 years; Group L: 41.8 ± 11.6 years; p = 0.76). Levobupivacaine had a faster onset of sensory block (8.3 ± 1.5 minutes vs. 10.2 ± 1.7 minutes; p < 0.001) and motor block (12.5 ± 1.8 minutes vs. 14.7 ± 2.0 minutes; p < 0.001). Sensory block duration was longer in Group L (240.5 ± 20.3 minutes) compared to Group R (215.7 ± 18.6 minutes; p < 0.001). Motor block duration was also longer in Group L (205.4 ± 17.2 minutes vs. 185.9 ± 16.5 minutes; p < 0.001). Both groups had similar safety profiles, with no significant differences in hemodynamic stability or adverse effects.

Conclusion

Levobupivacaine demonstrated faster onset, longer duration, and better anesthesia quality than ropivacaine, making it more suitable for longer surgeries. Both agents were well tolerated, with comparable safety profiles.

Recommendations

Further research is recommended to explore the long-term outcomes and cost-effectiveness of these anesthetic agents in different surgical settings.

COMPARISON OF THE EFFICACY OF ATOMIZED VERSUS NEBULIZED LOCAL ANESTHETIC FOR AWAKE NASAL FIBEROPTIC INTUBATION: A RANDOMIZED TRIAL.

2024-09-30T13:28:35+00:00

Background

Awake fiberoptic intubation (AFOI) is a critical technique for managing difficult airways requiring effective local anesthesia to ensure patient comfort and procedural success. Nebulization and atomization have been employed for the topicalization of the airway. This study compared the efficacy of atomized versus nebulized local anesthesia for awake fiberoptic intubations.

Methods

A random assignment was made to provide either atomized (n = 35) or nebulized (n = 35) local anesthetic to seventy adult patients who needed AFOI. Time to intubation and attempts for intubation were the primary outcomes while patient satisfaction, adverse hemodynamic changes, and complications were secondary outcomes. With p < 0.05 designated as the statistical significance level, the data were analyzed using SPSS version 21.0.

Results: The atomized group had a shorter intubation time (4.9 ± 1.1 vs. 7.0 ± 1.5 minutes, p < 0.001) and higher first-attempt success (85.7% vs. 62.9%, p = 0.005). Fewer required a second attempt (14.3% vs. 37.1%). The atomized group also had smaller increases in MAP (10.2 ± 2.1 vs. 12.5 ± 2.3 mmHg, p = 0.03) and HR (9.5 ± 1.9 vs. 12.3 ± 2.1 bpm, p = 0.01). Patient satisfaction was higher (9.0 ± 1.0 vs. 7.4 ± 1.3, p = 0.002), and complications like coughing, gagging, and desaturation were fewer but not statistically significant.

Conclusion

Atomized local anesthesia proved more effective than nebulized anesthesia for awake fiberoptic intubation, offering higher patient comfort, easier and quicker intubation, and greater satisfaction. Although complications were fewer with atomization, further research is needed. Thus, atomized anesthesia is recommended as the preferred method for AFOI.

Recommendations

Atomized local anesthesia is recommended for AFOI, particularly in patients with difficult airways, due to its higher efficacy and patient satisfaction. To validate these results and investigate long-term consequences, further extensive research is required.

RANDOMIZED STUDY: PROPOFOL VERSUS FENTANYL-MIDAZOLAM COMBINATION FOR CONSCIOUS SEDATION DURING FIBREOPTIC NASOTRACHEAL INTUBATION

2024-08-30T19:07:08+00:00

Background

The ideal characteristics of the sedative and analgesic that is used for awake fiberoptic intubation are that it should be easily titrable, that it should act rapidly, that it should maintain hemodynamic stability, that it should provide sufficient amnesia, and that it should have a short-acting time because the manipulation of the airway is only required until the intubation is finished. Currently, fentanyl and midazolam are used; propofol also fits the characteristics. This study aims to determine the efficacy and safety of both agents in the conduction of awake fiberoptic intubation.

Method

This study was a prospective randomized study. There were a total of 25 participants in the study. All of them underwent a pre-anesthetic assessment. The patients were divided into two groups. The first group received propofol as their sedating agent and the second group received fentanyl and midazolam combination as their sedating agent. The intubation period, sedation score, intubation score, hemodynamic vitals, oxygen saturation, degree of amnesia, and degree of global acceptance were recorded.

Results

Both propofol and the fentanyl-midazolam combination were effective for sedation during fiberoptic intubation. Propofol had a slightly higher sedation score at 2 minutes (mean: 13.3 vs. 15.5, p < 0.05), but both groups reached similar sedation levels at 6 minutes (score: 16). Intubation scores showed no significant differences between groups (p > 0.05). Propofol provided better hemodynamic stability, with lower systolic blood pressure during stage 2 (p < 0.05). Oxygen saturation remained stable in both groups. Complete amnesia was achieved in 75% of the propofol group and 85% of the fentanyl-midazolam group, with similar global acceptance ratings (75% vs. 85%).

Conclusion

Propofol alone is suitable for awake fiber optic insertion for artificial ventilation.

Recommendation

Propofol should be considered as a sedative agent for the performance of fiber optic insertion for artificial ventilation.

A RANDOMIZED TRIAL COMPARATIVE STUDY OF THE IMPACT OF ADDING CLONIDINE TO BUPIVACAINE AND USING BUPIVACAINE ALONE FOR AXILLARY BRACHIAL PLEXUS BLOCK

2024-09-30T13:08:27+00:00

Background

Numbing a specific nerve or a group of nerves with a shot of medicine is an essential part of anesthesia. Especially people who cannot bear general anesthesia during a procedure or suffer from hemodynamic instability consider peripheral nerve blockade as a primary substitute. Clonidine is an antihypertensive drug (α2 agonist) when used as an adjuvant to bupivacaine (a powerful local anesthetic), it may increase the period of blocks. This study aims to compare and evaluate the adjuvant effect of clonidine with bupivacaine and solo bupivacaine for “axillary brachial plexus block".

Methods

A randomized, controlled, prospective study was conducted involving 60 participants undergoing hand or forearm surgeries. Participants were divided into two groups: Group 1 received clonidine (0.8 ml, 120 µg) + normal saline (0.2 ml) + bupivacaine (25 ml, 0.5%), and Group 2 received normal saline (1 ml) + bupivacaine (25 ml, 0.5%). The onset time and duration of motor and sensory blocks were recorded.

Results

Group 1 had a significantly faster onset of nerve block and a longer duration of motor (440.5 ± 42.28 min vs. 198.43 ± 27.96 min) and sensory blocks (339.57 ± 40.82 min vs. 212.83 ± 35.25 min) compared to Group 2. These differences were statistically significant (p < 0.001). No major side effects were observed in either group.

Conclusion

This study clearly shows that the effect of adjuvant clonidine fastens the onset of nerve blockade and also gives a longer duration of analgesic effect to the patients without producing any major side effects.

Recommendation

Based on the findings, the study recommends using clonidine as an adjuvant to bupivacaine for axillary brachial plexus blocks in clinical practice, especially in cases where prolonged anesthesia and analgesia are desired, and minimal side effects are essential.

CHLORHEXIDINE ALCOHOL VERSUS POVIDONE-IODINE FOR SURGICAL SITE ASEPSIS: A RANDOMIZED TRIAL TO COMPARE OUTCOME IN SURGICAL PATIENTS

2024-09-23T16:49:22+00:00

Background

Common postoperative consequences that raise healthcare expenditures, lengthen hospital stays, and increase morbidity are surgical site infections (SSIs). Chlorhexidine alcohol (CA) and povidone-iodine (PI) are common antiseptics used for preoperative antiseptic skin preparation, which is essential for reducing the risk of superficial skin infections. The study evaluated surgical patients prepped with chlorhexidine alcohol vs. povidone-iodine in terms of the incidence of SSIs.

Methods

Two groups of 122 individuals each—Category A receiving CA and Category B receiving PI—were randomly assigned to a total of 244 individuals. Patients aged 18-60 undergoing elective non-laparoscopic surgeries were included. Data on demographic details, nutritional status, preoperative random blood sugar, procedure performed, operating time, duration of hospital stay, and secondary wound management interventions were collected. Statistical analysis was done using SPSS version 21.0.

Results

Both groups were demographically similar. Category A had 5 superficial and 3 deep SSIs, while Category B had 9 superficial and 6 deep SSIs, including a mesh infection after inguinal hernioplasty. Category A had 57 males, 65 females, and a mean age of 40.03 ± 16.09 years; Category B had 63 males, 59 females, and a mean age of 37.92 ± 12.73 years. The mean hospital stay for uncomplicated cases was similar (Category A: 8.84 ± 2.12 days, Category B: 9.0 ± 1.8 days), but patients with SSIs in Category B had longer stays (Category A: 15.21 ± 3.33 days, Category B: 18.23 ± 2.11 days).

Conclusion

While both antiseptics were effective in general use, CA was associated with a lower incidence of SSIs and shorter hospital stays for infected cases compared to PI.

Recommendations

For preoperative skin preparation, chlorhexidine alcohol ought to be chosen to lower the risk of SSIs and enhance patient outcomes.

CHEST PHYSIOTHERAPY AMONG PATIENTS UNDERGOING LAPAROSCOPIC SURGERY DURING THE IMMEDIATE POSTOPERATIVE PERIOD: A RANDOMIZED CONTROL TRIAL.

2024-08-27T06:33:17+00:00

Background

Laparoscopic surgery, although minimally invasive, can lead to postoperative respiratory complications due to the effects of general anesthesia and pneumoperitoneum. Chest physiotherapy has been effective in improving respiratory outcomes in various surgical populations, but its impact on patients undergoing laparoscopic surgery during the immediate postoperative period remains underexplored. This study aimed to evaluate the outcomes of chest physiotherapy in the immediate post-operative period among individuals undergoing laparoscopic surgery.

Methods

The study comprised 182 patients who underwent various types of laparoscopic surgery. Participants were allocated randomly into 2 groups: a control group and a chest physiotherapy group. The primary outcome was oxygen-hemoglobin saturation, while secondary outcomes included spirometry results, peak expiratory flow, pain levels, and analgesic use.

Results

The study included 52% males and 48% females with an average age of 45.7 ± 10.9 years. The chest physiotherapy group (n=91) showed significantly better postoperative outcomes: higher oxygen-hemoglobin saturation (95.8% ± 1.4% vs. 92.6% ± 2.0%, p=0.001), greater forced vital capacity (80.5% ± 9.1% vs. 72.4% ± 10.2%, p=0.001), and improved peak expiratory flow (335 ± 26 L/min vs. 298 ± 30 L/min, p=0.002). Pain levels were lower (4.5 ± 1.2 vs. 6.4 ± 1.4, p=0.000), and analgesic use was reduced (55 ± 8 mg vs. 75 ± 10 mg, p=0.002).

Conclusion

Chest physiotherapy during the immediate postoperative period significantly improves respiratory outcomes and reduces pain in patients undergoing laparoscopic surgery. These findings support the inclusion of chest physiotherapy in postoperative care protocols for this patient population.

Recommendations

Additional research with bigger samples is needed to validate these findings and determine the long-term advantages of chest physiotherapy in laparoscopic surgery patients. In clinical practice, standardized chest physiotherapy programs may enhance patient outcomes and prevent postoperative pulmonary problems.

Prospective Randomised Comparison of Unilateral Paravertebral Block and Spinal Anaesthesia for Inguinal Hernia Repair Surgery

2024-09-30T16:10:28+00:00

Background: For removal of hernia spinal anesthesia is prevalent. However, unilateral blockades with the paravertebral technique have many benefits.

Objectives: This study is conducted to compare the paravertebral block and subarachnoid block as a technique of anaesthesia in case of removal of an inguinal hernia

Materials and Methods: The patients undergoing inguinal herniorrhaphy were included in this study. They were divided into two groups. The first group was given a paravertebral block, and the second group was given a sub-arachnoid block. The vitals in both groups were compared preoperatively and throughout the surgery. The characteristics associated with anaesthesia were compared statistically among the groups.

Results: The mean duration of anaesthesia produced in the paravertebral group was 360.34±25.6 minutes compared to the spinal anaesthesia group which had a mean duration of. 165.45±18.65 minutes. The time required for discharge in the paravertebral group was 195.54±25.6 minutes compared to the time required for the spinal anaesthesia group which had duration of 372.33±18.65 minutes. There were no side effects reported in the paravertebral block group.

Conclusion: The paravertebral unilateral blockade technique of anaesthesia provides improved hemodynamic stability, decreased side effects, lesser duration of hospitalization and optimum sensory blockade compared to spinal anaesthesia.

Recommendation: The paravertebral blockade should be the preferred method of anaesthesia for inguinal herniorrhaphy.

COMPARISON OF PERCUTANEOUS VS. LAPAROSCOPIC DRAINAGE FOR RUPTURED LIVER ABSCESS: A RETROSPECTIVE COHORT ANALYSIS

2024-09-27T11:44:54+00:00

Background

Ruptured liver abscesses pose a significant clinical challenge due to their potential for severe complications, including peritonitis and sepsis. The study compares the outcomes of percutaneous drainage versus laparoscopic drainage for patients with ruptured liver abscesses.

Methods

Two groups of patients were developed: one for percutaneous drainage (n = 60) and another for laparoscopic drainage (n = 60). Analyses were conducted on baseline variables, procedural outcomes, complication rates, and clinical outcomes. The statistical analysis was done with SPSS 23.0.

Results

Middle-aged adults dominated the percutaneous and laparoscopic groups, with mean ages of 54.2 and 52.7 years, respectively. Men dominated both groups, with 63.3% of percutaneous and 60% of laparoscopic patients. Percutaneous drainage was associated with a significantly shorter procedure duration (45.3 ± 12.5 minutes vs. 73.8 ± 15.7 minutes, p < 0.001) and lower complication rate (13.3% vs. 30.0%, p = 0.03) compared to laparoscopic drainage. Additionally, patients in the percutaneous group experienced shorter hospital stays (7.2 ± 2.5 days vs. 10.3 ± 3.1 days, p < 0.001) and faster resolution of symptoms (5.1 ± 1.8 days vs. 7.8 ± 2.2 days, p < 0.001). There was no significant difference in the mortality rate between the two groups (3.3% vs. 5.0%, p = 0.56).

Conclusion

Percutaneous drainage demonstrates advantages over laparoscopic drainage in terms of shorter procedure duration, lower complication rates, and faster recovery for patients with ruptured liver abscesses. However, the slightly higher initial success rate of laparoscopic drainage suggests that both methods are viable, with the choice of procedure depending on individual patient factors and clinical judgment.

Recommendations

Future prospective studies are needed to validate these findings and explore long-term outcomes associated with each drainage method. Clinicians should consider patient-specific factors when selecting the appropriate drainage technique for ruptured liver abscesses.

LAPAROSCOPIC VERSUS OPEN APPENDICECTOMY IN ADULTS

2024-09-25T09:41:01+00:00

BACKGROUND

One of the most popular techniques is appendectomy. Though it is still debatable, laparoscopic appendectomy (LA) is thought to be the initial course of treatment for complex appendicitis. This study examines mean operating time, surgical site infection, and duration of hospital stay to compare open and laparoscopic appendectomy procedures for individuals with perforated appendices.

MATERIALS AND METHODS

This randomized research was performed at the Department of General Surgery, KIMS, Bhubaneshwar from 2022-23. A total of 100 individuals were enrolled in the research, with 50 people in both groups. Analysis was done on outcome metrics such as blood loss, length of hospital stays before oral intake, mean operating time and postoperative problems.

RESULTS

The mean operating time was significantly longer for LA (101.46 ± 44.4 minutes) compared to OA (84.4 ± 43.1 minutes; p = 0.008). However, LA showed a lower incidence of wound infections (2%) compared to OA (8%), though this difference was not statistically significant (p = 0.09). LA patients experienced a significantly shorter hospital stay (10.54 ± 5.57 days) compared to OA patients (13.19 ± 8.4 days; p = 0.015).

CONCLUSION

The laparoscopic procedure for appendectomy is an effective and efficient surgical procedure with marginally increased hospital expenses. The laparoscopic procedure has clinically advantageous benefits over the open method, including a reduced rate of wound infection, early food tolerance, a shorter stay in the hospital, and less need for postoperative analgesics.

RECOMMENDATIONS

LA is recommended over OA for perforated appendices due to its advantages, such as fewer wound infections and shorter hospital stays, despite longer operating times. Further research with larger randomized trials is needed to confirm these findings and evaluate the cost-effectiveness of LA.

A CROSS-SECTIONAL STUDY OF IQ, ACNE PREVALENCE, AND ANEMIA AMONG URBAN AND RURAL ADOLESCENTS: EXPLORING SOCIOECONOMIC AND ENVIRONMENTAL INFLUENCES

2024-09-30T10:17:31+00:00

Background

Obesity among adolescents has become a growing public health concern, particularly as lifestyle and dietary habits evolve. In addition to being influenced by socio-cultural, environmental, and economic factors, eating habits and physical activity levels have a significant impact on teenagers' nutritional health. This study examines the IQ level socioeconomic conduct and social surroundings of urban and rural school-age adolescents, as well as acne rates.

Methods

A cross-sectional analytical study was conducted between November 2015 and October 2017 in urban and rural schools in and around Bhubaneswar. A total of 641 students aged 10-19 were included. BMI, hemoglobin levels, IQ, acne prevalence, and vision acuity were measured using standardized tools. Data were analyzed using SPSS version 20.0, and Chi-square tests were employed to determine statistical significance.

Results

Urban areas have 48.6% females and 51.4% men, whereas rural areas have 49.5% females and 50.5% males. The study found higher rates of undernutrition and anemia among rural students, with 22.37% being underweight and 66.4% having moderate anemia. In contrast, urban students were more likely to be overweight (19.36%). IQ levels were significantly lower in rural students, with 60.68% falling into the borderline IQ category compared to 23.12% in urban students. Additionally, rural students exhibited a higher prevalence of acne (73.6%) and vision abnormalities (55.3%).

Conclusion

Rural adolescents face greater challenges related to undernutrition, anemia, cognitive development, and vision care, while urban students are more prone to obesity.

Recommendations

Public health interventions are needed to address these disparities and improve overall health outcomes among adolescents in urban and rural settings.

VISION PROBLEMS AND SCREEN TIME EXPOSURE AMONG ADOLESCENTS IN RURAL SCHOOLS: A CROSS-SECTIONAL STUDY.

2024-09-29T17:26:56+00:00

Background:

Adolescence is a critical period marked by rapid physical, emotional, and cognitive development. During this stage, various health issues, including myopia, anemia, and acne, can emerge, particularly influenced by lifestyle factors like screen time and socio-economic status. Understanding these factors is vital for promoting adolescent health and well-being.

Aim:

The study aims to assess and compare the physical health of school-going adolescents in urban and rural schools around Bhubaneswar, focusing on BMI, vision, and screen time exposure.

Method:

The study followed a descriptive cross-sectional design and was conducted in urban and rural schools around Bhubaneswar, India. A sample size of 641 adolescents aged 10-19 years was selected, and data was collected using a pretested questionnaire and clinical assessments. Physical health, including BMI, anemia, and vision, was evaluated alongside screen time exposure and its effects on ocular health. Statistical analysis was performed using SPSS 20.0.

Results:

The study found a significant association between screen time exposure and vision problems among adolescents, with 63% reporting visual discomfort. Myopia prevalence was higher in urban participants (28%) compared to rural participants (15%), with an overall prevalence of 22%. Urban participants had longer screen times and were more engaged in activities like gaming and social media, contributing to increased visual strain. Ocular biometric measurements showed greater axial length and corneal curvature in myopic individuals.

Conclusion:

The study concludes that excessive screen time is significantly associated with increased vision problems, including myopia and digital eye strain, among adolescents. Urban participants exhibited higher screen time and myopia prevalence compared to rural participants. These findings highlight the need for targeted interventions to mitigate screen-related vision issues in this population.

BREASTFEEDING MOTHER’S KNOWLEDGE OF NEONATAL HYGIENE AT MUKONO GENERAL HOSPITAL IN MUKONO MUNICIPALITY: A CROSS-SECTIONAL STUDY.

2024-05-22T04:17:21+00:00

Background

Knowledge refers to the information, breastfeeding mothers have on how and when to clean breast-feeding bottles, the breast during the breast-feeding process, the neonates and their clothing, and how to keep the neonate’s surroundings. The study aims to describe the knowledge of breastfeeding mothers on the hygiene of their neonates.

Methodology

A quantitative descriptive cross-sectional study involving only breast-feeding mothers with babies less than 28 days of life, both those who have gone through normal delivery and caesarian section irrespective of their age, tribe, and education level. Data was analyzed using SPSS version 24.0. A simple random method was used to select 296 respondents.

Results

93.3% (28/30) of the respondents managed to at least attend one or more than one level of education. 70.0 % (21/30) of the mothers were assisted by midwives, 10.0% (3/30) were assisted by doctors, 6.7% (2/30) were assisted by traditional birth attendants, and 13.3% (4/30) were assisted by other people in the community while delivering their current babies. About 53.3 % (16/30) of the mothers knew that the baby’s cord should be cleaned with saline water, 40.0% reported bathing their neonates with soapy water and dry, majority 56.7% (12/30) knew that the mother’s breast should first be wiped before breastfeeding. Concerning the prevention of diseases in babies, 53.3% of mothers reported that it is important to dry the baby after bathing.

Conclusion

The majority of the respondents had the right knowledge about Neonatal hygiene but the proportion of those who did not have relevant adequate knowledge is a threat to the general health of the children

Recommendations

Health workers need to bridge the gap between the community and health workers to encourage mothers to seek healthcare freely without fear.

EVALUATING THE IMPACT OF INFORMATION, EDUCATION, AND COMMUNICATION INITIATIVES ON MENSTRUAL HYGIENE PRACTICES AMONG ADOLESCENT GIRLS AGED 13-17: A RANDOMIZED CONTROL TRIAL

2024-09-30T13:19:13+00:00

Background

Adolescent girls' health, dignity, and general well-being depend heavily on menstrual hygiene management (MHM). Inadequate MHM practices have been connected to social problems including school absenteeism and health hazards like reproductive tract infections. The study evaluated how information, education, and communication (IEC) activities affected the menstrual hygiene practices of teenage females between the ages of 13 and 17.

Methods

A study was conducted over 6 months, with 400 adolescent girls (240 school-going and 160 out-of-school) participating. Data were collected through a predesigned, semi-structured questionnaire in the pre-and post-intervention phases. The IEC sessions focused on MHM, using visual aids and group discussions. Statistical analysis was performed using the chi-square test to determine significant changes in behavior.

Results

Before the intervention, only 45% of the participants used sanitary pads, while 55% used cloth. Post-intervention, the use of sanitary pads increased to 75%. The frequency of changing menstrual products also improved, with 70% of participants adopting the practice of changing products more than three times per day, compared to 35% pre-intervention. Handwashing with soap after changing menstrual products increased from 30% to 77.5%, and awareness of the menstrual cycle rose from 25% to 80%. All changes were statistically significant (p < 0.001).

Conclusion

The IEC intervention led to substantial improvements in menstrual hygiene practices and knowledge among adolescent girls. The study demonstrates that health education initiatives can significantly improve menstrual hygiene behavior, especially in resource-limited settings.

Recommendations

Future efforts should focus on scaling similar educational programs in other rural areas, improving access to affordable menstrual products, and ensuring the availability of water and sanitation facilities in schools and communities.

BARRIERS TO HEALTH CARE ACCESS PERCEIVED BY ADOLESCENT GIRLS: A CROSS-SECTIONAL STUDY.

2024-09-30T12:58:18+00:00

Background

Adolescent girls face numerous barriers when accessing healthcare, particularly in low-resource settings. These constraints include financial, cultural, and structural challenges, which significantly impact their ability to obtain timely and appropriate medical services. Addressing these barriers is essential for improving the health outcomes of adolescent girls, especially in rural areas. This study investigated the perceived constraints faced by adolescent girls in accessing healthcare in Darbhanga, Bihar, and identified socio-demographic factors associated with these barriers.

Methods

A cross-sectional study involved 250 adolescent girls aged 13-19 years. Data were collected using a structured questionnaire, which assessed socio-demographic characteristics and perceived healthcare barriers. Statistical analysis was performed using SPSS version 21.0. Descriptive statistics, chi-square tests, and multivariate logistic regression were used to identify significant associations between variables.

Results

The mean age of the participants was 16.2 years (± 1.8), with the majority (58%) being between 15 and 17 years of age. The study found that 72% of the participants reported barriers to accessing healthcare. Financial constraints (56%) were the most commonly reported, followed by structural (48%), cultural (40%), and knowledge-related barriers (32%). Family income and parental education were significantly associated with perceived barriers (p < 0.05). Multivariate analysis revealed that low family income (OR = 3.2, p < 0.001) and low parental education (OR = 2.5, p = 0.002) were the strongest predictors of healthcare access constraints.

Conclusion

Adolescent girls in Darbhanga face significant barriers in accessing healthcare, primarily due to financial and structural factors. Socioeconomic conditions, such as family income and parental education, play a crucial role in determining the extent of these barriers.

Recommendations

Policymakers should focus on reducing financial barriers and improving healthcare infrastructure, especially in rural areas. Additionally, educational programs aimed at families and communities could help address cultural and knowledge-related barriers to healthcare access for adolescent girls.

UPTAKE AND UTILISATION OF NATIONAL GUIDELINES FOR TUBERCULOSIS INFECTION, PREVENTION AND CONTROL AMONG NURSES WORKING IN RESOURCE-LIMITED SETTINGS; A CROSS-SECTIONAL STUDY IN UGANDA.

2024-07-22T05:38:14+00:00

Background

This study assessed the uptake and utilization of the “Uganda National Guidelines for TB IPC” among nurses working within health facilities in Bundibugyo District, Western Uganda. With a focus on knowledge, practices, and perceived barriers, based on a customized health belief model.

Methods

Focused on nurses, the research employed a cross-sectional design using qualitative and quantitative methods with a census technique involving 135 participants across 11 healthcare institutions, that manage TB cases within Bundibugyo district. Quantitative data was captured utilizing self-administered questionnaires and qualitative data by 11 KI and observational checklists, analyzed, and then presented in tables and narrations.

Key findings

The majority were enrolled nurses (42.9%), and gaps in nurses' recognition of the TB guidelines were attributed to limited training sessions. While nurses exhibited high knowledge of basic TB aspects, their awareness of the policy of handling TB clients in their facilities was low at 47.4% and only 35.5% of them had participated in a TB-related training or workshop during the past 2 years, weaknesses were further noted in the screening of patient beds, patient isolation units, and nose-covering practices. Perceived barriers included TB stigma, false beliefs, infrastructure inadequacies, and resources like PPE shortages.

Conclusion

There was insufficient uptake and utilization of the Guidelines within medical facilities in Bundibugyo. This is linked to a few trainings and acquaintance of the guidelines among nurses which have created knowledge gaps and other barriers: resources, stigma, and false beliefs within the surrounding communities.

Recommendations

Enhancing training programs, promoting awareness within health facilities, improving infrastructure, implementing monitoring and evaluation systems, allocating more resources, and addressing weaknesses in implementation. MoH Uganda; Policy review, centralize training programs, and continue research and development. Further research recommendations encompass in-depth studies on TB stigma, evaluating training impacts, and conducting longitudinal studies.

IMPROVING HEALTH CARE-SEEKING BEHAVIORS OF CARETAKERS OF CHILDREN AGED 0-59 MONTHS IN BUGIRI DISTRICT OF EASTERN UGANDA THROUGH THE IMPLEMENTATION OF THE INTEGRATED COMMUNITY CASE MANAGEMENT PROJECT: PRE AND POST IMPLEMENTATION EVALUATION.

2024-06-14T11:00:15+00:00

Introduction

Malaria, diarrhea, and pneumonia are the leading causes of death among children under five in Uganda and similar countries. The Integrated Community Case Management (iCCM) strategy aims to improve access to and use of services for these conditions at the community level. World Vision Uganda and Bugiri District, with funding from the Pfizer Foundation, implemented an 18-month iCCM project in Bugiri district. This article assesses the project's impact on health-seeking behaviors among caregivers of children aged 0-59 months for these conditions.

Methodology

453 Village Health Teams (VHTs) received a 7-day training on basic VHT skills and Integrated Community Case Management (ICCM). They were equipped with ICCM drugs, sick child job aids, and thermometers. VHTs conducted home visits to educate caretakers, and test, and treat sick children for three conditions. Severe cases were referred to health facilities. They received quarterly mentorships and used HMIS 097B to report data quarterly. Anonymized patient data were analyzed monthly using interrupted time series Poisson regression to assess intervention impact on under-five cases and mortalities.

Results

The number of under-five malaria cases tested and treated by VHTs significantly increased from 2209 to 12549 cases. at the same time, the number of cases managed at the health facilities increased from18040 to 35257 cases (P 0.000 CI 1.48-2.57). Under-five mortality due to malaria significantly reduced from 26 to 6 cases per 100000 (P 0.058 CI 0.95-12.8). Seeking treatment within 24 hours of the onset of signs (P=0.00), caregiver’s ability to recognize severe condition (P =0.00), and referral of severe cases to health facilities (P=0.001) improved.

Conclusion

Implementing iCCM significantly enhances health-seeking behaviors among caregivers of children aged 0-59 months.

Recommendations

Authors recommend extending iCCM programs to more districts and communities across Uganda and similar regions to ensure broader access to essential healthcare services for children under five.

ANTIMICROBIAL SUSCEPTIBILITY, MICROBIAL PROFILE AND PREVALENCE OF MDR/XDR PATHOGENS CAUSING MEDICAL DEVICE-ASSOCIATED INFECTIONS: A SINGLE CENTRE STUDY.

2024-09-06T12:16:00+00:00

Background

The development of nosocomial infection associated with pathogens that are multi-drug resistant and extensively drug-resistant leads to serious complications in hospitalized patients. Since this type of infection has limited treatment options it is necessary to identify and determine their prevalence. This study is conducted to determine the Microbial Profile, Antimicrobial Susceptibility, and Prevalence of MDR/XDR Pathogens Causing Medical Device Associated Infections at our institute.

Materials and Methods

The patients admitted at the RIMS Ranchi were included in the study. The demography and other clinical characteristics of the patients were recorded. The CLABSI, CAUTI, and VAP were confirmed in the patients. The causative pathogen was isolated. The microbiology profile, resistance, and susceptibility pattern of these organisms were studied.

Results

Among the 110 patients, 65 were confirmed to have MDAIs based on positive culture results. The average age of the patients was 43.5 ± 5 years, with a majority being male. Comorbidities included liver disorders (30.7%), cardiovascular disorders (29.2%), and renal disorders (21.3%). Immunosuppression was seen in 80% of patients. The infections identified were central line-associated bloodstream infections (53.8%), catheter-associated urinary tract infections (23.07%), and ventilator-associated pneumonia (23.07%). Of the 80 pathogens isolated, 54 were MDR, and 20 were XDR. Carbapenem resistance was noted in 35% of the isolates. Fungal resistance to amphotericin B and fluconazole was observed in 8.75% of cases. Two patients with ventilator-associated pneumonia did not survive.

Conclusion

MDAIs are inevitable, among them central-line bloodstream infection is found in most patients. The occurrence of resistance among the patients severely reduces the treatment options available and increases the complexities of the treatment.

Recommendation

Preventative measures and analysis of microbiology profiles are necessary to reduce the occurrence of infection associated with medical devices.

PREVALENCE OF POSITIVE CULTURE SAMPLES AND ASSOCIATED MICROORGANISMS AMONG CULTURES SAMPLES IN MICROBIOLOGY LABORATORY AT UGANDA MARTYRS HOSPITAL LABORATORY LUBAGA KAMPALA UGANDA.

2023-12-13T07:45:07+00:00

INTRODUCTION:

Microbiology culture before initiation of antimicrobial therapy is considered to be the gold standard for diagnosis of bacterial and fungal infections. In addition to facilitating the differentiation of harmless bacterial and fungal contaminants from bacterial pathogens. Accurate identification of specific bacterial and fungal species aids in the selection of antimicrobial and antifungal drugs. Failure to perform cultures and interpret results correctly may lead not only to diagnostic errors but to therapeutic failures as well. The study documents the Prevalence of positive culture samples and the microorganisms associated with the positive cultures at Uganda Martyrs Hospital Laboratory Lubaga Kampala

METHODOLOGY:

A cross-sectional study of randomly selected result reports was analyzed retrospectively for growth and the associated isolated organism from the positive samples.

RESULTS:

100 culture sample results were reviewed. The prevalence of positive culture sample is 40%. This laboratory reported that 40 (40%) specimens had a positive culture with 34 (85%) were bacterial and 6 samples (15%) were fungal. All the fungal growth was confirmed Candida Albicans. Escherichia coli 47.9%, Enterococcus Faecalis 14.7%. Staphylococcus Haemolyticus 17.6% Staphylococcus Aureus 8.2%. Klebsiella Pneumoniae, Streptococci Viridans, Citrobacter Freundii and Acinetobacter Baumannii each account for 2.9%.

CONCLUSIONS:

The prevalence of 40% positive culture samples is a high prevalence that shouldn’t be overlooked. Escherichia Coli is the most commonly encountered microorganism in this laboratory.

RECOMMENDATIONS:

Hand and oral hygiene coupled with vigorous environmental decontamination should be re-emphasized for adequate pathogen control.

CLINICAL RELEVANCE:

These preventive measures will control the spread of related infections and the rampant use of antibiotics. Controlled use of antibiotics plays a role in minimizing the raising antimicrobial resistance which is a major global health concern.

SURVEY OF THE STATUS OF THE MEDICINAL PLANT TRADE IN DURBAN, SOUTH AFRICA.

2024-07-04T08:26:51+00:00

Background

This study aimed to identify important plants and parts of medicinally harvested species traded in the Durban medicinal (muthi) market. A better understanding of the extent of the medicinal plant trade is necessary to enable conservationists and municipal managers to better manage threatened species and to take preventative action to protect this valuable resource.

Methods

Thirty traditional healers from the Durban muthi market in KwaZulu-Natal were interviewed and information was gathered on important plants and parts that were traded. Information was compared to previous data to ascertain whether muthi plants were being exploited.

Results

Approximately 13 species were widely harvested and sold at the Durban muthi market which includes: Siphonochilus aethiopicus, Hypoxis gerrardii, Aloe aristate, Scilla natalensis, Eucomis autumalis, Senecio serratuloides, Warburgia salutaris, Chrysanthemoides monilifera., Artemisia afra, Bidens Pilosa, Aloe ferox, Haworthia limifolia, Ocotea bullata.

These species are sold to cure a wide variety of ailments. The most common plant parts that are traded are the leaves and the stems although other parts are also collected. Single species are preferred rather than a mixture of parts from different plants. Approximately 22% of individuals interviewed indicated that they practiced unsustainable harvesting mainly due to poor harvesting practices and a lack of knowledge of the threatened status of many important species.

Conclusion

Domestication and mass cultivation may be key strategies to redress exploitation and unsustainable harvesting practices.

Recommendation

To address these issues, a multifaceted approach is required, including community engagement, improved regulatory enforcement, and initiatives to promote sustainable harvesting and cultivation practices.

THE RELATIONSHIP BETWEEN CONTROL ENVIRONMENT AND PERFORMANCE OF POST BANK AT KANUNGU AND NTUNGAMO DISTRICT BRANCHES. A CROSS-SECTIONAL STUDY.

2024-08-28T14:21:56+00:00

Background.

An effective control environment is where competent people understand their responsibilities, and the limits to their authority and are knowledgeable, mindful, and committed to doing what is right and doing it the right way. The control environment encompasses technical competence and ethical commitment. This study aimed to assess the relationship between the control environment and the performance of Post Bank at Kanungu and Ntungamo.

Methodology.

A correlation case study design was used. The respondents were selected randomly and purposively. Primary data was collected using the Questionnaires with support from an interview guide and documentary review. Data was analyzed using the SPSS package and descriptive, correlation, and regression analyses were carried out to establish relationships between the variables.

Results.

The majority 28 (80%) of the respondents were males and 26 (74.3%) were at Bachelor’s degree level. 31 (88.6%) of the respondents stated that ethical values were upheld in all management decisions, 30 (85.7%) of the respondents agreed that management promotes high integrity standards, 29 (82.9%) of the respondents agreed that job description exists in the bank, 17(48.6%) of the respondents agreed that turnover rate is monitored by HR and 27 (77.1%) of the respondents stated that there is an open communication to and from HR-department as stated.

Conclusion.

The control environment has a significant effect on performance. This means that any efforts put in the Control environment in the form of; upholding ethical values, maintaining an approved code of ethical conduct, creating free and open channels of communication plus monitoring the turnover rate may increase performance at Post Bank.

Recommendation.

Management of Post Bank should strengthen the approved ethical code of conduct for the promotion of high integrity standards to avoid cases of fraud which may affect the performance of the bank.

FACTORS AFFECTING PARENTS-ADOLESCENTS' COMMUNICATION ON SEXUAL AND REPRODUCTIVE HEALTH ISSUES IN JUBA CITY. A CROSS-SECTIONAL STUDY

2024-08-28T12:02:01+00:00

Background.

Effective communication between parents and adolescents on sexual and reproductive health issues is essential, yet challenging for many parents across Africa. The purpose of this study is to assess the effect of socio-demographic, cultural, and religious factors on communication between parents and their adolescent children concerning sexual and reproductive health (SRH) issues in Juba City.

Methods.

This study, conducted in Juba, employed a mixed-methods approach targeting parents and adolescents. Quantitative surveys and qualitative interviews were conducted in seventeen clusters, with a target sample of 384 households. Key informants, including village elders and school principals, were also interviewed.

Results.

Nearly half of parents (44.16%) were unaware of their children's sexual activity, while 41.55% of adolescents reported being sexually active. Most sexually active adolescents-initiated relationships between ages 10 and 13 years. Fathers/guardians primarily worked in government or NGOs (43.27%), while mothers/guardians were mostly business people (42.7%). The majority of adolescents (62.46%) lived in medium-sized families. 40.26% of parents had never provided sex education to their children. Most parents (37.34%) believed their communication efforts did not reduce adolescents' sexual activity, while 40.58% reported no delay in sexual activity due to communication. Religion was a significant communication barrier, with 27.9% of parents and 35.8% of adolescents citing it. Culture was also a major challenge, according to 25.97% of parents and 9.17% of adolescents.

Conclusion.

Despite a high prevalence of adolescent sexual activity, communication between parents and adolescents on sexual and reproductive health issues is low in Juba. Employment, culture, and religion significantly influence communication dynamics.

Recommendation.

There is a need to enhance information, education, and communication initiatives targeting both parents and adolescents to improve sexual and reproductive health outcomes.

KNOWLEDGE, ATTITUDES, AND PRACTICES ON ELECTRONIC WASTE MANAGEMENT AMONG MAKERERE UNIVERSITY STUDENTS, KAMPALA, UGANDA: A CROSS-SECTIONAL STUDY.

2024-09-20T13:00:25+00:00

Background

The need for electronics such as laptops and phones are on the rise, especially in academic institutions including universities. These electronics are required for day-to-day activities such as lectures and communication. As time goes by, these electronics may no longer be required by the original user hence resulting in high volumes of electronic waste (e-waste). This generation of e-waste requires proper management to protect human health and the environment. This study therefore assessed the knowledge, attitudes, and practices on e-waste management among Makerere University students in Kampala, Uganda.

Methods

A cross-sectional descriptive study using a structured questionnaire to collect quantitative data was conducted among 336 Makerere University students. Collected data was analysed at a univariate level in STATA 14 software to assess knowledge, attitudes, and practices on e-waste management among the students.

Results

The majority of participants 267 (79.5%) were aged between 20-25 years, and more than half 179 (53.3%) were males. Most participants 153 (45.5%) had low knowledge levels on e-waste management, though the majority 180 (53.6%) knew what e-waste is. The majority of participants 275 (81.8%) had positive attitudes toward e-waste management, and nearly all 319 (94.9%) agreed that e-waste should not be disposed of with general waste. Mobile phones 223 (42.6%) were the most disposed of e-waste. Many students 125 (35.3%) discarded e-waste by selling as second-hand.

Conclusion

There was low knowledge, positive attitudes, and poor practices towards e-waste management among the university students.

Recommendation

There is a need for various stakeholders to enhance knowledge among students regarding the effects of poor e-waste management on humans and the environment to improve management practices. For example, university administrations can organise campaigns, webinars, and seminars that focus on proper e-waste management including disposal practices and effects on human health and the environment.

THE FACTORS AFFECTING UPTAKE OF VOLUNTARY MEDICAL MALE CIRCUMCISION SERVICES AMONG ADULT MALES AGED 15–50 YEARS ATTENDING NAKIVALE HEALTH CENTER III ISINGIRO

2024-06-13T06:48:16+00:00

Medical male circumcision is the surgical removal of the foreskin which covers the penis of a male human being. Circumcision is believed to be one of the oldest and common procedures which has been done for various reasons ranging from cultural rituals, religious, and medical purposes (Sgaier et al., 2014). Traditional male circumcision has been in existence even during the times of the Old Testament. In Uganda, the Bugisu region (eastern Uganda) is regarded the birthplace of Traditional Male Circumcision (TMC) in Uganda. Common belief holds that the first male circumcision was performed in the region centuries ago. (Sabet Sarvestani et al., 2012). One hundred twenty-four (124) adult males were selected to participate in the study, and only one hundred twenty (120) adult males fully completed the study, yielding a response rate of 98.8%. On age majority of subjects were aged between 18 to 39 years 106(76.8%) and least were aged 40-49 years 14(10.1%). This study results revealed that most of the participants had received VMMC (65.2%) and received it from the health facility (68.8%). The prevalence of male circumcision in Nakivale HC III, Isingiro district was 62.5%. Education level, religion and occupation were independent significant demographic factor associated with VMMC uptake. The results of this study revealed gaps in knowledge and factors affecting VMMC, we therefore recommend that independent stake holders need no improve on sensitizing the society about VMMC through linking with nursing institutions to help in making up camps and outreaches and community education to these remote areas.

PREVALENCE OF COMORBIDITIES AMONG DIABETIC PATIENTS OF JINJA REGIONAL REFERRAL HOSPITAL. A CROSS-SECTIONAL STUDY.

2024-08-11T22:35:00+00:00

Background

Diabetes is a complex and multifaceted condition that is often accompanied by comorbidities, which are additional health conditions that co-occur with diabetes. Study aims to assess the Prevalence of comorbidities among diabetic patients of Jinja regional referral hospital.

Methodology

A descriptive cross-sectional study that employed quantitative data techniques was used. Simple random sampling was used to select participants in the study. Descriptive statistics was used to assess the frequency distribution of the three risk categories. A Chi-square test assessed the categorical variables and trends in the prevalence of diabetic comorbidities.

Results

185(65.1%) of the respondents were females while 99(34.9%) were males. The number of patients with high cholesterol levels was 94(33.1%). The number of patients who were HIV positive was 67(23.6%). Patients who had eye problems were 64(22.5%). Patients with kidney problems were 51(18%) and heart or brain problems were 78(27.5%). Patients with footing problems were 36(12.7%). The number of patients with DPN was 75(26.4%). Patients with comorbidities were 104(36.6%) and the number of patients without comorbidities was 180(63.4%). The prevalence of diabetic comorbidities was 36.6%. The number of patients with eye problems (retinopathy) was 64, kidney problems were 51, heart problems was 78, footing problems (diabetic foot) was 36, and peripheral neuropathy was 75.

Conclusion

The prevalence of comorbidities was high given the scarcity of resources and delayed diagnostic management of diabetic complications.

Recommendations

The Ministry of Health should put more strategies to improve early diagnosis and management of Diabetes and its comorbidities.

HEALTH INEQUALITIES AND NON-COMMUNICABLE DISEASES IN UGANDA: A SYSTEMATIC REVIEW.

2024-08-29T11:02:28+00:00

Background

Non-communicable diseases (NCDs), including cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes, are leading causes of death worldwide, particularly affecting low— and middle—income countries (LMICs). This study systematically reviews the extent of health inequalities in NCDs across various demographic groups in Uganda.

Methodology

This systematic review employed the PICO framework and followed standardized international protocols for data extraction and quality assessment. Comprehensive searches were conducted across PubMed and Web of Science databases, yielding 296 and 106 initial records from the databases respectively. After screening and applying inclusion criteria, 53 studies were included for qualitative synthesis. Data extraction focused on study characteristics, population demographics, interventions, outcomes, and key findings. Methodological quality was appraised to ensure validity, accuracy, and generalizability.

Results

The review highlights significant disparities in NCD prevalence across different demographic groups in Uganda. Notably, the elderly population in rural areas shows a high prevalence of NCDs, influenced by factors such as poor housing conditions, limited physical activity, and inadequate kitchen ventilation. Individuals living with HIV (PLHIV) exhibit compounded health burdens, with hypertension being a common comorbidity. Urban-rural disparities in NCD prevalence are evident, with lifestyle factors associated with urbanization contributing to increased risks. Alarmingly, mortality rates attributable to NCDs, particularly cardiovascular diseases and diabetes, have risen over the past decade. Barriers to healthcare access, including geographic, financial, and policy—related challenges, exacerbate these disparities.

Conclusion

Among the elderly population residing in rural areas, a strikingly high prevalence of NCDs is observed, influenced by factors such as substandard housing conditions, limited physical activity, and inadequate kitchen ventilation. This underscores the urgent need for targeted interventions aimed at improving living conditions and promoting healthy behaviors among this vulnerable demographic group.

Recommendation

Further research is warranted to explore the underlying determinants of these disparities in greater depth.

ASSESSING THE KNOWLEDGE ABOUT WASTE MANAGEMENT IN NABARI PAYAM SOUTH SUDAN. A CROSS-SECTIONAL STUDY.

2024-08-28T12:38:15+00:00

Background

In Uganda, management of waste within Team City is a challenge as reflected by 20.0 percent of total waste can only be collected and disposed of in Team City center and city divisions. The purpose of the study is to assess the knowledge about waste management in Nabari-Payam South Sudan.

Methodology

A cross-sectional survey, descriptive and explanatory design where quantitative and qualitative methods were adopted. A questionnaire and Focus group discussion were adopted and interviews for Key Informants. Data was analyzed descriptively using the Statistical Package for Social Sciences and thematic methods for quantitative and qualitative data.

Results

207 (62.0%) disagreed about being trained on waste management, concerning knowledge about color coding segregation for waste, 267 (79.9%) of the respondents disagreed, About labeling the containers before filling them with waste, 146 (49.1%) agreed, the mean score was 3.40 and standard deviation 1.12 denoting that most of the respondents agreed about labeling containers before filling them with waste Concerning segregation of waste. Regarding the use of personal protective gear when handling waste, 104 (31.1%) strongly disagreed, the variable mean score and standard deviation were 2.31 and 1.15 respectively noting that there was disagreement on matters of use of protective gear.

Conclusion

Knowledge regarding waste management for residents of Nabari Payam was low due to the absence of training on matters of waste and its management from the local authorities.

Recommendations

Payam residents in Nabari Payam and the line ministries of the Republic of South Sudan should increase their budget allocations for waste management to train residents and managers at all levels and acquire adequate knowledge on waste collection, segregation, storage, transportation, and disposal tools.

A CROSS-SECTIONAL INFOVEILLANCE STUDY ON WIKIPEDIA WAS USED FOR ACCESSING MAMMOGRAM INFORMATION.

2024-07-24T12:15:25+00:00

Background

Wikipedia has emerged as a source of health information for patients and the public. The study aimed to identify trends in the use of Wikipedia to access information on mammograms and to assess the quality of this information.

Methods

This was a trend analysis of cross-sectional data, namely Wikipedia page views for mammogram-related searches between 2016 and 2022. Data was analyzed with descriptive statistics. Overall trends in page views were analyzed by year and month. Pairwise comparisons were assessed with Analysis of Variance (ANOVA) testing. The quality of mammogram-related information on Wikipedia was evaluated using Couto and Lope's four quality assessment features (Completeness, authority, informativeness, and consistency).

Results

The total number of page views for mammography-related terms during 2016-2022 was 1 180 947. The data fluctuated across years and months. When analyzed by year, mean page views peaked during 2018 (mean = 20 600.6) and were lowest during 2021 (mean = 10 267.9). When analyzed by month, mean page views peaked during March and October (means = 15 845.7 and 15 608.6, respectively). Overall, there were strong trends in page views across years (R2=0.99) and months (R2=0.73). The pairwise comparisons revealed numerous statistically significant differences in mean page views across years and months, which manifested as the observed polynomial trends. The quality assessment scores were as follows: Completeness (Medium), authority (Medium), informativeness (Low), and consistency (Medium).

Conclusions

Wikipedia is a potentially important source of mammogram information for patients and the public. This platform could be improved (diversity of page content and image presentation) and used to support public health awareness campaigns in combating breast cancer worldwide.

Recommendation

Efforts should be made to encourage the sustained use of Wikipedia by patients and the public as a source of mammogram information.

ANTIMICROBIAL DRUG MISUSE IN THE EASTERN DEMOCRATIC REPUBLIC OF THE CONGO A CROSS-SECTIONAL STUDY: FACTORS INFLUENCING THE EMERGENCE OF ANTIMICROBIAL RESISTANCE

2024-07-30T05:47:35+00:00

Background

Antimicrobial resistance is a major global public health challenge. In sub-Saharan Africa, Plasmodium resistance to new molecules on the market continues unabated. This increase in resistance is mostly due to unhealthy community practices, and also to microbial control methods that are ineffective because of our health policies. This study aimed to analyze factors involved in the emergence of antimicrobial resistance in ancient Kivu, in the eastern part of the Democratic Republic of Congo (DRC).

Materials and methods

A cross-sectional study was carried out from November 2023 to February 2024 in two cities east of the Democratic Republic of the Congo, surveying pharmacies using a standardized questionnaire. We focused on four elements within the pharmacies: the nature of the provider, the way medicines are sold (consumption), the location of the pharmacies, and the nature of drugs.

Results

Our study included 98 (56.9%) pharmacies, 66.3% (65/98) of which were located in peripheral areas with most of the untrained providers (91.7%; 11/12; p = 0.006) and in all pharmacies, 81% (47/58; p < 0.001) of their sales were based on patients' wishes. Nursing sales are 76.9% (20/26; PR: 1.9; 95% CI: 0.5-7.4; p = 0.009) undocumented among qualified staff involved in pharmacy sales.

Conclusions

The risk factors for developing antimicrobial resistance in these two cities in eastern DRC are related to undocumented drug sales and qualified providers in pharmacies. This requires a high level of awareness among those involved in the sale of medicines and those who receive them.

Recommendation

Our proposal is for strict protection of antimicrobial resources through regulation of their sale in the region.

ASSOCIATION OF ABNORMAL UTERINE BLEEDING WITH BODY MASS INDEX AMONG WOMEN ATTENDING GYNAECOLOGY OUTPATIENT DEPARTMENT, PURNEA, BIHAR.

2024-08-27T06:19:58+00:00

Background

Abnormal uterine bleeding (AUB) is a general gynecological condition that significantly affects women’s health and quality of life. Body mass index (BMI) is a well-established factor influencing reproductive health, and its impact on AUB has been observed but not extensively studied in low-resource settings. This study aims to examine the association between BMI and AUB among women attending the gynecology OPD.

Methods

A total of 144 women were included based on specific inclusion and exclusion criteria. Data were collected on socio-demographic parameters, menstrual history, obstetric history, and BMI. BMI was calculated and categorized according to the World Health Organization (WHO) classification. The prevalence of AUB was determined across different BMI categories, and statistical analysis was accomplished using SPSS version 23.0.

Results

The study found that 54.9% of participants had AUB. Obese women had the highest incidence of AUB (73.7% in obese class I and 100% in obese class II and III), with a substantial relationship between higher BMI and increased AUB prevalence (p < 0.05). Obesity was also associated with higher rates of ovulatory dysfunction (32.4%) and iatrogenic causes of AUB. The prevalence of heavy menstrual bleeding and irregular periods was notably higher in women with higher BMI categories.

Conclusion

There is a significant association between higher BMI and increased incidence of AUB among women attending the gynecology OPD. These findings suggest that obesity is a critical factor contributing to menstrual irregularities and AUB, underscoring the need for targeted interventions in this population.

Recommendations

Comprehensive AUB care should include BMI testing in routine gynecological exams and weight management counseling. More study is needed to understand the processes between BMI and AUB and create customized therapies for obesity-related menstrual problems.

IMPACT OF MATERNAL ANEMIA ON UMBILICAL CORD HEMOGLOBIN LEVEL – PROSPECTIVE OBSERVATIONAL CROSS-SECTIONAL STUDY.

2024-07-23T06:22:30+00:00

Introduction

Anaemia is a prevalent condition in expecting mothers. Studies have shown that maternal anemia affects fetal growth and development which is evidenced by cord blood haemoglobin. The present study determines the effect of maternal anemia on fetal cord blood hemoglobin in the first and third trimesters.

Method

This study was conducted in a rural tertiary hospital in Eastern India in the department of obstetrics and gynecology. Women were recruited for 6 months and the follow-up analysis was conducted for up to 9 months. Women who delivered their babies at our institute were included in the study. Maternal hemoglobin in the first and third trimesters and cord blood hemoglobin after birth were measured to examine the impact of the former on the latter.

Result

Among 500 participants, the mean maternal hemoglobin was 11.51 ± 7.94 g/dl in the 1st trimester and 10.21 ± 1.52 g/dl in the 3rd trimester. Cord hemoglobin levels were 14.28 ± 2.08 g/dl. In the 3rd trimester, 342 (68.4%) women were anemic: 190 (55.56%) with mild, 137 (40%) with moderate, and 15 (4.3%) with severe anemia. Cord blood hemoglobin correlated positively with maternal hemoglobin in both trimesters (1st: F=5.55, p=0.001; 3rd: F=8.55, p=0.000). The 9-month follow-up showed that maternal anemia, especially in the 3rd trimester, was significantly associated with lower cord blood hemoglobin.

Conclusion

This study found a significant association between maternal hemoglobin and cord blood hemoglobin in the participants both in the 1st trimester and third trimester, and the association was identified to be linear.

Recommendations

Preventing neonatal complications requires early detection and treatment of anemia in pregnant women, especially in the third trimester. To protect maternal and fetal health, doctors should check hemoglobin levels throughout pregnancy.

AN ANALYTICAL STUDY ON PARENTERAL AND ORAL IRON THERAPY IN THE TREATMENT OF MODERATE DEGREE OF IRON DEFICIENCY ANEMIA IN PREGNANCY.

2024-07-22T10:31:55+00:00

Background

Anemia, especially caused by insufficient iron and acute blood loss, is prevalent in pregnancy and the postpartum period. Iron requirements rise significantly during pregnancy to support both maternal and fetal needs.

Aim: To evaluate the efficacy of Intravenous Iron and oral iron therapy in moderate degree of iron deficiency anemia in the second and third trimesters of pregnant women attending Antenatal OPD or labor room in Silchar Medical College and Hospital.

Methods

An Observational Cross-Sectional Study was done on 250 pregnant women attending Antenatal OPD and patients admitted to “The Department of Obstetrics and Gynecology of Silchar Medical College and Hospital” with hemoglobin 7-9.9 g/dl. 250 Population selected randomly, separated into 2 groups with 125 each. The first group of patients who were given IVIS. The second group of people received oral ferrous sulfate tablets twice daily. The patients were asked to report after 4 weeks for estimation of Hb.

Results

Baseline Hb of a group receiving oral iron therapy and parenteral iron therapy was 8.07 ±0.70 and 8.05±0.74 respectively. After 4 weeks of therapy, a mean difference of 0.61±0.53 was found in the oral therapy group and 1.44±0.62 in parenteral therapy where the P value is <0.001. The final rise in hemoglobin in the parenteral iron therapy group was found to be 9.47±0.97 and 8.69±0.86 in the oral receiving group.

Conclusion

Parenteral iron therapy was found to be an effective, safe, and alternative therapy to oral iron therapy in the treatment management of moderate degree of iron deficiency anemia in second and third-trimester pregnant women.

Recommendation

Further studies with newer IV iron formulations to overcome the issue of affordability and the risks of infusion-related complications and increase the sample size.

INDICATION, PREVALENCE AND MATERNAL OUTCOME OF EMERGENCY PERIPARTUM HYSTERECTOMY: A CROSS-SECTIONAL STUDY.

2024-08-27T06:23:56+00:00

Background

Emergency peripartum hysterectomy (EPH) is a critical surgical procedure performed to control life-threatening postpartum hemorrhage (PPH) when conservative measures fail. The study aims to assess the frequency, indications, and maternal outcomes of EPH.

Methods

A total of 144 women who underwent EPH following failed conservative management for PPH were included. Data were collected on maternal demographics, indications for hysterectomy, type of hysterectomy performed, and post-operative complications. Statistical analysis was accomplished using SPSS version 23.0.

Results

The average age of the patients was 29.5 ± 4.3 years, with 61.1% being multiparous. Previous cesarean sections were documented in 38.9% of cases. The leading indication for EPH was uterine atony (45.8%), followed by placenta previa (22.2%), placenta accreta (18.8%), and uterine rupture (13.2%). Total hysterectomy was performed in 72.9% of cases, while 27.1% underwent subtotal hysterectomy. Immediate postoperative complications occurred in 52.1% of patients, with infections (22.2%) and hemorrhage requiring additional surgery (16.7%) being the most common. A significant association was found between previous cesarean sections and the incidence of placenta accreta (χ²=12.34, p=0.002), as well as between total hysterectomy and higher postoperative complications (p=0.045).

Conclusion

Uterine atony and abnormal placentation are the predominant indications for EPH in this setting, with a substantial burden of postoperative complications observed. Prior cesarean deliveries significantly increase the risk of placenta accreta, underscoring the need for cautious evaluation of cesarean indications.

Recommendations

Enhancing antenatal care with early identification and management of high-risk pregnancies, promoting skilled birth attendance, and implementing standardized protocols for PPH management can potentially reduce the incidence of EPH and improve maternal outcomes. Additionally, efforts to limit unnecessary primary cesarean sections could decrease the risk of abnormal placentation in subsequent pregnancies.

Analysis of Polyps in the Female Reproductive Tract at a Tertiary Care Centre

2024-09-29T17:33:17+00:00

Background: Polyps in the female reproductive tract, particularly endometrial and cervical polyps, are common benign lesions that can cause symptoms such as abnormal uterine bleeding (AUB), pelvic pain, and infertility. While generally benign, they may carry a risk of malignant transformation, especially in postmenopausal women. This study aims to evaluate the presence and characteristics of polyps in the female reproductive tract.

Methods: This cross-sectional observational study was conducted, with 80 women diagnosed with reproductive tract polyps. Clinical data were collected via patient interviews, medical records, imaging studies, and histopathological analysis. Statistical analyses included chi-square tests and logistic regression to identify factors associated with recurrence and malignancy.

Results: The majority of patients were aged 35-50 years, with 62.5% presenting with AUB. Polyps were most commonly located in the endometrium (50%) and cervix (42.5%). Histopathological examination revealed that 75% of polyps were benign, while 15% were hyperplastic, and 10% showed precancerous or malignant changes. Surgical treatment via hysteroscopic polypectomy was performed in 70% of cases, and recurrence was noted in 10% of patients, with hyperplastic or malignant polyps showing a higher recurrence rate (p < 0.05).

Conclusion: Reproductive tract polyps are prevalent among premenopausal and postmenopausal women, often associated with abnormal bleeding. Although most polyps are benign, a significant proportion may exhibit hyperplastic or malignant changes, particularly in older women. Surgical treatment is effective, but vigilant follow-up is necessary for patients with histopathological abnormalities due to the risk of recurrence.

Recommendations: Regular screening for polyps in women presenting with AUB, especially postmenopausal women, is recommended. Further studies should explore the role of hormonal and microbial factors in the development and recurrence of polyps.

HYSTEROSCOPY AS DIAGNOSTIC PROCEDURE IN ABNORMAL UTERINE BLEEDING AND ITS CORRELATION WITH HISTOPATHOLOGY: A PROSPECTIVE COHORT STUDY.

2024-07-27T15:16:43+00:00

Background

The study aimed to correlate hysteroscopic findings with histopathological findings in women presenting with abnormal uterine bleeding and to study the accuracy of hysteroscopy in the evaluation of abnormal uterine bleeding

Methods

A prospective study was conducted in the Department of Gynecology at IGIMS, Patna from November 2021 to October 2023. A total of 58 patients who came with a history of abnormal uterine bleeding during this period were selected for the study. The hysteroscopic examination was done in all these patients post-menstrually, whenever possible, except in those cases where menstrual cycles were grossly irregular or patients came with continuous bleeding per vaginum. Endometrial biopsies were taken in the same sitting and sent for histopathological examination. Then correlation between findings on hysteroscopy and histopathological examination was done.

Results

Hysteroscopy revealed that 48.27% of patients had normal findings, while 51.73% had abnormalities. The most common abnormal hysteroscopic finding was hyperplasia (20.69%), followed by endometrial polyp (10.35%), myoma/myomatous polyp (6.86%), and endometrial carcinoma (5.18%). The histopathological examination showed 53.57% of patients had normal findings, with proliferative endometrium being the most common normal finding. Among abnormal histopathological findings, hyperplasia (16.07%) and endometrial polyp (8.93%) were prevalent. The accuracy of hysteroscopy in diagnosing normal endometrium, atrophic endometrium, and endometrial carcinoma was high, with a sensitivity of 100%.

Conclusions

Hysteroscopy allows direct visualization and biopsy of abnormal uterine bleeding. It can accurately diagnose normal and abnormal situations, although it may not detect hyperplasia as well as histology. The study emphasizes combining diagnostic methods to improve accuracy.

Recommendations

Whenever possible, hysteroscopy should be used to diagnose abnormal uterine bleeding. It permits direct visualization of the uterine interior. Diagnostic accuracy is improved with hysteroscopic biopsies. Hysteroscopic-histopathological correlations need further study to improve diagnostic methods.

A COHORT STUDY ON THE EVALUATION OF THE BRAIN BY MAGNETIC RESONANCE IMAGING IN PAEDIATRIC PATIENTS WITH DEVELOPMENTAL DELAY

2024-09-30T09:57:15+00:00

Introduction

One major neuromorbidity that affects children and may have long-term effects on quality of life is developmental delay (DD). Magnetic resonance imaging (MRI) has become a key tool in evaluating these patients. This study aimed to assess DD in pediatric patients by utilizing magnetic resonance imaging (MRI) to identify underlying brain abnormalities that may contribute to the condition.

Methods

This hospital-based prospective observational study included 100 pediatric patients referred for MRI brain evaluation due to developmental delay between January 2021 and July 2022. MRI scans were performed using 1.5 Tesla superconducting MRI machines (GE Optima MR360, Optima MR450W GEM, and SIGNA Artist) with appropriate sequences and planes, using sedation, when necessary, under anesthetist guidance. The brain's anatomical structures were assessed systematically for normalcy and maldevelopment, and the findings were categorized into different etiological groups.

Results

Normal MRI findings were observed in 13% of participants, while 87% showed abnormal results. The most commonly affected anatomical areas were the white matter (52.87%) and the ventricles (44.83%). Of the abnormal cases, 53% were attributed to neurovascular etiologies, such as hypoxic-ischemic encephalopathy (HIE), followed by 14% for congenital and developmental etiology, 13% for metabolic and neurodegenerative disorders, 4% for nonspecific findings, 2% for neoplastic lesions, and 1% for multifactorial causes.

Conclusion:

Clinical examination and analysis are the first steps in diagnosing developmental delay, but brain imaging should be done to rule out any causes and provide appropriate management. Due to its great soft tissue resolution, the MRI brain is the best imaging modality.

Recommendations

MRI should be standard in assessing pediatric developmental delay due to its high sensitivity and specificity in detecting abnormalities. It aids in early diagnosis and guides targeted treatment. Larger studies are needed to refine diagnostic criteria and better understand MRI's role.

INDICATION-BASED TYPICAL DIAGNOSTIC REFERENCE LEVEL FOR BARIUM SWALLOW EXAMINATION AT THREE CENTRES IN KAMPALA, UGANDA, A CROSS-SECTIONAL STUDY.

2024-08-05T10:27:28+00:00

Introduction

The reduction in utilization of barium examinations is attributable to excessive exposure to ionizing radiations but also due to more advanced imaging modalities. Diagnostic Reference Levels (DRLs) are employed in identifying unusually high radiation doses so that corrective action can be taken. DRLs are not established in many African countries, Uganda inclusive.

Objective

To determine the Typical Diagnostic Reference Level for barium swallow examination of patients with dysphagia at three centers in Kampala, Uganda.

Methodology

It was a cross-sectional, descriptive, and analytical study. It involved 90 adult patients with dysphagia, who were consecutively recruited and underwent barium swallow examination. The exposure parameters were recorded and used to calculate radiation doses, from which the 50th percentile was derived as the Typical diagnostic reference level.

Results

The overall mean; kilovoltage (69.4 kilovolts), Fluoroscopic time (2.5 minutes), and outcome dose area product (6.4 Gycm2) had significant differences between the 3 centers (p-value =0.001,0.001,0.006) respectively. The overall mean current was 27.1mAs, without significant differences between the 3 centers (p = 0.0197). There was a statistically significant (p = 0.002) positive relationship between radiation doses and BMI. There was a negative relationship between radiation doses and age. The median outcome dose area product was 5.7Gycm2which was the Indication based Typical DRL for the barium swallow examination.

Conclusion

There were significant differences in exposure factors between centers and a significant positive relationship between radiation doses and BMI. The Typical DRL value for barium swallow examination was 5.7Gycm2.

Recommendation

I recommend that all imaging centers adopt the established typical DRL, with a regular review of exposure factors in order to optimize radiation exposure.

ULTRASOUND FINDINGS OF BREAST MASSES WITH HISTOPATHOLOGICAL CORRELATION: A PROSPECTIVE STUDY.

2024-07-03T09:25:05+00:00

Background

Breast carcinoma is the most frequent cancer and cause of death in women worldwide and in India. Early breast cancer diagnosis and therapy reduce mortality. Breast lesions are first imaged using ultrasound due of its availability, radiation-free nature, and good cost-benefit ratio. Ultrasound is preferred over mammography for diagnosing breast lesions in thick breasts and during pregnancy and lactation.

Aim

To differentiate breast lesions into benign and malignant lesions. Correlate benign and malignant lesions with histopathological findings.

Methodology

This was a prospective study. 100 patients were evaluated by ultrasound and lesions were categorized according to the Breast Imaging Reporting and Data System, Sonographic findings were correlated with histopathological findings, and statistical analysis was done.

Results

The age distribution of the patients ranged from 15 to 75 years, with a mean age of approximately 45 years. The study found that 68% of the patients had benign lesions and 32% had malignant lesions according to ultrasound. Histopathological examination confirmed that 63 patients had benign lesions, while 37 had malignant lesions. There were 2 false-positive cases (radial scars) and 5 false-negative cases (malignant phyllodes, metastatic lesions, and papillary carcinoma). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ultrasound in diagnosing breast lesions were found to be 85.7%, 96.9%, 93.7%, 92.6%, and 93%, respectively. The most common benign lesions were fibroadenomas, followed by fibrocystic disease. Among malignant lesions, infiltrative ductal carcinoma was the most common.

Conclusions

Results demonstrated a positive correlation between the sonographic findings and histopathological diagnoses of the breast masses.

Recommendation

Ultrasound should be utilized as a primary imaging modality for evaluating breast lesions, particularly in resource-limited settings and for patients with dense breast tissue, to facilitate early and accurate differentiation between benign and malignant lesions, thereby improving patient management and outcomes.

CADAVERIC STUDY OF ANATOMICAL VARIATION OF SCIATIC NERVE IN POPULATION OF BIHAR AND ITS CLINICAL APPLICATION: A CROSS-SECTIONAL STUDY.

2024-07-13T17:31:47+00:00

Background

The sciatic nerve is the largest in the body. It has peroneal and tibial components. The sciatic nerve (SN) leaves the pelvis through the larger sciatic foramen under the Piriformis muscle (PM) to become the tibial nerve. After that, the sciatic nerve crosses between the pelvic ischial tuberosity and the bigger femur trochanter, ending at the popliteal fossa. Aim- Cadaveric research was undertaken to ascertain the differences in the anatomy of the sciatic nerve.

Methods

A cross-sectional investigation was done in 50 equally divided anatomical cadavers of both genders to determine the occurrence of anatomical variations in the SN exit associated with the PM. One of the methods used to acquire the data from the bodies of equal males and females involved dissecting 100 SN. The gluteal regions of the cadavers had to be in ideal condition and have been kept adequately to enable data collection and dissection, which was one criterion for inclusion.

Results

The study included 52% males and 48% females. The sciatic nerve exited inferior to the PM in 90% of limbs, inferiorly and between the PM's fascicles in 6%, and superiorly and between the fascicles in 4%. Unilateral abnormalities were 12% more common on the left side and 12.5% more frequent in females than males. The SN most often branched in the popliteal fossa (54%), followed by the gluteal region (38%) and the middle third of the thigh (8%).

Conclusion

This study highlights the anatomical variations between the SN and PM, which are crucial for clinical and surgical procedures. Awareness of these variations can enhance diagnostic accuracy and surgical outcomes, particularly in the context of SN-related conditions and interventions.

Recommendation

Further large-scale, multicenter studies are recommended to confirm these findings and provide more comprehensive insights into SN anatomical variations' prevalence and clinical implications.

Hyperkalemia influences the outcome of patients with cirrhosis with acute decompensation (AD) and acute on chronic liver failure (ACLF)

2024-09-30T15:03:54+00:00

Background: Liver cirrhosis is a chronic liver disease which affects multiple organs and is generally associated with electrolyte imbalance which is hyperkalemia. Hyperkalemia with cirrhosis that is associated with acute decompensation and acute-on-chronic liver failure have fatal outcomes.

Method: This was a prospective observational study conducted to determine the influence of hyperkalemia on liver cirrhosis. This study was conducted at ‘ABC’ institute for a period of a year. The biochemical screening was performed. Mortality rates were recorded. The obtained data was subjected to statistical analysis to obtain the prediction of mortality with hyperkalemia.

Results: 657 patients participated in this study. Amongst them, 147 patients had existing acute or chronic liver failure, whereas 56 of them developed acute or chronic liver failure during their hospital stay for 28 days. 72 patients who were admitted for liver cirrhosis also had hyperkalemia along with it. There were 45 patients who developed hyperkalemia during the course of the study. 128 patients with ACLF died within 90 days of follow-up. The statistical analysis predicted the mortality in the patients after 90 days as well in the patients who had average potassium levels from the admission above 5 mEq/L.

Conclusion: Hyperkalemia is associated with an increased mortality rate in patients with cirrhosis in cases of ACLF and AD. 90-day mortality rate increases significantly in patients who have hyperkalemia with ACLF.

Recommendation: Hyperkalemia should be used as a prognostic tool to assess the mortality associated with the current disease state and to determine the severity of the case in patients with ACLF.

EXAMINING THE ASSOCIATIONS BETWEEN GESTATIONAL AGE AND HEAD CIRCUMFERENCE IN THE SECOND TRIMESTER: A CROSS-SECTIONAL STUDY

2024-07-13T16:33:10+00:00

Background:

Accurate estimation of gestational age is crucial for optimal prenatal care, and fetal biometry, particularly head circumference (HC), plays a significant role in this assessment. Previous studies suggest that HC measurements during the second trimester can provide reliable indicators of gestational age, but further investigation is needed to establish their effectiveness across diverse populations.

Aim:

To evaluate the correlation between gestational age and head circumference measurements in singleton pregnancies during the second trimester.

Methods:

A study was conducted involving 100 pregnant women between 20 and 38 weeks at each gestational week. Participants were selected based on specific inclusion and exclusion criteria. Head circumference measurements were obtained via ultrasound, and gestational age was calculated using an average of three HC values. Statistical analyses included Pearson correlation coefficients and regression analysis to determine the relationship between HC and gestational age.

Results:

100 women were enrolled, with an average maternal age of 29.5 years (±4.8) and a pre-pregnancy BMI of 24.0 (±4.8). The analysis revealed a strong positive correlation between HC measurements and gestational age (Pearson r = 0.89, p < 0.001). Most participants (51%) had HC measurements ranging from 148 to 159 mm, corresponding to a gestational age of 18+0 to 18+6 weeks.

Conclusion:

The findings indicate that head circumference is a highly reliable indicator for estimating gestational age during the second trimester. The established regression equations provide a useful tool for predicting gestational age based on HC measurements.

Recommendations:

Future research should involve larger, multicentric studies to validate these findings and develop population-specific reference tables for fetal biometry. This will enhance the accuracy of gestational age estimation and improve prenatal care strategies tailored to diverse populations.

COMPARISON BETWEEN ROBOTIC ASSISTED LAPAROSCOPIC PYELOPLASTY AND LAPAROSCOPIC PYELOPLASTY AS STANDARD OF CARE FOR PELVI-URETERIC JUNCTION OBSTRUCTION: HOSPITAL-BASED COHORT STUDY.

2024-07-13T16:53:55+00:00

Introduction

Pelvi-Ureteric Junction Obstruction (PUJO) is a significant clinical difficulty that frequently necessitates surgical treatment. This study examines and contrasts the efficacy of Robotic-Assisted Laparoscopic Pyeloplasty (RALP) and Laparoscopic Pyeloplasty (LP) in treating this problem. The objective is to assess perioperative parameters and patient outcomes to identify the most effective technique for controlling PUJO.

Methods

The study comprised individuals diagnosed with PUJO who were scheduled to undergo surgical intervention. The study included a total of 48 patients, with 32 of them undergoing LP and the remaining 16 getting RALP.

Results

48 patients (32 LP, 16 RALP) aged 10-70 years were studied, with mean ages of 34.28 (LP) and 39.38 (RALP), a male-to-female ratio of 2.2:1, and success rates of 90.63% (LP) and 93.75% (RALP) in transitioning from an obstructed (TYPE 2) to a normal (TYPE 1) O' The RALP group had a longer mean operative time (226.87 ± 32.39 minutes) than the LP group (186.53 ± 33.58 minutes). The RALP group had better patient outcomes, including faster drain removal time (1.69 ± 1.40 days vs. 3.75 ± 1.50 days), shorter hospital stay (2.88 ± 0.88 days vs. 4.06 ± 1.39 days), and somewhat higher success rate (93.75% vs. 90.63%). The success criteria were an obstructed (TYPE 2) to normal (TYPE 1) O'Reilly Curve within 3 months of surgery.

Conclusion

Although RALP has a longer operational time, it has been shown to achieve better results than LP in terms of success rate, duration of drain usage, and total length of hospital stay.

Recommendations

It is recommended that future studies include larger sample sizes and longer follow-up periods to further evaluate the long-term effectiveness of RALP and LP in the management of PUJO.

A COMPARATIVE PROSPECTIVE STUDY OF GABAPENTIN'S ROLE IN TRAUMATIC BRAIN INJURY.

2024-09-21T16:36:25+00:00

Background

Traumatic brain injury (TBI) causes 65% of motor vehicle-related deaths in young individuals. Paradoxical sympathetic hyperactivity is a common and dangerous TBI complication. This study explores the potential of gabapentin to mitigate secondary brain injury and cerebral edema, alongside enhancing Glasgow Coma Scale (GCS) outcomes in TBI patients.

Method

This year-long study included adult ICU patients with moderate to severe GCS scores. Participants were randomly assigned to two groups: the experimental group received 300 mg of gabapentin orally twice a day, whereas the control group received multivitamin tablets. The 2-week treatment regimen includes telephone check-ins for up to 3 months after discharge.

Results

The study analyzed 67 participants, predominantly male (Group I: 79.4%, Group II: 72.73%), with an average age of 36.5 years in Group I and 40.4 years in Group II. Notable Improvements were noted in the experimental group, including a significant increase in GCS change from admission to discharge (53% in the study group and 25% in the control group, p = 0.009). The study group also demonstrated a significant reduction in mortality and a 25% improvement in the Glasgow Outcome Scale (GOS) at 30 and 90 days, with no improvement in the control group (p = 0.001). Additionally, there was a marked reduction in PSH episodes and daily sedative bolus requirements in the gabapentin group.

Conclusion

This study provides compelling evidence that gabapentin may be critical in preventing PSH and enhancing neurological outcomes in TBI patients, potentially offering a novel therapeutic approach to improve survival and recovery.

Recommendation

According to the study, gabapentin may be an effective treatment for TBI patients. Gabapentin reduced secondary brain injury, improved functional outcomes (GOS and GCS), and decreased PSH episodes, suggesting a neuroprotective effect in TBI therapy.

PREFERRED MENSTRUAL HYGIENE PRACTICES AMONG ADOLESCENT GIRLS IN PRIMARY SCHOOLS, A CASE STUDY OF SELECTED PRIMARY SCHOOLS IN MBARARA CITY.

2024-09-09T06:08:17+00:00

This survey examined the preferred menstrual hygiene among adolescent girls in primary Schools. The purpose was to contribute towards the academic performance of female pupils since menstrual hygiene is perceived as key to their concentration and participation in class. The study population included female candidate pupils, school matrons, teachers, parents/guardians of female pupils enrolled in the candidate class, and other education technocrats like head teachers. The findings of the investigation revealed that sanitary towels are the most commonly used and effective menstrual hygiene practice. Regarding materials used to clean external genitalia, the findings revealed that most adolescent girls use clean water to clean themselves. For the storage of menstrual materials, the results of the study manifested that most adolescent girls store their menstrual hygiene in their suitcases while others store materials with school nurses and matrons. From the study findings, the present study recommends the use of disposable sanitary towels since they were found to give comfort to these adolescent female pupils. In addition, the government should improve access and affordability of sanitary towels since they have an impact on pupils’ academic performance. Also, school administrators should maintain and ensure the availability of clean water inside school premises. Lastly, there is a need to intensify health education among both girls and boys.

NURTURING DEAF CHILDREN THROUGH INCLUSIVE PARENTING PROGRAMS COMPREHENSIVE ANALYSIS FROM INTERNATIONAL DEAF AWARENESS WEEK AND THE INTERNATIONAL DAY OF SIGN LANGUAGE IN UGANDA- A CROSS-SECTIONAL STUDY.

2024-03-01T15:24:53+00:00

Background

Inclusive parenting for individuals with disabilities, particularly within deaf families, has garnered global attention. Understanding the unique challenges faced by these families is crucial for developing culturally sensitive interventions on a global scale. This qualitative research was conducted during Uganda's International Deaf Awareness Week 2023 to delve into the diverse context of the deaf population and highlight areas for targeted Parenting interventions.

Methods

The study employed in-depth interviews with 20 deaf parents and utilized NVIVO software for thematic content analysis. Rigorous ethical considerations were adhered to throughout the research process to ensure the integrity and reliability of the findings. The focus was on exploring the transformative potential of specialized parenting programs tailored to the needs of deaf families.

Results

The findings of the study underscored positive behavioral changes, improved education outcomes, increased awareness levels, and a sense of empowerment among the participants. Key success factors identified include peer support networks, cultural acceptance of deafness, recognition of technology's benefits, and a strong emphasis on sign language as a vital communication tool within deaf communities.

Conclusion

The study advocates for the implementation of tailored interventions that take into account the unique challenges faced by deaf families, particularly in African and Sub-Saharan contexts. The transformative impact of inclusive parenting programs, as highlighted during Uganda's International Deaf Awareness Week 2023, demonstrates the potential for positive changes in family dynamics and educational outcomes.

Recommendations

Recommendations include adopting a holistic approach that combines awareness campaigns, collaborative efforts between stakeholders, leveraging technology for accessibility, and promoting cultural sensitivity in educational and support programs. These strategies aim to empower deaf families globally and nurture deaf children through context-specific and inclusive strategies

THE PREVALENCE OF CARBAPENEM-RESISTANT ENTEROBACTERIACEAE INFECTIONS IN HOSPITALIZED PATIENTS AT INKOSI ALBERT LUTHULI CENTRAL HOSPITAL: A RETROSPECTIVE COHORT STUDY IN DURBAN, SOUTH AFRICA.

2024-06-12T11:07:48+00:00

Introduction

Carbapenems are antibiotics that fall within the beta-lactam antibiotic family utilized against multidrug-resistant Gram-negative microorganisms due to their broad range of antimicrobial action. However, there has been a rise of carbapenemase-producing organisms that are resistant to carbapenems making the treatment of infections difficult.

Aims and Objectives

The primary aim of this research is to investigate the occurrence of carbapenem-resistant Enterobacteriaceae (CRE) infections among patients receiving hospital care in Durban, South Africa, and also ascertain the predominant organisms causing these infections and evaluate the efficacy of available treatment options.

Methodology

This was a quantitative, retrospective cohort study that investigated carbapenem-resistant Enterobacteriaceae among 534 patients of all genders and age groups. The procedure involved detecting microorganisms in a patient's blood and their susceptibility patterns. Data, spanning from January 1, 2021, to December 31, 2021, was retrospectively collected through medical laboratory reports.

Results

Results showed a total of 21.8% of cases were resistant to at least one of the three carbapenems (ertapenem, imipenem, or meropenem), with Klebsiella spp. This is the most prevalent (62.7%), followed by Enterobacter spp.(18.9%) and Escherichia coli (10.8%). Furthermore, the results showed that there was no significant difference between ertapenem and imipenem in terms of their efficacy against CRE. However, meropenem demonstrated the maximum effectiveness against CRE.

Conclusion

Klebsiella spp. Emerged as the predominant microorganisms, followed by Enterobacter spp. and Escherichia coli. Evaluating the effectiveness of antimicrobial drugs revealed that meropenem consistently demonstrated superior efficacy, particularly against Klebsiella spp. andEnterobacter spp., with imipenem also showing notable effectiveness, especially against Escherichia coli.

Recommendations

These include optimizing antimicrobial use through careful prescribing, providing education and training for healthcare personnel, expanding resistance surveillance, and fostering collaboration and data sharing among healthcare facilities to address the local and global challenges of CRE infections.

FACTORS ASSOCIATED WITH SCHOOL ATTENDANCE AMONG PUPIL REFUGEES IN RWAMWANJA REFUGEE SETTLEMENT IN KAMWENGE DISTRICT; A CROSS-SECTIONAL STUDY.

2024-08-22T06:33:50+00:00

Introduction

The study aimed to investigate the correlation between psychological factors and school attendance among primary school-going refugee pupils in the Rwamwanja refugee settlement, Kamwenge District.

Methodology

A cross-sectional study involving 205 respondents assessed the impact of psychological factors like depression, anxiety, and stress on school attendance using the Depression, Anxiety, and Stress method.

Results

The response rate for the survey was 95.1%, with 195 out of 205 surveys completed, surpassing the recommended 70% threshold for data collection (Amin, 2006). A majority of the survey respondents were female (56%), and most of them (67%) fell within the 13-15 age group. Participants hailed from four different countries, with the Democratic Republic of Congo being the most represented (45%), followed by Rwanda (41%), Burundi (8%), and South Sudan (7%). The analysis of psychological factors indicated average scores of 6.7 for depression, 5.9 for anxiety, and 6.2 for stress, with slight variations between those who attended low and high school.

The data analysis indicated a strong connection between depression and school attendance, as higher depression scores were correlated with increased attendance (cOR = 1.57, 95% CI = 1.31–1.88, p<0.001). Conversely, anxiety and stress did not exhibit a notable correlation with attendance. Through multivariate regression analysis, accounting for sociodemographic variables such as age, sex, and country of origin, it was confirmed that depression remained significantly linked to school attendance (aOR = 1.59, 95% CI = 1.33–1.91, p<0.001), while anxiety and stress still demonstrated no significant impact.

Conclusion

The study concluded that psychological factors are crucial in influencing school attendance among refugee pupils, while socio-demographic factors were insignificant.

Recommendations

The study suggests that interventions focusing on psychological support and addressing socio-economic barriers can improve school attendance among refugee pupils, emphasizing the need for a holistic approach to address their educational needs.

INFLUENCE OF GUIDANCE AND COUNSELING ORIENTATION SERVICES ON LIFE SKILLS DEVELOPMENT AMONG SELECTED SECONDARY SCHOOLS IN MUDUUMA SUB-COUNTY, MPIGI DISTRICT. A CROSS-SECTIONAL STUDY.

2024-07-29T15:36:23+00:00

Background

Guidance and counseling services are a set of comprehensive programs and interventions designed to support individuals in their personal, social, educational, and career development. The study aims to assess the Influence of guidance and counseling orientation services on life skills development in secondary schools in Muduuma Sub-county, Mpigi District.

Methodology

A cross-sectional study utilizing both qualitative and quantitative research methods. Qualitative component involved obtaining graphs, and charts. Simple Random Sampling and Purposive Sampling were used.

Results

(56.1%) of the respondents were male while (43.9%) were female. The mean score for participants' belief in the importance of the guidance and counseling Orientation services for personal development was M = 3.98 (SD = 0.981). Participants' satisfaction with the information provided during the guidance and counseling Orientation services yielded a mean score of M = 3.44 (SD = 1.218). Participants indicated a mean score of M = 3.34 (SD = 1.146) for the effectiveness of the guidance and counseling Orientation services in addressing their specific needs and concerns. The guidance and counseling Orientation services were perceived as effective in preparing participants for academic challenges, with a mean score of M = 3.66 (SD = 1.249). The perceived effectiveness of the guidance and counseling Orientation services in enhancing well-being and overall development had a mean score of M = 3.49 (SD = 1.136).

Conclusions

Individuals who held a more favorable view of the Orientation services were also more likely to report higher levels of life skills.

Recommendations

The study recommended that the Ministry of Gender, Labour and Social Development and Ministries of Education should, through District Education Officers (DEOs) and inspectors, encourage head teachers to enhance Orientation services quality and consistency.

ONLINE TEACHING OF MEDICAL STUDENTS DURING COVID -19 PANDEMIC – TEACHERS’ PERSPECTIVE: A CROSS-SECTIONAL STUDY.

2024-09-09T12:52:17+00:00

Background

The COVID-19 pandemic forced educational institutions to transition from traditional in-person teaching to online learning environments. In medical education, this shift posed unique challenges due to the reliance on hands-on and clinical teaching methods. The rapid switch to digital platforms was essential to ensure the continuity of medical education, despite the limitations and lack of preparedness. This study assessed the faculty's perceptions of online teaching during the COVID-19 lockdown.

Methodology

A cross-sectional observational study was conducted among the teaching faculty of Dr. Y. S. Parmar Government Medical College (DYSPGMC), Nahan. Feedback was collected via online Google Forms from April 2020 to September 2020. A total of 50 faculty members were invited to participate, and 29 responses were received. The survey utilized a Likert scale to evaluate comfort with online teaching tools, feedback on effectiveness, interaction with students, syllabus completion, and content delivery.

Results

75.9% of the faculty preferred PowerPoint presentations, with 37.9% incorporating narrative audio. Additionally, 44.8% used online videos, and 27.6% shared PDF notes. 44.8% of the teachers rated student interaction during live lectures as moderately good, while 37.9% found it very good. Only 27.6% of the faculty reported that lectures were completed within the stipulated time. 44.8% of respondents found the online teaching tools convenient, but 10.3% reported poor audio-visual quality due to network issues.

Conclusion

The study concluded that online classes were generally accepted by the faculty, but challenges such as limited student interaction and technological difficulties were prevalent. Although online teaching helped maintain the continuity of education during the pandemic, faculty members expressed that it cannot fully replace traditional classroom and clinical instruction.

Recommendation

To improve the online teaching experience, institutions should provide better IT support, including high-speed internet, premium access to online teaching platforms, and dedicated teaching spaces.

EXAMINING MORTALITY RATES FOLLOWING PERIPROSTHETIC FEMUR FRACTURES IN PATIENTS UNDERGOING PRIMARY AND REVISION TOTAL HIP ARTHROPLASTY: RETROSPECTIVE COHORT RESEARCH

2024-07-13T17:04:36+00:00

Introduction

Following total knee and hip arthroplasty (TKA and THA), periprosthetic fractures (PPF) have risen. The study evaluated morbidity and mortality after PPF surgery for the knee and hip.

Methods

A level-1 trauma center examined 248 patients, throughout two years. These patients were included retrospectively. Mortality was taken into consideration as the main event in Fine and Gray's model when assessing risk factors for postoperative morbidity. Cox regression models, both univariate and multivariate, were used to identify death risk variables.

Result

The mean age was 77 years; 77.40% were female with PPF of the hip (n = 194) and knee (n = 54). Out of all the fracture types in Vancouver, B2 (n = 78; 42.4%) was the most common, followed by B1 (n = 46; 25.00%). Form I fractures (n=28; 51.9%) were the most common form of Lewis-Rorabeck fracture in the PPF of the knee. Complication rates for PPF of the knee and hip were 44.0% and 29.9%, respectively. Six patients experienced early and late problems, 50 had early complications, and 38 had late implant-related complications that required surgery.

Conclusion

Younger patients and those undergoing ORIF have higher postoperative morbidity from implant issues. Accounting for mortality prevents underestimating complications. The retrospective study at a level 1 trauma hospital shows that, with careful planning, surgeries longer than two days do not harm patient outcomes.

Recommendation

An earlier study found that for patients with native hip fractures or periprosthetic fractures, surgery is still advised 24 to 48 hours after admission.

A RETROSPECTIVE STUDY OF MANAGEMENT OF UNSTABLE INTERTROCHANTERIC FEMORAL FRACTURES IN THE ELDERLY: A COMPARISON OF PROXIMAL FEMORAL NAIL ANTI-ROTATION AND CEMENTED HEMIARTHROPLASTY.

2024-09-27T11:50:57+00:00

Background

Unstable intertrochanteric femoral fractures (IFF) are common in elderly populations and are correlated with significant morbidity and mortality. Surgical management is the mainstay of treatment, with two commonly used options: Proximal Femoral Nail Antirotation (PFNA) and cemented hemiarthroplasty. This study compared the clinical outcomes, perioperative characteristics, and complication rates in elderly patients with unstable intertrochanteric femoral fractures treated with PFNA versus cemented hemiarthroplasty.

Methods

A retrospective study involved 78 individuals aged 65 years or older with AO type 31 A2 or A3 unstable IFF. Patients were treated with either PFNA (n=42) or cemented hemiarthroplasty (n=36). The primary outcome was functional recovery assessed by the Harris Hip Score (HHS), while secondary outcomes encompassed operating time, blood loss, hospital stay, and complication rates. SPSS was used for the statistical analysis, with a significance level of p < 0.05.

Results

With 52 female patients and 26 male patients, the average age was 72.6 ± 4.8 years. Patients in the hemiarthroplasty group showed better functional results, as evidenced by a greater mean HHS (88.6 vs. 85.8, p<0.01). The PFNA group saw decreased intraoperative blood loss (220 mL vs. 410 mL, p<0.001) and a shorter mean operating time (85.3 vs. 110.6 minutes, p<0.001). Patients who underwent hemiarthroplasty, however, spent much less time in the hospital (7.3 vs. 10.2 days, p=0.02). There were no appreciable differences in the rat

Conclusion

Hemiarthroplasty provided better short-term functional outcomes and a quicker recovery, while PFNA resulted in shorter surgical times and less blood loss. Both methods are effective, but the choice should be individualized based on patient health, fracture type, and rehabilitation needs.

Recommendations

Further long-term studies are recommended to assess the durability of both treatments. Individual patient factors, such as comorbidities and pre-fracture mobility, should guide treatment decisions to optimize outcomes.

A COHORT STUDY COMPARING SHOULDER PRIMARY ADHESIVE CAPSULITIS TREATMENT WITH ARTHROSCOPIC CAPSULAR RELEASE, SUBACROMIAL DECOMPRESSION, ROTATOR INTERVAL RELEASE AND MANIPULATION UNDER GENERAL ANESTHESIA

2024-07-13T17:44:18+00:00

Background

In 90% of cases, adhesive capsulitis is manageable using conservative management strategies but it requires optimum surgical intervention if it is not cured with conservative strategies. This study aims to compare the combination of arthroscopic capsular release and rotator interval release and manipulation under general anesthesia.

Method

A total of 120 patients who did not respond to conservative management strategies were included in this study. They were divided into two groups: 60 patients underwent manipulation under general anesthesia (GA) alone, and the other 60 patients received a combination of arthroscopic capsular release, rotator interval release, and manipulation under GA. Visual Analog Scale (VAS) and the Oxford Shoulder Score (OSS)were recorded before surgery and at follow-ups after one week, one month, three months, and six months.

Results

Both VAS and OSS declined significantly in both groups. For the manipulation under the GA group, the OSS decreased from 49.8±3.3 to 30±4.4 after six months, while the combination group saw a reduction from 50.1±4.4 to 17.4±3.0 after six months. Similarly, the VAS decreased from 6.65±0.93 to 1.47±0.8 in the manipulation group, and from 7.6±1.0 to 0.29±0.47 in the combination group after six months. The combination procedure showed significantly better outcomes in terms of both pain reduction and improved shoulder function (p<0.001).

Conclusion

The combination of arthroscopic capsular release, rotator interval release, and manipulation under general anesthesia provides significantly better outcomes than manipulation under general anesthesia alone for adhesive capsulitis, as evidenced by improvements in VAS and OSS over six months.

Recommendation

Symptoms and stages of adhesive capsulitis should be taken into consideration while selecting the best possible conservative management strategy and surgical intervention.

AN INSTITUTIONAL EXPERIENCE WITH TOPICAL GLYCERYL TRINITRATE FOR TENNIS ELBOW: A RANDOMIZED TRIAL.

2024-08-22T15:15:26+00:00

Objective

This study is conducted to analyze the efficacy of glyceryl trinitrate in the treatment of tennis elbow.

Method

90 participants were divided into treatment groups and placebo groups. The placebo group received placebo patches, and the treatment group was given glyceryl trinitrate patches. The participants of the study were selected if the pain, as well as the tenderness, was evident with pain-stimulating maneuvers. The pain was evaluated using a visual analog scale before the treatment and after the treatment. A criterion was specified to determine the outcome of the study.

Results

A substantial difference in the VAS (Visual Analogue Scale) score of pain was observed in the 3rd week of follow-up between the two groups. In the treatment group, the VAS score reduced significantly from 9.2 to 5.28 (p < 0.00001), indicating a marked improvement in symptoms. In contrast, the control group showed a minimal reduction in the VAS score from 9.13 to 8.48 (p = 0.18), with no significant change in pain levels. The statistical analysis demonstrated that the difference in pain reduction between the treatment and control groups was highly significant.

Conclusion

The topical application of GTN patches is effective in reducing pain and tenderness associated with lateral epicondylitis.

Recommendation

Based on the findings of this study, the topical application of glyceryl trinitrate is recommended as a first-line treatment for tennis elbow, given its significant effect in improving pain and elbow function.

COMPARATIVE RESEARCH OF SURGICAL AND CONSERVATIVE SPINAL CORD INJURY TREATMENT IN A BIHAR TERTIARY CARE HOSPITAL: ANALYTICAL, CASE-CONTROL AND PROSPECTIVE STUDY

2024-07-13T17:21:27+00:00

Background

Spinal cord injuries (SCI) pose a substantial clinical challenge due to their complex nature and profound impact on patients' quality of life. Effective management strategies, including operative and conservative treatments, are crucial for improving patient outcomes. This study aims to compare the outcomes of operative versus conservative treatments in individuals with spinal cord injuries, focusing on functional recovery, complication rates, and overall patient outcomes.

Methods

A total of 300 participants were comprised, with 150 individuals in the operative treatment group and 150 in the conservative treatment group. Data were collected through clinical examinations and radiological evaluations. Patients were grouped based on the thoracolumbar injury severity score (TLISS). Functional outcomes were assessed using the ASIA impairment scale and Frankel grading system. Statistical analysis was done using SPSS version 23.0.

Results

The operative group showed significantly better functional outcomes, with a 26.7% improvement in ASIA scores and a 30% improvement in Frankel grades compared to 16.7% and 18.7%, respectively, in the conservative group. The recovery rate was faster in the operative group, with 36.7% recovering within three months compared to 20% in the conservative group. Complications were fewer in the operative group, with lower incidences of infection (6.7% vs. 13.3%), persistent pain (13.3% vs. 23.3%), and mortality (1.3% vs. 5.3%).

Conclusion

Operative treatment for spinal cord injuries offers superior benefits over conservative treatment, resulting in better functional outcomes, faster recovery rates, and fewer complications and mortality rates. These findings support the recommendation of operative intervention for suitable patients with SCI to optimize recovery and reduce adverse outcomes.

Recommendations

It is advised to conduct more studies with bigger sample sizes and a wider range of demographics to confirm these results and create thorough protocols for the treatment of spinal cord injuries.

A PROSPECTIVE STUDY EXAMINING THE CLINICAL AND FUNCTIONAL OUTCOMES OF ADULTS WITH PROXIMAL HUMERUS FRACTURES TREATED USING A LOCKING COMPRESSION PLATE (LCP): A COHORT STUDY.

2024-07-13T16:18:18+00:00

Background

Proximal humerus fractures (PHF) are common, particularly among the elderly, and can significantly impact functional outcomes. The introduction of locking compression plates (LCP) has enhanced the management of these complex fractures by providing stable fixation. The study assessed the clinical and functional results of locking compression plate treatment for PHF in adult patients.

Methods

Included were 150 patients who had closed proximal humerus fractures that were categorized as 2-, 3-, or 4-part fractures according to NEER guidelines. Using a deltopectoral technique, patients received open reduction and internal fixation with LCP. The Constant-Murley scoring system was used to estimate clinical and functional outcomes, such as pain, daily living activities, range of motion (ROM), and muscle power. There were follow-ups at two weeks, six weeks, three months, six months, and a year. The statistical analysis was carried out with SPSS 23.0.

Results

The study included participants with a mean age of 38.6 years, 56.7% males. Significant improvements were observed in all outcome measures. Pain scores decreased from a preoperative mean of 12.5 to 2.1 at one year. Activities of daily living scores improved from 10.3 to 20.0. ROM increased from 22.3 degrees to 80.2 degrees, and muscle power improved from 14.7 to 24.3. Complications were noted in 12% of cases, including infection, hardware failure, nonunion, and subacromial impingement. Statistical analysis confirmed these improvements were highly significant (p < 0.001).

Conclusion

Locking compression plates effectively improves clinical and functional outcomes for proximal humerus fractures. The significant reduction in pain and enhancement in ROM and muscle power support the use of LCPs in managing these complex fractures.

Recommendations

Further studies should focus on long-term outcomes and strategies to minimize complications associated with LCPs. Additionally, patient selection criteria and individualized treatment protocols should be optimized based on specific fracture patterns and patient characteristics.

FUNCTIONAL OUTCOME OF LATERAL APPROACH FOR TOTAL HIP REPLACEMENT: A COHORT STUDY.

2024-08-03T02:16:42+00:00

Background

The majority of the cases undergoing total hip replacements have favorable outcomes in a significant number of cases the outcomes are not as per the requirement. The outcome of the surgery depends on the approach taken to perform Total hip replacement (THR). This study aims to determine the effect of the lateral approach in performing total hip replacement on the outcome of the surgery.

Method

This study considered the retrospective data as well as the prospective data of the patients undergoing total hip replacement surgery. The patients underwent THR by lateral modified approach. Harris hip score was used for functional evaluation of the hip bone and the Trendelenburg test was performed for abductor muscle strength.

Results

Among the 100 patients included in the study, the mean age was 55.55 years (SD ± 7.2), with 45% being male and 55% female. THR was performed on the left side in 63% of patients and on the right side in 37%. The most common indication for surgery was a fracture of the neck of the femur (66%). Postoperatively, 39% of patients had excellent outcomes, 55% had good outcomes, and 6% had fair outcomes based on the Harris hip score. No patients were reported to have poor outcomes. Complications included heterotrophic ossification in 5% of patients and superficial infections in 4% of patients.

Conclusion

The modified lateral approach provides a better visualization of the hip, the dissection of the muscles is not involved and the retention of the posterior capsule prevents it from dislocation and provides extra stability.

Recommendation

A lateral modified approach should be considered for performing total hip replacement surgery irrespective of the indication as the complications reported in this study are comparatively lesser than the other approaches used.

CHALLENGES IN ACCESSING HEALTH CARE SERVICES IN AWO-OMAMMA, ORU EAST LOCAL GOVERNMENT AREA, IMO STATE, NIGERIA: A CROSS-SECTIONAL SURVEY RESEARCH DESIGN.

2024-09-07T15:11:32+00:00

Background

Challenges in access to healthcare facilities, especially in rural settings, have been a great concern to some scholars, and thus, a lot of studies have been carried out on this issue. This study focuses mainly on the challenges of access to the healthcare delivery system in Awo-mamma. The study critically looked at the challenges faced by the people of Awo-mamma in Imo State.

Methods

A simple random sampling method was used in selecting 200 respondents, and a convenience sampling method was adopted in selecting 3 interviewees for the in-depth interview, which represent both probability and non-probability sampling methods. Frequency and simple percentages were also used in the presentation, interpretation, and analysis of the data. The hypothesis was tested using Chi-Square (x2) inferential statistics, and it will help to bring out the relationship between different variables.

Results

The study discovered some of the challenges experienced by healthcare receivers, such as lack of money, distance, excessive wastage of time, unfair attitude of workers, etc., and those challenges experienced by healthcare givers, such as shortage of medical facilities, dilapidation of hospital buildings, ill-behaviour of patients towards medical staff, etc. These challenging factors make people seek medical attention/health care through other consequential means, such as patronizing the chemist shop, which lacks proper prescription, consulting the traditional cure, etc.

Conclusion

Sound health is a fundamental requirement for living a socially and economically productive life. Poor health inflicts great hardships on households, including debilitation, substantial monetary expenditures, loss of labor, and sometimes death.

Recommendations

Rural development policies should promote the creation of an enabling environment to enhance participation in modern healthcare delivery by organizing a sensitization program to create awareness about the importance of using modern healthcare facilities.

INFLUENCE OF CONFLICT MANAGEMENT COUNSELING ON MARRIAGE STABILITY OF COUPLES IN PENTECOSTAL CHURCHES IN KAMPALA, UGANDA. A CROSS-SECTIONAL STUDY.

2024-08-05T18:03:40+00:00

Background

African Traditional Societies systematically initiated boys and girls which prepared them for adulthood experiences like marriage. The study aims to assess the Influence of conflict management counseling on marriage stability of couples in Pentecostal Churches in Kampala, Uganda.

Methodology

A cross-sectional research design using quantitative approaches to collect data from different categories of respondents at a single point in time. The study employed a descriptive correlation study to determine the relationship between pre-marital counseling and the marriage stability of couples.

Results

Based on the aggregate mean, conflict management scored a very high aggregate mean of 4.65 and a standard deviation of 0.67. This means that pre-marital counseling in terms of conflict resolution counseling is provided to couples in Pentecostal churches at a very high level. Conflict management counseling has a weak, positive, and significant influence on the marital stability of couples in a Pentecostal church in Kampala City, r = 0.440** which means that conflict management counseling had a positive, weak, and significant influence on marital stability. When the provision of conflict management counseling increases by one unit, the marital stability of couples in Pentecostal churches also changes positively or increases by one unit.However, at a weak level. The fact that the P-value was lower than the significance level (0.000 < 0.05) when r2 was calculated, 0.193 (100), means that conflict management counseling influences positively the marital stability of couples in Pentecostal church in Kampala, Uganda at 19.3%.

Conclusion

Conflict management counseling had a weak, positive, and significant influence on the marital stability of couples in the Pentecostal church in Kampala

Recommendations

Churches should continue sensitizing the public on the benefits of pre-marital counseling as the church remains the biggest institution that provides these services to couples.

COMPARING THE EFFECTIVENESS OF ORAL ISOTRETINOIN AND CYPROTERONE COMPOUND IN ACNE TREATMENT AMONG ADULT FEMALES WITH CUTANEOUS HYPERANDROGENISM: A PROSPECTIVE STUDY.

2024-07-09T17:35:32+00:00

Background:

Acne is a complex illness caused by androgenic stimulation of the sebaceous glands. As a result, combined oral contraceptives (COCs) including anti-androgenic progestogens are good candidates for acne treatment. The purpose of this study is to compare the effectiveness of oral isotretinoin and cyproterone compound in the treatment of nodulocystic acne, in adult females with signs of cutaneous hyperandrogenism.

Materials and Methods:

Thirty female patients with SAHA syndrome were randomly assigned into two groups of fifteen each. Group A got cyproterone compound (35 μg ethinyl estradiol and 2mg cyproterone acetate) starting day 5 of the menstrual cycle. Group B got isotretinoin at a dose of 0.5mg/kg daily. All recruited patients got topical benzoyl peroxide 3.5% gel regularly. SPSS was used to do statistical analysis. P-values < 0.05 were considered significant.

Results:

Despite a consistent reduction in ASI score in both groups, according to both physician (P = 0.63) and patient (P = 0.25) assessment, the cyproterone compound was not statistically more successful than traditional treatment of nodulocystic acne at the end of the trial. Patients in both groups reported minor and acceptable side effects, except in two cases.

Conclusion:

This study found that cyproterone compound is not more effective than isotretinoin in the treatment of nodulocystic acne in patients with SAHA syndrome or cutaneous hyperandrogenism. Indeed, additional research is needed to assess the efficacy of cyproterone molecules (independent of testosterone level) and isotretinoin in people with just nodulocystic acne.

Recommendation:

Oral isotretinoin is recommended for treating nodulocystic acne in patients with cutaneous hyperandrogenism due to its comparable efficacy to cyproterone compound and established effectiveness in reducing acne lesions. Further research should compare these treatments regardless of androgen levels in nodulocystic acne patients.

A STRUCTURED APPROACH TO FOSTERING A HEALTHY PUBLISHING CULTURE FOR CASE REPORTS IN THE DERMATOLOGY DEPARTMENT AT MBARARA UNIVERSITY OF SCIENCE AND TECHNOLOGY: BRIDGING THE PUBLICATION GAP.

2024-09-08T19:12:29+00:00

Established in 1998, the Georg Klingmüller Clinic at Mbarara Regional Referral Hospital (MRRH) is Uganda's only center for specialized dermatology training. Despite its role as a center of excellence in specialist dermatologic care and training, there is a notable lack of published case reports from the dermatology clinic at MUST, creating a knowledge gap with resulting diagnostic challenges, particularly in the rare presentation of some dermatoses.

This article guides how dermatology postgraduate students at MUST can publish their case studies. It outlines the process from case presentation to drafting and submitting manuscripts, emphasizing the importance of selecting suitable journals and adhering to publication guidelines.

The article also highlights the benefits of a robust publication culture, including improved diagnostic accuracy, career advancement opportunities, and enhanced global collaboration. By fostering a healthy publication environment, students can contribute valuable knowledge to the field and advance their professional development.

DOES MICRORNA-140 PLAY A ROLE IN THE DEVELOPMENT AND PROGRESSION OF OESOPHAGEAL SQUAMOUS CELL CARCINOMA? - A SYSTEMATIC REVIEW.

2024-07-25T13:03:09+00:00

Background

Oesophageal squamous cell carcinoma (OSCC) is one of the most common and lethal cancers worldwide. Despite advances in treatment, the five-year survival rate for OSCC remains suboptimal. Recent studies reveal that microRNAs (miRNAs) are involved in developing and progressing various types of cancer. Therefore, the modulation of miRNAs could have implications for new OSCC treatments. The purpose of this research was to summarise the published evidence on the impact of miRNA-140 on OSCC development and progression.

Methods

PubMed and Scopus were searched for the relevant literature. Study inclusion criteria were: basic science studies published during 1 June 2014–1 June 2023. Study exclusion criteria were: research without an appropriate analysis, non-English language publications, and grey literature. No study quality assessment tool currently exists for basic science studies, and all studies that met the eligibility criteria were incorporated in the review. The literature search results were analyzed with descriptive statistics (frequencies, percentages) and presented as a narrative synthesis.

Results

Eight papers were included in this review. All included studies were from China, and ECA109 was the most common OSCC cell line used (8 studies, 100%). Findings from studies involving transfection of OSCC cell lines with miRNA-140 mimics suggest that increased levels of miRNA-140 impair OSCC development and progression. Several genes appear to be regulated by miRNA-140 in OSCC development and progression (NFYA, ZEB1 & 2, ErbB4, and NRIP1). Hypoxia reduces miRNA-140 levels, thereby promoting OSCC development and progression. High levels of miRNA-140 were found to confer resistance to platinum-based chemotherapy drugs.

Conclusion

miRNA-140 plays multiple roles in the development and progression of OSCC, including influencing tumorigenesis, apoptosis of tumor cells, genome instability, invasion, metastasis, and chemotherapy resistance.

Recommendation

More research is needed to extend and validate these results, and to develop OSCC therapies aimed at modulating miRNA-140.

EVALUATION OF MALONDIALDEHYDE AND SUPEROXIDE DISMUTASE IN PATIENTS OF ALCOHOLIC LIVER DISEASE AND HEALTHY CONTROLS: A CROSS-SECTIONAL STUDY

2024-09-23T09:56:36+00:00

Background

Oxidative stress and an imbalance between oxidants and antioxidants are hallmarks of alcoholic liver disease (ALD), a major global cause of morbidity and mortality. Superoxide dismutase (SOD) and malondialdehyde (MDA) are important indicators for assessing the antioxidant and oxidative stress state in ALD. To comprehend the function of oxidative stress in ALD, this study intends to assess the blood levels of MDA and SOD in patients with ALD and compare them with healthy controls.

Methods

An analytical cross-sectional study was conducted involving 120 male participants. Serum MDA and SOD levels were measured using the Draper and Hadley method and the Marklund and Marklund method, respectively. Statistical analysis was done using an unpaired t-test with a significance level set at p < 0.05.

Results

The study included 120 male participants, divided into two groups: 60 patients with ALD and 60 healthy controls. All participants were age- and sex-matched. The serum MDA levels were notably higher in ALD patients (mean ± SD: 11.45 ± 3.01 nmol/ml) compared to controls (mean ± SD: 3.86 ± 0.73 nmol/ml) (p < 0.001). Similarly, serum SOD levels were notably elevated in ALD patients (mean ± SD: 13.69 ± 1.07 units/ml) compared to controls (mean ± SD: 5.04 ± 1.46 units/ml) (p < 0.001). A strong positive correlation was detected between MDA and SOD levels (rs = 0.988, p < 0.001).

Conclusion

ALD patients exhibit enhanced oxidative stress as indicated by elevated serum MDA levels and a concomitant rise in antioxidant SOD levels. This suggests a compensatory mechanism against oxidative damage in ALD.

Recommendations

Future studies should focus on therapeutic interventions aimed at modulating oxidative stress and antioxidant defense mechanisms in ALD.

ASSOCIATION OF SERUM VITAMIN D LEVELS WITH SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS- A CASE CONTROL STUDY FROM TERTIARY CARE HOSPITAL.

2024-07-09T07:32:25+00:00

Background-

The Vitamin D deficiency prevalence is increasing and has been linked to numerous chronic and autoimmune conditions. This research aims to establish the relationship among Vitamin D and SLE (Systemic Lupus Erythematosus).

Methodology- A case-control research has been conducted on 42 confirmed SLE patients at the Department of Dermatology and the Department of Medicine at Silchar Medical College and Hospital, along with 50 healthy controls matched for age and gender. All samples underwent immunofluorescence testing for dsDNA, ANCA, ANA, and radioimmunoassay for levels of Vitamin-D.

Results- The average Vitamin-D levels in the SLE cases group have been calculated to be 17.57 with a SD (Standard Deviation) of 4.51. The control group had a mean of 52.23 and an SD of 2.01. A paired test comparing Vitamin-D levels in the cases of SLE as well as control groups showed a p-value of <0.001, indicating statistical significance. Following supplementation of Vitamin-D, the average in the SLE cases group had been 46.82, with an SD of 14.65. A paired sample t-test has been conducted on the data collected before as well as after Vitamin D supplementation in the SLE cases group, giving a p-value of <0.001, indicating statistical significance. There has been no statistically major relation between the various ANA types, with p-values of 0.09 following supplementation and 0.21 prior to it. As a result, statistical insignificance was concluded.

Conclusion- SLE patients have lower levels of Vitamin-D than the healthy individuals. Vitamin-D did not display a major correlation with the different patterns of ANA in patients of SLE.

Keywords: Vitamin D, SLE, Immune responses.

COMPARATIVE STUDY OF OXIDATIVE STRESS AND ANTIOXIDANT VITAMINS STATUS IN ALCOHOLIC LIVER DISEASE - A CASE-CONTROL STUDY

2024-09-23T10:02:34+00:00

Background

Oxidative stress in the case of ALD can be treated with antioxidants which improve the treatment outcome of liver cirrhosis. It is necessary to determine the levels of vitamins which act as antioxidants.

Objectives

This study aimed to compare the levels of antioxidant vitamins in patients with ALD and the control group.

Materials and Methods

There were 60 controls and 60 ALD patients reporting at the gastroenterology department who were categorized as mild, moderate, and severe ALD. The bilirubin and MDA for oxidative stress were determined which indicated severity. The vitamin C & E levels were determined and compared between the controls and the study groups.

Results

The study included 120 participants. ALD participants had significantly higher weight and BMI compared to controls (p < 0.001), and most were male. Alcohol consumption increased with ALD severity, from 976.45±57.45 ml/week in the mild group to 1876.55±45.1 ml/week in the severe group, versus 355.12±50.1 ml/week in controls (p = 0.002). Age differences were not significant. Bilirubin in the severe ALD group was 6.4±0.34 mg/dl and in the control group was 0.92±0.2 mg/dl. MDA in the severe ALD group was 14.13±0.56 mg/dl and in the control group was 6.8±0.34 mg/dl. Vitamin C in the severe ALD group was 0.19±0.31 mg/dl and in the control group was 0.71±0.23 mg/dl. Vitamin E in the severe ALD group was 0.32±0.37 mg/dl and in the control group was 0.85±0.43 mg/dl. The difference in each case was statistically significant.

Conclusion

The severity of alcoholic liver disease increases with oxidative stress and with an increase in the bilirubin level. Also, in the case of severe liver disease, there is a significant decrease in vitamin C & E levels.

Recommendation

Vitamin C & E antioxidant therapy should be included in treating ALD.

PHARMACISTS’ PERCEPTIONS ON FACTORS CONTRIBUTING TO STOCK-OUTS OF ESSENTIAL MEDICINES AT A TERTIARY HOSPITAL IN SOUTH AFRICA: A QUALITATIVE CROSS-SECTIONAL STUDY.

2024-07-03T13:32:10+00:00

Background

Essential medicines are one of the vital components in the provision of health services and their availability plays a crucial role in the reduction of mortality and morbidity associated with disease burden. Despite the committed action plans and several initiatives by the South African National Department of Health, there are ongoing medicine stock-outs at public health facilities across the country and this affects thousands of people. To explore this problem, this study explored pharmacists’ perceptions about factors contributing to stock-outs of essential medicines at a tertiary hospital in South Africa.

Methods

A qualitative cross-sectional study was conducted among pharmacists at a tertiary hospital in South Africa. Participants were purposively sampled and due to data saturation, 8 pharmacists participated in the study. Semi-structured, face-to-face interviews were used to collect data. Interviews were recorded and transcribed verbatim and analyzed using Tesch’s open coding process. Trustworthiness of data was measured through transferability, confirmability, credibility, and dependability.

Results

The participants included five procurement pharmacists, one stock controller pharmacist, one receiving pharmacist, and one contract pharmacist. All participants held a Bachelor of Pharmacy degree. Shortage of resources coupled with poor procurement processes affected the availability of medicines and hampered service delivery. Inconsistent deliveries from the Provincial Pharmaceutical Depot to hospitals and clinics as well as poor communication between stakeholders were also perceived as factors contributing to stock-outs of medicines.

Conclusions

Medicines supply chain management within the hospital has several gaps and shortcomings. The hospital should invest in strengthening the procurement and supply chain processes to ensure the availability of medicines.

Recommendations

To improve the availability of essential medicines, pharmacists and supply chain officers should receive continuous training on procurement processes. Formal communication forums to address challenges encountered in the provision of essential medicines should be established and sustained.

A CROSS-SECTIONAL MORPHOMETRIC ANALYSIS OF THE PROXIMAL FEMUR IN THE INDIAN POPULATION: IMPLICATIONS FOR TOTAL HIP ARTHROPLASTY

2024-09-30T10:40:25+00:00

Background

Total hip arthroplasty (THA) is one of the most popular orthopedic operations in the world. Implant design and surgical outcome are greatly influenced by the proximal femur's anatomy. Morphometric variations between populations necessitate region-specific data to ensure optimal outcomes. The study assessed the morphology of the proximal femur in dry human cadaveric bones, which has potential implications for THA.

Methods

110 dry cadaveric femur bones of unknown age and sex were analyzed. Parameters such as femur length (FL), femoral head diameter (FHD), femoral neck length (FNL), femoral neck width (FNW), neck-shaft angle (NSA), and the length of the intertrochanteric line were measured using digital calipers, goniometers, and osteometric boards. Descriptive statistics were applied, and comparisons with global populations were made using the Unpaired Student's t-test.

Results

The mean femur length was 427.56 mm, shorter than the global average. Statistically significant variations (p < 0.05) were observed in FL, FNL, and NSA when compared to global populations. Significant correlations were also identified between femur length and femoral head diameter (r = 0.48) and between femur length and neck-shaft angle (r = -0.42).

Conclusion

The study highlights significant morphological differences in the proximal femur of the Indian population compared to global populations, indicating the necessity for region-specific prosthetic designs. Standard implants may not provide an optimal fit for Indian patients, leading to potential complications.

Recommendations

Further research is recommended to develop customized prostheses tailored to the Indian population’s anatomical variations. This would enhance THA outcomes and reduce the risk of post-operative complications.

ANALYSIS OF SPLENIC NOTCHES IN HUMAN CADAVERS AND ITS CLINICAL RAMIFICATIONS: A CROSS-SECTIONAL STUDY

2024-09-30T10:26:18+00:00

Introduction

Understanding the exterior shape of the spleen anatomically is crucial for both radiological and surgical diagnosis. The superior border splenic notches are a defining trait of the spleen, yet they hardly ever go into detail to be regarded as fissures or divide the spleen into several lobes. There aren't many splenic fissures cadaveric reports to date. To determine the frequency and clinical importance of splenic notches, lobation, and fissures, this study looked at the morphological structure and anatomy of spleens removed from cadavers.

Methods

This cross-sectional study was conducted at the Department of Anatomy, Medical College and Hospital, Keonjhar, over one year. A total of 100 spleens were obtained from cadavers, dissected, and preserved in 10% formalin. The spleens were analyzed for notches, lobation, and fissures, and their morphological characteristics were documented.

Results

Of the 100 spleens studied, 40% showed notches on the superior border, while 10% exhibited notches on the inferior border. The remaining 50% had no notches on either border. Fissures were observed in 10% of the spleens. Among these, six (6%) had incomplete fissures, while four (4%) had complete fissures that divided the spleen into two lobes. The complete fissures resulted in bilobed spleens, with distinct hila for each lobe. In cases where fissures were present, they varied in depth and width, with incomplete fissures reaching depths of 0.5-1 cm without leading to lobation.

Conclusion

The results of this investigation shed important light on the morphology and frequency of bilobed spleens and splenic fissures. Different from other recognized splenic defects, a bilobed spleen is an uncommon congenital abnormality. When performing conservatory splenectomy procedures, surgeons might use the splenic fissures in bilobed spleens as guidance.

Recommendation

To lower the risk of surgical complications, we recommend a procedure of partial splenectomy in less severe cases.

TECHNIQUE FOR REMOVAL OF EAR OSSICLES: A DIAGONAL CORONAL SECTION METHOD

2024-10-01T15:08:17+00:00

The present study is under taken to retrieve the ossicles intact from the temporal bone to measure the various parameters of these ossicles in North Indian population for designing and constructing the implants. The method adopted in this study is easy and reliable method to retrieve the ossicles, especially stapes, the most fragile bone. This method proves out to be less destructive and is suggested as routine procedure for extracting the tiny bones which can be used for further research purposes and learning material for medical students.

Assessment of learning style preferences utilising the VARK questionnaire

2024-09-30T10:47:13+00:00

Background- Medical students have a wide range of diversity in their learning preferences. So, educators need to be aware of different learning styles to effectively tailor instructional strategies and methods to cater to the students’ learning needs and support a conductive learning environment. Thus, the VARK [an acronym for visual (V), aural (A), read/write (R) and kinaesthetic (K)] instrument is a useful model to assess learning styles. The study has been conducted to identify learning style preference among students of MBBS first year.

Materials and methods- The study was a cross-sectional study. It has been conducted for 3 months at Dharanidhar medical College and hospital, Keonjhar, Odisha, India. Consent was obtained from the participants before initiation of the study. VARK questionnaire has been provided to the enrolled participants in the form of Google Forms. Descriptive statistics were used to analyse the student’s preference for various VARK components

Results- Overall, 160 students participated in the study. Among all the participants, 90 students were male and rest 70 were female students. The study has shown that 54% of the students were fitted into multimodal learning, while other 46% were comfortable with unimodal learning. Read/write (29.1%) followed by Kinaesthetic (37.5%) were the most common learning style preferences.

Conclusion- The results obtained from this study provide convincing evidence for educators to use a blended teaching approach to cater to different learning styles to promote learning. To attain the higher level of student learning process, it is important to identify the preferred learning style of students and use innovative, multimodal teaching methods to make the classroom

STUDY OF THE RADIOLOGICAL CARRYING ANGLE IN MALES AND FEMALES AND ITS CLINICAL SIGNIFICANCE: A CROSS-SECTIONAL OBSERVATIONAL STUDY.

2024-09-30T10:33:25+00:00

Background:

The carrying angle, or cubital angle, is the angle formed between the upper arm and forearm when the elbow is fully extended and supinated, with a notable difference between genders. This anatomical feature plays a significant role in activities like walking and carrying objects, while also serving as a key indicator for sex differentiation in anthropology.

Aim:

The study aims to assess the gender differences in the carrying angle among males and females and explore its clinical implications for orthopedic practices.

Method:

This study was conducted in Keonjhar, analyzing 70 elbow radiographs (36 males and 34 females) aged 16 - 40 years. The carrying angle was measured using specific anatomical references on the radiographs, and statistical analysis was carried out to evaluate gender differences.

Results:

The average age of participants was 35 years, with 51.4% being male and 48.6% female. The mean carrying angle was prominently higher in females (22.29°) when compared to males (15.72°), with a difference of 7.25° (p < 0.0001). The minimum and maximum carrying angles for females were 17.50° and 29.60°, while for males, they were 9.00° and 18.70°. Variance analysis confirmed significant differences in carrying angles between genders.

Conclusion:

The study demonstrates a significant gender-based variation in the carrying angle, with females exhibiting a greater angle than males. These findings can aid in clinical assessments and orthopedic treatments related to elbow anatomy and function.

PAIN MANAGEMENT OF PATIENTS WITH CHRONIC RENAL FAILURE: A CASE STUDY OF PATIENTS IN A PRIVATE RENAL FACILITY IN KWAZULU-NATAL.

2024-06-21T14:31:27+00:00

Background

Pain management in chronic kidney disease patients is extremely complicated. An estimated 82% of patients with chronic kidney disease have moderate to severe pain. The purpose of this study was to investigate the types, frequency, and severity of pain experienced by patients with chronic kidney disease, as well as to suggest strategies that patients and staff could use to manage the patient's pain.

Methods

At the Durban Kidney and Dialysis Centre, 60 patients were given questionnaires to assess their level of pain severity and management control. The participants were subjected to inclusion and exclusion criteria. The patient's medical records were examined. The research was carried out between September 2017 and March 2018. For analysis, relevant statistical methods were used. Patients were all on hemodialysis and averaged 57 years old.

Results

According to the findings of this study, most patients reported pain symptoms during dialysis, and 72.3% of the pain experienced was moderate to severe, indicating that pain is a major symptom burden in this patient population.

Conclusion

Both patients and staff would benefit from learning about different types of pain management therapies (both pharmacological and non-pharmacological), as well as the long-term consequences of pain going undiagnosed and untreated.

Recommendations

The results show that pain is a major symptom burden but the use of analgesics is under-prescribed. Pain management, interventions, and strategies should be a research priority because pain is a valid and considerable health concern in the increasing CKD patient population.

The Influence of Chronic Inflammation on the Development of Atherosclerosis and Cardiovascular Events

2024-09-28T03:41:21+00:00

Background

Atherosclerosis, a key contributor to cardiovascular diseases (CVD), is influenced by multiple risk factors. Chronic inflammation has been increasingly recognized as a significant driver in the progression of atherosclerosis and the subsequent development of cardiovascular events. This study investigates the role of chronic inflammation in accelerating atherosclerotic plaque formation and its contribution to cardiovascular complications.

Materials and Methods

A cohort of 200 patients, selected from various hospitals in Kerala, india aged 40–70 years, with established risk factors for atherosclerosis (hypertension, hyperlipidemia, smoking) were enrolled in this prospective study. Inflammatory markers, including C-reactive protein (CRP) and interleukin-6 (IL-6), were measured at baseline and followed over a 2-year period. All patients underwent carotid intima-media thickness (CIMT) measurements and coronary artery calcium (CAC) scoring as indicators of atherosclerotic burden. The cohort was divided into two groups based on baseline inflammation levels: high inflammation (n=100) and low inflammation (n=100). Cardiovascular events, including myocardial infarction (MI) and stroke, were recorded.

Results

At the 2-year follow-up, patients in the high inflammation group demonstrated a significant increase in CIMT (mean increase of 0.15 mm) and CAC scores (average increase of 120 points) compared to the low inflammation group (mean increase of 0.05 mm in CIMT and 40 points in CAC). Cardiovascular events were more frequent in the high inflammation group, with 25% experiencing MI or stroke compared to 10% in the low inflammation group. Elevated CRP (>3 mg/L) and IL-6 (>10 pg/mL) were independently associated with a 2.5-fold increased risk of cardiovascular events.

Conclusion

Chronic inflammation plays a pivotal role in the progression of atherosclerosis and the occurrence of cardiovascular events. Higher levels of inflammatory markers are associated with increased atherosclerotic plaque burden and a greater risk of MI and stroke. Targeting chronic inflammation may provide a novel therapeutic avenue to mitigate the progression of atherosclerosis

THE EVALUATION OF THE QUALITY OF SANITATION AND STORED WATER FOR DOMESTIC USE IN THE UMLAZI P SECTION INFORMAL SETTLEMENT IN SOUTH AFRICA.

2024-06-05T19:18:35+00:00

Background

South Africa is faced with a struggle to manage the supply of water due to growing informal settlements where infrastructure is limited resulting in the contamination of water during collection and storage. The researcher aims to determine the level of knowledge and awareness of water contamination and the safety of water in terms of microbial and chemical content.

Aim: This study aimed to investigate the quality of stored water and the handling of storage vessels for domestic use at the informal settlement of the Umlazi P Section, in the south-west of Durban.

The study objectives:

The objectives of the study were to determine the knowledge and awareness of water contamination using a questionnaire and investigate the exposure of water to microbial agents due to poor hygiene and storage. To test stored water samples for pathogenic organisms as well as compliance with the South African Water Quality Guidelines for domestic use.

Methodology

Data collection entailed the administration of a questionnaire to 269 participants, including the laboratory analysis of water samples collected from water storage containers used in each household.

Results

A positive total coliform count was found among 13 (5%) households in the study of 269 households rendering their drinking water a high risk for domestic use despite only accounting for 5% of the population. The remaining 256 showed to have a negligible exposure to waterborne contamination. The Escherichia coli was not detected making drinking water acceptable in terms of fecal coliform bacteria.

Conclusion

The data collected from the study showed that poor hygienic practices and infrastructure were at the center of water contamination.

Recommendations

The study recommended infrastructure development, hygiene monitoring tools, and cost-effective water treatment products.

THE ROLE OF GEO-ENVIRONMENTAL VARIABLES IN UNDERSTANDING CAUSAL CO-FACTORS OF DISEASES OF UNKNOWN AETIOLOGY AND OTHER ENIGMATIC DISEASES IN AFRICA: A NARRATIVE REVIEW.

2024-07-04T07:27:09+00:00

Idiopathic diseases (ID) or diseases of unknown aetiology (DUA) are poorly understood diseases. These diseases are widespread in Africa and other regions of the world. In Africa, we also experience occasional outbreaks in a population, or a cluster of diseases appears for which the causes are unclear. Until now, there has been a lack of literature linking geo-environmental variables with DUA, perhaps due to under- and misdiagnosis of these diseases. However, some of the few existing reports have implicated geo-environmental variables as inducers of a wide spectrum of pathophysiological responses including apoptosis, fibrosis, inflammation, molecular damage, and oxidative tissue injuries. The present review therefore seeks to explore the critical role that these variables may play as co-factors or risk factors in the incidence and progression of a range of DUA in Africa.

A comprehensive online search of journal databases (Google Scholar, ScienceDirect, PubMed, Scopus, and SpringerLink) was mounted to obtain requisite data that would enable tangible deductions to be drawn on the extent to which geo-environmental variables act as co-factors or risk factors in unraveling the mysteries of unknown aetiology; and to demonstrate the importance of including the geo-environmental component in a multi-factor explanation of the disease causative web. The databases were used to obtain reports related to DUA, disease clusters, and geo-environmental variables as disease risk factors in Africa.

Findings from the present study help us understand and interpret unexpected DUA aetiological data, which are prerequisites for developing accurate and effective diagnosis, prevention, and improved management strategies for these diseases.

It became clear from the present study that for us to fully understand the pathogenesis and progression of DUA, healthcare professionals investigating disease clusters should, perhaps team up with Medical Geologists, a research collaboration that rarely exists in most developing countries today.

Acinetobacter Baumannii and the Challenges: Insights into Various Clinical and Pathophysiological Conditions with Reference to Biofilm Formation

2024-09-30T13:38:29+00:00

Acinetobacter baumannii is a Gram-negative, multidrug-resistant pathogen that poses a significant threat to public health, particularly in healthcare settings. Its ability to resist desiccation, colonize abiotic surfaces, and form biofilms contributes to its persistence in medical environments. The various clinical and pathophysiological challenges posed by A. baumannii are explored, with a focus on biofilm formation, surface motility, and virulence factors. The bacterial resistance to common antibiotics, including carbapenems, fluoroquinolones, and cephalosporins, exacerbates its role in nosocomial infections, such as pneumonia, catheter-associated bacteremia, and soft tissue infections. A. baumannii demonstrates various mechanisms of virulence, including twitching motility, type IV pili- mediated adherence, and secretion of biofilm-associated proteins. These biofilms offer protection against desiccation and enhance the pathogen's resistance to environmental and antibiotic stressors. This article further reviews the bacterial quorum sensing systems, outer membrane vesicles, and iron uptake mechanisms that are critical for the pathogen's survival in host tissues and medical environments. Understanding the multifaceted nature of A. baumannii virulence can guide future therapeutic strategies aimed at mitigating its impact, particularly in critical care units.

THE QUEST FOR ROBUST ENFORCEMENT OF THE LAW ON TRADEMARKS IN UGANDA TO MAXIMIZE ITS ECONOMIC BENEFITS. A SYSTEMATIC REVIEW.

2024-08-05T10:37:32+00:00

Introduction

With ever-increasing cases of trademark counterfeiting and infringement globally due to sophisticated technological advancements, it has become imperative for companies to register their trademarks to enjoy the benefits that accrue from their registration. Not only has registration of trademarks benefited trademark owners, but it is also a means of technological transfer between states and a source of government revenue. In this study, the law on trademark enforcement was examined in a quest for robust enforcement mechanisms to maximize the economic benefits.

Purpose:

This study analyzed the law on trademark enforcement in Uganda in a quest for robust enforcement mechanisms to maximize the economic benefits. It involved a probe into the adequacy of the existing legal and institutional framework on trademark enforcement mechanisms since it is a necessity to any given country irrespective of its level of economic development. It not only enhances the protection of the existing trademark rights but also encourages creators and investors to settle in an environment that is conducive to creativity and investment.

Methodology

The study utilized doctrinal research methodology, analyzing data from authoritative sources like statutes, conventions, and judicial decisions, and utilizing content analysis techniques for clear and concise answers.

Results

The study revealed that Uganda has a robust legal and institutional framework for trademark enforcement though with weak penalties. The institutional framework is weak, lacking sufficient funds and trained personnel to effectively deter counterfeiting and infringement.

Conclusion

The empirical literature indicates that Uganda has a robust legal framework for trademark enforcement but the penalties are insufficient to deter counterfeiting and infringement.

Recommendations

The authors recommended the amendment of the Trademarks Act to provide sentences that are deterrent in nature, promotion of public awareness, and training of the required personnel.

FACTORS ASSOCIATED WITH VOLUNTARY BLOOD DONATION AMONG LIRA UNIVERSITY STUDENTS. CROSS-SECTIONAL STUDY.

2024-09-04T06:30:22+00:00

Abstract

According to UBTS, the total units of blood collected increased from 131,226 in 2007/2008 to 274,308 in 2018/19 but still less than the WHO recommendation of 1% of Uganda's population. To save the lives of patients due to accidents, obstetric and gynecological bleedings, cancers, and severe anemia with low blood volumes. This study will assess the factors associated with voluntary blood donation among Lira University students.

Methodology

A cross-sectional study using mixed methods of data collection was carried out among Lira University students. A sample size of 311 was calculated using the Yamane formula and recruited using a stratified random sampling technique and 5 key informants for qualitative data. SPSS version 20 was used for data entry and analysis. Univariate analysis was used to determine frequencies, proportions, and ranges. At bivariate analysis, a bivariate logistic regression was performed between the independent variables and dependent variable at a 95% confidence interval, Crude odds ratios (COR) were used as measures of association. Variables with P ≤0.05 were considered significant associations with the dependent variable.

Results

Their mean age was 23.7 years. The study population comprised approximately 40.5% blood donors of which 23.8% were blood donors. The majority of the participants (79.8%) had positive attitudes towards blood donation and the non-donors (61.7%) had never got a chance to donate. The majority of the respondents (59.5%) were male.

Conclusion

High awareness, influencing positive attitude, and regular blood donation drives should be prioritized if we are to achieve 1% donors of the population as recommended by WHO.

Recommendation

The Uganda Blood Transfusion Service should do more talk shows via announcements in public gatherings, and mouth-to-mouth engagements with the students, and handle first-time donors well to recruit and retain donors.