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Pattern of Stroke Admissions, Radiodiagnostic Compliance, and Outcomes in the Intensive Care Unit of a Tertiary Hospital, South-South, Nigeria

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Journal of Behavioral and Brain Science 2022年第9期12卷 401-412页

作者： Abiodun Oyinpreye Jasper Joyce Ikubor department of Anaesthesia and Intensive Care Delta State University Teaching Hospital Oghara Nigeria department of Radiology Delta State University Teaching Hospital Oghara Nigeria

Background: Stroke patients form an integral part of patients admitted into the intensive care unit (ICU);and may need airway maintenance, supplemental oxygen and even endotracheal intubation for mechanical ventilation. Method: In this retrospective study, the medical records and radiological investigations of the patients were assessed. Also, their socio-demographics, and clinical diagnosis and background co-morbidities were noted. The radiological diagnosis post CT was used to determine the type of stroke for those compliant;while clinical assessment alone was used to determine the diagnosis in those who did not do CT. They were also classified into 2 groups: those requiring mechanical ventilation (for ICU care) and those without the need for mechanical ventilation (for high dependency Unit (HDU) care). The eventual clinical outcome was noted. Result: A total of eighty-eight cases, 67% (n = 59) were males and 33% (n = 29) females. 89.8% (n = 79) had hypertension, 3.4% (n = 3) had diabetes while 6.8% (n = 6) had both hypertension and diabetes. Of the hypertensives, 36.7% (n = 29) had hemorrhagic stroke and 66.3% (n = 50) had ischaemic stroke. 53.3% (n = 46) patients had High dependency Unit (HDU care while 47.7% (n = 42) were mechanically ventilated. Of the number in HDU, 51.5% (n = 17) were haemorrhagic, while 52.7% (n = 29) were ischaemic. Clinical diagnosis of ischemic stroke was done in 55 (62.5%) and hemorrhagic stroke in 37.5% (n = 33). Of the lot, only 19.3% (n = 17) of them did CT and 80.7% (n = 71) did not have CT done. None did MRI. Late presentation (beyond 24 hrs) was a common feature for most of the patients, for whom immediate cardio-respiratory support became necessary. Overall mortality rate was 62.5% (n = 55). 39.1% (n = 18) of the HDU (46) patients died, while 88.1% (n = 37) of the ventilated (42) patients died. 56.6% (n = 26) were discharged from the HDU and 4.3% (n = 2) referred to another facility. Of the 42 patients on mechanical ventilation 8

关键词： Ischaemic Stroke Hemorrhage Stroke CT Scan MRI Late Presentation Intensive Care Management Poor Outcome Comprehensive Health Insurance

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Hydroelectrolytic Disorders in Cerebroleted Patients in the Intensive Care Unit of Gabriel Touréteaching Hospital

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Neuroscience & Medicine 2020年第2期11卷 45-51页

作者： Diop Thierno Madane Mangané Moustapha Issa Almeimoune Abdoul Hamidou Mariko Mahamane Beye Seydina Alioune Dembele Alaji Seidou Coulibaly Mahamadoun Ouattara Kassoum Kaloga Mahamane Asseye Siriman Koita Ebongue Sandrine Diango Djibo Mahamane department of Anesthesia-Intensive Care and Emergency Gabriel Toure Teaching Hospital Bamako Mali department of Imagery Luxembourg Teaching Hospital Bamako Mali department of Anesthesia-Intensive Care and Emergency PG Teaching Hospital Bamako Mali Anesthesia department Ophthalmological Institute West African University Hospital Bamako Mali department of Anesthesia-Intensive Care and Emergency Luxembourg Teaching Hospital Bamako Mali

A cerebrole is a patient with a neurological deficit of central origin;these patients very often present disorders of the ion concentration, hence the need for hospitalization in intensive care. The aim of our study was to study hydro-electrolyte disorders in brain-damaged patients, to describe the clinical aspects, to identify the contributing factors and to determine the prognosis of these patients in the intensive care unit of gabriel touré teaching hospital. Material and Methods: It was a prospective cross-sectional study, descriptive of a period of 11 months going from June 2015 to April 2016 in the intensive care unit of CHU Gabriel TOURE we included all the cerebral patients admitted in intensive care in which hydro-ionic disorders have detected on arrival or during hospitalization. Data were collected through transfer sheets, a survey sheet and medical records. Data entry and analysis were done respectively on SPSS software (version 19) and Microsoft Word Starter 2010 software. Results: During our study, out of 450 hospitalization patients, we identified 110 brain-damaged patients and 75 patients were retained in our study, i.e. a prevalence of 16.6%. Male was predominant with 72% with a sex ratio of 2.5 the age group 20 - 50 years was majority with 45.3%, the average age was 38.49 years. The majority of patients (58.7%) were admitted from the emergency department. The most common reason for admission was impairment of consciousness in 94.7% (Table 1) of cases and the Glasgow admission score was less than or equal to 8 in 58.7% (Table 1) of patients. Hydro-electrolyte disturbances were present in 93.3% of patients on admission. Hyponatremia was the most common disorder with 56% (42 cases). Followed by hyperkalaemia 10.7% (8 cases), hypernatremia 9.3% (7 cases), at hypocalcemia 9.3% (7 cases), associated disorders 8% (6 cases). Brain CT was performed in 52% of the patients. In our study, malaria was the most common etiology o

关键词： Hydro-Electrolyte Disorders Cerebroleses Resuscitation teaching Hospital Gabriel Toure

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Post-Operative Complications of Transvesical Prostatic Adenomectomy at Bouake teaching Hospital: Epidemiological, Diagnostic and Therapeutic Aspects

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Open Journal of Urology 2023年第9期13卷 345-352页

作者： Ndiamoi Akassimadou Kouassi Patrice Avion Brice Aguia Freddy Zouan Vénance Alloka Ben Sadia Kamara Beh Yake Koffi Dje department of Urology Bouaké Teaching Hospital Bouaké Ivory Coast

Introduction: The treatment of benign prostatic hyperplasia (BPH) responds to a medical aspect at first, the effectiveness of which is indisputable. However, the curative treatment is surgery. Trans-urethral resection of the prostate (TURP) represents the reference surgical technique when the technical platform is correct. In Bouaké, the FREYER HRYNTCHACK trans vesical approach is the technique used in our department. It sometimes leads to complications that can be life-threatening. The general objective of this work was to describe the morbidity and mortality of trans-bladder adenomectomy and their management at the Bouaké University Hospital. Material and Methods: This is a retrospective descriptive study carried out at the Bouaké teaching Hospital over a period of 5 years from January 2016 to December 2022. It involved 150 patients operated on for BPH by the trans vesical route and who experienced postoperative complications. The parameters studied were age, postoperative complications, treatment, and mortality. Results: The mean age of the patients was 67.2 ± 7.37 years. Hemorrhage was the main immediate complication. Parietal suppuration, in 48% of cases, was the most common secondary complication, followed by vesicocutaneous fistula (18%), orchiepididymitis (15.33%) and urinary leakage (3.33). Late complications were: retrograde ejaculation in 73.33%, urethral stricture (10.66%) and sclerosis of the compartment (6.66%). Mortality was 1.33%. Conclusion: Post-operative complications of adenomectomies according to Freyer Hrynstchak remain dominated by infections. However, postoperative hemorrhage remains the surgeon’s fear because it can cause the death of the patient.

关键词： Adenomectomy Complication Freyer Hemorrhage Vesicocutaneous Fistula

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Analysis of risk factors leading to anxiety and depression in patients with prostate cancer after castration and the construction of a risk prediction model

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World Journal of Psychiatry 2024年第2期14卷 255-265页

作者： Rui-Xiao Li Xue-Lian Li Guo-Jun Wu Yong-Hua Lei Xiao-Shun Li Bo Li Jian-Xin Ni Urology Hospital Xi'an People's Hospital(Xi'an Fourth Hospital)Xi'an 710199Shaanxi ProvinceChina department of Surgery Xi'an Hospital of Traditional Chinese MedicineXi'an 710199Shaanxi ProvinceChina

BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and *** cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages that cannot be treated by radical surgery and which are accompanied by complications such as bodily pain and bone ***,attention should be given to the mental health status of PC patients as well as physical adverse events in the course of clinical *** To analyze the risk factors leading to anxiety and depression in PC patients after castration and build a risk prediction *** A retrospective analysis was performed on the data of 120 PC cases treated in Xi'an People's Hospital between January 2019 and January *** patient cohort was divided into a training group(n=84)and a validation group(n=36)at a ratio of 7:*** patients’anxiety symptoms and depression levels were assessed 2 wk after surgery with the Self-Rating Anxiety Scale(SAS)and the Selfrating Depression Scale(SDS),*** regression was used to analyze the risk factors affecting negative mood,and a risk prediction model was *** In the training group,35 patients and 37 patients had an SAS score and an SDS score greater than or equal to 50,*** on the scores,we further subclassified patients into two groups:a bad mood group(n=35)and an emotional stability group(n=49).Multivariate logistic regression analysis showed that marital status,castration scheme,and postoperative Visual Analogue Scale(VAS)score were independent risk factors affecting a patient's bad mood(P<0.05).In the training and validation groups,patients with adverse emotions exhibited significantly higher risk scores than emotionally stable patients(P<0.0001).The area under the curve(AUC)of the risk prediction model for predicting bad mood in the training group was 0.743,the specificity was 70.96%,and the sensitivity was 66.03%,while in the validation

关键词： Prostate cancer Castration Anxiety and depression Risk factors Risk prediction model

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Adult Onset Still’s Disease in Tropical Area: Illustration of Diagnostic and Therapeutic Difficulties from 3 Senegaleses Observations

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Open Journal of Internal Medicine 2017年第4期7卷 135-143页

作者： Nafy Ndiaye Ngoné Diaba Diack Michel Assane Ndour Biram Codou Fall Ghislain De Chacus Daouda Thioub Ameth Dieng Yakham Mohamed Leye Abdoulaye Leye Internal Medicine department Teaching Hospital of Pikine Dakar Senegal

Introduction: The Adult Onset Still’s Disease (ASD) is a systemic auto-inflammatory affection of unknown cause seldom described in sub-Saharan Africa. We report 3 observations of ASD illustrating the diagnostic and therapeutic difficulties of this affection in our areas. Observation 1: Our first patient is a 56 years old schoolteacher presenting an ASD in its chronic articular form. She had been followed for an inflammatory arthralgia for 10 years and of the pharyngal pains without exact diagnosis. She presented ASD’s criteria of Yamaguchi and of Fautrel. The prednisone was begun at the dose of 0.8 mg/kg/day with fast appearance of a progressive muscular weakness. Use of methotrexate at a rate of 15 mg per week, associated with low dose of prednisone was effective in long-term without any flare of the disease so far. Observation 2: Our second patient is a 30 years old dressmaker presenting an ASD in its complicated systemic form of lymphohistiocytic activation syndrome. She validated the criteria of Yamaguchi and Fautrel for ASD. She also presented resistance to corticosteroid therapy. The evolution was marked by a hospital-acquired septicemia and a multi-organ failure leading to death. The diagnosis was retrospectively confirmed after that, with the low level of the glycosylated ferritin serum value. Observation 3: The third patient is a 22 years old Guinean student who presented prolonged fever and inflammatory polyarthralgia without articular deformation. He had been misdiagnosed for ASD with diagnostic wandering of several months. He was treated successfully with prednisone after set up of ASD diagnosis according common criteria. Corticosteroid therapy was stopped after 8 months without any relapse noted so far. Conclusion: Caring for ASD is difficult in our context mainly because of high cost of several explorations needed to set up its exact diagnosis while making differential one. Evolution under corticosteroid therapy is usually favorable but diagnostic dela

关键词： Still’s Disease Diagnosis Treatment Tropical Area

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Clinico-Pathologic Study of Salivary Gland Disorders at a Sub-Urban Nigerian Tertiary Hospital: A 5 Year Retrospective Review

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International Journal of Otolaryngology and Head & Neck Surgery 2019年第3期8卷 106-112页

作者： Obitade S. Obimakinde Olabamiji A. Olajuyin Waheed A. Adegbiji Abidemi E. Omonisi Christopher O. Ibidun department of Oral and Maxillofacial Surgery Ekiti State University Teaching Hospital Ado Ekiti Nigeria department of Otorhinolaryngology Ekiti State University Teaching Hospital Ado Ekiti Nigeria department of Anatomic Pathology Ekiti State University Teaching Hospital Ado Ekiti Nigeria

Background: The spectrum of salivary gland lesions is wide and the relative incidence of neoplastic and non-neoplastic lesions is variable in different studies. Despite the relatively common nature of salivary gland disorders, there is dearth of literature on these lesions, especially in sub-Saharan Africa. We therefore embarked on this study to analyze the differential diagnosis of salivary gland lesions seen and managed at our institution. Methods: A retrospective review of salivary gland disorders that presented at our facility from January 2012 to December 2016 was done. Information on patients’ demographic details, type and location of salivary gland lesion, histologic diagnosis and treatment were retrieved and analyzed with SPSS version 20. Result: A total of 65 patients were treated for salivary gland lesions of various types during the study period. The age of the patients ranged from 3 months to 68 years [mean 33.8 ±12.3]. Neoplastic lesions [n = 39, 60.0%] were the commonest followed by sialolithiasis [n = 14, 21.5%] while mucous retention/extravasation cysts accounted for 13.9% of the cases. Pleomorphic adenoma was the predominant tumor in this series [87.2%] and the commonest site was the parotid gland [58.8%]. On the contrary submandibular gland appeared to be the commonest site for sialolithiasis [57.1%]. The majority of mucous retention/extravasation cysts occurred in the sublingual gland [55.5%]. Conclusion: Neoplastic lesions remain the commonest salivary gland disorder and pleomorphic adenoma was the most prevalent. Sialolithiasis and mucous cysts are salivary gland lesions with equally wide disease spectrum.

关键词： Salivary Gland Lesion Pleomorphic Adenoma Sialolithiasis

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Medical Morbidity Profile of Adults in a Rural Community in Enugu, Southeast Nigeria: A Cross Sectional Survey

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Health 2023年第7期15卷 711-727页

作者： Nkeiruka Chigekwu Mbadiwe Birinus Adikaibe Ezeala-Adikaibe Celestine Chibuzor Okwara Monday Umeh Nwobodo Fintan C. Ekochin Casmir Orjioke Nkiruka P. Onodugo Titus Okpara Denise Paul Okoli Uzoma C. Okechukwu Mark Ezeme Obumneme B. Anyim Grace O. Eneh Obinna Donatus Onodugo Innocent Okoye Uchenna N. Ijoma department of Medicine Enugu State University Teaching Hospital Enugu Nigeria department of Medicine University of Nigeria Teaching Hospital Enugu Nigeria Memfys Hospital for Neurosurgery Enugu Nigeria Anambra State University teaching Hospital Awka Nigeria

Introduction: People in rural communities are exposed to the risk factors for non-communicable disease as those in urban areas. Correct interpretation and management of symptoms are important in primary care especially in rural communities where diagnostic facilities are not readily available. Materials and Methods: This was a cross-sectional study carried out in a village in Enugu South Local Government area of Enugu State. Thorough medical history was taken from all eligible participants who gave their consent. Data were analyzed using SPSS version 26. Results: Data from a total of 1019 (64.7%) out of 1576 participants were analysed. Fever was by far the most common presenting complaint 580 (56.9%) of all participants and 67.9% of medical complaints seen in the clinic. This was followed remotely by musculoskeletal problems and neurological problems 15.6% and 3.8% of the participants respectively. Across all age groups, febrile illness was more than non-febrile illness except in those 65 years. Generalized body pains 74 (7.3%), back pains 55 (5.1), headache 33 (3.2%) and abdominal pains 24 (2.4%) were the commonest symptoms presented by the participants. About 15 (1.5%) of the population surveyed had had trauma/surgery in the past. This was twice the number who presented to the clinic with symptoms related to injury and trauma 7 (0.7%). Conclusions: Fever and musculoskeletal pains are the dominant medical complaints presented by adults in a rural community clinic. This may be related to the season of the year and the occupation of the population studied.

关键词： Symptoms Infectious Diseases Non-Communicable Diseases Rural Community Southeast Nigeria

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Optimal Preemptive Online Algorithms for Scheduling with Known Largest Size on Two Uniform Machines

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Acta Mathematica Sinica,English Series 2007年第1期23卷 165-174页

作者： Yong HE Yi Wei JIANG Hao ZHOU department of Mathematics Zhejiang University. Hangzhou 310027. P. R. China Faculty of Science Zhejiang Sci- Tech University Hangzhou 310018 P. R. China. department of Mathematics Zhejiang University Hangzhou 310027. P. R. China Basic course department Zhejiang Shorten University Hangzhou 310015. P. R. China

In this paper, we consider the seml-online preemptive scheduling problem with known largest job sizes on two uniform machines. Our goal is to maximize the continuous period of time （starting from time zero） when both machines are busy, which is equivalent to maximizing the minimum machine completion time if idle time is not introduced. We design optimal deterministic semi-online algorithms for every machine speed ratio s ∈ [1, ∞）, and show that idle time is required to achieve the optimality during the assignment procedure of the algorithm for any s 〉（s^2 ＋ 3s ＋ 1）/（s^2 ＋ 2s ＋ 1）. The competitive ratio of the algorithms is （s^2 ＋ 3s ＋ 1）/（s^2 ＋ 2s ＋ 1）, which matches the randomized lower bound for every s ≥ 1. Hence randomization does not help for the discussed preemptive scheduling problem.

关键词： semi-online preemptive scheduling uniform machines competitive ratio

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Prevalence, Pattern and Risk Factors of Soil Transmitted Helminth Infections amongst Children in a Tertiary Institution in South East, Nigeria

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Open Journal of Gastroenterology 2023年第8期13卷 267-277页

作者： Okoro Jude Chidi Ezeogu Joseph Ogbonna Ikechukwu Frank department of Paediatrics Imo State University Teaching Hospital Orlu Nigeria department of Paediatrics Federal University Teaching Hospital Owerri Nigeria department of Paediatrics Federal Medical Centre Umuahia Nigeria

Introduction: Soil-transmitted helminthic infection (STHI) is a common public health challenge of children in the most deprived communities in low income countries. In the long-term, STHI can cause developmental and growth disorders leading to future learning defect. Objective: Our aim was to determine the prevalence and pattern of soil-transmitted helminthic infection among children attending a tertiary hospital in Imo State, Nigeria. Patients and Method: The study involved a cross-sectional survey of 268 children, aged 7 months to 18 years seen in a tertiary health facility in Nigeria;from August to December 2022. Data were collected using a structured questionnaire and stool samples were analyzed for intestinal helminths using the Kato-Katz method. Results: The prevalence of soil-transmitted helminthic infection (STHI) was 38.4%. Of all STHIs, Ascaris lumbricoides was the commonest geohelminth observed, 81 (62.1%). Multiple infections were noted in 25 (62.4%) of the specimen. The prevalence of soil-transmitted helminthic infection amongst subjects’ 5 - 9 years was high and least in children older than 15 years. This difference was not statistically significant (p = 0.3407). Statistically significant relationship was detected between STHI and low socioeconomic class. Conclusion: The high prevalence rate of soil-transmitted helminthic infection amongst the subjects is disturbing. This high rate justifies strengthening a structured and routine deworming amongst children in order to improve outcome.

关键词： Helminthes Multiple Infections Children Deworming

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Geriatric Otorhinolaryngology, Head and Neck Emergency in a Nigerian teaching Hospital, Ado Ekiti

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International Journal of Otolaryngology and Head & Neck Surgery 2019年第3期8卷 81-90页

作者： Waheed Atilade Adegbiji Shuaib Kayode Aremu Abdul-Akeem A. Aluko ENT department Ekiti State University Teaching Hospital Ado Ekiti Nigeria ENT department Federal Teaching Hospital Ido-Ekiti Afe-Babalola University Ado-Ekiti Nigeria ENT department Aminu Kano Teaching Hospital Bayero University Kano Nigeria

Background: Issues of geriatric otolaryngologic emergency have not been widely applied despite an increase in the geriatric population. This study aimed at determining the prevalence, sociodemographic features, etiology, clinical features, complications and sources of referral of geriatric otorhinolaryngological, head and neck emergency in our center. Materials and Methods: This was a prospective hospital-based study of geriatric otorhinolaryngology emergency in the Ear, Nose and Throat department of Ekiti State University teaching Hospital. The study was carried out between October 2016 and September 2018. Data were obtained by using a pretested interviewers questionnaire. All data were collated and analyzed using SPSS version 18.0. The data were expressed by frequency table, percentage, bar charts, and pie charts. Results: Geriatric otorhinolaryngology, head and neck emergency accounted for 5.3%. Major prevalence age group was 43.9% in the age group (60 - 64). There were 38.6% of males with a male to female ratio of 1:1.5. The main etiology of geriatric otorhinolaryngology emergency was 29.5% trauma/road traffic accident/foreign body impaction and 25.8% tumor. Main anatomical distribution of geriatric otorhinolaryngology emergency was 38.6% throat diseases and 31.1% ear diseases. The most frequent clinical features were the pain in 27.3%, hearing loss in 21.2%, tinnitus in 15.9%, bleeding in 14.4%, difficulty breathing in 12.9% and discharge in 11.4%. common diagnosis in this study was 15.9% sinonasal tumor, 14.4% upper aerodigestive foreign body impaction, 10.6% earwax impaction and 19.8% otitis externa. Acute presentation (Conclusion: Geriatric otorhinolaryngological emergency is a common pathology associated with comorbid illnesses. Detailed clinical assessment is mandatory for effective management outcome.

关键词： Emergency Geriatric Head Neck Otorhinolaryngology

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