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D-Dimer: Predictor of Postpartum Hemorrhage among Pre-Eclampsia at kilimanjaro christian medical centre

Open Journal of Obstetrics and Gynecology 2024年第6期14卷 923-937页

作者： Husna Silim Ally Nyasatu G. Chamba Raziya Gaffur Nasra Batchu Glory Mangi Pendo S. Mlay Bariki Mchome Mtoro J. Mtoro Thomas J. Kakumbi Rafiki N. Mjema Doris Rwenyagila Eusebius Maro Fredrick Mbise Gilleard Masenga Patricia S. Swai Department of Obstetrics and Gynaecology KCMC Hospital Moshi Tanzania Department of Obstetrics and Gynaecology Kilimanjaro Christian Medical University College (KCMUCo) Moshi Tanzania

Background: Postpartum hemorrhage (PPH) is the major contributor to maternal mortality and morbidity worldwide as well as in Tanzania. Studies have shown Pre-eclampsia as a risk indicator for Postpartum hemorrhage and D-dimer tends to rise in women with pre-eclampsia. Few studies that have shown the association between D-dimer and PPH have been controversial and differ according to ethnicity and lifestyle. Hence there is no suitable reference interval for D-dimer in predicting Postpartum hemorrhage among women with pre-eclampsia. Broad Objective: This study aimed to assess the association, sensitivity, and specificity of D-dimer as a laboratory predictor of postpartum hemorrhage among women with pre-eclampsia at KCMC hospital. Methodology: This was a hospital-based analytical cross-sectional study conducted at KCMC Hospital in Northern Tanzania from September 2022 to March 2023. A total of 195 women with pre-eclampsia were included in this study. Plasma D-dimer levels were taken from women with pre-eclampsia pre-delivery. Haematocrit was compared before and after delivery, and a fall of 10% was considered as Postpartum hemorrhage together with clinical assessment of the patient. Participants were divided among those who had severe features and those who did not have severe features and were further categorized into those who had PPH and those who did not have PPH. Logistic regression was used to determine the association between D-dimer and PPH adjusting for other factors. The Receiver Operating Curve (ROC) was used to evaluate the predictive value. Results: Higher median D-dimer levels were seen among women who had PPH compared to those who had no PPH. D-dimer was seen to be associated with PPH, thus for every unit increase of µg/ml of D-dimer among women who had pre-eclampsia without severe features there was a 14% significant increase in the odds of having postpartum hemorrhage and a 45% significant increase of having postpartum hemorrhage among those who had pre

关键词： D-Dimer Preeclampsia Postpartum Hemorrhage Tanzania

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Total hip arthroplasty for sequelae of childhood hip disorders:Current review of management to achieve hip centre restoration

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World Journal of Orthopedics 2024年第8期15卷 683-695页

作者： Anil Thomas Oommen Department of Orthopaedics Christian Medical College HospitalVellore 632004India

Adults requiring total hip arthroplasty(THA)for childhood disorder sequelae present with shortening,limp,pain,and altered ***,which can be particularly challenging due to altered anatomy,requires careful planning,assessment,and computed tomography *** templating is essential to establish the appropriate acetabular and femoral *** regarding neck length and offset is needed to ensure the proper options are available at *** centre restoration must be planned preoperatively and achieved intraoperatively with appropriate exposure,identification,and stable fixation with optimum-size *** the actual acetabular floor is essential as changes include altered anatomy,distortion of the margins and version *** femur changes include anatomical variation,decreased canal diameter,cortical thickness,changes in anteversion,and metaphyseal and diaphyseal *** assessment should consist of limb assessment for variations due to prior surgical *** of the shortening pattern with the relationship of the lesser trochanter to the teardrop would help identify and plan for subtrochanteric shortening osteotomy,especially in high-riding *** surgical approach must ensure adequate exposure and soft tissue release to achieve restoration of the anatomical hip *** femoral components may require modularity to enable restoration of anteversion and optimum fixation.

关键词： Total hip arthroplasty Childhood disorder sequelae Templating Hip centre restoration Soft tissue release Offset

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Assessment of the Spatio-Temporal Trends of Annual Extreme Temperature Indices over Tanzania during the Period of 1982-2022

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Journal of Geoscience and Environment Protection 2024年第1期12卷 33-50页

作者： Justus Renatus Mbawala Huixin Li Daudi Mikidadi Ndabagenga Jiani Zeng Peter Nicky Mlonganile Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters/Key Laboratory of Meteorological Disaster Ministry of Education School of Atmospheric Sciences Nanjing University of Information Science and Technology Nanjing China National Meteorological Training centre Kigoma Tanzania Tanzania Meteorological Authority (TMA) Forecasting Office Kilimanjaro International Airport (KIA) Kilimanjaro Tanzania

Extreme weather and climatic phenomena, such as heatwaves, cold waves, floods and droughts, are expected to become more common and have a significant impact on ecosystems, biodiversity, and society. Devastating disasters are mostly caused by record-breaking extreme events, which are becoming more frequent throughout the world, including Tanzania. A clear global signal of an increase in warm days and nights and a decrease in cold days and nights has been observed. The present study assessed the trends of annual extreme temperature indices during the period of 1982 to 2022 from 29 meteorological stations in which the daily minimum and maximum data were obtained from NASA/POWER. The Mann-Kendall and Sen slope estimator were employed for trend analysis calculation over the study area. The analyzed data have indicated for the most parts, the country has an increase in warm days and nights, extreme warm days and nights and a decrease in cold days and nights, extreme cold days and nights. It has been disclosed that the number of warm nights and days is on the rise, with the number of warm nights trending significantly faster than the number of warm days. The percentile-based extreme temperature indices exhibited more noticeable changes than the absolute extreme temperature indices. Specifically, 66% and 97% of stations demonstrated positive increasing trends in warm days (TX90p) and nights (TN90p), respectively. Conversely, the cold indices demonstrated 41% and 97% negative decreasing trends in TX10p and TN10p, respectively. The results are seemingly consistent with the observed temperature extreme trends in various parts of the world as indicated in IPCC reports.

关键词： Climate Extremes Absolute Extreme Temperature Percentile Extreme Temperature Mann-Kendall Test NASA

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Analysis of Changes of Extreme Temperature during June to August Season over Tanzania

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Journal of Geoscience and Environment Protection 2024年第2期12卷 44-56页

作者： Justus Renatus Mbawala Huixin Li Jiani Zeng Daudi Mikidadi Ndabagenga Anqin Tan Daniela Janine Beukes Praksed Mrosso Rafael Samuel Ekwacu Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters/Key Laboratory of Meteorological Disaster Ministry of Education/School of Atmospheric Sciences Nanjing University of Information Science and Technology Nanjing China National Meteorological Training centre Kigoma Tanzania Tanzania Meteorological Authority (TMA) Forecasting Office Kilimanjaro International Airport (KIA) Kilimanjaro Tanzania Namibia Meteorological Service Windhoek Namibia Uganda National Meteorological Authority Kampala Uganda

Natural and human systems are exposed and vulnerable to climate extremes, which contributes to the repercussions of climate variability and the probability of disasters. The impacts of both natural and human-caused climate variability are reflected in the reported changes in climate extremes. Particularly at the local community levels in the majority of the regions, there is currently a dearth of information regarding the distribution, dynamics, and trends of excessive temperatures among the majority of Tanzanians. Over the years 1982-2022, this study examined trends in Tanzania’s extreme temperature over the June to August season. Based on the distinction between absolute and percentile extreme temperatures, a total of eight ETCCDI climate indices were chosen. Mann-Kendall test was used to assess the presence of trends in extreme climatic indices and the Sen’s Slope was applied to compute the extent of the trends in temperature extremes. The study showed that in most regions, there is significant increase of warm days and nights while the significant decrease of cold days and nights was evident to most areas. Moreover, nighttime warming surpasses daytime warming in the study area. The study suggests that anthropogenic influences may contribute to the warming trend observed in extreme daily minimum and maximum temperatures globally, with Tanzania potentially affected, as indicated in the current research. The overall results of this study reflect patterns observed in various regions worldwide, where warm days and nights are on the rise while cold days and nights are diminishing.

关键词： Indices Warm Days and Nights Cold Days and Nights ECA&D Tanzania

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Retrospective study of the incidence, risk factors, treatment outcomes of bacterial infections at uncommon sites in cirrhotic patients

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World Journal of Hepatology 2024年第3期16卷 418-427页

作者： Sophie Schneitler Christina Schneider Markus Casper Frank Lammert Marcin Krawczyk Sören L Becker Matthias christian Reichert Institute of medical Microbiology and Hygiene Saarland UniversityHomburg 66421Germany Department of Medicine II Saarland University Medical CenterHomburg 66421Germany Health Sciences Hannover Medical SchoolHannover 30625Germany Laboratory of Metabolic Liver Diseases Department of GeneralTransplant and Liver SurgeryCentre for Preclinical ResearchMedical University of WarsawWarsaw 02-097Poland

BACKGROUND Bacterial infections(BI)negatively affect the natural course of *** most frequent BI are urinary tract infections(UTI),pneumonia,and spontaneousbacterial peritonitis(SBP).AIM To assess the relevance of bacterial infections beyond the commonly recognized types in patients with cirrhosis and to investigate their relationship with other clinical *** We retrospectively analyzed patients with cirrhosis and BI treated between 2015 and 2018 at our tertiary care *** were classified as typical and atypical,and clinical as well as laboratory parameters were compared between the two *** In a cohort of 488 patients with cirrhosis,we identified 225 typical BI(95 UTI,73 SBP,72 pulmonary infections)and 74 atypical BIs,predominantly cholangitis and soft tissue infections(21 each),followed by intra-abdominal BIs(n=9),cholecystitis(n=6),head/throat BIs(n=6),osteoarticular BIs(n=5),and endocarditis(n=3).We did not observe differences concerning age,sex,or etiology of cirrhosis in patients with typical vs atypical *** BIs were more common in patients with more advanced cirrhosis,as evidenced by Model of End Stage Liver Disease(15.1±7.4 vs 12.9±5.1;P=0.005)and Child-Pugh scores(8.6±2.5 vs 8.0±2;P=0.05).CONCLUSION Atypical BIs in cirrhosis patients exhibit a distinct spectrum and are associated with more advanced stages of the ***,the work-up of cirrhosis patients with suspected BI requires detailed work-up to elucidate whether typical BI can be identified.

关键词： Bacterial infection Empirical antibiotic therapy End-stage liver disease Escherichia coli Multi-resistant pathogens

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Advanced brain organoids for neuroinflammation disease modeling

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Neural Regeneration Research 2024年第1期19卷 154-155页

作者： Sonia Sabate-Soler Henry Kurniawan Jens christian Schwamborn Luxembourg centre for Systems Biomedicine University of LuxembourgEsch-sur-AlzetteLuxembourg

Brain organoids mimic closely the embryonic human brain:Over the last decade,the development of human organoid systems has evolved *** tissues have been modeled with organoids,such as the gut,lung,liver,kidney retina and *** systems have a high cellular heterogeneity,with many cell types integrated into the same ***'cellular populations interact between and amongst each other in a cellular and molecular level,which represents an advantage with respects to monolayer 2D cell culture systems.

关键词： inflammation lung kidney

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High-speed silicon photonic electro-optic Kerr modulation

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Photonics Research 2024年第1期12卷 51-60页

作者： JONATHAN PELTIER WEIWEI ZHANG LEOPOLD VIROT christian LAFFORGUE LUCAS DENIEL DELPHINE MARRIS-MORINI GUY AUBIN FARAH AMAR DENH TRAN XINGZHAO YAN CALLUM G.LITTLEJOHNS CARLOS ALONSO-RAMOS KE LI DAVID J.THOMSON GRAHAM REED LAURENT VIVIEN University Paris-Saclay CNRSCentre for Nanoscience and Nanotechnology(C2N)Palaiseau 91120France University Grenoble Alpes CEALETIGrenoble 38000France Optoelectronics Research centre Zepler Institute for Photonics and NanoelectronicsFaculty of Engineering and Physical SciencesUniversity of SouthamptonSouthampton SO171BJUK

Silicon-based electro-optic modulators contribute to easing the integration of high-speed and low-power consumption circuits for classical optical communications and data *** the plasma dispersion modulation,an alternative solution in silicon is to exploit the DC Kerr effect,which generates an equivalent linear electro-optical effect enabled by applying a large DC electric *** some theoretical and experimental studies have shown its existence in silicon,limited contributions relative to plasma dispersion have been achieved in high-speed modulation so *** paper presents high-speed optical modulation based on the DC Kerr effect in silicon PIN *** contributions of both plasma dispersion and Kerr effects have been analyzed in different waveguide configurations,and we demonstrated that the Kerr induced modulation is dominant when a high external DC electric field is applied in PIN ***-speed optical modulation response is analyzed,and eye diagrams up to 80 Gbit/s in NRZ format are obtained under a *** of 30 *** work paves the way to exploit the Kerr effect to generate high-speed Pockels-like optical modulation.

关键词： waveguide dispersion effect

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Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Coinfection with Malaria in Selected States in Nigeria

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Advances in Infectious Diseases 2024年第2期14卷 442-455页

作者： Oluwagbemiga Olanrewaju Aina Olufemi Samuel Amoo Kazeem Adewale Osuolale Adewale Kayode Ojogbede Azuka Patrick Okwuraiwe David Ayoola Oladele Adesola Zaidat Musa Tajudeen Akanji Bamidele Celestina Onyinye Okoyenta Abideen Olurotimi Salako Toyosi Yekeen Raheem Ifeoma Eugenia Idigbe Fehintola Anthonia Ige Joseph Ojonugwa Shaibu Gregory Aigbe Ohihoin Kikelomo Wright Bisola Adebayo Hussein Abdu-Razzaq Abdulrahman Ahmad Mustapha Imam Bashir Bello Tambuwal Muhammad Shuaibu Gobir Richard Ikwuogu christian Tetsola Gloria Patrick-Ferife Nathaniel Enamuotor Mildred Okowa William Nwachukwu Cornelius Ohonsi Magdalene Egede Chinwe Ochu Ehimario Igumbor Oliver Chukwujekwu Ezechi Babatunde Lawal Salako Rosemary Ajuma Audu Biochemistry and Nutrition Department Nigerian Institute of Medical Research Lagos Nigeria centre for Human Virology and Genomics Microbiology Department Nigerian Institute of Medical Research Lagos Nigeria Monitoring and Evaluation Unit Nigerian Institute of Medical Research Lagos Nigeria Public Health and Epidemiology Department Nigerian Institute of Medical Research Lagos Nigeria Clinical Sciences Department Nigerian Institute of Medical Research Lagos Nigeria Molecular Biology and Biotechnology Department Nigerian Institute of Medical Research Lagos Nigeria Department of Community Health & Primary Health Care Lagos State University College of Medicine Lagos State University Teaching Hospital Lagos Nigeria Research Unit Lagos State Ministry of Health Lagos Nigeria Sokoto State Ministry of Health Sokoto Nigeria Department of medical Biochemistry Usmanu Danfodiyo University Sokoto Nigeria centre for Advanced medical Research and Training Usmanu Danfodiyo University Sokoto Nigeria Delta State Ministry of Health Asaba Nigeria Nigeria centre for Disease Control Abuja Nigeria Center for Infectious Disease Research Nigerian Institute of Medical Research Lagos Nigeria

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Plasmodium species are the causative agents of coronavirus disease 2019 (COVID-19) and malaria respectively with similar clinical presentations. The objective of this study is to determine the burden of co-infection of SARS-CoV-2 and malaria in the general population. Five (5 mLs) of blood samples were collected for SARS-CoV-2 and malaria parasite test. The malaria test was performed using a commercially available one-step malaria antigen Plasmodium falciparum histidine-rich protein 2 (Pf HRP-II) rapid test kit. The results of the study showed that the participants that were coinfected with SARS-CoV-2 IgG and malaria were 13 (2.5%) in Lagos, 1114 (39.1%) in Delta and 49 (2.3%) in Sokoto States. The prevalence of coinfection of SARS-CoV-2 and malaria in urban areas in Lagos, Delta and Sokoto States were 7 (2.2%), 1373 (48.1%), and 5 (0.2%) respectively. In rural areas, the prevalence of coinfection of SARS-CoV-2 and malaria in Lagos, Delta and Sokoto States were 6 (0.3%), 365 (12.8%), and 44 (2.1%) respectively in this study. This suggests that participants in the urban areas were more prone to co-infections than the rural areas in Lagos and Delta states, while it was otherwise in Sokoto State. In conclusion, the co-infection of SARS-CoV-2 and malaria was very high in Delta State compared to the other States. It is important for clinics to screen for both diseases when patients present with symptoms of malaria. This is because the infections have similar symptoms and the public is quick to assume malaria infection without diagnosing for COVID-19 and vice versa.

关键词： SARS-CoV-2 Malaria Coinfection

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Trends and Factors Associated with Changes in Early Initiation of Breastfeeding: Analysis of the Tanzania Demographic and Health Surveys 2004-2016

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Open Journal of Epidemiology 2022年第4期12卷 505-520页

作者： Hans P. Maro Tara Mtuy Levina J. Msuya Baraka Moshi Michael J. Mahande Department of Epidemiology and Biostatistics Institute of Public Health Kilimanjaro Christian Medical University College Moshi Tanzania Faculty of Public Health and Policy London School of Hygiene and Tropical Medicine London UK Department of Pediatrics and Child Health Kilimanjaro Christian Medical University College Moshi Tanzania Department of Pediatrics and Child Health Kilimanjaro Christian Medical Centre Moshi Tanzania

Background: Despite WHO recommendations on the benefits of early initiation of breastfeeding for both the mother and child, only 53.5% of newborns in Tanzania are breastfed within the first hour of life. The trend for early initiation of breastfeeding shows little progress and Tanzania is still far behind reaching the global recommended rate of 70% of early initiation of breastfeeding. This study aims to determine trends and factors associated with changes in the early initiation of breastfeeding in Tanzania from 2004-2016. Methodology: This was an analytical cross-sectional study utilizing secondary data from the Tanzania Demographic and Health Surveys (TDHS) for the years 2004-2005, 2010, and 2015-2016. Data analysis was performed using Stata 15. Frequencies and proportions were used to summarize categorical variables. A Modified Poisson regression model was used to determine factors associated with the early initiation of breastfeeding. Multivariable Poisson decomposition analysis was used to assess factors associated with changes in the early initiation of breastfeeding across surveys. Results: Trends in early initiation of breastfeeding decreased from 59.53% in 2004/2005 to 46.72% in 2010, and then increased to 51.94% in 2015/2016. Only 5.9% of the overall change in early initiation of breastfeeding was contributed by the difference in characteristics such as mode of delivery and working status. The difference in coefficients contributed to a 94% decrease in early initiation of breastfeeding mostly due to a decrease in early initiation of breastfeeding among caesarean section delivery patients. Conclusion: The prevalence of early initiation of breastfeeding in Tanzania decreased between 2004 and 2016, then increased from 2010-2016. Interventions and health policies need to target factors that had significant effects on the early initiation of breastfeeding such as increasing health facility delivery and promoting the initiation of breastfeeding soon after caesa

关键词： Early Initiation of Breastfeeding Trends Factors Associated with Changes Tanzania

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Postoperative Complications and Risk Factors among Women Who Underwent Caesarean Delivery from Northern Tanzania: A Hospital-Based Analytical Cross-Sectional Study

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Open Journal of Obstetrics and Gynecology 2022年第4期12卷 243-257页

作者： Glory Mangi Pendo Mlay Olola Oneko Werner Maokola Patricia Swai Department of Obstetrics and Gynecology Kilimanjaro Christian Medical Center Moshi Tanzania Department of Obstetrics and Gynaecology Kilimanjaro Christian Medical University College Moshi Tanzania Ministry of Health and Social Welfare Dodoma Tanzania

Introduction: Caesarean section (CS) causes some complications. We here attempted to determine the rate of CS complications, characterize their timing, and identify their risk factors among women delivered at kilimanjaro christian medical Center (KCMC). Methods: Patients who underwent CS in KCMC were interviewed and analysed. Risk factors were expressed with Odds ratio (OR) and 95% CI. Results: Of 386 deliveries, 106 (27.5%) had one or more complications. Common early complications (24 - 72 hours after CS) were puerperal sepsis, anaesthesia-related complications, blood transfusion and ICU admission. Longer duration of surgery was significantly associated with all complications (aOR 2.90;95% CI: 1.02 - 8.50). Grand multiparity was significantly associated with blood transfusion (7.0;1.40 - 34.35) and PPH (6.4;1.5 - 24.24) while pre-operative anaemia was significantly associated with blood transfusion (4.34;1.90 - 9.45). Conclusion: Longer duration of surgery, grand multiparity and pre-operative anaemia are associated with complications. Physicians should be aware that these are risk factors for CS-complications.

关键词： Caesarean Section Complications Risk Factors

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