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Acute Metabolic Complications of Diabetes in the Oueme-Plateau Provincial teaching hospital: Epidemiological, Clinical, Paraclinical and Evolutionary Aspects

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Open Journal of Internal Medicine 2024年第1期14卷 83-92页

作者： Finangnon Armand Wanvoegbe Comlan Jules Gninkoun Hubert Dedjan Kouessi Anthelme Agbodande Van Carrel Yongolo Prosper Singbo Elisé Boko Manchouhoud Alalade Adele Cakpo Ingrid Thomas Angele Azon Kouanou Internal Medicine Department Oueme-Plateau Provincial Teaching Hospital Porto-Novo Benin Endocrinology Department Hubert Koutoukou Maga National Teaching Hospital Cotonou Benin Endocrinology Department Oueme-Plateau Provincial Teaching Hospital Porto-Novo Benin Internal Medicine Department Hubert Koutoukou Maga National Teaching Hospital Cotonou Benin

Introduction: Diabetes mellitus, a metabolic disease, is now an important public health problem across the world. Our aim was to study the epidemiological, clinical, paraclinical, and evolutionary aspects of acute metabolic complications (AMC) of diabetes in the endocrinology department of the Oueme-Plateau Provincial teaching hospital. Methods: This was a descriptive cross-sectional study with data collection based on the medical records of patients presenting with acute metabolic complications of diabetes in the endocrinology department of the Oueme-Plateau Provincial teaching hospital during the 3 years study period (from January 2020 to December 2022). Results: Over 788 patients hospitalized during the study period, 157 had an acute metabolic complication of diabetes, which is a hospital prevalence of 19.9%. Among these 157 cases, 140 were suitable for analysis and therefore constituted our study sample. The mean age of the patients was 49.9 ± 14.7 years, with 19 as minimum and 90 years as maximum. Most of them were women (52.4%). Hypertensive diabetics accounted for 54.9% of cases. Ketoacidosis was the most common complication (62.1%), followed by hyperosmolar hyperglycemic syndrome (23.6%) and hypoglycemia (14.3%). Infection (69.3%) and therapeutic noncompliance (22.9%) were the most common triggers. The average length period of their hospital stay was 7.1 ± 5.1 days, and the outcome was satisfactory in 87.9% of the cases. Unfortunately, there were 3.6% deaths during hospitalization. Conclusion: Acute metabolic complications of diabetes were dominated by ketoacidosis. Infection was the dominant factor in decompensation. Therapeutic education of diabetic patients as well as clinical and biological monitoring must be more stringent and rigorous.

关键词： Acute Metabolic Complications Diabetes Ketoacidosis Porto-Novo

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Assessment of the Vaccination Status of Children Aged 6 to 30 Months in a Tertiary Level Health Care Center in Côte d’Ivoire

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Open Journal of Pediatrics 2024年第3期14卷 536-546页

作者： Yenan John Patrick Kpangni Jean Bertrand Yao Kouassi Christian Yeboua Yao Kossonou Roland Aka-Tanoh Koko Aude Hélène Avi-Siallou Christelle Honorine Asse Kouadio Vincent Department of Pediatrics University Teaching Hospital of Bouake Bouake Ivory Coast Unit Pediatric Surgery University Teaching Hospital of Bouake Bouake Ivory Coast

Introduction: Vaccination coverage in Côte d’Ivoire over the period 2011 to 2015 was below the target of 95% for all antigens. The objective of this study was to analyze the vaccination status of children aged 6 to 30 months with a view to improving vaccination coverage. Patients and Methods: This was a descriptive cross-sectional study which took place from June to September 2018 in a tertiary health center, focusing on children aged 6 to 30 months with a correctly completed health record. The parameters studied were sex, age, educational level of mothers, dates of vaccine administration and reason for missed vaccination opportunities. Results: We retained 212 children. The sex ratio was 1.21 and 93% had received the BCG vaccine before the age of 1 month. The average ages of combined and co-administered vaccines for the 1st and 2nd doses were 7.66 ± 3.81 and 12.88 ± 3.95 weeks, respectively. The median was 16.57 weeks for the 3rd dose. The proportion of vaccinated subjects was greater than 90% for the BCG vaccine and the 3 doses of combined vaccines, and 77% for the yellow fever and measles vaccines. The reasons for non-vaccination were attributable to the children’s parents and health facilities. Conclusion: Improving vaccination coverage requires regular supply of vaccines to centers, and the involvement of all health professionals, community and religious leaders in the vaccination awareness process.

关键词： Children Vaccination Coverage Missed Opportunities

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Surgical Treatment of Nephroblastoma in a 4-Year Male Child: A Case Report and Literature Review

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Case Reports in Clinical Medicine 2024年第2期13卷 43-51页

作者： Alexander Kofi Egote Samuel Kolonziah Blay Constance Amuzuah Egote Cardinal Kofi newton Albert Afriyie Akowuah Emmanuel Nana Bosoma Urology Unit Sunyani Teaching Hospital Sunyani Ghana

Herein we report a patient with nephroblastoma which was successfully removed at the Sunyani teaching hospital CJ Oppong theatre in Ghana in sub-Saharan Africa by extended below umbilical incision. Our patient had a family history of Wilms tumour predisposing him to the disease. His main symptoms were haematuria and abdominal mass which was noticed later. Examination and investigation were suggestive of a late-stage unilateral Nephroblastoma resulting in the need for nephrectomy. To reduce the need for such radical surgeries among children at an early stage, there is the need for early screening of children for Wilms tumours especially, those with family predisposition as in our case study. The case report presented here constitutes a rare case of nephroblastoma in the literature.

关键词： Nephroblastoma Wilms Tumour Nephrectomy Screening

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Glaucoma drainage device implantation and cyclophotocoagulation in the management of refractory glaucoma after Descemet-stripping automated endothelial keratoplasty

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International Journal of Ophthalmology(English edition) 2024年第2期17卷 257-264页

作者： Min-Shu Wang Xue-Chuan Dong Mi-Yun Zheng Xiang Fan Ge-Ge Xiao Jing Hong Ling-Ling Wu Department of Ophthalmology Peking University Third HospitalBeijing 100191China Key Laboratory of Restoration of Damaged Ocular Nerve Beijing 100191China NIMO Ophthalmology Research Institute Beijing 100176China Department of Ophthalmology the First Hospital of PutianTeaching HospitalFujian Medical UniversityPutian 351100Fujian ProvinceChina

AIM:To compare the surgical outcomes of glaucoma drainage device implantation(GDI)and trans-scleral neodymium:YAG cyclophotocoagulation(CPC)in the management of refractory glaucoma after Descemetstripping automated endothelial keratoplasty(DSAEK).METHODS:This retrospective study on observational case series enrolled 29 patients who underwent DSAEK and posterior anti-glaucoma surgery(15 with GDI and 14 with CPC).The main outcome measures were intraocular pressure(IOP),glaucoma surgery success rate(defined as IOP of 6–21 mm Hg without additional anti-glaucoma operation),number of glaucoma medications,endothelial graft status,and best-corrected visual acuity(BCVA).RESULTS:The mean follow-up time was 34.1 and 21.0mo for DSAEK or glaucoma surgeries,both for the GDI and CPC *** groups showed significant IOP reduction after glaucoma *** GDI group presented a significantly higher success rate in IOP control than the CPC group(60%vs 21.4%,P=0.03).Both procedures significantly decreased the number of glaucoma medications(P=0.03).Forty percent and 57%of cases in the GDI and the CPC group,respectively,experienced endothelial graft failure during follow-up(P=0.36).Significantly worse BCVA after surgery was observed in the CPC group but not in the GDI ***:Both GDI and CPC significantly decrease IOP in eyes with glaucoma after *** is preferable to CPC in refractory glaucoma cases after DSAEK,as it manifests a significantly higher success rate for IOP control,similar endothelial graft failure rate,and relatively preserves BCVA than CPC.

关键词： glaucoma drainage device implantation cyclophotocoagulation refractory glaucoma Descemetstripping automated endothelial keratoplasty

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Association of Cytokines with Clinical Indicators in Patients with Drug-Induced Liver Injury

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Biomedical and Environmental Sciences 2024年第5期37卷 494-502页

作者： CAO Wei Hua JIANG Ting Ting SHEN Ge DENG Wen WANG Shi Yu ZHANG Zi Yu LI Xin Xin LU Yao ZHANG Lu LIU Ru Yu CHANG Min WU Shu Ling GAO Yuan Jiao HAO Hong Xiao CHEN Xiao Xue HU Lei Ping XU Meng Jiao YI Wei XIE Yao LI Ming Hui Department of Hepatology Division 2 Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China Department of Hepatology Division 2 Peking University Ditan Teaching HospitalBeijing 100015China Department of Gynecology and Obstetrics Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China

Objective To explore characteristics of clinical parameters and cytokines in patients with drug-induced liver injury(DILI)caused by different drugs and their correlation with clinical *** The study was conducted on patients who were up to Review of Uncertainties in Confidence Assessment for Medical Tests(RUCAM)scoring criteria and clinically diagnosed with *** on Chinese herbal medicine,cardiovascular drugs,non-steroidal anti-inflammatory drugs(NSAIDs),antiinfective drugs,and other drugs,patients were divided into five *** were measured by Luminex *** characteristics of clinical biochemical indicators and cytokines in DILI patients and their correlation were *** 73 patients were *** among five groups was statistically different(P=0.032).Alanine aminotransferase(ALT)(P=0.033)and aspartate aminotransferase(AST)(P=0.007)in NSAIDs group were higher than those in chinese herbal medicine ***-6(IL-6)and tumor necrosis factor alpha(TNF-α)in patients with Chinese herbal medicine(IL-6:P<0.001;TNF-α:P<0.001)and cardiovascular medicine(IL-6:P=0.020;TNF-α:P=0.001)were lower than those in NSAIDs *** was a positive correlation between ALT(r=0.697,P=0.025),AST(r=0.721,P=0.019),and IL-6 in NSAIDs *** Older age may be more prone to *** with NSAIDs have more severe liver damage in early stages of DILI,TNF-αand IL-6 may partake the inflammatory process of DILI.

关键词： Drug-induced liver injury Cytokines Non-steroidal anti-inflammatory drugs Inflammation

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Prevalence, Awareness and Risk Factors for Hypertension in Adults Attending a Tertiary hospital in South-East Nigeria

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Open Journal of Clinical Diagnostics 2024年第2期14卷 7-24页

作者： Jideuma Egwim Osarieme Omokhua Bede Azudialu Hope Igbonagwam Nkechinyere Oke Uzoma Amajo Frances Ugonne Ogunnaya Department of Family Medicine Federal University Teaching Hospital Owerri Nigeria Department of Family Medicine Benue State University Teaching Hospital Makurdi Nigeria Department of Ophthalmology Enugu State University Teaching Hospital Enugu Nigeria Department of Family Medicine Lagos University Teaching Hospital Lagos Nigeria Department of Internal Medicine Newark Beth Israel Medical Center Newark NJ USA

Hypertension, a non-communicable disease, is considered a major public health challenge because of its widespread prevalence globally coupled with its huge morbidity and mortality burden, which is largely preventable if early detection and prompt initiation of management are done. Hypertension prevalence is increasing especially in the developing world, despite this, its awareness among the general population is low. This study aimed at determining the prevalence of hypertension among adult attendees of the General Outpatient Clinic of the Federal University teaching hospital (FUTH), Owerri, with an assessment of the proportion of hypertensives who were aware of their hypertensive status, and identifying risk factors of hypertension in the study participants. A cross-sectional analytical study was conducted between October and November 2022 at the General Outpatient Clinic of the FUTH, Owerri. A total of 257 consenting and eligible adult patients made up of 135 males and 122 females, aged 18 years and above, were selected by systematic random sampling method. The overall prevalence of hypertension was 34.6%. The prevalence was higher in females than in males (37.7% vs 31.9%, P = 0.325). Among the hypertensive subjects 56.2% had awareness of their hypertensive status. Following a multiple regression analysis, hypertension was independently associated with age, family history of hypertension, occupation (retirees, traders, farmers and the unemployed), and marital status (being widowed). Hypertension is prevalent in our environment;the prevalence rate from this study is higher than in most studies in our environment, suggesting possibly, a rising burden. The results from the study underscore the need for increased and sustained advocacy for implementation of policies and programs directed at increased detection and management of hypertension in the different population groups such as annual wellness check for employees in the formal sector, largescale dietary and lifes

关键词： Hypertension Prevalence Awareness Nigeria

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Prognosis Factors of Urinary Quality of Life in Parkinson Disease

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Open Journal of Therapy and Rehabilitation 2024年第1期12卷 10-17页

作者： Ngor Side Diagne Sakhi Othman Ababacar Mamadou Gueye Marie Jeanne Sakho Fatou Dialo Mboup Amélie Ndeye Makarame Sy Papa Ndiouga Lo Ba Seydina Ousmane Anna Modji Basse Maouly Fall Adjaratou Dieynaba Sow Moustapha Ndiaye Amadou Gallo Diop Physical Médicine and Rehabilitation Department Fann Teaching Hospital Dakar Senegal Neurology Department Pikine Hospital Dakar Senegal Physical Médicine and Rehabilitation Department Ibn Rochd Teaching Hospital Casablanca Morocco Physical Médicine and Rehabilitation Department Military Hospital Dakar Senegal Neurology Department Fann Teaching Hospital Dakar Senegal

Introduction: Quality of life in Parkinson disease is not necessary linked to motor symptoms. It’s correlated of overactive bladders and prostatic symptoms. Prognosis factors of urinary quality of life are unknown. Objectives: Our study aims to find prognosis factors of quality of life associated specifically of urinary disorders in PD. Patients and methods: We conducted a transversal, analytic and descriptive study in Physical Medicine, and Neurology departments, Fann teaching hospital, Dakar and included patients followed for treatment of PD. Urinary disorders, quality of life and functional autonomy were assessed respectively by Urinary Symptoms Profile (USP), Qualiven Short Form, Schwab and England Scale. Results: 38 patients presented PD, with a mean age of 60.89 ± 13.6 years and sex-ratio of 2.45. Mean duration of PD was 3.1 ± 2.9 years. Urinary disorders were found in 47.36% and dominated by incontinence (88.88%) and overactive bladders (88.88%) which were minor in more than 55%. Quality of life was impaired in 88.88% of cases. Minor forms (43.75%) were predominant and constraint dimension (50%) was the most severely altered. Prognosis factors for quality of life of urinary disorders were PD stages (0.046) and functional autonomy (0.042). Discussion and conclusion: Urinary disorders in PD are common, impaired quality of life, especially the constraint dimension, depends on stage of evolution of PD and functional autonomy of patients.

关键词： Urinary Quality of Life Parkinson Disease Dakar

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The Timing of Primary Neurosurgical Repair and Wound-Site Infection in Children with Myelomeningocele

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Open Journal of Modern Neurosurgery 2024年第2期14卷 137-148页

作者： Joseph O. Obande Paul T. Bitrus Elizabeth I. Obande Division of Neurosurgery Department of Surgery University of Abuja Teaching Hospital Abuja Nigeria Post-Basic School of Critical Care Nursing University of Abuja Teaching Hospital Abuja Nigeria

Background: The optimal time to closure of a newborn with a myelomeningocele has been the focus of a number of evaluations. The Timing of primary surgery has received significant attention due to its relationship to repair-site infection that can lead to increased morbidity and prolonged hospital stays. It is on this basis that recommendations have utilized 48 - 72 hours post birth as ideal time of closure. This is not only prevent infection at the site but also prevent ventriculitis and neural structure damage. We therefore, hypothesized an increase in wound infection rates in those patients with delays in myelomeningocele repair. Methods: We retrospectively reviewed the records of 103 children with myelomeningocele treated between 2016 and 2023. At discharge the patients were followed up at the post-operative clinic visit 2 weeks later. Children were assigned to 1 of 2 groups, those who underwent primary neurosurgical repair within 72 hours of delivery (Group 1) and those undergoing repair after 72 hours (Group 2). We compared the infection rates. Results: 103 children who underwent myelomeningocele repair were identified, with a median time from birth to treatment of 1 day. Eight (7.8 %) patients were noted to have post-repair surgical site complications. There was no significant difference in rates of infection between Group 1 and Group 2 repair times. The presence of infection was associated increased length of stay when compared to neonates without infection. Conclusion: In children with myelomeningocele, the timing of primary neurosurgical repair appears not to have a significant impact on surgical site infection. Closure of the spinal lesion within the first 72 hours of life may be more favorable for neural damage prevention. These results suggest that early myelomeningocele repair may not impart significantly on the rate of wound-site infection.

关键词： Spina Bifida Surgical Timing Excision and Repair Surgical Site Infection Myelomeningocele

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Smoking of Carica papaya in Nigeria:The rationale,the public health effects and policies for intervention

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Asian Pacific Journal of Tropical Medicine 2024年第3期17卷 95-96页

作者： Abolaji Paul Adekeye Mental Health Department Federal Teaching HospitalIdo-EkitiEkiti StateNigeria Mental Health Department Afe Babalola UniversityAdo-EkitiEkiti StateNigeria

Psychoactive substance use is characterized by the habitual use of substances that have significant effects in altering the activities of neurotransmitters in certain regions of the ***,these alterations manifest as c... 详细信息

关键词： rational behaviour emotional

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Injuries Associated with Auto-Tricycle Crashes in an African City: Incidence and Pattern

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Open Journal of Orthopedics 2024年第5期14卷 229-246页

作者： Augustus Nii Kwame Okleme David Anyitey-Kokor Dominic Konadu-Yeboah Adam Gyedu Kwabena Agbedinu Johathan Boakye Department of Orthopaedics and Trauma Komfo Anokye Teaching Hospital Kumasi Ghana School of Medical Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana Department of Surgery Komfo Anokye Teaching Hospital Kumasi Ghana Department of Emergency Medicine Komfo Anokye Teaching Hospital Kumasi Ghana

Purpose: The aim of this study was to determine the incidence and pattern of injuries resulting from auto-tricycle crashes among patients in a tertiary referral centre in Ghana. Methods: Data were retrospectively extracted from hospital records of patients who got involved in auto-tricycle crashes and presented to the Accident and Emergency Centre of the Komfo Anokye teaching hospital (KATH), over a one-year period using a structured questionnaire. The gathered data were then entered into an electronic database and then analysed with SPSS version 20.0. Results: The incidence of injury following auto-tricycle crashes over the one-year period was 5.9% (95% CI: 4.9% - 7.0%) with a case fatality rate (FR) of 3.8% (95% CI: 1.3% - 8.7%). All the mortalities resulted from head and neck injuries and none of the patients involved wore a crash helmet. Only 5% of those studied wore crash helmets and were all drivers. Closed fractures accounted for 58% of the injuries, followed by open fractures, 28%. The most commonly fractured bones were the tibia/fibula, followed by the femur and then radius/ulna. The most common mechanism of injury was auto-tricycle toppling over (29%). Passengers were the most injured (48%), followed by drivers (37%) and pedestrians (15%). Most (72%) injuries among participants involved a single body part. On the injury severity scale, most (61%) of patients had minor trauma and 38% had major trauma. Conclusion: Auto-tricycle crashes account for 5.9% of injuries at the study site with a case fatality rate of 3.8%. Passengers had a higher injury rate (48%) than drivers (37%). Fractures of the tibia/fibula were most commonly associated with auto-tricycle crashes. Injuries to the head and neck were responsible for the deaths in the study participants and non-use of a crash helmet was associated with mortalities.

关键词： Auto-Tricycle Knock-Down Rickshaw Road Traffic Crashes

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