British Journal of Healthcare and Medical Research

Branched Chain Amino Acid Ketones, or Ketolysis of Beta Hydroxybutyrate Support Lipogenesis and Tumour Growth

Maurice Israël, Eric Berg, Guy Tenenbaum — Sat, 13 Jul 2024 00:00:00 +0100

The glycolytic and fatty acid sources of mitochondrial acetyl-CoA being impaired or inhibited in tumour cells, they become dependent of ketone bodies for its production and for sustaining their metabolism. The ketone bodies are provided by liver ketogenesis or from ketogenic branched-chain amino acids (BCAA) to produce acetyl-CoA in tumour cells. Two pathways are involved: the ketolytic SCOT-oxct1 route, and the BCAA transaminase - keto dehydrogenase pathway. Acetyl-CoA and in fine succinyl CoA are formed. The two pathways converge at the lipogenic route, supporting tumour progression.

Work-Related Stressors in Employees Presenting with Musculoskeletal Disorders

Laran Chetty — Sun, 07 Jul 2024 00:00:00 +0100

Background: The purpose of this project was to evaluate work-related stressors in employees presenting with musculoskeletal disorders using the Management Standards for Work-Related Stress survey proposed by the Health and Safety Executive (HSE) at an occupational health service. Methods: An OPAS-G2 database was utilised to identify and select employees with musculoskeletal disorders that attended the occupational health service within the data collection period. Employees were mailed the HSE survey and asked to complete and return it in a pre-paid envelope. Results: The standards Demands, Managers’ Support, Relationships and Role were in the red category while Control, Peer Support and Change were in the yellow category. Conclusion: The stressors associated with musculoskeletal disorders were not being optimally managed. An organisational strategy to tackle work-related stressors should be developed and implemented as a matter of high priority.

Capacity-Development as Correlate of Access to Healthcare Services and Satisfaction among Health Care Workers and their Clients in Osun and Ogun States in Nigeria

Helen U. Ekpo, Nnodimele O. Atulomah — Sat, 13 Jul 2024 00:00:00 +0100

Nigeria is considered to have one of the lowest health indices in the world and contributes to 10 % of global maternal deaths. Households and individuals bear the burden of a dysfunctional and inequitable health system characterized by delayed or absence of seeking health care and having to pay out-of-pocket for health care services that are not affordable. Nigeria’s commitment to improvement of maternal and child health indices and Universal Health Coverage was symbolised by the passage of the National Health Act of 2014, section 11, which mandated the establishment of Basic Health Care Provision Fund (BHCPF) to expand the fiscal space by deploying financial resources for primary health care services [1]. Despite the introduction of the scheme, many states have not obliged to adopt the scheme. The study was Ex-post Facto cross-sectional design undertaken in Osun and Ogun States, to explore the relationship between capacity-development of health care workers in BHCPF supported facilities and quality of the services provided defined by satisfaction of services rendered and received by clients seeking health care and to demonstrate that these parameters are better in state that have adopted the BHCPF scheme for achieving UHC. Data collected were coded and analyzed using the Statistical Package for Social Sciences (SPSS) version 23, providing summaries which were used to derive test of significance of hypothesis. Clients in Osun State had significantly higher levels of satisfaction to the services received in BHCPF supported facilities when compared to those of clients accessing services in PHCs in Ogun state where the BHCPF had not commenced. The study findings provided some evidence to show that there is need for states governments in Nigeria to buy into the BHCPF program which is a veritable scheme that will contribute to provision of equitable health care services to all Nigerians and will contribute ultimately to achievement to universal health coverage to all Nigerians in the nearest future.

Femoral Artery Trauma: It Is A Challenge

Sun, 07 Jul 2024 00:00:00 +0100

Introduction: in Mexico there is a high rate of violence in men, as there is throughout the world, with a mortality rate from homicides as alarming as the sixth cause of death in 2023; furthermore, those who become survivors of aggression consequently have temporary or mostly permanent and disabling consequences. Objective: presentation of a case. Method: 26-year-old male who is attacked by third parties, on the left thigh he has a cutting wound in the left inguinal region with dimensions of 2 x 1 cm, with the presence of an evolving hematoma of more than 10 cm., he undergoes surgery. emergency and in the vascular examination a lesion of the superficial femoral artery was identified 5 cm from the division of the common femoral artery complex. Discussion: in most cases the diagnosis of femoral artery trauma is immediately apparent, however, deep rupture of the femoral artery must also be considered. The surgical options regarding femoral artery repair technique will depend on each case: vein graft, end-to-end anastomosis, Fogarty thrombectomy, ligation, arterial repair, use of prosthetic graft, use of patch and arterial bypass. At the level of the femoral vein, its repair is ligation and venous repair, anecdotally. Conclusions: vascular injuries of the femoral arteries are a real challenge for the Trauma Surgeon of this Country, since they put in check the ability to resolve the surgical emergency in a correct, technical, and ethical way. However, despite the lack of supplies and poor infrastructure conditions of the Health System, it still manages to make a difference.

Flipping the Script: Description of Needs and Personality Traits of People Living with HIV in Malawi and Zimbabwe

Sun, 07 Jul 2024 00:00:00 +0100

Effective HIV prevention programs require a combination of behavioral, biomedical and structural interventions. Behavior interventions address the cultural contexts within which risk behaviors occur and aim to stimulate uptake of HIV prevention services. This research seeks to understand the relationship between the underlying needs people living with HIV (PLHIV) have from treatment, their personality traits, and how it influences treatment behavior. The overall focus is to develop the most successful campaign across sub-Saharan Africa, but primarily in Malawi and Zimbabwe. This was a cross-sectional quantitative study where interviews with 786 adult PLHIV and 504 healthcare workers (HCWs) were conducted via Computer Assisted Telephone Interviewing (CATI) in Malawi and Zimbabwe. PLHIV in Malawi and Zimbabwe are typically adherent to their medication. For PLHIV the power of the pill is scary and controlling but also liberating. Early associations with HIV tend to derive from negative comments being made about PLHIV, which fosters a sense that PLHIV are not accepted by the wider community. HCWs in Malawi and Zimbabwe do prioritize emotional support but have limited capacity to provide wider pastoral care. PLHIV, and HCWs, have good awareness of what viral suppression is, but do not always understand what it truly means. Utilization of communication channels that are acceptable and trusted will be key to successful HIV literacy treatment campaigns.

Surgical Management of Urogenital Fistula UGF: Sikasso’s Hospital Eperience

Wed, 24 Jul 2024 00:00:00 +0100

Acquired abnormal communication between the urinary and genital tracts. UGF are obstetrical in our context and result from a stagnation of labour in delivery. Whereas they follow urogenital instrumentation and surgical interventions in industrialized countries. [1, 2]. Obstetric fistula involves anatomical lesions whose location, size, number, and depth differ according to the length of time for labour stagnation and the therapeutic modality adopted for its management. There are many existing classifications and, although they are all based on the same parameters, namely: fistula size, location, locoregional trophicity and the possibility of affecting the continence system, none of them is unanimous.

How to Destroy the Main Reservoir of HIV After Infection: New Medicine

Vladimir Zajac — Wed, 24 Jul 2024 00:00:00 +0100

Every virus is a parasite that cannot exist on its own and is fully dependent on its host. This is the basic condition of its existence. It is fully dependent on the host and thus it is - a living cell. What kind of living cell? It was found that the carriers of BLV and the new coronavirus are commensal bacteria of the intestinal tract. HIV carriers are bacteria and yeasts of the intestinal and respiratory tract.

Intestinal Occlusion: Consequence or Diagnosis?

Sat, 13 Jul 2024 00:00:00 +0100

Introduction: Intestinal occlusion is a very common pathology in health services, both in admission to the Emergency Department and in the definitive treatment and/or complication of surgical practice in Surgery. Its definition is per se underestimated. Objective: Presentation of a case. Method: A 39-year-old female with intestinal obstruction was a carrier of an intragastric balloon for more than 2 years without follow-up. With frank data of acute abdomen, exploratory laparotomy was performed, removing the foreign object by enterotomy. Discussion: The prevalence of obesity has multiplied in recent decades, which has led to an increase in bariatric surgery and other endoscopic modalities, which were developed for the first time around 1985 with the intragastric balloon, which today is the most widely used endoscopic modality, which therefore, surgical treatment of complications should be considered, if necessary, in case of perforation and/or gastrointestinal obstruction. Conclusions: Intestinal occlusion is not a definitive surgical diagnosis, but a consequence of another real disease.

Autoimmune Pancreatitis and Pancreatic Cancer. Is There A Relationship Between These Conditions? About A Case and Review of The Literature

Thu, 18 Jul 2024 00:00:00 +0100

Introduction: Chronic pancreatitis is a risk factor for pancreatic cancer, but the association with autoimmune pancreatitis (AIP) is less clear. AIP is a rare disease with a challenging diagnosis. Two types of AIP are presented: type 1 and type 2. Case Presentation: A 35-year-old female with a history of pancreatitis and subsequent diagnosis of pancreatic cancer. Discussion: AIP can be difficult to diagnose because it shares characteristics with pancreatic cancer. IgG4 levels can help diagnose AIP, but they are not always elevated. There is a possible association between AIP and pancreatic cancer, especially in type 1 AIP. Treatment of AIP with steroids can improve symptoms. Conclusions: AIP should be considered in the differential diagnosis of patients with obstructive jaundice and pancreatic lesions. Pancreatic biopsy is necessary for a definitive diagnosis of AIP.

70 Cases of Incomplete Pancreatic Divisum (IPD) – the Usefulness of MRCP Diagnosis and the Safety of Endoscopic Treatments via Duodenal Major and Minor Papilla

Sun, 07 Jul 2024 00:00:00 +0100

Incomplete Pancreatic Divisum (IPD) is a rare congenital disease caused by maljunction between the ventral duct and the dorsal duct in the 7th week in embryonic stage. In our hospital over the past 10 years, 70 cases of IPD were diagnosed. This is 3.7% (70/1915) of naïve ERP cases during this period (2014.9.～2024.3.). Many classifications were proposed in the literature. We classified them by modified “Hirooka’s classification” into stenotic fusion typeⅠ,Ⅱ(sfⅠ７cases, sfⅡ1 case), ansa pancreatica type (0 case) and branch fusion typeⅠ,Ⅱ,Ⅲ(bfⅠ17 cases , bfⅡ0 case, bfⅢ 44 cases). MRCP was performed in 57 cases, and 20 cases (20/57=35%) were diagnosed by MRCP alone. Finally 49 cases could be correctly diagnosed by MRCP (49/57=86%). Symptomatic cases were treated by endoscopy -13 cases,ESWL -1 case, and ESWL + endoscopy -39 cases. Asymptomatic 14 cases had no therapy. About the Endoscopic treatment, via major papilla were performed in 19 cases with a technical success rate of 100%, while via minor papilla were performed in 34 cases with a technical success rate of 90% (28/34) without severe complications. In difficult cases, we performed our new endoscopic procedures; rendezvous precut method and reverse balloon dilation method in 8 cases. 81％(43/53) of symptomatic patients had a history of alcohol intake, while 71% (12/17) of asymptomatic case had no alcohol intake. So alcohol intake may make IPD symptomatic . After endoscopic treatments, the prognosis was good in 48, poor in 4 and 1 had an operation by pain relapse. In 50 calcified cases, ESWL and/or endoscopy were performed more repeatedly than 20 non-calcified cases .EPS is still placed in 39 cases (major14 , minor 25 ) to maintain the pancreas juice flow and to prevent the papilla occlusion.

Gastrointestinal Parasites Amongst Epileptic and Non-Epileptic: Prevalence and Associated Risk Factors of Gastrointestinal Parasites Amongst Epileptic and Non-Epileptic Individuals in Batibo Subdivision, Northwest Region of Cameroon: A Community-Based Cross-Sectional Survey

Mbah Sylvie Bih — Sun, 07 Jul 2024 00:00:00 +0100

The aim of this study was to investigate the prevalence of gastrointestinal parasites and establish the relationship between the prevalence of these parasites and epilepsies amongst the population and associated risk factors. This cross-sectional survey was carried out in Batibo Health District from April 2021 to July 2021. A total of 402 stool samples were collected and examined using the Formol-Ether concentration technique to detect the presence of helminth eggs. A well-structured and pretested questionnaire was administered to collect socio-demographic data and to assess the risk factors. Data was analyzed using SPSS vs 23. P values ≤0.05 were considered significant. Ages ranged from 3-72 years and the highest number of participants were females 275(68.4%). Results obtained showed that the overall prevalence of persons with intestinal helminths was 12.4% (50/402). Taenia spp was the most prevalent parasite 4.2% (17/402) followed by Ascaris lumbricoides 4.0% (16/402), Entamoeba coli 3.0% (12/402) and the least prevalent species was Ancylostoma/Necator spp, 2.2% (09/402). Two participants (0.5%) each had multiple infections with Ascaris /E coli and Ascaris/hookworm infection. Parasitic infections were significantly higher in participants of age group 15-24 years (29.5%; p= 0.0001), and insignificantly higher in females (13.5%; p=0.363) and students (32.1%; p=0.070). Parasitic infections were also significantly (p=0.004) higher in epileptic participants 34.04% (16/47) who were more infected with Taenia spp 17.02% (8/47). Multivariate analyses showed significant predisposing social factors of intestinal parasites identified in this study such as source of water (boreholes, 0.041 and streams, 0.018), frequency of deworming (twice yearly, 0.043), lack of latrines (0.034) and geophagia (0.023). Multivariate analyses also showed that the use of boreholes 2.815(0.849-9.3), streams 4.329 (1.29-14.5), deworming once in six months 0.28 (0.08-0.98), geophagia participants 1.02 (1.24-10.45) and participants who eat pork or beef 0.034 (0.58-1.0) were risk factors for the development of intestinal parasites. Thus, the prevalence of gastrointestinal parasites has increased considerably over the years although the rate is not alarming.

Forunier's Gangrene: A Replainable Disease

Sun, 07 Jul 2024 00:00:00 +0100

Introduction: Fournier's gangrene is a rare disease that is defined as the infection of soft tissues and muscle fascia that are specifically necrotic, potentially fatal, of polymicrobial cause and of specific topography. Objective: presentation of a case. Method: A 59-year-old male with type 2 diabetes mellitus without treatment, with 14 days of evolution, the diagnosis of Fournier's gangrene is made, he undergoes immediate surgical management with drainage, debridement and aggressive surgical lavage and exploratory laparotomy, which despite due to the relentlessness of the infection and necrosis, his evolution was satisfactory. Discussion: the triggering factor or cataclysm of Fournier's gangrene is not known, but it is associated with its own elements that converge and create a synergy of the infectious event in the patient. Early surgical care reduces mortality by up to 16%, otherwise it increases by up to 68%. There are multiple treatment options, without leaving aside the aggressive surgical management essential in the first line but associated with sitz baths, or daily dressings, consecutive surgical washings, use of wet dressings, or negative pressure therapy. Conclusions: Fournier's gangrene is a fatal disease, which as science advances, the essence of its treatment does not change. It's surgical! where early aggressive debridement, drainage and surgical lavage is the turning point in having or not having a good prognosis.

The Paleolithic Ketogenic Diet (PKD) is Associated With Low C-peptide Levels In Non-T1DM Patients And Healthy Subjects

Sat, 13 Jul 2024 00:00:00 +0100

C-peptide is used as a measure of endogenous insulin production. Given that insulin and C-peptide are produced in equal amounts, C-peptide is typically used to differentiate between external and endogenously produced insulin in insulin-treated type 1 diabetes mellitus (T1DM). In a clinical setting, a decline in C-peptide is regarded as a loss of beta cell function. However, physiological conditions may also be associated with low C-peptide levels. The authors of this paper use a low-carbohydrate diet, the so-called paleolithic ketogenic diet (PKD), in the treatment of various conditions and observed that C-peptide is typically low on this diet. In order to characterize C-peptide levels on this diet, we designed a study to retrospectively assess C-peptide levels in 100 non-T1DM subjects. We found that 55% of the subjects had a C-peptide level below the standard reference range. C-peptide levels correlated with glucose levels. A significant correlation was found between C-peptide and age, with younger subjects having lower C-peptide levels. Males also showed lower C-peptide levels than females. Given the increasing number of patients using low-carbohydrate diets worldwide, physicians should be aware of laboratory correlates of low-carbohydrate diets, including low C-peptide levels, most importantly to prevent incorrect T1DM diagnosis.

Body Mass Index (BMI) is a Risk Factor for Coronary Artery Disease (CAD)

Ghazi Daradkeh, Farrookh Haider, Asma Al Obahi, Asma Al Muhannadi — Wed, 17 Jul 2024 00:00:00 +0100

Background: Although excess adiposity appears to increase the risk of coronary artery disease (CAD) in the general population, its importance in patients with established coronary disease is less defined. Aims: We evaluate a population-based inception cohort of survivors retrospectively as a review to assess the association between body mass index (BMI) and the risk of coronary artery diseases. Methods: literature search in PubMed was done by using the following keywords combination: (cardiovascular diseases or heart disease or coronary artery disease) and body mass index BMI. Screened the topics and removed duplicates, papers that contained abstracts only or papers that had no access to the full article were excluded from the study. This review article has retrieved 51 papers through a PubMed search. The first screening was to remove duplicates (n = 13), followed by removing articles with only an abstract or without access to the entire research (n = 16). Finally, a complete research revision revealed non-eligible papers (n = 29). A final number of (n = 22) research was included. Results: all 22 articles were full-text free downloads from PubMed. Conclusion: Obesity is a significant component of metabolic syndrome. A greater risk of CAD is associated with an increased BMI and metabolically unhealthy people. Metabolically unhealthy obese people have a greater risk of coronary artery disease when compared to metabolically healthy obese people. Additionally, it has been proven that obese people can benefit from losing weight and physical activity.