https://journals.scholarpublishing.org/index.php/JBEMi/issue/feed British Journal of Healthcare and Medical Research 2023-01-12T17:49:59+00:00 Victoria Bloom jbemi@scholarpublishing.org Open Journal Systems <p>British Journal of Healthcare &amp; Medical Research (<strong>BJHMR</strong>) is an international, peer-reviewed, open access journal that provides an easy access to high quality manuscripts in all related aspects of diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in human beings. The journal also focuses upon the challenges and opportunities and how healthcare can benefit from it in terms of reduced costs and improved diagnosis, therapy, and care. Access to health care manuscripts provides an insight that varies across countries, groups, and individuals, largely influenced by social and economic conditions as well as the health policies in place.</p> <p>The journal brings professionals in medicine, psychology, physiotherapy, nursing, dentistry, midwifery (obstetrics) and allied health, plus many other disciplines such as public health practitioners, community health workers and assistive personnel, who systematically provide personal and population-based preventive, curative and rehabilitative care services in health care under single roof.</p> https://journals.scholarpublishing.org/index.php/JBEMi/article/view/13631 Prevalence and Outcome of Post- thyroidectomy Hypocalcaemia: A Prospective Clinical Study 2022-12-08T08:10:59+00:00 M. SriVignesh srivignesh.doc@gmail.com Alok Mohanty Arun srivignesh.doc@gmail.com Smile R. Robinson srivignesh.doc@gmail.com <div class="page" title="Page 1"> <div class="layoutArea"> <div class="column"> <p><strong><span style="text-decoration: underline;">Aims</span>: (1) To record the incidence of post-thyroidectomy hypocalcaemia. (2) To correlate blood calcium levels with symptoms of hypocalcaemia. (3) To find out the type of hypocalcaemia whether temporary or permanent. (4) To assess the risk factors for development of hypocalcaemia. <span style="text-decoration: underline;">Design</span>: Prospective analysis of 50 consecutive patients undergoing thyroid surgeries. <span style="text-decoration: underline;">Materials &amp; Method:</span> All patients undergoing any thyroidectomy in the department of general surgery were followed for a period of 3 months. The type of surgery, Histopathology and clinical diagnosis to predict the outcome of post-operative hypocalcaemia was validated. The influences of Patient factors, intra-operative identification of RLN and parathyroid were also observed. <span style="text-decoration: underline;">Results</span>: The overall prevalence of hypocalcaemia was 28% of which 12 patients had temporary and 2 had permanent hypocalcaemia. Only 12 patients developed clinical symptoms. Hypocalcaemia typically ensues during the early post-operative period (24-48 hrs). Hypocalcaemia was significantly associated with the type of surgery (p=0.0293), Histopathology (p=0.0312) and clinical diagnosis (p=0.0008). Age, Sex and identification of RLN and Parathyroid did not play a significant role in predicting the outcome of post-operative hypocalcaemia. <span style="text-decoration: underline;">Conclusion</span>: Hypocalcaemia either transient or permanent can be debilitating and lead to significant morbidity. Temporary hypocalcaemia is common after surgery for malignancies. Histopathology, clinical diagnosis and extent of surgical resection influence the outcome of hypocalcaemia. Early measurement of serum calcium and albumin levels can ensure early management and prevent complications of hypocalcaemia.</strong></p> </div> </div> </div> 2023-01-12T00:00:00+00:00 Copyright (c) 2023 M. SriVignesh, Alok Mohanty Arun, Smile R. Robinson https://journals.scholarpublishing.org/index.php/JBEMi/article/view/13746 Decision Delivery Interval for Emergency Caesarean Section and Associated Maternal and Neonatal Outcomes in a Tertiary Hospital in South- South Nigeria 2022-12-24T07:30:58+00:00 L. A. Okpara ozoriniseod@yahoo.com I. Orisabinone ozoriniseod@yahoo.com E. O. S. Aigere ozoriniseod@yahoo.com Ebiogbo Stanley Ozori ozoriniseod@yahoo.com G. Atemie ozoriniseod@yahoo.com P. I. Ogidigba ozoriniseod@yahoo.com <p>Standard guidelines recommend that delivery by caesarean section should be initiated within 30 minutes of decision to operate to avoid adverse maternal and fetal outcome. Patient however encounter delays despite recommended time frames. The aim of the study was to determine the average decision delivery interval and its effect on perinatal outcomes in emergency caesarean sections</p> <p>The study was a descriptive cross sectional study. The study population consisted of 120 consecutive pregnant women who had emergency caesarean section who met the inclusion criteria. Data was collected using a structured questionnaire and analyzed with SPSS version 20.</p> <p>Sixty – two (51.7%) of the study participants were booked. The commonest indication for CS was cephalo-pelvic disproportion (35%). The mean DDI was 209.5± 98.9 minutes. Patient factor was the leading cause of delay due to lack of funds and non-provision of surgical materials (55%). Only delay in obtaining consent was statistically significant in prolonging DDI interval. Five minute APGAR score was normal in 91.7%. Indication for emergency CS was significantly related to fetal outcomes; asphyxia and mortality.</p> <p>There was lack of association between DDI, perinatal and maternal outcome, which may indicate decision delivery interval of 30 minutes or less may not be applicable to all emergency CS, especially in developing countries with infrastructural challenges. However, decision- delivery interval should be considered as an important contributing factor for adverse neonatal outcomes. Therefore, clinical judgment is required to assess the urgency of caesarean section to prevent neonatal morbidity and mortality.</p> 2023-01-12T00:00:00+00:00 Copyright (c) 2023 Ebiogbo Stanley Ozori https://journals.scholarpublishing.org/index.php/JBEMi/article/view/13800 Does a Temporary Increase in Glycosaminoglycan (GAG) Indicate Positive Intervertebral Disc Adaptation? 2023-01-03T22:19:54+00:00 Aaron Horschig squatuniversity@gmail.com Andrew Lock admin@strengthrehab.com.au Brogan Williams brogan.s.williams@gmail.com David Johnson libretto73@bigpond.com.au <p><strong>Many in the scientific community have been debating the extent to which the spine can adapt. While it is widely accepted that vertebral bones can adapt and become stronger/denser with appropriately dosed loading, many unanswered questions remain regarding intervertebral discs (IVDs). Recently, some claim that IVDs can adapt to stress under load and become stronger and more resilient over time based on the findings from a recent study “Imaging of exercise-induced spinal remodeling in elite rowers” by Frenken et al 2022 in the Journal of Science and Medicine in Sport. The Frenken paper investigated the IVD Glycosaminoglycan (GAG) increases in elite rowers over the course of a training period, which was to indicate a positive adaptation to training based on the assumption that GAG is decreased in discs with degeneration. A cause-and-effect relationship does not exist and in fact, is unlikely to exist particularly with a historically high prevalence of disc degeneration in rowers. The Frenken paper supports the notion that the GAG content alters in response to certain stimuli; however, we can not conclude that a temporary increase in GAG content supports the hypothesis that the IVD adapts positively to load. An alternative postulate is that repetitive biomechanical loading of the intervertebral disc through intra-lumbar flexion (as observed in rowing) does stimulate nutrient transport across the vertebral endplates; however, this biochemical response is of limited benefit and should not be perceived as a positive adaptation to the overall longevity and health of the disc. In this context, the elevation in GAG may be more appropriately interpreted as a maladaptive indicator of undesirable biomechanical intra-lumbar flexion stress that progressively drives cartilaginous endplate sclerosis leading ultimately to the clinically observed accelerated disc degeneration, future back pain symptoms, and reduced GAG concentration in rowers. This contrasting interpretation is consistent with the clinical observation of intra-lumbar flexion biomechanical stress, the transient rise in GAG followed by a reduction that correlates with the radiological findings and back pain symptoms evolving over time in elite rowers.</strong></p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 Brogan Williams, PhD, MSc, Aaron Horschig, DPT, CSCS, Andrew Lock, D.D., MPhysio, David Johnson, MBBS, FRACS (Neurosurgery) https://journals.scholarpublishing.org/index.php/JBEMi/article/view/13794 Effect of Aerobic Exercise Training on Circulating s-Klotho in a Heart Transplant Recipient; A Case Report 2023-01-03T15:19:24+00:00 T. J. Exford moransaghiv@gmail.com Moran Sciamama-Saghiv moransaghiv@gmail.com Ehud Goldhammer moransaghiv@gmail.com David Ben-Sira moransaghiv@gmail.com Michael Sagiv moransaghiv@gmail.com <p><strong>Reduced circulating s-Klotho has been seen in heart failure patients, However, its values are increased following aerobic exercise training. The purpose of the case study was to examine whether high intensity aerobic exercise training increase serum s-Klotho levels in untrained heart transplant recipient, and to examine the relation between plasma s-Klotho concentration and peak oxygen uptake (VO2peak). Methods: Untrained heart recipient 25 years old trained for 60 min<sup>-1</sup>×4 times×wk<sup>-1</sup> for 12 wks<sup>-1</sup> at 85% of VO2peak. Testing sessions were performed at 0, and 12 weeks. Blood samples were analyzed for s-Klotho by an ELISA kit. Results: Subject increased its VO2peak&nbsp;from 25.1 to 31.2 mL×kg<sup>-1</sup>×min<sup>-1</sup>, s-Klotho increased from 349 to 467 pg×mL<sup>-1</sup>. Conclusions: This case report indicated that aerobic exercise was tolerated without any difficulties, along with significantly improve in s-Klotho and peak oxygen uptake values. In addition, it is apparent that training at 85% work capacity in young heart transplant recipients following heart failure benefits to reestablish functional of central oxygen delivery variables mainly; cardiac output. Thus, it may have a better prognosis for the entire heart transplant recipient's population.</strong></p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 Moran Sciamama-Saghiv https://journals.scholarpublishing.org/index.php/JBEMi/article/view/13642 Surveillance of antibiotic resistance in the northern zone of Senegal: Molecular characterization of beta-lactam resistance genes in Enterobacteriaceae (extended spectrum beta-lactamase, plasmid cephalosporinases, carbapenemases). 2022-12-09T16:14:28+00:00 Amadou KANE kaneamadou5@gmail.com <p><strong>Introduction:</strong> With the increase in bacterial resistance to antibiotics, policies are being implemented on a national scale. These resistances are multiple, especially in enterobacteria, and represent a real public health problem due to the difficulty of their treatment. The objective of this work was to identify ESBL, cephalosporinase and carbapenemase producing enterobacteria in laboratories in the northern part of Senegal and to compare the mechanisms involved.&nbsp;</p> <p><strong>Materials and methods:</strong> This is a retrospective study conducted at the Saint-Louis Regional Hospital and the Microbiology Unit of the Pasteur Institute of Dakar. Bacterial strains were collected between January and June 2021 in eight bacteriology laboratories in the regions of Saint-Louis, Louga and Matam. Bacterial identification was done by studying morphological, cultural and biochemical characteristics using an API® 20 E gallery and the MALDI-TOFF technique. The antibiogram was performed by the disc diffusion method according to the CA-SFM version 2021 procedure including the search for specific resistances (ESBL). The ESBL genes (CTX, TEM, OXA, and SHV) were identified by polymerase chain reaction (PCR) with specific primers and then analyzed by gel electrophoresis.</p> <p><strong>Results:</strong> Forty-five strains of Enterobacteriaceae were ESBL producers and each had at least one beta-lactam resistance gene. The CTX-M gene was found in all strains, followed by the OXA (64.44%), TEM (53.33%) and SHV (20%) genes. A simultaneous presence of these 4 genes was noted in 6 isolates (13.33%). Apart from resistance to ertapenem, all strains were sensitive to imipenem. For quinolones, almost all strains (93%) were resistant.</p> <p><strong>Conclusion:</strong> These results show the need to reinforce the surveillance of ESBL-producing Enterobacteriaceae in the Senegal area. These important data should help to orientate strategies for the reduction of MRBs and their dissemination in the community.</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 Amadou KANE https://journals.scholarpublishing.org/index.php/JBEMi/article/view/13817 Ultrasonography in the Diagnosis of Traumatic Haemothorax 2023-01-06T09:03:19+00:00 A. Hilendarov dr_hill@abv.bg <p>.</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 A. Hilendarov https://journals.scholarpublishing.org/index.php/JBEMi/article/view/13825 Alarming Cases of Cancer in Kenya: A case for Meru and Tharaka Nithi Counties 2023-01-08T07:45:30+00:00 Joshua Mutiso mutisovic@gmail.com Ciriaka Gitonga mutisovic@gmail.com Bulle Abdullahi mutisovic@gmail.com Jemimah Simbauni mutisovic@gmail.com Michael Gicheru mutisovic@gmail.com <p><strong><u>Background:</u></strong> Cancer is one of the leading causes of morbidity and mortality worldwide. In Kenya, cancer as a disease ranks third as a cause of death after infectious and cardiovascular diseases and the cancer cases are increasing at an alarming rate. <strong><u>Objective:</u></strong> The current study was aimed at determining the prevalence trends of cancer in Meru and Tharaka Nithi Counties with an aim of putting proper infrastructural and human capacity development to combat cancer. <strong><u>Methods:</u></strong> A random selection of patients aged between five to eighty-two years clinically diagnosed as cancer patients who were visiting Meru and Chuka General Hospitals for a period of one year were recruited for the study. The participants were requested to give a verbal consent and respond to a brief questionnaire concerning their gender, age and the type of cancer they are suffering from. This study used retrogressive approach where the trend of cancer incidences and death rate were determined for the last eight years (2011 to 2018) using the hospital data. Data were analysed using statistical package for social sciences (SPSS). <strong><u>Results:</u></strong> This study established that the prevalence of cancer in people visiting hospitals in Meru and Tharaka Nithi Counties was 0.32% and 0.38% respectively. Further, the prevalence trends of cancer cases in the two counties have been increasing over the last eight years. <strong><u>Conclusion:</u></strong> The study concludes that cancer is prevalent in Meru and Tharaka Nithi Counties. It is therefore recommended that proper infrastructural and human capacity development be put in place to combat cancer.</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 Joshua Mutiso, Ciriaka Gitonga, Bulle Abdullahi, Jemimah Simbauni, Michael Gicheru https://journals.scholarpublishing.org/index.php/JBEMi/article/view/13824 Prevalence and factors associated with condom use among people living with HIV/AIDS in Bayelsa state, Nigeria 2023-01-07T11:19:58+00:00 IFEOMA OFURUM ifeoma.ofurum@uniport.edu.ng <p>Epidemiological and laboratory studies have demonstrated that latex condoms effectively prevent HIV and other sexually transmitted diseases. However, inconsistent use or nonuse of condoms among people living with HIV/AIDS (PLWHAs) could propagate the spread of infection. The aim of the study was to determine the prevalence of condom use and identify the associated factors among PLWHAs in Bayelsa state, Nigeria. Six hundred (600) participants were recruited for this cross-sectional study from the HIV clinics at Federal Medical Centre (FMC), Yenagoa, and Otuasega Cottage Hospital, Ogbia in Bayelsa State, Nigeria after giving informed consent. An interviewer-administered questionnaire was used to collect data comprising socio-demographic characteristics, condom use and ART status of the respondents. The data obtained were analyzed and presented as frequencies and percentages. Chi-square and Binary logistic regression were used to test the association between variables with statistical significance set at p&lt;0.05. Results showed a mean age of 34.6±6.4 years, comprising 160 males (26.7%) and 440 females (73.3%). The prevalence of condom use was 69.2%. There were statistically significant associations between age (X<sup>2</sup>=7.305, P=0.007), sex (X<sup>2</sup>=7.919, P=0.005; OR=1.6 (1.1-2.4), P=0.033), religion (X<sup>2</sup>=12.238, P=0.007; OR=2.7(1.1-6.8), P=0.039), having skipped medication (X<sup>2</sup>=22.295, P&lt;0.001; OR=2.1 (1.5-3.2), P&lt;0.001), revealed status to someone (X<sup>2</sup>=12.002, P=0.001; OR=2.7 (1.2-6.2), P=0.020) and number of sexual partners (X<sup>2</sup>=14.684, P&lt;0.001; OR=3.0 (1.7-5.4), P&lt;0.001) with condom use. In conclusion, condom use among PLWHAs in Bayelsa state is sub-optimal. There is a need to explore measures that target these factors to promote the attainment of the optimal prevalence of condom use among PLWHAs.</p> <p>&nbsp;</p> 2023-01-24T00:00:00+00:00 Copyright (c) 2023 IFEOMA OFURUM https://journals.scholarpublishing.org/index.php/JBEMi/article/view/13851 Giant borderline mucinouscystadenoma in a woman of 46 years-old. Clinical case 2023-01-11T18:22:51+00:00 Patricia Alejandra González-Rodríguez aleglezrdgz@gmail.com Paula Cecilia Rodríguez-Villalobos Paulacrv26@gmail.com Maira Fernanda Hernández-Albino amaranto_mayra@hotmail.com Alejandro Collí-Chan alexcc.05@live.com.mx Dalia Gómez-Aguilar dalilasifuentes@hotmail.com Alejandro Lenin Villalobos Rodríguez alejandrovillalobos96@hotmail.com Rafael Del Carmen Cárdenas-Núñez Dr.rafaelcardenas@gmail.com Juder Narváez-Palacios alejandrovillalobos96@hotmail.com Guillermo Padrón Arredondo gpadronarredondo@hotmail.com <p><strong>Introduction. </strong>Ovarian cysts more than 10 cm in dimension are labeled as giant ovarian cysts. Mucinous cystadenomas have the potential to grow into huge mass and rarely remain undiagnosed till they become giant ovarian cysts, they are incidentally found on routine physical examination. Mucinous tumors constitute of benign 75%, borderline 10% and malignant lesions 15%. Giant ovarian tumors generally pose risk due to their location and pressure effects on surrounding structures. <strong>Clinical case. </strong>A 46-year-old female patient who comes to the consultation because presents a progressive increase in volume of the abdominal region of more than two years of evolution. She presents with dyspnea, low back pain on walking and constipation. An MRI of the abdomen is requested where the abdominal and pelvic cavity is found occupied by a multilocular tumor measuring 297 x 340 x 198 mm, with thin and fine walls, some with internal septa, the signal intensity within the cystic lesions is variable within the different sequences made, but with characteristics of liquid content; with contrast medium applications there is diffuse reinforcement of the wall of the lesions without observing undulations or papillary projections. Unaltered uterus; the anatomical delimitation of both ovaries is not possible due to the characteristics and size of the lesion. Laboratory studies: were normal. Alterated antigens. Exploratory laparotomy + salpingo-oophorectomy bilateral are performed. A transoperative study of the tumor was carried out, which reported: borderline seromucinous cystadenoma, measuring 44 x 36 x 30 cm and weighing 10,170 kg. <strong>Discussion. </strong>The differential diagnoses of benign ovarian cysts include dermoid cysts, Brenner cysts, and mucinous cysts. Dermoid cysts are sac-like growths on ovaries containing fat, hair, and other tissue types. Brenner cysts are found incidentally and are solid outgrowths on the ovarian surface. Of all the ovarian tumors, mucinous cystadenomas account for 15-20%. These tumors arise from the ovarian surface epithelium and have smooth inner and outer thin walls.</p> 2023-01-27T00:00:00+00:00 Copyright (c) 2023 Patricia Alejandra González-Rodríguez , Paula Cecilia Rodríguez-Villalobos , Maira Fernanda Hernández-Albino , Alejandro Collí-Chan , Dalia Gómez-Aguilar, Alejandro Lenin Villalobos Rodríguez, Rafael Del Carmen Cárdenas-Núñez , Juder Narváez-Palacios , Guillermo Padrón Arredondo https://journals.scholarpublishing.org/index.php/JBEMi/article/view/13075 Opsoclono-Myoclonic Syndrome Revealing a Neuroblastoma in an Infant: A Rare and Unusual Case Report 2022-08-30T20:10:39+00:00 siham mouhdi siham.mouhdi@gmail.com <p><strong>Introduction </strong>Opsoclonomyoclonic syndrome (OMS) is an uncommon childhood illness. Opsoclonus, myoclonus, ataxia, and behavioral abnormalities are all symptoms. Long-term prognosis is dismal, however the introduction of novel immunotherapy regimens may improve it.</p> <p><strong>Case report </strong>We present the case of an 18-month-old previously healthy newborn who was hospitalised for gait problem and widespread tremors that lasted four days, along with food vomiting and photophobia. A conscious patient with a 38°C temperature, a cerebellar syndrome, and aberrant palpebral and ocular myoclonic movements led us to suspect an opsoclonomyoclonic syndrome. The biological examination and brain CT were both normal, however the cerebral-medullary MRI revealed a signal anomaly. Given the close link between OMS and neuroblastoma, a thoraco-abdominal CT scan revealed a neuroblastoma. The child was transported to the paediatric oncology department, where he received surgical resection with chemotherapy, as well as corticosteroids, clonazepam, and antiepileptic medication. Oncologically and neurologically, the evolution was favorable.</p> <p>Conclusion: Although OMS is an uncommon condition in children, the fact that it has a significant connection with neuroblastoma allowed us to identify the diagnosis and begin therapy early, resulting in a positive patient outcome.</p> 2023-01-27T00:00:00+00:00 Copyright (c) 2023 siham mouhdi https://journals.scholarpublishing.org/index.php/JBEMi/article/view/13809 Isolation of Dermatophytes among Primary School Pupils in Akungba Akoko, Ondo State 2023-01-05T15:34:12+00:00 V. T. Folorunso tayofolorunso22@gmail.com <p><strong>Dermatophytic infection remain a public health problem among children globally and particularly in Nigeria. Hence, A cross sectional study was conducted to investigate the prevalence of dermatophytic infection among primary school children in Akungba Akoko, a part of Ondo State, Nigeria. A total of one hundred and forty-five (145) children were included in the study. Sixty-five (65) of the study population (145 pupils) was infected with dermatophytosis. The nails, skin scrappings and hair samples of participant were collected aseptically randomly. The samples were appropriately cultured, examined microscopically, and characterized using molecular methods. The study revealed that the prevalence of dermatophytic infection among school children was 44.82%. Furthermore, the study showed higher prevalence and distribution of dermatophytosis in boys (69.23%) than in girls (30.77%). Among the isolated dermatophytes, <em>M. audounii</em> had the highest frequency of 32.20% while <em>M. gypseum </em>had the least frequency of 4.61%. The study also revealed that school children of age group 1-5 and 6–10 years appeared more susceptible to dermatophytic infection. In respect to infection site, majority of the identified dermatophytes were isolated from the scalp (93.85%) compared with those that occurred as skin lesions (6.15%). From this findings, the prevalence of dermatophytes among school children in Akungba akoko area of Ondo state demands an urgent public health measures from concerned personnels. Meanwhile, a survey of larger population size is recommended to validate the findings from this study.</strong></p> 2023-01-27T00:00:00+00:00 Copyright (c) 2023 V. T. Folorunso https://journals.scholarpublishing.org/index.php/JBEMi/article/view/13587 Acute appendicitis plus in uterus foreign body. Clinical case 2022-11-30T04:00:42+00:00 Alejandro Lenin Villalobos Rodríguez alejandrovillalobos96@hotmail.com Guillermo Padrón Arredondo alejandrovillalobos96@hotmail.com Dalia Lucía Gómez-Aguilar alejandrovillalobos96@hotmail.com Mónica Campos-Sanchez alejandrovillalobos96@hotmail.com Orlando Sarmiento-Haydar alejandrovillalobos96@hotmail.com <p><strong>Introduction. </strong>Uterine perforation by an intrauterine device (IUD) is classified into primary and secondary, the first case occurs within the first month of its insertion and the second after this period. This migration may be due to spontaneous uterine contractions, bladder contractions, increased intestinal peristalsis, and movement of peritoneal fluid. <strong>Clinical case.</strong> A 28-year-old patient came to the emergency department with abdominal pain that had lasted 8 hours until admission, accompanied by anorexia and nausea. Physical examination, a painful abdomen in the right iliac fossa with a positive Mc Burney sign. Vital signs with a low-grade fever of 37oC, BP ​​80/50, rest normal. Laboratories: leukocytosis 14.1/103 uL, neutrophilia 89%, rest normal, pregnancy test negative. The patient admitted to the operating room, and an open appendectomy was performed, finding a perforated appendix at the appendicular base with a retroileocecal abscess, classifying it as grade IV appendicitis. It was incident; the finding of an IUD emerging from the uterus a segment of the copper T that involves the right Fallopian tube and the rest into the utero is reported. <strong>Discussion.</strong> Reversible and long-acting contraceptives are safe and effective in their application, they involve the risk of immediate, mediate, and late uterine perforation, so their incidence is 1-2 cases per 1000 insertions; in the first setting it may be due to inexperience of the doctor who applies it by applying excessive force at the time of application, and it will surely give alarm symptoms immediately depending on the site of the perforation. <strong>Conclusions.</strong> How can be seen in this report, appendicular surgeries led to the location of this translocate IUD that had perforated the uterus and was halfway to being completely expelled. This finding is rare, and two pathologies were successfully resolved in the same surgical time.</p> 2023-01-27T00:00:00+00:00 Copyright (c) 2023 Alejandro Lenin Villalobos Rodríguez, Guillermo Padrón Arredondo https://journals.scholarpublishing.org/index.php/JBEMi/article/view/13866 Abdominal Trauma by Impalement. Clinical case. 2023-01-12T12:30:31+00:00 Guillermo Padrón-Arredondo gpadronarredondo@hotmail.com Alejandro Alberto Flores-López gpadronarredondo@hotmail.com Onasis Pinzón-Oregón gpadronarredondo@hotmail.com Luis Arturo Falcón-Cancino gpadronarredondo@hotmail.com Segundo Yépez-Vallejo gpadronarredondo@hotmail.com Mónica Ríos-Pacheco gpadronarredondo@hotmail.com Héctor Gerardo Lujan-Vargas gpadronarredondo@hotmail.com Fidel Echavarría-Fernández gpadronarredondo@hotmail.com Alejandro L. Villalobos-Rodríguez gpadronarredondo@hotmail.com <p><strong><u>Introduction.</u></strong> Impalement injury is one of the most spectacular and potentially dramatic rare forms of penetrating trauma.[2,3] In many cases, the impaled patient dies at the scene.[3] The patient who manages to reach the hospital alive and is hemodynamically stable has a good chance of overcoming a traumatic event. However, the non-removal of a foreign object represents the cornerstone of initial treatment, as possible vascular lesions remain compressed by the object in situ, thus avoiding irrepressible hemorrhages. <strong><u>Clinical case.</u></strong> A 32-year-old male was brought in by a paramedic after suffering electrical burns to the right thoracic limb and right pelvic limb that caused a fall from a power pole with subsequent penetrating abdominal trauma due to impalement. He denies antecedents of importance for the current condition. Upon arrival, he was hemodynamically stable, with the presence of a first-degree electrical burn in the right hand and forearm and the right thigh, as well as a metallic rod passing through the abdomen from the left groin to the right flank, for which it was decided to perform Exploratory Laparotomy who reported the following findings: Intestinal perforation of more than 50% of the lumen at jejunum level, side-to-side anastomosis was performed. During his stay on the floor of General Surgery, he had a torpid post-surgical evolution, intolerance to the oral route, abdominal distension, absence of gas channeling, and symptoms of intestinal obstruction, for which it was decided to perform a new Exploratory Laparotomy, finding intestinal stenosis at the level of the previous anastomosis was dismantled and reconstructed in side by side, on this occasion with favorable evolution and he was discharged due to improvement after 14 days of hospital stay. <strong><u>Discussion.</u></strong> Prehospital emergency medicine (PHEM) offers unique and challenging perspectives to orthodox emergency medicine. Impalements are extremely rare and often require a multidisciplinary team approach in the prehospital setting. Most cases of impalements are fatal at the scene. Patients surviving the initial trauma and arriving at the hospital alive, usually make a good recovery with multidisciplinary team management underpinning the importance of meticulous prehospital care in transporting patients with impalements safely. This case highlights the role of PHEM clinicians as experts in clinical knowledge, decision-making, leadership, team working skills, and improvisations.</p> 2023-01-27T00:00:00+00:00 Copyright (c) 2023 Guillermo Padrón-Arredondo , Alejandro Alberto Flores-López , Onasis Pinzón-Oregón , Luis Arturo Falcón-Cancino , Segundo Yépez-Vallejo , Mónica Ríos-Pacheco , Héctor Gerardo Lujan-Vargas, Fidel Echavarría-Fernández, Alejandro L. Villalobos-Rodríguez https://journals.scholarpublishing.org/index.php/JBEMi/article/view/13815 Challenges and Opportunities of a Shared Medical Facility for the Training of Medical Students in Rivers State: Perspective of Stakeholders and the Medical Students 2023-01-06T06:07:56+00:00 Tondor Cleopatra Uzosike tondor.uzosike@ust.edu.ng Christie Nwidum Mato christie.mato@uniport.edu.ng Rex Friday Ogoronte Alderton Ijah rexijah@gmail.com Aloni Adolphus Alali alonialali@gmail.com <p><strong>Background: </strong>Teaching hospitals are known to manage complex health conditions and train medical students. This study aims to explore the experiences of medical students from different universities and stakeholders who share a teaching hospital facility in Rivers State in terms of challenges and opportunities, and to suggest ways of overcoming the challenges encountered.</p> <p><strong>Materials and Methods: </strong>A qualitative phenomenological study design was employed for this research conducted in Port Harcourt among medical students and stakeholders from both the Rivers State University and PAMO University of Medical Sciences, using a purposive sampling method. There were in-depth interviews and focus group discussions, and data obtained was uploaded for analysis into ATLAS.ti version 8.4.24.</p> <p><strong>Results: </strong>There was a total of 10 females and 14 males, comprising 2 management staff, 8 lecturers from the two universities who were also medical doctors and 14 medical students. The commonly shared facilities were lecture halls, clinics, wards, theatres, hospital space and time. Some challenges identified were space constraint, distance between the Universities and teaching hospital, limited exposure to calls and clinical practice and academic work load.&nbsp; Inter-university interactions emerged as the most common opportunity, followed by a win-win for the teaching hospital and universities. Some suggestions were made for improvement in sharing a facility.</p> <p><strong>Conclusion: </strong>A report of the experiences with shared facilities for undergraduate medical education is presented in this study. It is hoped that the findings will assist medical educators and teaching hospital management to make necessary changes that will enhance medical education.</p> 2023-01-31T00:00:00+00:00 Copyright (c) 2023 Dr Uzosike, Prof. Mato, Dr. Ijah, Dr. Alali