Student's Journal of Health Research Africa

ASSESSMENT OF THE RELATIONSHIP BETWEEN SERUM ALBUMIN AND GLUCOSE LEVELS IN HEALTHY, PRE-DIABETIC, AND DIABETIC INDIVIDUALS’ CASE-CONTROL OBSERVATIONAL STUDY

Kanchan Kumari — 2024-12-17

Introduction

Diabetes mellitus is a metabolic disorder characterized by chronic persistent hyperglycemia. If it persists for a prolonged period, it may lead to microvascular and macrovascular complications. Several studies were done to estimate serum albumin in diabetes mellitus, and there is uncertainty about the relationship between serum albumin and diabetes.

Aim and objectives

The aim of this study is to compare serum albumin in normal, pre-diabetic, and diabetic individuals.

Materials and methods

Glucose estimation was done using the Glucose oxidase Peroxidase method, and Albumin estimation was done using the Bromocresol Green method in Pawapuri, Nalanda.

Results

A total of 160 cases of age between 30-80 years were selected out of which 40 each were healthy, pre-diabetic, diabetic with Glucose levels less than 300mg/dl and above 300mg/dl. The mean Serum albumin level with standard deviation in normal individuals was 4.63± 30, in pre-diabetic individuals was 4.38 ± 0.24, in diabetic individuals were 4.23 ± 0.41, in uncontrolled diabetic individuals were3.98± 0.35. There was a significant decrease in serum albumin in pre-diabetic, diabetic, and uncontrolled diabetic individuals from normal individuals.

Conclusion

There was an inverse relationship between serum Albumin and Glucose in diabetic individuals. By regular estimation of serum albumin in diabetic individuals, the development of complications in diabetic individuals can be delayed.

Recommendation

Regular estimation of serum albumin levels in diabetes and keeping serum albumin levels within normal limits is required to delay diabetic complication development.

INCIDENCE OF PSYCHOTROPIC DRUGS PRESCRIBED IN CHILDREN AND ADOLESCENTS WITH AUTISM AT EL. TEGANI-ALMAHI REFERENCE HOSPITAL KHARTOUM SUDAN. A CROSS-SECTIONAL STUDY.

Alrazi Eisa Shogar — 2024-12-20

Background:

Autism spectrum disorder (ASD) among vulnerable populations frequently presents with complex mental health diagnoses, and psychotropic medications are often a component of comprehensive biopsychosocial treatment plans for these conditions. The primary aim of this study is to determine the incidence of usage of psychotropic drugs and to assess the response of psychotropic medications prescribed in children and adolescents with autism in a resource-constrained setting in Khartoum Sudan.

Materials and methods:

Following an institutional review board approval, Department of Innovation, Development and Scientific Research, Ministry of Health, Khartoum State (IDSREC-2020-EATA/44/A), A cross-sectional retrospective hospital-based study was conducted from January 2018 to Jan-2021 among 261 children and adolescents aged 1 to 17 years diagnosed with ASD using The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) as a guideline. SPSS version 25.

Results:

The prevalence of ASD was greater in males than females; 45% of autistic patients have at least one comorbid disease. Attention Deficit Hyperactivity Disorder (ADHD), learning disability (LD), and epilepsy are the three most comorbid diseases among autistic patients. The Average number of psychotropic drugs per prescription was 1.8 out of 2.61. The most often prescribed medications among this group were risperidone (49%), methylphenidate (33%), and valproic acid (15%). All the patients received at least one psychotropic prescription; 30% of the patients were receiving polytherapy. Non-adherence of the patient to their medication account for 24%. This indicated the efficacy of other treatment approaches and the importance of combining medication and non-medication therapy.

Conclusion:

The study revealed a significant use of psychotropic medication, with a notable emphasis on antipsychotics. There is a high incidence of prescription rates for psychotropic medications for comorbid psychiatric disorders.

STUDY OF MICROALBUMINURIA AS A CARDIOMETABOLIC RISK FACTOR IN TYPE 2 DIABETES MELLITUS: A CROSS-SECTIONAL STUDY.

Sugatha Sahu — 2024-12-20

Background

The rising occurrence of type 2 diabetes mellitus (T2DM) presents considerable health hazards, particularly concerning heart-related complications. The presence of microalbuminuria acts as an important indicator for the early identification of vascular injury and cardiometabolic risks in individuals with T2DM, emphasizing the necessity for regular screening.

Aims

This work aims to assess the prevalence of microalbuminuria in individuals with type 2 diabetes mellitus in patients residing in Odisha.

Methods

This cross-sectional study took place for over 2.5 years at MKCG Medical College and Hospital, involving 110 patients diagnosed with T2DM. Participants were recruited from the outpatient and inpatient departments of General Medicine and Endocrinology, after obtaining informed consent. Comprehensive demographic and clinical data were collected, alongside laboratory assessments for microalbuminuria using an immunoassay method.

Results

The study comprised 65 males and 45 females, with an average age of 57.07 years. Microalbuminuria was found in 24 of 27 patients (88.89%) with diabetes for 11 years or more (p < 0.05). Additionally, 25 of 41 patients (61%) with elevated HbA1C levels had microalbuminuria. Mean fasting blood sugar was significantly higher in the microalbuminuria group (142.83 ± 37.32 mg/dL vs. 127.85 ± 31.36 mg/dL).

Conclusion

Microalbuminuria is significantly associated with the duration of diabetes, poor glycemic control, dyslipidemia, and renal dysfunction in patients with type 2 diabetes mellitus.

Recommendation:

Microalbuminuria is a marker of vascular disease and can be used to support further therapy directed at this complication. For the stated reasons, microalbuminuria testing is recommended.

HEALTH FACILITY FACTORS INFLUENCING MALE INVOLVEMENT IN ANTENATAL CARE AMONG CLIENTS ATTENDING ANTENATAL CLINIC AT NEBBI GENERAL HOSPITAL, NEBBI DISTRICT A CROSS-SECTIONAL STUDY.

Teddy Adero — 2024-12-13

Background

Antenatal care (ANC) is crucial for maternal and fetal health, yet male involvement in ANC remains low globally. Despite efforts to encourage male participation, studies indicate low levels of involvement across Africa, including Uganda. This study aims to identify factors influencing male involvement in ANC at Nebbi General Hospital.

Methods

The study employed a cross-sectional quantitative approach using purposive sampling to collect data from pregnant women and their partners attending the antenatal clinic, with a final sample size of 37 participants, and data analysis conducted using SPSS version 20.0

Results and discussions

There was a 100% response rate with 37 participants. The study revealed that distance to the facility, discussion of antenatal care with health workers, and comfort with health workers' gender were key determinants of male involvement.

Conclusion

Various health facility factors significantly influence male participation in antenatal care (ANC), affecting maternal and child health outcomes.

Recommendation

To improve male involvement in ANC, hospitals should provide flexible clinic hours, especially for working men. District health officers should address health facility factors and train health workers to effectively engage with male partners.

Nursing implications

Nurses should educate expectant mothers and their male partners on the importance of male involvement in ANC and its impact on pregnancy outcomes, advocating for flexible clinic hours to accommodate diverse backgrounds.

PREVALENCE AND FACTORS ASSOCIATED WITH POOR PHARMACEUTICAL WASTE DISPOSAL PRACTICES AMONG HOUSEHOLDS IN NANSANA MUNICIPALITY, WAKISO DISTRICT, UGANDA: A CROSS-SECTIONAL STUDY.

HERI LEMBA — 2024-12-02

Introduction

The rising demand for pharmaceuticals globally raises concerns about poor disposal of pharmaceutical waste. Pharmaceutical waste lacks clear guidelines for its management, contributing to environmental pollution and high healthcare costs. While some countries implement effective pharmaceutical waste policies, many developing nations including Uganda, face challenges due to insufficient awareness, regulations, and infrastructure. This study determined the prevalence and factors associated with poor pharmaceutical waste disposal practices in Nansana Municipality Wakiso District, Uganda.

Methods

A cross-sectional study was conducted among 399 households in Nansana Municipality. Stratified sampling was conducted across the four divisions of Nansana Municipality, and a random selection of respondents was made. Data was gathered using a structured questionnaire that included demographics, knowledge, attitudes, and pharmaceutical waste disposal practices. Univariate, bivariate, and multivariable modified Poisson regression analyses identified the prevalence and factors associated with poor pharmaceutical waste disposal.

Results

The study revealed that 72.2% of Nansana Municipality households used poor pharmaceutical waste disposal, predominantly using toilets (91%). Several factors were significantly associated with poor pharmaceutical waste disposal practices in Nansana Municipality. Respondents aged ≥ 30 years were 1.33 times more likely to engage in poor disposal compared to those aged 20-25 years (APR = 1.33; 95% CI: 1.15-1.54). Household monthly income above USD 137 was linked to a lower likelihood of poor pharmaceutical waste disposal (APR = 0.76; 95% CI: 0.59-0.98).

Conclusion

The study found a high prevalence of poor pharmaceutical waste disposal in Nansana Municipality, Wakiso District Uganda. Given the influence of age, gender, education, and income on these behaviors, public health strategies must combine educational, economic, and infrastructural measures for effective impact.

Recommendation

Implementing voluntary take-back programs, enforcing producer responsibility for eco-friendly packaging, and raising public awareness of safe pharmaceutical waste disposal are needed.

TETANUS IMMUNIZATION STATUS AND KNOWLEDGE AMONG UNIVERSITY FEMALES AND DOCTORS AT WAD-MEDANI, SUDAN: A DESCRIPTIVE CROSS-SECTIONAL STUDY.

Omnia Motassem — 2024-12-09

Background

Tetanus is a bacterial disease with the majority of reported cases being birth-associated due to unhygienic deliveries and lack of routine maternal vaccination, however, it can be prevented by routine vaccination. The current study aimed to determine tetanus vaccination status and knowledge among university females of childbearing age and the doctors who comprise an important category of maternal healthcare service delivery at Wad-Medani City, Sudan, based on the recommended WHO guidelines.

Methods

A descriptive cross-sectional survey was conducted using two types of researcher-administered questionnaires.

Results

The majority of the surveyed females were never (41.6%) or didn’t know (22.4%) whether they were vaccinated or not, while some were incompletely vaccinated (26.4%), and few (9.6%) were completely vaccinated with the 5 doses of tetanus vaccine. The main reason for none or incomplete vaccination among the females was the lack of awareness (77.4%). On the other hand, 31% of the respondent doctors knew the correct target population to achieve maternal tetanus elimination as recommended by the documented guidelines with only 25% who knew the complete set of vaccine doses, while 63% were under the misconception that it should target only pregnant women or patients with wounds. Further analysis showed that females who have given birth to children or had a history of pregnancy were more likely to receive the complete 5 doses of the vaccine, while correct knowledge was found higher among doctors with advanced years of experience.

Conclusion

Tetanus vaccination coverage was relatively poor, and the main reason was the lack of knowledge about the vaccination program and its importance.

Recommendation

Improving public knowledge through media sources along with other guidance at healthcare facilities can play a vital role in imparting immunization. It is also necessary to ensure the availability of the vaccine and its accessibility for all females.

A HEALTH WORKERS’ PERSPECTIVE ON TB PREVENTIVE THERAPY FOR CONTACTS OF TB PATIENTS: A CROSS-SECTIONAL STUDY FROM SOUTH WESTERN UGANDA

Dan Mugisha — 2024-12-01

Background

Tuberculosis Preventive Therapy is the key, cost-effective Tuberculosis (TB) prevention strategy but its coverage remains sub-optimal, globally. The objective of the study was to establish factors associated with TPT prescription among PBC TB patients.

Methods

A cross-sectional study was conducted. Data was collected using a data abstraction tool and a self-administered, semi-structured questionnaire from the 17 TB diagnostic and treatment health facilities in Bushenyi district, South Western Uganda. Abstract data was analyzed in Excel for descriptive statistics. Factor analysis was done on the data collected using the questionnaire using. R Core Team, 2023 was used for the analysis.

Results

Of the 781 contacts line-listed for contact tracing, only 442 (77.1%) were prescribed TPT, which is below the 90% target. Factor analysis revealed six factors affecting TPT prescription and these are Latent TB testing, TPT service delivery, TPT financing, human resources for TPT, Monitoring, and evaluation for TPT, and health workers' attitude towards TPT. In the bivariate logistic regression analysis, perception of patient as being uncomfortable with TPT (OR 4.42 95% CI:1.87-11.7; p=0.001), low healthcare worker’s knowledge of TB and TPT (OR 3.94 95% CI: 1.61-11.1; p=0.005), and negative healthcare worker’s attitude towards TPT prescription (OR 4.56 95% CI: 1.28-29.2; p = 0.045) were significantly associated with low TB prescription. In multivariate logistic regression, the perception of the patient is uncomfortable with TPT (aOR 5.58 95% CI: 2.18-16.0; p = <0.001). Gaps in knowledge among healthcare workers about TB and TPT (aOR 5.97 95% CI: 2.08-19.6; p=0.002) were significantly associated with less likelihood of TPT prescription by a healthcare worker.

Conclusions

Whereas TPT is an efficient intervention for the prevention of TB, health system factors remain impediments to its implementation.

Recommendation

Studies be conducted to evaluate the impact of TPT on reducing TB incidence among contacts of PBC TB patients.

DYSLIPIDEMIA IN ELDERLY PATIENTS WITH CEREBROVASCULAR ACCIDENTS: A CROSS-SECTIONAL STUDY.

Rachita Sinha — 2024-12-01

Background

Dyslipidemia is a significant risk factor for cerebrovascular accidents (CVA), especially among the elderly, due to age-related metabolic changes. This demographic is more vulnerable to lipid abnormalities, which increase the risk and severity of ischemic strokes. Despite established guidelines, dyslipidemia remains poorly controlled in elderly populations, underlining the need for targeted lipid management. This study aimed to examine the prevalence of dyslipidemia in elderly CVA patients.

Methods

A study was conducted at MGM Institute of Health Sciences, Navi Mumbai, over 1.5 years, involving 150 elderly CVA patients. Participants underwent lipid profile assessments, and data were collected on demographic, clinical, and lifestyle factors. Statistical analyses were performed using SPSS version 22.0, with chi-square tests and logistic regression applied to determine associations between dyslipidemia and risk factors.

Results

Of the 150 participants, 74.7% had dyslipidemia, with high LDL levels in 60% and low HDL levels in 70.7% of cases. Dyslipidemia was significantly associated with hypertension (OR 2.58, p < 0.01) and diabetes (OR 1.98, p = 0.02). Patients with severe CVA had significantly higher LDL and total cholesterol levels than those with milder CVA presentations (p < 0.05).

Conclusion

The study reveals a high prevalence of dyslipidemia in elderly CVA patients, particularly among those with hypertension and diabetes. Dyslipidemia is associated with increased CVA severity, suggesting that lipid abnormalities may exacerbate stroke outcomes in elderly individuals.

Recommendations

Regular lipid screenings and targeted lipid management should be prioritized in elderly patients with CVA, especially those with hypertension and diabetes. Implementing effective lipid management strategies may reduce morbidity and improve outcomes in this high-risk population.

TYPES OF WASTE GENERATED IN NABARI PAYAM SOUTH SUDAN. A CROSS-SECTIONAL STUDY

Agaar Chep Aboor — 2024-12-01

Background

There is a dire need to create environmental education and awareness, practices, and knowledge in high schools to enhance environmental monitoring and management in the country for both present and future periods. The study aims to assess the types of waste generated 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

197 (59.0%) were male and 137 (41.0%) were female. (47.9%) mentioned inorganic waste, 10 (3.0%) with recyclable waste, 53(15.9%) with solid waste, 100 (29.9%) organic waste, 4 (l .2%) for liquid waste and 4 (1.2%) of the respondents mentioned hazardous waste. Qualitative information also revealed that waste of different types was mixed since there were not enough storage facilities, and in some health centers, nothing was available to store waste generated. One participant said, “….. Here wastes are mixed despite the source and this is due to limited containers. Wastes are discarded together in open space outside the Payam and sometimes I could see the safety boxes are being burnt using kerosene”.

Conclusion

Inorganic and organic waste were the main types of waste generated followed by sharp objects and solid waste. The local people and authorities have limited capacity to manage waste generated per day and this affects the health and environmental aspects of the Payam.

Recommendations

Residents of Nabari Payam should reduce the generation of different types of waste most especially those that are more dangerous, especially if not well managed.

SPATIAL AND TEMPORAL DISTRIBUTION OF TUBERCULOSIS INFECTION IN PLATEAU STATE, NIGERIA: A DESCRIPTIVE ECOLOGICAL STUDY.

Ibrahim Bakshak KEFAS — 2024-12-01

Background

This study aimed to describe the spatial and temporal patterns of notified TB patients in 2018, 2019, and 2020 in Plateau State.

Methods

The data were obtained from the State Tuberculosis and Leprosy Control Programme Unit, and the population information was obtained from the National Population Commission. The spatial analysis techniques and time series considered the 17 local government areas as the unit of analysis. The global Moran statistic was used to demonstrate a trend towards clustering over the years of study.

Results

7804 TB cases were reported during the three years of the study from 2018 to 2020. The LGAs with high incidences of tuberculosis were Jos North, Jos South, Mangu, and Langtang North. The global Moran statistic demonstrated an increasing trend towards clustering over the years of study. The Local Indicators of Spatial Association (LISA) statistics showed an insignificant relationship between LGAs and their neighbors (z score of -0.035124 and a p-value of 0.886253). Nevertheless, Jos North, Jos South, and Riyom were the LGAs found to have clustered.

Conclusion

A spatial-temporal pattern that revealed the dynamics of disease spread as the tendency of TB patients to cluster and hot spots of space-time disparities provides useful and detailed information to guide policy formulation to address the burden of TB in the state briefly.

Recommendations

Spatial analysis techniques should be integrated into routine epidemiological surveillance to monitor tuberculosis risk factors in Nigeria. Government policies should support mapping high-risk areas for infectious diseases among the general population to understand prevalence better and enable precise public health interventions.

JOHN LOCKE’S THEORY OF KNOWLEDGE IN RELATION TO THE BATAGWENDA PEOPLE. A CASE OF KICHECHE SUB-COUNTY, KITAGWENDA DISTRICT, UGANDA.

Innocent Ampaire — 2024-12-16

Background

Knowledge is a set of mental and psychological capacities that make mankind a unique, morally different creature. Although all the created may have capacities of reproduction, self-care, and memory, it is only human beings who are self-conscious, rational, and autonomous, can use language, and are responsible for their actions. This study aimed to examine the theory of knowledge according to John Locke about the Batagwenda people of Kicheche Sub-County, Kita Gwenda district, Uganda.

Methods

An explorative case study design with qualitative research approaches was used. Data was collected using a semi-structured interview guide and analyzed thematically to systematically identify, code, and report recurring patterns in a narrative form. It was augmented by a systematic literature review on the life and works of the empiricist philosopher John Locke with a focus on his theory of knowledge.

Results

A total of 30 participants participated in the study. It was affirmed that knowledge is a distinct attribute proper to human beings. It is obtained through sense experience, reasoning, and revelation from God. However, knowledge is limited and all ideas should be subjected to the criteria of truth and certainty.

Conclusion

Knowledge is the highest mental and psychological faculty that defines human beings other factors notwithstanding. It is limited in nature although human beings can obtain knowledge sufficient for their functions. It is obtained in many ways including experience, reasoning, and revelation. It should be subjected to proof based on truth and certainty since it cannot be wholly grasped as it is.

Recommendation

There should be a constant search for knowledge through interactive experiences, reading, and meditation. It requires substantiation based on truth and certainty because it is relative. It should be sought and guarded jealously because it makes human beings unique while fostering a natural tendency toward perfection.

A REVIEW OF THE INTEGRATION OF TRADITIONAL AND MODERN MEDICINE

Ntombizanele Tshali — 2024-12-13

The integration of traditional medicinal plant knowledge with contemporary pharmaceutical research has enormous potential for the development of novel and cutting-edge modern medication. This study explores how indigenous and traditional uses of medicinal plants can informatively enhance drug discovery and development procedures. Traditional knowledge, honed over decades, frequently includes a thorough understanding of plant-based cures and their therapeutic applications. Case studies where traditional medicinal plants have been used to formulate new drugs will be examined. For instance, the discovery of artemisinin from the traditional Chinese medication sweet wormwood has revolutionized the treatment of malaria. The Madagascar periwinkle, which was traditionally used to treat diabetes, is now the source of the pediatric cancer treatments vinblastine and vincristine. Technologies and methods that can be used to accelerate the translation of traditional practices into modern medicine will also be evaluated. These include systems biology techniques, metabolomics, and high-throughput screening to clarify the mechanisms of action of traditional treatments. Through the documentation of the safety, efficacy, and chemical composition of traditional remedies, researchers can confirm their effectiveness and possibly identify active ingredients for additional research. This approach makes use of indigenous knowledge of traditional medicine to treat modern health issues while also acknowledging the cultural and historical relevance of the practice. Additionally, opportunities and challenges in this multidisciplinary collaboration will be identified.

EFFICACY AND SAFETY OF RETROGRADE INTRARENAL SURGERY (RIRS) FOR RENAL STONE CLEARANCE: A PROSPECTIVE INTERVENTIONAL STUDY.

Nikhil Ranjan — 2024-12-20

Background

The management of kidney stones has advanced with the development of minimally invasive techniques like Retrograde Intrarenal Surgery (RIRS). RIRS, which employs flexible ureterorenoscopy and laser lithotripsy, is a highly promising and safe method for the removal of stones, even in complicated cases. Recent technological improvements have expanded its use, particularly for larger stones (> 2 cm), which were previously treated through percutaneous nephrolithotomy.

Aims

This study seeks to assess the safety and efficacy of RIRS for renal stone clearance in adults. Key objectives include evaluating the success rate of stone removal and analyzing perioperative factors such as surgical duration, complications, and recovery.

Methods

Conducted at IGIMS, Patna, this interventional investigation was performed on 20 adult patients with kidney stones over one year. The surgery utilized a Holmium laser for stone fragmentation, with post-procedural evaluation through X-ray imaging. Data on stone clearance rates, procedure time, complications, and recovery were collated to examine the procedure’s safety as well as effectiveness.

Results

The study included 20 patients with a greater proportion of males and a mean age of 33.4 ± 10.6 years. The stones were mainly located in the middle calyx (40%) and lower calyx (20%), with an average size of 1.06 ± 0.36 cm. RIRS achieved a 100% stone-free rate, with an average surgical duration of 90 ± 18.7 minutes and an average duration of hospitalization (approx. 4.6 days). Complications were minimal, with 90% classified as Grade I and 10% as Grade II. A second RIRS session was required in 10% of cases, and 20% of patients needed a postoperative blood transfusion.

Conclusion

RIRS proved to be a promising treatment for renal stones, demonstrating high stone clearance rates with minimal complications. This technique offers a dependable alternative to traditional treatments, providing shorter hospital stays and manageable recovery outcomes.

THE GREAT PRETENDER: URETHRAL LEIOMYOMA POSING A DIAGNOSTIC CONUNDRUM - A CASE REPORT

Divyanshu Joshi — 2024-12-20

Background

Acute urinary retention (AUR) is a common urological emergency, but it is relatively rare in females. The management of female AUR varies due to the diversity of potential underlying causes, often leading to a lack of consensus in treatment protocols. This case highlights a rare cause of AUR in a female patient, presenting a unique diagnostic challenge.

Case presentation

A 35-year-old female presented to an outside outpatient department (OPD) with complaints of sudden urinary retention, abdominal pain, painful menses, and a mass protruding from the urethra. Examination revealed a tender, non-reducible mass of 5 x 3 cm at the 12-3 o’clock position of the urethra, with a per urethral catheter in place. Pelvic MRI indicated a well-defined, nodular lesion with altered signal intensity along the anterior aspect of the urethra, consistent with a benign mesenchymal lesion. The patient underwent surgical excision of the mass under regional anesthesia. Histopathological examination confirmed the diagnosis of urethral leiomyoma.

Conclusion

Urethral leiomyomas are rare, benign tumors that can present with symptoms similar to other urethral pathologies, including AUR. Surgical resection is the definitive treatment, with a low risk of malignant transformation but potential for local recurrence.

Recommendation

This report emphasizes the need for greater awareness and research into female AUR, especially in developing countries, to improve early diagnosis and management.

"CLINICAL AND SURGICAL OUTCOMES OF DORSAL SPINE INTRADURAL EXTRAMEDULLARY SPACE-OCCUPYING LESIONS: A PROSPECTIVE INSTITUTIONAL EXPERIENCE"

Dr. Hazi Zawar Sadiq Abbas Dr. Hazi Zawar Sadiq Abbas — 2024-12-09

Background

Space-occupying lesions (SOLs) within the spinal canal can cause compression and distortion of nearby neural tissue. These lesions create space by causing atrophy in the surrounding spinal tissue, leading to neurological deficits. While advancements in neuroimaging techniques have significantly transformed neurologic diagnosis in recent decades, the definitive diagnosis of any central nervous system SOL still requires histological examination of tissue obtained through surgical biopsy.

Aims

To assess the outcome of space-occupying lesions in the spinal region and assess the prevalence of different lesions, including their clinical characteristics based on age, gender, compartmental distribution, and the specific spinal levels affected.

Materials and methods

In this prospective study spanning 1 year at a well-equipped tertiary care hospital in India with a neurosurgery department, 12 specimens (biopsy and surgical) from spinal cord and adjacent structure lesions were examined. The study included indoor patients from the neurosurgery department exhibiting clinical signs, symptoms, and imaging features indicative of spinal space-occupying lesions (SOL). Exclusions comprised primary bone tumors and congenital anomalies, including vascular malformations not involving the cord.

Results

The prevalent age group affected was 41-60 years, with an average age of 47 years, and a higher incidence among females. Neoplastic lesions constituted the majority at 87%, primarily benign or low-grade. Meningioma emerged as the most frequent histologic diagnosis, followed by schwannoma.

Conclusion

Tissue diagnosis is crucial given the diverse range of lesions in the spinal region, each with distinct prognoses and treatment approaches.

Recommendations

Early diagnosis and prompt surgical intervention are essential for managing dorsal spine intradural extramedullary lesions, attention should be given to common diagnoses like meningiomas and schwannomas, to ensure timely and effective treatment.

PERIOPERATIVE OUTCOMES OF SARS-COV-2 POSITIVE PATIENTS WHO UNDERWENT URGENT AND EMERGENCY SURGERY: A RETROSPECTIVE COHORT STUDY AT A SOUTH AFRICAN QUATERNARY HOSPITAL DURING THE SARS-COV-2 PANDEMIC

faheem baba — 2024-12-13

Purpose

This study aimed to assess the perioperative outcomes of SARS-CoV-2-positive patients undergoing urgent and emergency surgeries during the COVID-19 pandemic at a South African quaternary hospital. The primary goal was to determine whether mortality rates and complications in the local setting were consistent with global findings.

Methods

This retrospective review included all SARS-CoV-2-positive patients presenting for surgery from March 1, 2020, to December 28, 2021, at IALCH, Durban, South Africa. Data were extracted from electronic medical records, including demographics (age, sex, American Society of Anesthesiologists (ASA) grading, planned surgery), clinical factors (COVID diagnosis details, degree of respiratory compromise, anesthesia type), and complications.

Results

The major finding from the dataset was the relatively young population of the cohort, with a mean age of 32.5 years among all patients presenting for surgery. Most patients who died were classified as ASA 3 or 4, with multiple comorbidities. Multiple trauma cases were common during the study period, which coincided with a period of strict lockdown.

Conclusion

In this retrospective cohort study of surgical patients with confirmed SARS-CoV-2 infection, 22.8% of patients died. The findings suggest that SARS-CoV-2 may not have had a significant impact on overall all-cause mortality in this cohort. Trauma was a major contributor to mortality, particularly among ASA 3 and 4 patients.

ASSESSING VILLAGE SAVINGS & LOAN ASSOCIATIONS AND HOUSEHOLD WELFARE IN SELECTED VSLA IN KAMULI DISTRICT. A CROSS-SECTIONAL STUDY.

AMBROSE WOLUKAWU — 2024-12-20

Background

For over 100 years, household welfare has remained a major problem affecting a significant portion of the global population. The study aims to assess village savings & loan associations and household welfare in selected VSLA in the Kamuli district.

Methodology

The cross-sectional survey design was implored to collect data. The sample size determination was performed using the Krejcie and Morgan (1970) table. The responses were coded and organized in tables to facilitate their interpretation. To analyze the data, we employed the Statistical Package for Social Sciences version 23.0 (SPSS).

Results

The majority were females at 69% whilst males at 31%. The Pearson correlation coefficient testing the significance between savings and poverty was 0.450 and positive. The p-value for the Pearson coefficient (p = 0.000) is less than 5% significance. The Pearson correlation coefficient testing the significance between loans and household welfare was 0.436 and positive which indicated a moderate positive significance between savings and poverty. The p-value for the Pearson coefficient (p = 0.000) is less than 5% significance. The Pearson correlation coefficient testing the significance between entrepreneurship and poverty was 0.484 and positive. The p-value for the Pearson coefficient (p = 0.000) is less than 5% significance.

Conclusion

Respondents expressed skepticism regarding the capacity of savings to enhance financial security, stability, and independence a divergence from conventional wisdom. There was Skepticism about the efficacy of loans in various aspects of life and a divergence of perspectives among survey participants and key informants regarding various facets of entrepreneurship in the community. Recommendation

VSLAs should reconsider the punitive fines imposed on members who fail to repay their loans promptly.

RISKS ASSOCIATED WITH MEDICAL GLAUCOMA TREATMENT FOR CATARACT PATIENTS: A PROSPECTIVE OBSERVATIONAL COHORT STUDY

Ratkal Ashwini Mallikarjun — 2024-12-20

Background

Glaucoma and cataracts are common ocular conditions often found together, posing significant challenges in patient management. The concurrent presence of both conditions can complicate treatment strategies, as glaucoma medications may accelerate cataract formation. This study examines the impact of glaucoma treatment on cataract progression and visual outcomes.

Methods

This prospective observational cohort study at Mahaveer Institute of Medical Sciences, Telangana, enrolled 80 adults with glaucoma and cataracts. Participants received glaucoma treatment and were monitored for IOP, visual acuity, and cataract progression over six months. Data collected at baseline, 1, 3, and 6 months were analyzed using SPSS. Ethical approval and informed consent were obtained.

Results

The study included 80 participants with glaucoma and cataracts, with a mean age of 65.4 years. Cataract progression occurred in 35% of participants, with higher rates in those with more severe baseline cataracts. Intraocular pressure (IOP) decreased significantly from 24.1 mmHg at baseline to 16.8 mmHg at 6 months (p < 0.001). Visual acuity worsened considerably over the study period (p = 0.02). Ocular side effects were reported in 31.3% of participants, but these were not significantly correlated with specific glaucoma treatments (p > 0.05).

Conclusion

The study found that glaucoma medications significantly reduce intraocular pressure but may contribute to cataract progression and a decline in visual acuity. Ocular side effects were common, though not linked considerably to specific treatments.

Recommendation

We recommend lifelong annual examinations by an ophthalmologist for patients who have had surgery for cataracts. Future studies are needed to assess the long-term glaucoma risk for patients treated with current aspiration techniques.

FACTORS ASSOCIATED WITH BLINDNESS AMONG DIABETIC PATIENTS ATTENDING MITYANA GENERAL HOSPITAL. A CROSS-SECTIONAL STUDY.

ALEX KISITU — 2024-12-18

Background.

Diabetes is on the rise as it is no longer a disease of predominantly rich nations. Diabetic-associated eye disease is steadily increasing everywhere, most markedly in the world’s middle-income countries including Uganda. This study assessed the factors associated with blindness among diabetic patients attending Mityana General Hospital.

Methodology.

A descriptive cross-sectional study design was adopted using a quantitative method of data collection. The study was conducted in Mityana district at Mityana General Hospital, data was collected using a structured questionnaire among 80 respondents. A probability sampling technique was used.

Results.

39 (48%) respondents were between the ages of 41 and 60, and 48 (60%) were females only. Salary was a major economic factor, and 42(52%) of the respondents earned less than UGX 100,000. 46 (57%) of the respondents were farmers by occupation. Physical inactivity was a serious lifestyle factor discussed, with 28 (35%) respondents rarely engaging in physical activities and only 13 (16%) engaging in daily physical activity.

Conclusions.

Females were most affected by blindness due to diabetic eye disease and most of the respondents are of ages 41-60 years and many are farmers by occupation. In addition, the results agreed that the highest percentage rarely engaged in physical activity.

Recommendations.

The government, through the Ministry of Health, should fund free screening of diabetic patients for diabetic-related eye complications, especially from their communities through outreaches. In addition, sensitization and education on lifestyle modification and behavior can end blindness due to diabetic-related eye disease.

A RETROSPECTIVE CROSS-SECTIONAL OBSERVATIONAL STUDY INVESTIGATING THE PREVALENT AETIOLOGIES AND CO-MORBIDITIES IN PATIENTS PRESENTING WITH VERTEBRA PLANA IN A SINGLE CENTER SPINE UNIT IN KWAZULU-NATAL, SOUTH AFRICA.

Zovuyo Mgoduka — 2024-12-01

Background

Vertebral plana (VP), characterized by the flattening of vertebrae, presents a diagnostic challenge due to its myriad causes. This study investigated the common histological diagnoses of VP within the unique healthcare context of the King Dinuzulu Hospital Complex (KDHC) Spine Unit in Durban, South Africa, to identify the most common aetiologies in this setting to guide management and prognosis.

Methods

A retrospective observational study was conducted, involving a review of medical records from January 2015 to December 2020. A cohort of 32 patients with VP was analysed for demographics, clinical presentation, imaging findings, and histological diagnoses. The primary objective was to identify prevalent histological causes, enhancing diagnostic precision.

Results

The mean age of participants was 51.1 years, with a slight female predominance. Most patients had low albumin levels and were classified as having complete neurological injury or normal neurological function. HIV status revealed a 34.4% prevalence, influencing histological diversity, while 31.25% had comorbidities, primarily hypertension. The lumbar spine, particularly L2, was frequently affected, correlating with neurologic fallout. Histological analysis revealed a surprising diversity, with multiple myeloma (26.09%) and plasmacytoma (21.74%) emerging as leading diagnoses, challenging prior assumptions. The study found no significant difference in comorbidity prevalence between genders, but a statistically significant discrepancy in the prevalence of diabetes and reduced vertebral density (RVD) between females and males.

Conclusion

This study challenges prevailing assumptions about the aetiology of VP, emphasizing the necessity for a nuanced approach to diagnostic investigations. The unexpected prevalence of multiple myeloma and plasmacytoma suggests a shift in VP aetiology, prompting a re-evaluation of clinical practices.

Recommendation

The study paves the way for further investigation into the pathophysiology and clinical features of vertebra plana. Future research should include multi-institutional diagnosis comparisons and evaluate outcomes based on early versus late or inappropriate management.

EVALUATION OF CONCURRENT MALARIA AND DENGUE CO-INFECTIONS AMONG FEBRILE PATIENTS VISITING A TERTIARY CARE HOSPITAL: A CROSS-SECTIONAL OBSERVATIONAL STUDY

Binay Kumar Mahto KUMAR — 2024-12-01

Background

Malaria and dengue are mosquito-borne diseases found in Bihar, West Bengal, Uttar Pradesh, Punjab, Haryana, Delhi, Gujarat, Kerala, Karnataka, and Tamil Nadu. High mortality and morbidity rates make these diseases a major public health issue in these places. The underreporting and misdiagnosis of dengue and malaria concomitant infection is common.

Aim and Objective

To assess the incidence of co-infections with dengue and malaria and to evaluate and compare the severity of these co-infections with that of mono-infections of either disease, based on clinical and laboratory parameters.

Material and Method

A cross-sectional observational study was conducted involving patients who presented with fever and symptoms indicative of malaria and/or dengue. A total of 497 serum samples were collected from these clinically suspected cases. All samples were tested for dengue NS1 antigen and IgM/IgG antibodies using ELISA and immunochromatographic (ICT) tests. Diagnosis of malaria was confirmed via rapid malaria antigen test kits and the identification of Plasmodium spp. through peripheral blood smear microscopy (both thick and thin films).

Results

Among the febrile patients, 155 (31.19%) tested positive for dengue infection, while 342 (68.81%) tested positive for malaria parasites. Notably, 15 (3.02%) cases exhibited co-infections with both dengue and malaria parasites, predominantly Plasmodium falciparum. Haemoglobin <12g/dl 100%, thrombocytopenia, haemorrhagic symptoms (26.67%), renal failure (13.33%), and hepatomegaly (46.67%). 93.33% prevalent in co-infections, more with Plasmodium falciparum.

Conclusion

Co-infections are not uncommon, and failing to identify either condition in cases of concurrent infections can lead to severe complications and potentially disastrous outcomes. Patients from endemic regions must be thoroughly examined, as early diagnosis is critical for effective treatment and can be lifesaving.

Recommendation

It is essential for all febrile patients exhibiting suggestive symptoms to undergo comprehensive testing for both dengue and malaria infections.

FACTORS ASSOCIATED WITH H. PYLORI INFECTION AMONG PATIENTS ATTENDING OUTPATIENT DEPARTMENT AT OUR LADY OF CONSOLATA, KISUBI HOSPITAL. A CROSS-SECTIONAL STUDY.

Catherine Tusingwire — 2024-12-01

Background

Helicobacter pylori (H. pylori) is a Gram-negative spiral bacterium that has long been recognized for its ability to chronically colonize the gastric mucosa and intestine, causing gastritis duodenal ulcers, and gastric carcinoma. This study aimed to assess factors associated with H. pylori infection among patients attending the outpatient department at Our Lady of Consolata, Kisubi Hospital.

Methodology

A descriptive cross-sectional study was employed, and a total of 115 study participants were enrolled using a simple random sampling technique. A semi-structured questionnaire was used to collect information on demographic data, family structure, socio-economic status, level of education, type of drinking water, and hygienic habits of the study participants, stool samples collected from the study participants were tested for the presence of H. pylori using H. pylori antigen test strips.

Results

68(59.1%) of the respondents were married, the most frequent age was that of below 20 years 27.8%, not washing hands 43(55.1%) with OR=2.6(1.12-5.81), p value= 0.0247 was associated with H. pylori infection. H. pylori was exhibited more in married participants at a rate of 51.3%, OR=0.3(0.14-0.81), p=0.0149) and in single people at a rate of 48.7%, OR=2.9(1.24-7.07). Taking unboiled water by the participants increased the chances of them being positive for H. pylori, as this was seen in participants who took unboiled water, these exhibited 64.1%, OR=5.5(2.29-13.42), p=0.0001 and Participants that lived more than 4 people in a household exhibited a high rate of 59.0% OR=0.6(0.26-1.40).

Conclusion

Improper hand washing and drinking of un-boiled water were the most predisposing factors associated with H. pylori infection.

Recommendation

Village health team with local leaders should emphasize hand washing after visiting the latrine and before eating found this will reduce the transmission of H. pylori.