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Superior Mesenteric Artery Syndrome, a Rare Complication of Severe Malnutrition: Two Cases from a Subsaharian Endocrinology Department

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Open Journal of Endocrine and Metabolic Diseases 2024年第4期14卷 87-93页

作者： Nafy Ndiaye Ngone Diaba Diack Yakham Mohamed Leye Sokhna Awa Balla Sall Moussa Gueye Mouhamed Fawaz Mouhamadou Moustapha Ndong Abdoulaye Leye Department of Internal Medecine and Endocrinology Teaching Hospital of Pikine Dakar Senegal

Introduction: Superior mesenteric artery syndrome (SMAS), a rare diagnosis due to compression of the third duodenum between the superior mesenteric artery (SMA) and the aorta resulting in bowel obstruction, may lead to severe malnutrition. We report two cases of patients hospitalised in the Internal Medicine, Endocrinology, Diabetology, and Nutrition Department of the National hospital Center (NHC) of Pikine. Observations: Patient 1: A 35-year-old female was referred for an aetiological diagnosis due to a rapid weight loss of 15 kilograms in one month, accompanied by persistent vomiting, following an appendectomy performed a month before admission. Upon clinical examination, she presented severe malnutrition (Buzby index of 76%), early post-prandial chronic vomiting, and a poor general condition. An abdominal CT scan revealed aortomesenteric clamp syndrome (AMCS) with an angulation between the aorta and the SMA of 13˚. The underlying cause in this patient was severe malnutrition. Fortunately, her condition improved with medical treatment. Patient 2: We report the case of a 30-year-old female hospitalized due to unusual weight-bearing post-prandial epigastric pain and intermittent vomiting over the past six months. Upon physical examination at admission, she exhibited severe malnutrition with a body mass index (BMI) of 14 kg/m2, a Buzby index of 71%, trophic disorders, and a stage IV general condition assessment according to the World Health Organization (WHO). An abdominal CT scan revealed AMCS with an angle between the aorta and the SMA of 22˚ and an aortomesenteric space of 4 mm. The outcome was poor with medical treatment failure and, unfortunately, the patient died before surgery. Conclusion: SMAS is rarely evoked in clinical practice despite the presence of contributing factors and suggestive clinical signs. The prognosis depends on management time.

关键词： Superior Mesenteric Artery Syndrome Malnutrition Pikine

Relationship between Inter Canine Width and Inter Alar Width, Inter Commissural Width, and Inter Canthal Distance: A Pilot Study

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Open Journal of Stomatology 2024年第6期14卷 279-290页

作者： Grevisse Bindele Ndombolo Augustin Mantshumba Milolo Fidele Nyimi Bushabu Em Kalala Kazadi Pierrot Kumpanya Ntumba Jean Marie Kayembe Bukama Elias Lubadi Tshilumba Jean Paul Sekele Isouradi Department of Prosthodontics Teaching Hospital of Kinshasa University Kinshasa Democratic Republic of the Congo National Center of Research in Dental Sciences Kinshasa Democratic Republic of the Congo Department of Oral and Maxillofacial Surgery Teaching Hospital of Kinshasa University Kinshasa Democratic Republic of the Congo Department of Periodontology Teaching Hospital of Kinshasa University Kinshasa Democratic Republic of the Congo Department of Operative Dentistry Teaching Hospital of Kinshasa University Kinshasa Democratic Republic of the Congo

The aim of this study was to determine the relationship between inter canine width (ICW) and inter alar width (IAW), inter commissural width (ICoW), and inter canthal distance (ICaD) in Bantu population. Materials and Methods: It was a pilot study included all participants who were aged at least 18 years, without a history of orthodontics treatment from Prosthodontics Department, Faculty of Dental Medicine, University of Kinshasa. The Ethics committee of the National Center of Research for Dental Sciences in DR Congo approved the study protocol (CNRSB 1504.218). The participants medical records were obtained from the interview and dental examination. Nature of the study was explained with participant information sheet, and an informed consent of all participants was obtained. The inclusion criteria were no missing maxillary and mandibular teeth, no diastema, and no anterior restorations, 18 years old before enrollment in the study. The exclusion criteria were inability to meet the above requirements, pregnancy, and refusal to participate in the study. The inter-canine width (ICW), inter alar width (IAW), inter canthal distance (ICaD) and inter-commissural width (ICoW) of each participant were measured with a digital Vernier caliper (Mitutoyo, UK Ltd.,) (0.01 mm) three times and the average value was recorded. The inter canthal distance (ICaD) was measured without applying pressure by bringing the recording parts of the caliper just in contact with the medial angle. The inter alar width (IAW) was marked with a fine marked pencil on the widest outer surface of the alae of the nose on either side or width. Those two points were measured without applying pressure by bringing the recording parts of the caliper just in contact with the outer surface. The participant was told to stop breathing shortly to avoid any change in shape of the nose. The inter-commissural width (ICoW) was determined by measuring the maxillary lip vermilion from commissure to commissure without the

关键词： Relationship Inter-Canine Width Inter Alar Width Inter Canthal Distance Inter Commissural Width

Risk Factors for Lower Extremity Amputation among Diabetic Patients with Diabetic Foot Gangrene in ATBUTH, Bauchi

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Open Journal of Orthopedics 2024年第9期14卷 391-403页

作者： Stephen Yusuf Shaphat Shuaibu Ibrahim Abubakar Musa Yusuf Aliyu Salihu Friday Titus Nyako Ngwan David Wujika Department of Orthoepaedics and Trauma Abubakar Tafawa Balewa University Teaching Hospital Bauchi Nigeria Radiology Department Abubakar Tafawa Balewa University Teaching Hospital Bauchi Nigeria Department of Orthopedic and Trauma Surgery University of Maiduguri Maiduguri Nigeria Department of Surgery Modibbo-Adama University Teaching Hospital Yola Nigeria

Background: Diabetic mellitus was described as an evolving global epidemic of the twenty-first century, due to the exponential rise in the number of people with the condition. Lower extremity amputation is one of the common complications of diabetes. With increase in the number of people with diabetes there will also be increase in the number of diabetics going for lower extremity amputation, increasing both the financial as well as psychologic burden of treatment. Methodology: A prospective cross-sectional study of all diabetic patients going for lower extremity amputation will be done. All the patients with advanced diabetic foot syndrome needing lower extremity amputation are enrolled (Wagener stage IV and V), both through the clinic and emergency center. Informed consent is obtained from the patient after which data are collected using a structured questionnaire. All the investigation results of the patients were also documented. Data collected are analyzed using the SPSS version 29. Chi-square and student t-test were used to measure significant relationship between the variables at 95% confident interval. Results: Within the period of study, which extends from 1st January 2022 to 1st of January 2024, a total of 171 patients were recruited. All diabetic patients with diabetic foot Wagener grade IV and V who presented to the clinic or emergency department were enrolled in the study. We found a significant relationship between gender, previous procedure on the affected limb or amputation of the contralateral limb, knowledge of foot care among diabetics and risk of amputation. There was, however, no statistically significant relationship between. There is no statistically significance relationship between the level of education, occupation, presence of co-morbidity with the risk of amputation among diabetic patients with foot syndrome. Conclusion: Previous lower limb procedure/amputation, male gender, paucity of knowledge on foot care, prolonged duration of the dis

关键词： Diabetes Mellitus Lower Limb Amputation Risk Factors Rehabilitation

Determinants and Outcomes of Pregnancies among Booked versus Unbooked Patients in a Tertiary hospital South East, Nigeria

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 144-161页

作者： Chijioke S. Anyigor-Ogah John O. Egede Chijioke O. Ogeh Chika C. Agunanne Alphosus I. Ozioko Chinyere C. Duru Department of Family Medicine Alex Ekwueme Federal University Teaching Hospital Abakaliki Ebonyi State Nigeria Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki Ebonyi State Nigeria Department of Paediatrics Alex Ekwueme Federal University Teaching Hospital Abakaliki Ebonyi State Nigeria

Background: Inadequate antenatal care, both in coverage and standard, has been linked with poor pregnancy outcomes. In a resource poor setting, home delivery is considered very cheap, but the possible outcome of such pregnancies has been a subject of interest. This study evaluated the association of booking status with pregnancy outcomes. Objectives: To examine the factors that influence booking and impact of the booking status on pregnancy outcomes. Methods: This was a hospital-based prospective cohort study of 240 (120 booked and 120 un-booked) pregnant mothers selected through systematic random sampling. The study was carried out at the Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University teaching hospital Abakaliki, Nigeria. Chi-square test, t-test and logistic regression were used for analysis. Results: The mean age of the participants was 30.39 ± 5.05 years and 29.05 ± 6.36 years respectively for the booked and unbooked. Marital status (OR = 6.35, 95% CI = 1.24 - 32.59), educational status (OR = 36.40, 95% CI = 5.26-152.83), place of residence (OR = 0.15, 95% CI = 0.06 - 0.41), partner’s support (OR = 0.05, 95% CI = 0.01 - 0.37), family support (OR = 0.03, 95% CI = 0.01 - 0.13), mode of delivery (OR = 0.23, 95% CI = 0.12 - 0.46), APGAR score in first minute (OR = 6.02, 95% CI = 2.45 - 14.83) and NBICU admission (OR = 3.75, 95% CI = 1.67 - 8.43) were associated with booked status. However, being unmarried, nulliparity/grandmultiparity, low level of education, blue colar jobs, low income, rural dwelling and poor partner and poor family support were associated with the unbooked. The booked parturients had a better perinatal outcome compared the unbooked. Conclusion/Recommendation: There was high prevalence of operative deliveries, perinatal morbidity and mortality among the unbooked mothers. Girl child education, employment and poverty alleviation would improve antenatal care utilization.

关键词： Socio-Demographic Characteristics Booking Status Antenatal Delivery

Prevalence and Causes of Neonatal Mortality at Chu-Mel, Cotonou in 2023

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Open Journal of Pediatrics 2024年第5期14卷 908-920页

作者： Léhila Bagnan Tossa Nicole Enianloko Tchiakpè Hayath Séidou Abdou Madjidou Sénahoun Unit of Neonatology at Hubert K. Maga National teaching hospital (CNHU-HKM) Cotonou Benin Unit of Neonatology at Mother and Child teaching hospital of LAGUNE (CHU-MEL) Cotonou Benin

Introduction: Neonatal mortality represents a global health problem that has been at the core of programs developed by the World Health Organization (WHO) for more than 30 years. In our country, it represents a real scourge and remains high despite the efforts made by the Ministry of Health. The goal of this study was to investigate the prevalence and causes of neonatal mortality at CHU-MEL of Cotonou in 2023. Material and Methods: This was a cross-sectional and descriptive study with retrospective data collection, carried out in the neonatology unit of the Mother and Child teaching hospital of Lagune (CHU-MEL) in Cotonou over a period of six months from January 1, 2023 to June 30, 2023. All neonates, premature or full-term, born alive and who died during hospitalization in the unit were included. Results: 211 cases of neonatal deaths were recorded among the 2884 neonates hospitalized in the unit during the study period, representing a hospital prevalence of 7.31%. Early neonatal mortality represented 81.5% of cases. The average age at admission was 4.6 days ± 5.3. The average weight of deceased neonates was 1609.08 ± 798.35 g. The most frequent reasons for hospitalization were represented by prematurity (60.66%) and respiratory distress (23.22%), respectively. Prematurity was the leading cause of neonatal mortality (41.7%), followed by neonatal infections (29.4%) and perinatal asphyxia (10.9%). Conclusion: The prevalence of neonatal mortality in the neonatology unit of CHU-MEL is high. Efforts to improve the quality of perinatal care departments must be intensified to reduce this prevalence.

关键词： Neonatal Mortality Neonates Prevalence Causes Cotonou (Benin)

Amitriptyline inhibits NLRP3 inflammasome activation via the ASM/CE pathway in a cell model of NAFLD

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BIOCELL 2024年第5期48卷 759-769页

作者： QIN LIU CHUNYAN NIU QIANG ZHANG SHIQIN SUN YUE CHEN YONGQIANG SHI Shengli Clinical Medical College Fujian Medical UniversityFuzhou350001China Department of Gastroenterology Nanjing Lishui People’s HospitalZhongda Hospital Lishui BranchSoutheast UniversityNanjing211200China Department of Gastroenterology Yancheng Third People’s Hospital(The Yancheng School of Clinical Medicine of Nanjing Medical University)Yancheng224000China Administrative Department of teaching and Scientific Research Nanjing Lishui People’s HospitalZhongda Hospital Lishui BranchSoutheast UniversityNanjing211200China

Background:Nonalcoholic fatty liver disease(NAFLD)is a global health concern with the acid sphingomyelinase(ASM)/ceramide(CE)pathway and the NOD-like receptor family,pyrin domain-containing protein 3(NLRP3)inflammasome identified as pivotal players in lipid disorders and *** study explores the interaction mechanism between the ASM/CE pathway and NLRP3 in NAFLD cell models,aiming to understand the impact of amitriptyline(Ami),an ASM inhibitor,on lipid deposition and hepatocyte injury by regulating the ASM/CE-NLRP3 ***:HepG2 and HL-7702 cells were exposed to free fatty acids(FFAs)to establish the NAFLD *** cells were divided into 5 groups:control group,model group,Ami group,tumor necrosis factoralpha(TNF-α)group,and Ami+TNF-α*** lipid droplets were visualized using Oil Red O staining,and Western blot analysis quantified ASM,NLRP3,and caspase 1 protein *** linked immunosorbent assay(ELISA)was measured CE and ASM levels,while qRT-PCR assessed mRNA *** apoptotic rate was evaluated by flow cytometry(FCM).Results:Following FFAs incubation,significant increases in ASM and CE levels were observed in HepG2 and HL-7702 cells,accompanied by elevated expression of NLRP3,and caspase 1,and IL-1β.TNF-αtreatment further amplified these *** demonstrated a reduction in lipid deposition,suppressed ASM/CE pathway activation,downregulated NLRP3 and caspase 1 expression,and improved ***,MCC950,a selective inhibitor of the NLRP3,mitigated NLRP3,caspase 1,and IL-1βexpression,alleviating lipid deposition and apoptosis in the NAFLD cell ***:The ASM/CE-NLRP3 pathway in NAFLD cells promotes hepatocyte steatosis,inflammation,and cell *** emerges as a promising therapeutic agent by inhibiting the ASM/CE-NLRP3 pathway,underscoring its potential as a key target for NAFLD treatment.

关键词： Nonalcoholic fatty liver disease Hepatocyte Amitriptyline ASM/CE pathway NLRP3 Nonalcoholic steatohepatitis

Abnormal Thyroid Stimulating Hormone Level and Heavy Menstrual Bleeding

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 110-123页

作者： Varatharaja Vasantharaja Registrar Registrar Obstetrics and Gynaecology Colombo South Teaching Hospital Kalubowila Sri Lanka

Heavy Menstrual Bleeding is one of the common Gynaecological issues. There are several causes. Some of the women presented with these issues found to have underling thyroid abnormality which was not discovered earlier. This research tries to find the prevalence of the Thyroid Disorder among the women present with Heavy menstrual bleeding in Sri Lankan women.

关键词： Heavy Menstrual Bleeding TSH Levels Thyroid Disorders

Post Episiotomy Morbidity among Parturient in Alex Ekwueme Federal University teaching hospital Abakaliki, Ebonyi State

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Open Journal of Obstetrics and Gynecology 2024年第8期14卷 1144-1160页

作者： John Chinedu Obasi Ayodele Adegbite Olaleye Boniface N. Ejikeme John O. Egede Charles Nwambeke Edene Enemma Christian Enemma Victor Onuchukwu Emmanuel Onyekelu Nathan C. Ekpe Wendy Oliobi Emmanuel C. Uwakwe Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital AbakalikiNigeria

Background: Episiotomy is a very common obstetric surgery, and it could be associated with serious complications. However, these complications largely are not noticed due to the shift of attention from mother to baby, after a successful delivery. Objective: To identify the morbidities associated with episiotomies and factors associated with such morbidities. Method: This was a questionnaire based cross sectional descriptive study among women who attended the Obstetric Department of Alex Ekwueme Federal University teaching hospital Abakaliki Ebonyi State, between 1st July and 31st Nov, 2023. The study population consisted of parturients who had episiotomies in their previous confinements, attending either the antenatal clinic or the postnatal clinic at Alex Ekwueme Federal University teaching hospital Abakaliki Ebonyi State. Results: Macrosomia was the most common indication of episiotomy at a rate of 31.6%. The majority of episiotomies were performed on the parturients in their first confinement at a rate of 64.5% and the majority of repairs were performed by the Registrar at a rate of 65.0%. Informed consent was obtained from 45.79% of parturients while 54.21% were not informed before the episiotomy was administered. Only 55.3% of the parturient received analgesia before episiotomy was administered. The majority of the parturients had their episiotomy repaired between 10 - 15 minutes at a rate of 40.3%. Postoperative pain at the rate of 44.5% was the most common complication and dyspareunia as a form of sexual complication was the commonest at a rate of 31.3%. Conclusion: The parturient needs to be properly counselled before administration of episiotomy and adequate analgesia should be given, as episiotomy is a surgical procedure. Proper training of health workers on both the technique of administering and repairing episiotomy is important. Restrictive use of routine episiotomy in primigravidae is advised to reduce the rate of episiotomy.

关键词： Episiotomy Vulva Pains Primigravidae Morbidities Analgesia

Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome:Modeling the Epidemic in Sichuan Province,China

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Biomedical and Environmental Sciences 2024年第9期37卷 1003-1014页

作者： Yuan Li Qinxi Liu Rongsheng Luan Yi Yang Tao Wu Bihui Yang West China School of Public Health&No.4 West China teaching hospital Sichuan UniversityChengdu 610041SichuanChina Chengdu University of Traditional Chinese Medicine Chengdu 611137SichuanChina

Objective Our study aimed to provide a comprehensive overview of the current status and dynamic trends of the human immunodeficiency virus(HIV)prevalence in Sichuan,the second most heavily affected province in China,and to explore future *** The epidemiological,behavioral,and population census data from multiple sources were analyzed to extract inputs for an acquired immunodeficiency syndrome(AIDS)epidemic model(AEM).Baseline curves,derived from historical trends in HIV prevalence,were used,and the AEM was employed to examine future intervention *** In 2015,the modeled data suggested an adult HIV prevalence of 0.191%in Sichuan,with an estimated 128,766 people living with HIV/AIDS and 16,983 individuals with newly diagnosed *** current high-risk behaviors,the model predicts an increase in the adult prevalence to 0.306%by 2025,projecting an estimated 212,168 people living with HIV/AIDS and 16,555 individuals with newly diagnosed *** Heterosexual transmission will likely emerge as the primary mode of AIDS transmission in ***,we anticipate a stabilization in the incidence of AIDS with a concurrent increase in *** comprehensive intervention measures aimed at high-risk groups could effectively alleviate the spread of AIDS in Sichuan.

关键词： HIV/AIDS AIDS Epidemic Model Heterosexual transmission Sichuan province