British Journal of Healthcare and Medical Research

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

Yuriko Inoue — 2025-01-04

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

Essohanam Mouzou — 2025-01-04

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

Stephen Ogweno — 2025-01-04

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

Ngetich Geofrey Kibiwot — 2025-01-12

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

Shreya Shah — 2025-01-12

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

Bashir Ahmed Bulbulia — 2025-01-17

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?

Bertha Zenaida Acevedo Martínez — 2025-01-17

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

Giulio Tarro — 2025-01-21

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

Ibrahim M S Shnawa — 2025-01-26

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

Oyeyemi Pitan — 2025-01-26

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.