British Journal of Healthcare and Medical Research

Gallbladder Fossa Abscess Rare Complication Laparoscopic Cholecystectomy: A Case Report

2025-01-19T11:47:03+00:00

Gallbladder fossa abscesses are a rare serious complication of laparoscopic cholecystectomy. We present a 62-year-old male patient who had undergone laparoscopic cholecystectomy and subsequently developed a gallbladder fossa abscess. The diagnosis was confirmed by ultrasound and computed tomography (CT), and it was successfully treated with percutaneous catheter drainage and antimicrobial therapy.

Aetiology, Clinical Profile and Outcome of Acute Kidney Disease in Children Presenting in a Tertiary Health Institution in Southwest, Nigeria

2025-02-06T05:16:37+00:00

Acute kidney injury (AKI) in children is a disease entity resulting from acute insult to both kidneys leading to reduced glomerular filtration rate, impairment of fluid and electrolyte homeostasis in the body, and accumulation of waste product of metabolism. It is a recognized cause of morbidity and mortality in children. Aim: This study aims to detect the risk factors and prevailing causes of AKI in children presenting at a tertiary hospital in South West Nigeria, identify the various intervention/treatment modalities and determine the predictors of disease outcome. Methods: A retrospective cross-sectional study of children presenting in both the children’s emergency unit and children’s outpatient clinic of Ekiti State University Teaching Hospital Ado Ekiti, Nigeria with AKI over five years September 2019-September 2024. AKI was defined by reduction in urine output (<0.5mls/kg/hour for older children and urine output of< 1ml/kg /hour in infants) of more than 6hours duration and/or increased serum creatinine of either ≥ 0.3mg/dL or a percentage increase of ≥ 1.5 times baseline. Results: A total of 55 children with a diagnosis of acute kidney injury were seen over a period of 5 years. Twenty-nine (52.7%) of them were male with male to female ratio of 1.1:1. The age range was 1 month to 18 years. AKI was seen more in preschool-aged children of less than 3years (32.7%), severe dehydration and sepsis were majorly implicated while AKI secondary to haemoglobinuria was more prevalent among school-aged children. Forty-six (83.6%) children presented with oliguric AKI. Thirty-five (63.6%) children with AKI were conservatively managed, haemodialysis was done in 12(21.8%) patients while peritoneal dialysis was done in 3(5.5%) patients. The mortality was 16.4% (9patients). Statistically significant factors that contributed to the outcome included the age of the patients (p=0.046), the aetiology of AKI (p=0.038), and modality of treatment intervention (p=0.010). Conclusion: Sepsis, severe dehydration and haemoglobinuria were major risk factors for AKI in this study especially in younger children. Primordial prevention of risk factors for AKI and being proactive may stop the progression to acute tubular necrosis and the need for renal replacement therapy.

Jealousy - The Green-Eyed Monster and Its Relationship with Depression, and Personality. Causal or Coincidental?

2025-01-06T05:48:52+00:00

This research is an example of theory and therapeutic practice converging. Using experiential and subjective ideation gained as a therapist and then as a researcher to test and evaluate hypotheses. Furthermore, this research is a continuation of Thomson (2019) and earlier research Thomson (1996, 2011) which investigated the nature and consequences of a depressive illness. There is no one accepted theory of depression. To extend the research profile a questionnaire : the Self-Defeating Quotient; SDQ, (2016, 2017). The SDQ is an anonymous self administered questionnaire. The bottom-up approach was used to start with the patients themselves by using the SDQ to obtain data concerning the underlying factors in a depressive illness. Jealousy and neuroticism were found to be significantly correlated with a depressive illness... Results: Jealousy was found to be significantly correlated with depression. Factor analysis played a significant but unexpected part in defining the emotion jealousy in a cohort of depressed patients. Additional variables found to be associated with jealousy were family, family time, and education: The implication being that these foundational variables may have causative connections with jealousy and depression. The inference for treatment is briefly discussed alongside the implications following previous findings on the mortality of a depressive illness. Summary: The results found in this pilot study ideally justify further verification using a larger sample of depressed patients.

Effects of Constraint-induced Movement Therapy on Patients with Post-cerebrovascular Disease Hemiplegia in the Maintenance Phase: Evaluation of Gait Improving Effects by Biomechanical Analysis

2025-02-03T07:23:22+00:00

In this study, a series of constraint-induced movement therapy for the lower extremity (LE-CIMT) was performed on patients with post-stroke hemiplegia, and biomechanical analyses were conducted on the effective changes in their gait to examine if any long-term improvement in walking functions was observed. Participants were seven patients with hemiplegia (five men and two women) in their maintenance phase who were independent in their daily lives. Assessments using Fugl-Meyer Assessment (FMA)-Lower Extremity, FMA-Balance, 10-Meter Walking Test If possible, please give the version of the software here. For example, this information could be Nexus 2.14 or Nexus 2.16. (10MWT), and Time Up and Go Test (TUG) were conducted at 1) five weeks before intervention (baseline); 2) before therapy implementation on Day 1 of intervention (pre); 3) on the final day of intervention period [two weeks: post (2w)], and 4) on the day 16 weeks after the Day 1 of intervention [post (16w)], respectively. In addition, joint angles (at hip and ankle joints) and joint moment (at ankle joint) were measured at baseline and post (2w) using a three-dimensional motion analysis software (Nexus 2.12.1, Vicon Motion Systems Ltd, Oxford, UK) and a ground reaction force measurement device (AMTI BP400600, Advanced Mechanical Technology, Inc., Massachusetts, USA). The results indicated significant differences after the intervention, exhibiting an increase in hip joint extension angle, ankle joint dorsiflexion angle, and ankle joint plantar flexion moment on participants' paralyzed side extremities. Participants' gait propulsion on the paralyzed side also exhibited improvement from the angle increases, indicating evident improvements in 10MWT and TUG and suggesting that the effects of LE-CIMT were associated with the long-term effects observed in the participants.

The Role of Optical Coherence Tomography in Diagnosis and Grading of Papilledema and its Correlation to Clinical Assessment

2025-01-28T16:44:56+00:00

Background: Papilledema, or optic disc swelling because of elevated intracranialpressure, was sorted using the Frisen Scaling. Optical coherence tomography (OCT) is a possible device to measure variations in the degrees of papilledema and to displaythe effectiveness of treatments. Objective: To identify and correlate the role of the OCT of the optic nerve head with the clinical grading of papilledema using the Frisen Scale via digital fundus photographs. Patients and methods: This was a randomized trial in which 50 eyes with papilledema have been enrolled from the cases attending the outpatient clinic of Beni-Suef University Hospital. Digital optical disc photos of the left or right eye have beenchosen for comparison with OCT optic nerve head (ONH) images results. To correlate OCT results with clinical grading of papilledema using the Frisen scale. Results: There was a highly significant association between stages of papilledema by OCT and stages of papilledema by modified Frisen scale (p.value<0.001). A strong positive significant association among stages of papilledema by OCT and stages of papilledema by modified Frisen scale (r= 0.871, P <0.001). Conclusion: Present OCT measurements may be beneficial as an adjunct to clinical grading. For lower-stage anomalies, OCT compares positively with clinical grading of optic nerve photos. With elevated stages, OCT-RNFLT processing algorithms frequently failed.

Ectopic Duodenal Varices as a Rare Cause of Bleeding

2025-01-27T00:20:47+00:00

Ectopic varices are dilated veins resulting from portosystemic venous collaterals that appear anywhere in the gastrointestinal mucosa except the gastroesophageal region. Gastrointestinal bleeding caused by this type of varices accounts for 5% of all variceal hemorrhages, making it an unusual cause with a high mortality rate. The optimal treatment for gastrointestinal bleeding due to ectopic duodenal varices has not been well established because of its rarity. Various treatment options have been analyzed for cases with active bleeding, with endoscopic treatment in its various modalities being the preferred choice for achieving initial hemostasis. Additionally, endoscopic treatment can be complemented with therapy guided by interventional radiology, which helps reduce the rate of rebleeding.

Cerebral Venous Thrombosis in the University Hospital of Ouagadougou in Burkina Faso

2024-12-18T17:36:54+00:00

Introduction: Cerebral venous thrombosis (CVT) accounts for less than 1% of strokes in Western countries, and probably more in sub-Saharan Africa (SSA). The aim of this study was to investigate CVT in the University Hospital Centres (UHC) of Ouagadougou in Burkina Faso. Patients and methods: This was a prospective, multicentre, cross-sectional hospital-based study in the University Hospital of Ouagadougou, Burkina Faso, from 1 June 2018 to 31 January 2023. It concerned patients admitted for CVT confirmed by the demonstration of a thrombus seated in the dural sinus and/or cortical vein on brain CT or MRI. The socio-demographic, clinical, paraclinical, aetiological and evolutionary characteristics of the patients were analysed using Epi-Info 7.2.5.0 software. Results: We consecutively included 37 patients (1% of all strokes), predominantly female (64.9%), with an average age of 38.2 years. The clinical picture was polymorphous, dominated by focal neurological deficit in 24 cases (64.9%), intracranial hypertension (ICHT) in 18 cases (48.6%) and epileptic seizures in 12 cases (32.4%). On neuroimaging, the most frequent topographies were the lateral sinus with 23 cases (62%), followed by the superior sagittal sinus with 16 cases (43%) and multiple localisations with 9 cases (24%). Cerebral oedema in 18 cases (48.6%), cerebral infarction in 7 cases (18.9%) and meningoencephalitis in 6 cases (16.2%) were the other cranioencephalic lesions most frequently found on neuroimaging. Isolated or associated aetiological factors were found in 29 patients (78.4%), dominated by gynaeco-obstetrical factors in 13 patients (35.1%) and cervicocephalic infections in 12 patients (32.4%). Clinical outcome on curative anticoagulants was favourable in 35 patients (94.6%); 2 patients (5.4%) died in hospital. Conclusion: CVT accounts for 1% of strokes in Ouagadougou. Our study confirms the clinical and paraclinical polymorphism and good prognosis of CVT. However, aetiological factors are dominated by gravidopuerperal factors and cervicocephalic infections.

Pathophysiology of Biophoton: Vibrational Impact Syndrome Leading to Physical Effects and Metabolic Alterations. Part 2

2025-01-23T01:48:44+00:00

Vibrational impact syndrome caused by biophotons is a syndrome resulting from excessive and ultra-weak photon emission. It is worth noting that at the beginning of the clinical picture, the photon emission was diffuse and disseminated, covering several organs and systems, subsequently leading to excessive long-term retention of biophotons, with energy elimination perceived throughout the body surface. This syndrome involves peripheral nerves with changes in electromyography, as well as damage to blood vessels leading to bleeding in the nose, lips and mouth, as well as damage to the saphenous vein in the right leg and metabolic changes, such as elevated blood levels of triglycerides, cholesterol, fasting glucose and testosterone, as well as a reduction in Vitamin B12 that can damage peripheral nerves. Furthermore, in August 2024, Prostaglandin E2 was measured with a significant increase, with titers above 4,000%, leading to several clinical implications. In fact, this is a case report in a 72-year-old patient with pathological photon emission for 10 years that persists to this day. I assume this is the first study reported in the literature and the most surprising, reported by the patient and also the author of this essay who, fortunately, is a physician. It arose spontaneously and without interference from any external factor. However, there appears to have been internal interference. In fact, it appeared a week after his wife underwent breast cancer surgery. Here it became clear that the role of Consciousness in the emission of biophotons is unquestionable. It follows an intelligent and intentional pattern. Consciousness, the Intelligent Principle of the Universe, is the product of Universal Consciousness, the Supreme Intelligence of the Universe, the first cause of all things. It is undoubtedly the one that actually absorbs and metabolizes the photon captured from the sun, which ultimately comes from the “sea of energy” called the ‘zero-point quantum field’ [ZPF] studied by contemporary science.

A Roadmap Toward Building Trust in AI Environment: Research Agenda

2025-01-17T01:19:46+00:00

This paper explores the critical interplay between trust in AI technology and trust in its deployment, focusing on the gaps in interpersonal trust often overlooked in AI adoption. While AI enhances operational efficiency and decision-making, it struggles to replicate the emotional and psychological foundations of human trust. Drawing on interdisciplinary literature, the study highlights three trust dimensions—technological, organizational, and user-centric—and their misalignment, which fuels skepticism about AI reliability and ethical behavior. Despite AI's potential to transform industries, trust deficits persist due to concerns about transparency, accountability, and the emotional resonance of AI. The findings underscore that trust in AI must evolve as a complementary construct, bridging human and machine interactions without displacing interpersonal trust. The study proposes a framework emphasizing cultural and organizational adaptation, regulatory oversight, and user engagement to foster a balanced, sustainable AI.

Navigating the Oesophagus: Case Series on Tackling Complications Post-Esophagectomy in Achalasia Patients

2025-01-12T18:07:18+00:00

Achalasia, a primary esophageal motility disorder, manifests as impaired peristalsis and dysfunctional relaxation of the lower esophageal sphincter. Treatment aims to alleviate the functional obstruction at the gastroesophageal junction, facilitating esophageal emptying. For end-stage cases, esophagectomy is often recommended as the primary intervention, despite the considerable postoperative complications it entails. In this case series, we present instances of various complications post-McKeown's esophagectomy in achalasia patients with sigmoid oesophagus. These complications encompass anastomotic strictures, leaks, hydrothorax, tracheal injury, and laryngeal nerve damage.

Management of Emergencies in the Hepato-Gastro-Enterology Department of the Kara University Hospital

2025-01-07T03:59:56+00:00

Introduction: Emergency care in hepato-gastroenterology (HGE) at CHU-Kara is expanding. Objective: To assess the management of emergencies in the general hospital ward at CHU-Kara. Materials and methods: This was a retrospective study of patient records from 1 January 2023 to 30 June 2024. It ran from July 1 to September 31, 2024. Results: 170 emergencies were identified, with a hospital frequency of 20.90% and a sex ratio of 1.6. The average age was 49 years. Digestive haemorrhage was the leading emergency (69.41%), dominated by ruptured oesophageal varices (RVO), followed by peptic ulcers. Other emergencies were hepatic encephalopathy (12.94%), acute abdominal pain (11.77%), ingestion of caustic products (2.94%) and chronic vomiting (2.94%). All patients had undergone an initial assessment combined with non-specific resuscitation. All patients had not undergone aetiological investigation. Vasoactive drugs in the splanchnic territory were not available. In addition to secondary prevention of RVR, their management was based on the administration of non-cardioselective beta-blockers used alone. The course of treatment was marked by a high mortality rate of 31.76%, due to the delay in consultation, the severity of the life-threatening condition, the patients' lack of financial resources, the absence of health insurance and the inadequacy of the technical facilities. Conclusion: Emergencies in the Emergency Department are frequent at CHU-Kara; they are dominated by upper digestive haemorrhage, which is life-threatening.

The Burden and Cost of Diabetes Amongst Latin Minorities in California

2025-02-11T03:57:53+00:00

Diabetes disproportionately impacts older people generally, while Hispanics are almost twice as likely as non-Hispanic whites (nHWs) to be diagnosed. Racial and ethnic disparities exist and influence the burden and cost of diabetes care for Medicare recipients among Hispanics. The current annual global costs estimated to be U.S. $673 billion, and these are projected to rise to U.S. $802 billion by 2040 and diabetes care accounts for one of every dollar spent on health care. It can be said that old age and diabetes place a disproportionate burden on racial and ethnic minorities compared with non-Hispanic whites (nHWs), Hispanics (who comprise 18% of the U.S. population are almost twice as likely to develop type 2 diabetes (T2D) as nHWs) and experience high rates of poorly controlled diabetes and related complications [1]. This research aims to influence policy decisions at multiple levels. Policymakers can utilize the insights gained to advocate for targeted interventions that improve diabetes management and reduce healthcare costs among Latinx minorities in California.

Retroperitoneal Hematoma: What is the Procedure?

2025-02-05T08:07:29+00:00

Introduction: the causes of retroperitoneal hematomas are multiple, acute and/or chronic; it is common for underreporting to be underreported, overtreatment or, worst of all, misdiagnosis. Objective: to present the surgical experience of the Surgery Service of the "Rubén Leñero" General Hospital of patients with retroperitoneal hematomas in Trauma Surgery in 5 years, in Mexico City. Method: retrospective, longitudinal, observational and descriptive study, in a period from 2020 to 2024, with a confirmed diagnosis of retroperitoneal hematoma. Results: 106 patients of which 94 (89 %) men, 12 women (11 %), mean of 27 years, 31 of them present with retroperitoneal hematoma. In this group of patients, 30 men (96.77%) and one woman (3.22%), with a mean age of 24 years, range from 18 to 33 years. The first cause of retroperitoneal hematoma is a blunt trauma of the abdomen due to a motorcycle accident, reaching 32.25%. Morbidity of 41.93% and zero mortality. Discussion: computed tomography is the gold standard for the diagnosis of retroperitoneal hematoma, with a sensitivity and specificity of 100%. The first organ affected retroperitoneally is the colon, in the second pancreas, and in the third place the kidney. Conclusion: the incidence of retroperitoneal hematoma is low when compared to anterior abdominal lesions with hemoperitoneum. Conservative management is the most appropriate approach, reducing morbidity and bleeding and avoiding overtreatment, with beneficial and correct results for patients.

Comparative Assessment of Hemostasis Patients with Compensated and Decompensated Cirrhosis

2025-01-28T16:42:23+00:00

We have studied the pro- and anticoagulant systems in patients with compensated and complicated course of the disease in dynamics. The presence of thrombophilia in patients with compensated course of liver cirrhosis, which may be one of the pathogenetic factors in the development of complications, and disseminated intravascular coagulation in patients with decompensated cirrhosis, which is a consequence of thrombophilia and the cause of hemorrhagic syndrome, has been shown. The aim: to give the comparative assessment of the state of hemostasis system in patients with liver cirrhosis with uncomplicated and complicated course of the disease. Materials and methods: The study involved 240 patients with liver cirrhosis hospitalized during 2017-2021. 190 patients were assigned to the group with complicated - decompensated course of cirrhosis: 123 had gastrointestinal bleeding, 67 had ascites. 62 patients died during the follow-up. 50 patients were referred to the group of patients with uncomplicated - compensated course of the disease. At the time of examination they had no specific complaints. Assessment of procoagulant link included the determination of the number of platelets, prothrombin index, activated partial thromboplastin time, fibrinogen, and activity of coagulation factor F VIII. Assessment of anticoagulant link included the determination of protein C activity. Additionally, markers of thrombosis were assessed by the level of fibrinogen "B" and D-dimer. Results: When assessing the hemostatic system in decompensated patients with liver cirrhosis, the indicators of the pro- and anticoagulant link at admission and in dynamics were changed within wide limits, both in the direction of hypo- and hypercoagulation, regardless of the complications nature. In compensated patients, the standard coagulogram did not differ from normal values. At the same time, the activity of coagulation factor FVIII in 65.2% of patients was at the upper limit of the parameters taken as the norm, and in 35.6% it exceeded the upper limit of the norm. The activity of anticoagulant protein C in plasma in 88.0% of patients with LC was 1.5 - 1.8 times lower than the lower limit taken as the norm. At the same time, a decrease in the number of platelets, prothrombin index, fibrinogen, and an increase in the APTT level characteristic of decompensated patients can be regarded as manifestation of disseminated intravascular coagulation syndrome. Confirmation of the presence of disseminated intravascular coagulation syndrome is an increase in the level of D-dimer in blood, which was observed in 75.0% -97.0% of patients upon admission, and in 90.0% -99.0% in dynamics among the deceased, regardless of the complications nature. Conclusions: In compensated patients with liver cirrhosis, the state of hemostasis during the natural course of the disease is characterized by imbalance in the direction of hypercoagulation, which is confirmed by a decrease in the activity of protein C against the background of normal or increased activity of the coagulation factor FVIII. Decompensated patients have DIC syndrome in varying degrees of severity, characterized by laboratory thrombocytopenia, a decrease in the prothrombin index, fibrinogen, an increase in APTT, the appearance of fibrin degradation products (D-dimer), which clinically determines the hemorrhagic syndrome in liver cirrhosis. Among the deceased patients, the content of D-dimer practically did not change over time, being increased in 90.0% of patients with bleeding and 99.0% with ascites.

Three-Dimensional Printed Flow Phantom Model of the Carotid Artery in Preterm Infants: Vessel Lumen Diameter Measurements Using Different Printing Materials

2024-12-27T18:56:26+00:00

Background: Diameter forms an integral part of blood flow measurement. This study aimed to explore different three-dimensional (3D) printed materials to develop flow phantom models of the carotid artery in preterm newborn infants and to investigate best materials for diameter measurement validation. Methods: We produced a 3D printed Doppler flow phantom model with vessel lumen diameter of 2.0 mm with varying vessel characteristics using data from 21 preterm infants (right carotid vessel lumen diameter, wall thickness, blood flow measurements using Doppler ultrasound and distance of the carotid artery from skin surface) examined for research or clinical purposes. Flow phantom vessel lumen diameters were measured by a single operator blinded to flow phantom diameter. Results: 15 diameter measurements were performed. Ultrasound measured vessel lumen diameter measurements resulted in underestimation of the true lumen diameter. The measured mean (SD, range) diameter was 0.163 (0.105, 0-0.420) mm. This study found that difference in vessel lumen diameter measurements were least with the hybrid material (FLXA9895-DM) with shore value of 95 in matte finish. Vessel wall thickness was systematically overestimated in the majority of the measurements {Anterior wall thickness, mean(SD, range) 0.145(0.081, 0.020–0.300) mm and posterior wall thickness, mean(SD, range) 0.103(0.117, minus 0.100–0.370) mm}. Conclusion: We successfully produced a 3D printed flow phantom model of the carotid artery in preterm infants with varying vessel characteristics and identified flow phantoms that produced the least difference in ultrasound measured vessel lumen diameter measurements. Researchers and clinicians can use this information for further studies involving ultrasound diameter measurements.

Satisfaction and Quality of Life in Patients with Dental Implants

2025-01-27T05:35:30+00:00

Satisfaction and quality of life are important factors in assessing the outcome of dental therapy. Method: Minimal risk, retrospective, years 2022 -2023. Sample 36 patients with the use of dental implants contacted by telephone, voluntary participation and signing of the informed consent. Variables studied: demographic data of each patient, assessing the degree of satisfaction with implant placement in the preoperative, postoperative and rehabilitation phases by means of a survey (OIIP -15 questions) on a Likert scale from 1 to 5: 1 very satisfied, 2. satisfied, 3. partially satisfied 4. Dissatisfied and 5 very dissatisfied. Quality of life assessment by survey (OHIP-14 questions): 1. Never, 2. Rarely, 3. Sometimes, 4. Repeatedly, 5. Always. Descriptive statistics with absolute and relative frequencies; inferential statistics using medians and interquartile range with Fisher's test and chi-square. Results: Mean age 65.8 ± 9.7 years, Healthy (ASAI) (55.6%). Patients very satisfied (75-100%) with dental implant treatment (OIIP-15) and never presented an alteration in their quality of life (OHIP-14) during the two years of study, both in terms of functionality and socialization (61.1%-100%). The rehabilitation of the patients, with significant difference Hybrid Prosthesis (p=0.039.), overdenture (p=0,046), single crowns (p=0.011), fixed prosthesis (P=0,003). Conclusion: Adults of legal age, healthy or with controlled systemic diseases, are satisfied with the use of dental implants during two years of use and have a good quality of life.

The Small Monetary Incentive for Blood Pressure Self-monitoring Behavior in Online Hypertension Management

2025-01-23T14:24:03+00:00

Objective: To assess the effectiveness of two methods of delivering a fixed total monetary incentive to improve blood pressure self-monitoring behavior in hypertensive patients. Design: This study is a randomized, double-blinded controlled trial. Methods: A 3-arm trial with 99 participants, randomly assigned to a control group and two intervention groups (1:1:1 ratio). Participants utilized internet-based blood pressure monitors and implemented guideline-based standardized hypertension management through an online platform. The two intervention groups received different time-dependent incentives (1 RMB per day) over a 3-month period: immediate or delayed. Results: In the first month, no significant difference was observed in blood pressure self-monitoring among three groups (P > 0.05). In the second month, the intervention groups showed significantly higher monitoring days compared to the control (immediate incentive: 21.5 days vs. 16.3 days, P = 0.009; delayed incentive: 21.3 vs. 16.3 days, P = 0.029). In the third month, the intervention groups had significantly more measurements (31.1 and 31.4 vs. 17.9 times, P = 0.013 and P = 0.014). Monitoring behavior declined in all groups over 6 months, with the delayed incentive group declining at a slower rate (p < 0.001 for regression coefficient comparison). Conclusions: Monetary incentives effectively improved blood pressure monitoring behavior in the short term. However, their impact diminished after the incentives were withdrawn, with delayed incentives resulting in a slower decline. Small, delayed monetary incentives may provide benefits for remote hypertension management. Future research should investigate the long-term effects and clinical outcomes.

Factors Reducing Pressure Ulcer Risk and the Importance of Care in ALS Patients: A Comprehensive Review

2024-12-27T04:11:57+00:00

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease characterized by muscle atrophy, weakness, and loss of motor function. ALS patients are often bedridden for extended periods, increasing their risk of pressure ulcers. However, clinical data suggests that the incidence of pressure ulcers in ALS patients is lower compared to other bedridden patients. This review analyzes the factors contributing to reduced pressure ulcer risk in ALS patients, focusing on "pressure redistribution due to muscle atrophy," "stabilized postures caused by joint contractures," and "comprehensive care provided by caregivers." Additionally, this paper discusses a comprehensive approach to pressure ulcer prevention, including nutritional management, skincare, pressure redistribution techniques, and advanced technologies. Challenges in pressure ulcer prevention and the importance of ALS-specific care are also emphasized.

Perioperative Acute Renal Failure at Chu-Kara

2024-12-16T01:16:21+00:00

The aim of this study was to take stock of perioperative acute renal failure (ARF) in intensive care at Kara University Hospital. This was a retrospective, descriptive and analytical study of the records of patients with renal failure in the surgical intensive care unit of Kara University Hospital from 1 January 2021 to 31 December 2023. The parameters studied were: epidemiological, diagnostic, therapeutic and evolutionary aspects. Results: 94 cases of ARF were studied, with a frequency of 2.11%. The average age of the patients was 45.65 ± 20.02 years. The most common age group was elderly patients aged 60 and over. The sex ratio was 4.7. The majority of patients were rural (71.30%). The most common type of ARF was functional ARF (76%), followed by obstructive ARF (18%). Digestive surgery was the most common in 60.63% of cases, followed by uronephrological surgery (19.1%) and traumatological surgery (11.7%). General anaesthesia was most common, accounting for 85.10% of cases. The average length of stay in intensive care was 4.25 ±6.42 days. Complications accounted for 40.42% of cases, dominated by infections and hyperkalaemia. Management was associated with a high mortality rate of 31.91%. Conclusion: Perioperative ARF was the result of a combination of numerous factors related to the patient's condition, delay in consultation, type of surgery, precarious haemodynamic events and perioperative infections. Management of perioperative acute renal failure is primarily preventive and aetiological.

Health Interventions for Health Promotion in Sub-Saharan Africa: Assessing Impact on Health Literacy and Comparative Analysis of Online Communication Channels

2024-12-21T14:17:30+00:00

Introduction: Considering the increased incidence of noncommunicable diseases (NCDs) and the need for novel approaches to health promotion, this study investigates the feasibility of cross-country mHealth interventions in Sub-Saharan Africa. The study, which focuses on using digital platforms for health communication, intends to investigate the feasibility and effectiveness of cross-country mhealth interventions aimed at disseminating health promotion materials in Sub-Saharan Africa across various platforms. The study is based on the NCDs 365 project, a year-long health promotion initiative in five nations aimed at promoting NCD literacy. Methodology: The study utilized a multi-stage sample technique, including an intentional selection of five nations (Cameroon, Kenya, Nigeria, Uganda, and Zimbabwe) with active local partner organizations conducting the initiative. The following stage was convenience sampling of members of these organizations who participated in the NCD365 project activities. Data gathering included the distribution of questionnaires via local partners, followed by thorough analysis using descriptive techniques and comparison tests such as ANOVA and the Kruskal-Wallis test. The extensive methodology ensured a broad and representative sample, which increased the findings' validity and generalizability. Results: The findings demonstrated the potential of mHealth interventions to close health literacy gaps and promote positive health behaviors throughout Sub-Saharan Africa. According to an analysis of online communication platform usage, WhatsApp was the most popular (58.6%), followed by X (20.8%) and Facebook (6.8%). The study also found significant trends in platform preference across all five countries. Furthermore, gender-specific study indicated comparable literacy rates, with males slightly outperforming females. The Kruskal-Wallis test found no significant difference in the efficacy of various online communication channels for health promotion, confirming the viability of cross-country mHealth programs. Conclusions: This study highlights the significant potential of cross-country mHealth interventions for health promotion in Sub-Saharan Africa. The study's strong methodology, agreement with current research, and gender-specific analysis add to its dependability and credibility. The findings of this analysis provide significant recommendations to policymakers seeking to optimize platform-specific policies and stimulate cross-country collaborations in health promotion. Finally, these findings expand the discussion on health literacy promotion and establish the groundwork for evidence-based recommendations that might drive effective health communication initiatives in the region and beyond.

Appropriate Blood Usage and Adherence to Guidelines in Orthopaedic Patients Managed at Moi Teaching and Referral Hospital, Eldoret, Kenya

2024-12-28T03:06:53+00:00

Blood transfusion is required in the management of life threatening orthopaedic trauma hemorrhage. However, this practice is faced with erratic supply, increasing demand for safe blood and inappropriate transfusions which may expose patients to transfusion associated risks. Appropriate use of blood and related products as well as adherence to transfusion guidelines has been shown to ameliorate these challenges. This study set out to determine the appropriate blood and blood components usage and adherence to guidelines in orthopaedic patients managed at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. Descriptive cross-sectional study design was and involved 132 transfused orthopedic trauma patients, recruited by consecutive sampling, between March 2019 and January 2020. Data was collected using interviewer administered structured questionnaire. Continuous data were summarized as median (inter-quartile range) and categorical data as frequency tables and proportions. Fisher’s Exact Test was used to assess associations between categorical variables and non-parametric Kruskal-Wallis Test was used for continuous independent variables. A p value < 0.05 was considered statistically significant. The results: Males were 101 (76.5%), median age was 36 (IQR 28, 47) years, majority of the patients, 95 (72%) were referrals, 64 (48.5%) were unskilled workers and 64 (48.5%) had primary school level of education. Most of the patients, 105 (79.5%) were injured in road traffic accidents. Most patients, 105 (79.5%) and 115 (87.1%) had normal pulse rate and systolic blood pressure respectively while 77 (58.3%) had increased respiratory rate. The median pre-transfusion haemoglobin was 8.90 (IQR 7.98, 10.35) g/dl and the commonest blood group was O positive. Patients with isolated femur fractures were 62 (47.0%). Patients who underwent primary open reduction and internal fixation were 61(46.2%). Majority of the patients, 127 (96.2%) received packed red blood cells. The proportion adherent to transfusion guidelines was 16.7% [95% CI: (10.75, 24.14)]. The factors associated with adherence were pre-transfusion haemoglobin and haematocrit levels, Fisher’s Exact and Kruskal-Wallis p value being < 0.001. Mild transfusion reactions were noted in 15 (11.4%) patients. Conclusions made were that most patients were males, transfused with packed red blood cells and majority of injuries sustained were due to road traffic accidents. The level of adherence to the institutional transfusion guidelines was low at 16.7%. Factors associated with transfusion guidelines adherence were pre-transfusion haemoglobin and haematocrit levels. The recommendation was that Moi Teaching and Referral Hospital Transfusion Committee should increase transfusion guidelines awareness among clinicians in orthopaedic trauma.

Paediatric Traumatic Endophthalmitis in Western India: A Study of Clinical Presentation, Management, and Treatment Outcomes

2024-12-28T13:24:46+00:00

Introduction: Endophthalmitis is a devastating sight-threatening condition following open globe injury. The study aims to determine the rate of endophthalmitis and assess risk factors for the development of endophthalmitis following open globe injury (OGI). Methods: A retrospective review of all children treated for OGI at the Drashti Netralaya from January 2008 to December 2022 was conducted according to predefined inclusion and exclusion criteria. The main outcome measures were the rate of endophthalmitis, different variables, and visual outcome. Result: In this study, 53/1551 (3.42%) eyes had endophthalmitis. Cross-tabulation and descriptive analyses identified presenting vision (0.012), corneal condition (0.009), vitreous opacities (0.000), and age group (0.003) as high-risk factors of developing endophthalmitis. The type of interventions and subconjunctival antibiotic injection at the time of globe closure (0.011) was associated with a decreased risk of developing endophthalmitis. Conclusion: Careful aggressive management according to clinical findings, has a statistically significant impact on the visual outcome even in the pediatric age group.

Central Airway Obstruction: Diagnostic Challenges and Management Strategies in Subglottic Stenosis and Poly Chondrites with Case Studies

2025-01-06T17:05:29+00:00

Tumours or strictures compressing the trachea /bronchial tree cause central airway obstruction (CAO). Subglottic stenosis are a cause of respiratory symptoms and distress. Idiopathic sub glottic stenosis (ISGS) is a rare disease occurring mainly in women and has a history of recurrences. Endoscopic laser microsurgery and balloon dilatation are used in the management of strictures. Recurring strictures may require tracheoplasty. Poly chondrites is a rare disorder causing poly arthritis and inflammation of cartilaginous tissue. Inflammatory changes in the lung cause tracheobronchomalacia (TBM) and lung collapse. Relapsing polychondritis (RP) effecting the airway is life threatening as there is dynamic airway closure during expiration. The medical therapy in RP includes steroids, disease modifying agents ( methotrexate) and biologics. Surgical interventions include tracheostomies and tracheobronchial stents for severe forms of the illness.

Colon Volvulus: Disease or Consequence?

2025-01-06T17:12:59+00:00

Introduction: Sigmoid colon volvulus is produced by torsion on itself, which causes an obstruction and endangers the blood supply to the organ and represents a condition because of another underlying pathology, the highest prevalence is in men over 70 years of age. Objective: Presentation of a case. Method: A 73-year-old man with paranoid schizophrenia under treatment presented to the emergency department for acute constipation of 72 hours, with no evacuation and flatus. She refers to abdominal distension of 48 hours prior in a sudden and evolutionary way, continuous abdominal pain of a colic type and generalized oppressiveness. An emergency exploratory laparotomy was performed initially, with the finding of volvulus of the giant sigmoid colon not perforated, but with intestinal ischemia. Intestinal resection of the sigmoid colon and stoma is performed. Discussion: Strangulated colon volvulus makes it a surgical emergency due to intestinal necrosis, septic shock and death; the computed tomography study is the gold standard for confirming the diagnosis of colon volvulus, surgical treatment is definitive. Conclusion: Sigmoid colon volvulus is a consequence of another pathology (such as benign prostatic hypertrophy) and not a disease. Its initial treatment (endoscopically) will depend on the time of evolution, infrastructure, expertise and/or each case. But at the end of the day, management is urgent, priority to scheduled, with partial resection of the colon, stoma, and/or bowel reconnection.

Artificial Intelligence Can Assist the Homeopath, But It Cannot Replace Him: Listening to a Doctor is Different from Listening to a Robot

2025-01-08T16:44:34+00:00

Homeopathy is a clinical methodology discovered about two centuries ago by the Saxon doctor Samuale Hahnemann, it is based on the law of similarities and treats the individual with a "small dose" of a specific substance that, in "high doses" would make him sick. The infinitesimal homeopathic doses are prescribed after a long medical visit during which the homeopath listens carefully to the patient's narrative, takes into account the smallest narrative details, evaluates every kind of disorder accused by the patient and, based on the law of similarities, prescribes the appropriate, personalized, individualized homeopathic therapy. The attention paid to the patient, and not only to the disease, makes the narrative medical approach of classical homeopathy typical, which takes into account global, physical, mental and existential suffering. Listening homeopathically, therefore, means expanding listening based on a clear and precise motivation aimed at humanly understanding the overall meaning of pain. Generative AI, not having an internal motivation, is different from natural and human intelligence, that's why the natural and well-motivated listening of a homeopath is very different from the artificial and unmotivated listening of a robot. To establish a natural and human relationship with the patient, one must listen naturally and humanely, but this does not exclude that the good use of artificial intelligence, in homeopathy, can prove extremely useful.

Proinflammatory TNF Alfa TNF Beta, Interleukin 6, Anti-inflammatory Interleukin 10 Cytokines and the Associated Cytokine Imbalance in the Specific Immune Primed Rabbit Models with Streptococcus Pneumonia Serotype 1 and Serotype 6 Capsules

2025-01-13T18:37:06+00:00

The capsular polysaccharide Type 1 and type 6 of the human clinical local pneumotropic isolates of Streptococcus pneumoniae were separated, characterized and purified. Then quantified to concentrations of 1 mg/ml. To be ready as immunogens they were admixed with an equal volume of lanline. These were standing as the test immunogens. The test immune system was that of rabbits. The test rabbit groups were assigned as C 1 group,C6 group and saline S control group each of five animals. The test rabbit groups C 1 and C6 were primed once through intramuscular route separately with capsule-lanoline mixtures and left for 21 days, then bleed. Sera were saved from the primed rabbits blood samples in 0.5 ml aliqoutes till use. Trachial mucosal immunoglobulin were separated, partially characterized and kept in alqoutes of 0.5 amounts in forml normal saline till use. One step sandawich eliza technique for TNF alfa, TNF beta, IL6 and IL10 were performed for both sera and mucosal globuilin of the primed rabbits and controls. The immune features of the capsule-lanline primed rabbits were found as; capsules were weak immunogen needs adjuvant in order to become good immunogen, cytokine responses were serotype dependent, mucosal cytokines have shown to be of higher levels than systemic responses, C1 was higher immune convertor than C 6, and both associated with cytokine imbalance towards pro-inflammatory cytokines.

Spotlighting Nigeria's New Health Agenda: A Case Study on the Alignment of Global Health Initiatives with National Health Priorities Through the SRMNCAEH+N Lens

2024-12-14T05:09:23+00:00

Background: Alignment of global health initiatives (GHIs) with national health priorities is crucial for effective and sustainable healthcare interventions and strengthening health systems. Despite widespread recognition of this need, achieving alignment between GHIs and national priorities has proven challenging. The importance of addressing this challenge has led to a growing focus on GHIs alignment, evident in forums such as the Paris Conference in 2015 and the Lusaka Agenda in 2023. As Nigeria embarks on a new mid-term health agenda based on the sector-wide approach (SWAp), understanding the country-level implications of alignment becomes paramount. Method: This study utilized qualitative research methods to examine the issues affecting GHI alignment within the context of the sexual, reproductive, maternal, neonatal, adolescent, elderly, nutrition health plus nutrition (SRMNCAEH+N) program. Through 24 interviews and focus group discussions with key stakeholders including government officials, representatives of global health institutions, civil society actors, health workers, and community members, this research identified and validated six critical issues influencing GHI alignment at the country level. Result: The findings shed light on current practices, challenges, and recommendations, highlighting Nigeria's readiness to implement the new health agenda and SWAp effectively. The research identified and validated six critical issues influencing GHI alignment at the country level through the perspectives of diverse stakeholders. Conclusion: The paper underscores the importance of extensive stakeholder involvement, including communities, in achieving optimal alignment between GHIs and national health priorities. The study's insights into the alignment dimensions of Nigeria’s SRMNCAEH+N program reveal key areas for improvement and collaboration, essential for the successful implementation of Nigeria's new health agenda.