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Spousal Involvement in the Workplace of Doctors: What Is Defined as Appropriate or Inappropriate

Health 2024年第3期16卷 187-203页

作者： Uchenna Onubogu Boma Oyan Martha Okorie Department of Paediatrics & Child Health Rivers State University Teaching Hospital Port Harcourt Nigeria

Background: Workers spend a significant amount of time in the workspace. Involvement of a spouse in a doctor’s workplace can take different forms and come with different intentions. Objectives: The survey aimed to determine the prevalence and extent of spousal involvement in physicians’ workplaces as well as the outcome of such involvement on doctor’ swell-being, productivity, and relationship with colleagues. Methods: This cross-sectional online survey on spousal involvement in the workplace of doctors was conducted among 83 responding doctors from July to August 2023. Results: Among the respondents, 60 (72.3%) had witnessed a doctor’s spouse being involved in the workplace. The most common reason for spousal involvement in the workplace was to protect the spouse from what they perceived as a threat 34 (54.0%). Spouse’s ignorance of boundaries in the workplace (OR: 6.09 (95% CI: 1.70, 21.79) P: 0.003) and exertion of control by the spouse (OR: 11.2 (95% CI: 2.26, 56.41) P: 0.002) were significantly associated with higher odds of inappropriate spousal involvement in the workplace, while expression of love for spouse with acts of kindness was significantly associated with a lowered odd of inappropriate spousal involvement (OR: 0.11 (95% CI: 0.03, 0.36) P: 0.0001). Conclusion: Spousal involvement in the workplace is relatively common. Ignorance of the boundaries of the workplace and exertion of control by the spouse were significant enablers of inappropriate spousal involvement in the workplace of doctors. The establishment of workplace policies that define the limits of spousal involvement in the doctor’s workplace can foster a healthy workspace environment, enhance doctors’ well-being, and improve patient care.

关键词： Spouse Workplace Involvement hospital Healthcare Workers Conflicts Appropriate

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Unusual Brain Trauma Injury

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Open Journal of Modern Neurosurgery 2024年第3期14卷 218-227页

作者： Diallo Moussa Traoré Youssouf Kanikomo Drissa Diarra Sounkalo Izoudine B. Koumaré Sogoba Youssouf Sogoba Boubacar Diallo Oumar Gabriel Tour Teatching hospital Bamako Mali Bocar Sidy Sall Teatching hospital Kati Mali Hopital du Mali teaching hospital Bamako Mali

Unusual head trauma is rare with various mechanisms of occurrence. The injuries can be similar to those of road accidents but sometimes with significant complexities. The objective was to determine the frequency of this pathology in our practice, describe the different mechanisms and report the craniocerebral lesions caused by this type of trauma. Materials and Method: This was a descriptive study with retrospective collection spread over a period of 3 years. After selecting the files, the patients and/or their companions were contacted by telephone to inquire about them and then returned to the consultation for reassessment. Disease history and information were obtained from patients’ medical records. Result: The frequency of this pathology was 1.78% and his incidence was 0.4 cases per month. The average age of the patients was 13.47 years. All the victims were male. 41.17% of patients were in school. The mechanisms of trauma were the hoof blow 47.1%, the horn blow 29.4% and the stone blow 11.7% respectively. 23.5% of patients were confused and 11.7% children were in coma. One patient presented an anisocoria. The motor deficit was present in 5 cases. CT-scan made it possible to highlight a skull depressing fracture 58.8% and confirm a craniocerebral wound in 35.3%. The average time between patient admission to hospital and completion of surgery was 24.5 hours. The surgery had consisted of the trimming of cranio-cerebral wounds, exploration, duroplasty and lifting of skull depressing fracture. After 15 months of follow-up, the evolution was favorable in 53.3%, the morbidity was 33.4% and the mortality 17.6%. Conclusion: These are rare but serious conditions because they are fatal and disabling. An early and multidisciplinary management can hope to have a good favorable.

关键词： Brain Trauma Injury Insolite Unusual Skull Depressing Fracture Hoof Kick Horn Blows Stone Bows Motorcycle Gear Lever

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Overview of Adrenals Tumors in Dakar hospitals

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Open Journal of Internal Medicine 2024年第2期14卷 141-150页

作者： Nafy Ndiaye Yakham Mohamed Leye Mouhamadou Moustapha Ndong Ngoné Diaba Diack Amadou Fall Cisse Abdoulaye Leye Baidy Sy Kane Alpha Omar Touré Cherif Mohamed Dial Pape Saloum Diop Internalmedeccine and Endocrinology Department Teaching Hospital of Pikine Dakar Senegal General Surgery Department Aristide Le Dantec Teaching Hospital of Dakar Dakar Senegal Anatomo-Pathology Department General Hospital of Grand Yoff Dakar Dakar Senegal General Surgery Department General Hospital of Grand Yoff Dakar Dakar Senegal

Introduction: Adrenal tumours (AT) are commonly encountered in clinical practice. For any patient presenting an adrenal mass, there are two crucial points to consider: is the adrenal mass malignant and is it hormonally active? The objective of our study was to evaluate the epidemiological, diagnostic, therapeutic, and evolutionary aspects of AT in a developing country. Methodology: We conducted a retrospective study spanning 17 years (from January 2005 to October 2022) in four Dakar hospital services. We included all patient medical records with explored AT. Results: AT was diagnosed in 35 patients who had a mean age of 36.62 years (range: 12-79), and a female predominance (26 women to 9 men). Among these patients, 17.2 % had incidental AT. Hypertension was the commonest presenting symptom in 27 patients (77%), which was associated with Mnards triad in 14 patients (40%). Abdominal pain was reported by 20 patients (57%), and 14 presented with an abdominal mass. Among the patients, 29 had functional AT: 22 with pheochromocytoma, 5 with primary hyperaldosteronism, and 2 with hypercortisolism. Imaging evaluations revealed that 33 patients had unilateral AT and one had bilateral AT. Tumour sizes varied, 5 patients had tumours 10 cm. Two patients presented with metastases. The therapeutic approach involved adrenalectomy in 32 patients. Perioperative complications were observed in five patients, including haemorrhage (two patients), hypotension (two cases), and hypertensive crisis (one case). One patient with bilateral pheochromocytoma developed acute adrenal insufficiency postoperatively, followed by abdominal herniation. Histopathological examination confirmed pheochromocytoma in 21 patients, Conns adenoma in 5, adrenocortical carcinoma in 3, cortisol adenoma in 2, and adrenal cyst in 1 patient. Non-functional AT included adrenocortical carcinoma (three patients), adrenal cyst (one patient), and pheochromocytoma (two patients). After a one-year follow-up, 29 patients wit

关键词： Tumour Adrenal Pheochromocytoma Conn Adrenocortical Carcinoma Dakar

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Severe Cut Throat Injury in a Child: A Case Report and Review of Literature

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第4期13卷 285-292页

作者： Nafisatu Bello-Muhammad Hamisu Abdullahi Yasir Nuhu Jibril Auwal Adamu Manir Hamza Anka Muhammad Ghazali Hasheem Department of ENT Aminu Kano Teaching Hospital Bayero University Kano Nigeria Department of ENT Abubakar Tafawa Balewa University Teaching Hospital Bauchi Nigeria Department of ENT Federal University of Health Sciences Azare Bauchi State Nigeria

Background: Cut-throat injury is a potentially fatal condition that may be associated with serious morbidity and mortality. The neck region is particularly at risk of serious injuries due to the location of vital structures, including nerves, viscera, and major vessels. Although cut-throat injury is said to be rare in children, its occurrence has been reported in some series. Management of this condition requires a multidisciplinary approach for a better outcome. Aim: The aim of this report is to highlight the successful management of an alarming case of severe cut-throat injury with associated laryngeal injury in a child. Case presentation: A 12-year-old boy presented with a cut-throat following an assault by an unknown person. Examination revealed an acutely ill child, conscious but pale. He sustained a deep transverse laceration that transected the thyroid cartilage, exposing the laryngeal cavity. An assessment of Zone II penetrating neck injury was made. He was resuscitated, and had emergency neck exploration, tracheostomy, and repair of the injuries. The patient was followed up for 6 months, and had a good voice outcome, with no significant complication. Conclusion: Cut-throat injury is rare in children. But it is a potentially life-threatening condition. It is therefore important to recognize this entity and develop effective protocol of management in our environment.

关键词： Cut-Throat Neck Trauma Penetrating Neck Injury Neck Exploration Tracheostomy

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Morphometric Study of the Mastoid Process and its Role in Sex Differentiation:A Nigerian Computed Tomography Study

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Journal of Forensic Science and Medicine 2024年第1期10卷 1-10页

作者： Beryl Shitandi Ominde John NIgabari Joyce Ekeme Ikubor Department of Human Anatomy and Cell Biology Delta State UniversityAbrakaNigeria Department of Mathematics Delta State UniversityAbrakaNigeria Department of Radiology Delta State University Teaching HospitalOgharaNigeria

Background:The mastoid process can be utilized in forensic identification due to its resistance to alterations and population variations in its *** study investigated the role of mastoid parameters in the determination of sex in a Nigerian *** and Objectives:The aim of this study was to determine the gender differences in measurements of the mastoid ***,the study aimed at assessing the percentage accuracy of using the mastoid variables in sex *** and Methods:This cross-sectional study used computed tomographic images of the brain,stored in the radiology unit of a referral hospital in Delta State,*** was granted by the hospital’s Ethics *** measurements of the mastoid process were taken on images of 310 patients(170 males and 140 females)aged 20-80 *** were summarized using means and standard ***,side,and age group comparisons were assessed using the independent t-test,paired t-test,and analysis of variance,*** association between variables was probed using Pearson’s correlation *** discriminant function analysis was used to determine the accuracy of correct sex *** probability value was set at<***:All the measurements were larger in males than in females(P<0.05).All except the conventional height,oblique sagittal diameter,and mediolateral inclination angle showed significant differences between age groups(P<0.05).The true height and oblique coronal diameter showed a significant positive correlation with age(0

关键词： Forensic mastoid process measurements sex determination

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Psychological Experience of Mothers of Children with Sickle Cell Disease Followed at the Pediatric Department of Bouaké University teaching hospital

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Open Journal of Pediatrics 2024年第1期14卷 149-163页

作者： Akanji Iburaima Alamun Aka-Tanoh Koko Aude Hélène Yao Kouassi Christian Adou Leioh Romeo Sahi Gnantin Josette Landryse Amani Ehi Alexise Eleonore Boune Aboulaye Asse Kouadio Vincent Paediatrics Department Bouaké University Teaching Hospital Bouaké C&#244te d’Ivoire

Introduction: Sickle cell disease has physical and emotional repercussions on the child and his family. The aim of this study was to describe the psychosocial experiences of mothers of children with sickle cell disease in order to improve the overall care of the child. Methods: This was a descriptive cross-sectional study carried out in the pediatrics department of Bouaké University teaching hospital from June to September 2023. It focused on mothers of major sickle-cell-affected children followed up in the pediatrics department of the Bouaké University teaching hospital. The variables studied were sociodemographic, psychological, social and economic. Results: Of the 40 mothers surveyed, 15% were not in school and 32.5% were unemployed. For them, sickle cell disease was of natural (genetic) origin in 90% and supernatural in 10%. They stated that the child had an average age of 36 months (extremes 7 and 108 months) when the disease was discovered. And 52% of them were satisfied with the way the disease was clearly and completely announced. Following the announcement, the questioned mothers said they had felt shock (35%), sadness (31.7%), guilt (23.3%) and discouragement (10%). Anxiety and depression were experienced by 77.5% and 22.5% respectively. In 60% of cases, they stated that the disease was incurable, and the outcome was fatal in 2.5% of cases. The child’s illness was a source of problems in the home in 25% of cases, represented by arguments in 92% and divorce in 8%. In 97.5% of cases, the mother told her family and friends about the child’s illness. In 90% of cases, the mother and child benefited from psychological support from family and friends. Conclusion: Sickle cell disease is a serious illness with a psychological and social impact on mothers. We recommend psychological support for mothers from the moment of diagnosis and throughout follow-up.

关键词： Psychosocial Experience Sickle Cell Disease Côte d’Ivoire

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The Effect of Uterine Artery Occlusion with Tourniquet on Ovarian Reserve during Open Myomectomy at a University teaching hospital in Southern Nigeria

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Advances in Reproductive Sciences 2024年第1期12卷 37-50页

作者： William Amebeobari Mube Justina Omoikhefe Alegbeleye Ngozi Clare Orazulike Department of Obstetrics and Gynaecology University of Port Harcourt Teaching Hospital Rivers State Port Harcourt Nigeria

Background: The most common surgical treatment for symptomatic uterine fibroids, particularly in women with fertility concerns, is open myomectomy. Given the high vascularity of the uterus, haemorrhage during the procedure is a serious risk that is often mitigated with a uterine tourniquet. Aim and Objectives: To evaluate the effect of uterine artery occlusion with a tourniquet during open myomectomy on ovarian reserve using serial anti-Mullerian hormone (AMH) measurements. Materials and Methods: This was a prospective longitudinal study with a quasi-experimental design and a convenient sampling technique. The study enrolled 47 women who had abdominal myomectomy between September 1, 2021, and March 31, 2022, at the University of Port Harcourt teaching hospital. Blood samples were collected before anaesthesia was administered in theatre, on day two, and three months after open abdominal myomectomy for anti-Mullerian hormone assay. The data was collected using a semi-structured proforma, entered into an Excel spreadsheet, and analyzed using SPSS version 25.0 with a 95% confidence interval. Statistical significance level was set at 0.05. Results: The pre-surgery AMH mean value was 1.67 ± 1.44 ng/ml, while the values after using a uterine tourniquet at myomectomy on the second day and three months later were 1.22 ± 1.24 ng/ml and 1.59 ± 1.43 ng/ml, respectively. There was no statistically significant change in AMH levels, and there was no statistically significant relationship between blood loss and tourniquet time and AMH after open abdominal myomectomy. Conclusion: The use of a uterine tourniquet and blood loss during open myomectomy has no effect on ovarian reserve.

关键词： Uterine Tourniquet Open Abdominal Myomectomy Ovarian Reserve Anti-Mullerian Hormone Nigeria

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Predictors of Abnormal Vaginal Discharge among Women of Reproductive Age in Southeast Nigeria

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International Journal of Clinical Medicine 2024年第7期15卷 240-256页

作者： Jideuma Egwim Victor Dike Hope Igbonagwam Nkechinyere Oke Uzoma Amajo Akuchi Okafor Angela Izegbune Ijedimma Okafor Department of Family Medicine Federal University Teaching Hospital Owerri Nigeria Department of Public Health Central Michigan University Mount Pleasant Michigan USA Department of Ophthalmology Enugu State University Teaching Hospital Enugu Nigeria Department of Family Medicine Lagos University Teaching Hospital Lagos Nigeria Department of Internal Medicine Alex Ekwueme Federal University Teaching Hospital Ebonyi State Nigeria Field Office World Health Organisation Imo State Nigeria Department of Internal Medicine Ebonyi State University College of Health Sciences Ebonyi State Nigeria

Background: An abnormal vaginal discharge is a common complaint among women of reproductive age, and it can indicate serious conditions like pelvic inflammatory disease and cervical cancer. This study aimed to assess the predictors of abnormal vaginal discharge in women of reproductive age group in Imo State, Southeast Nigeria. Methods: A cross-sectional study was conducted among 368 women of reproductive age group attending the clinic at Federal University teaching hospital Owerri, in Imo State, Nigeria. Respondents were recruited using a systematic sampling technique. Data were collected using a pre-tested interviewer-administered questionnaire. Multivariable analysis was performed to determine predictors of abnormal vaginal discharge. Statistical significance was set at p Results: The mean age of the respondents was 30 ± 4.5 years. Predictors of abnormal vaginal discharge were: age 36 - 45 years (OR: 4.5;95% C.I: 1.023 - 8.967, p = 0.041), being a student (OR: 2.4: 95% C.I: 1.496 - 7.336, p = 0.003), use of oral contraceptives (OR: 3.4;95% C.I: 1.068 - 6.932, p = 0.010), use of water cistern (OR: 4.7;C.I: 1.654 - 5.210, p = 0.028) anal hygiene practices (OR: 2.7;95% C.I: 1.142 - 4.809, p Conclusion: These findings suggest that targeted sexual and reproductive health interventions should be provided to reduce the risk of abnormal vaginal discharge in women of reproductive age group.

关键词： Predictors Abnormal Vaginal Discharge

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Ethmoidal Polyposis, Adenoid Hypertrophy and Tympanic Membrane Perforation—A Case Report

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第3期13卷 178-186页

作者： Ahmad Mahmud Mohammed Bello Fufore Abubakar Umar Hamisu Abdullahi Thomas Musa Samdi Auwal Adamu Onyekwere George B. Nwaorgu Department of Otorhinolaryngology Modibbo Adama University/Modibbo Adama University Teaching Hospital Yola Nigeria Department of Otorhinolaryngology Bayero University/Aminu Kano Teaching Hospital Kano Nigeria National Ear Care Centre (NECC) Kaduna Nigeria Department of ENT Abubakar Tafawa Balewa Teaching Hospital Bauchi Nigeria Department of ENT Federal University of Health Sciences Azare Bauchi Nigeria Department of Otorhinolaryngology University College Hospital Ibadan/College of Medicine University of Ibadan Ibadan Nigeria

Background: Ethmoidal polyposis coexisting with adenoid enlargement and tympanic membrane perforation is a rare condition in otolaryngological practice. Evidences have shown that antrochoanal polyp often times coexists with adenoid enlargement especially in the young which was in sharp contrast to ethmoidal polyposis occurring in the presence of adenoid enlargement. Moreover, the hidden location of nasopharynx housing the adenoids, coupled with the masking effect of bilateral sinonasal polyps, leads to inadvertent misdiagnosis of this complex pathology with subsequent difficulty in providing effective management. Case Presentation: A 24 year-old lady presented with recurrent bilateral nasal obstruction that became persistent associated with nasal discharge and anosmia. She also had recurrent right otorrhoea with associated hearing loss. Diagnostic rigid nasal endoscopy revealed mucoid discharge with bilateral polypoid masses filling both nasal cavities. Otoendoscopic finding revealed a small (about 5%) central tympanic membrane perforation. A clinical assessment of chronic rhinosinusitis with nasal polyposis complicated by chronic suppurative otitis media (CSOM) was made. A non-contrast CT scan of the paranasal sinuses showed isodense lesions in the nasal cavities, all paranasal sinuses and the entire nasopharynx. She had endoscopic sinus surgery and a nasopharyngeal clearance biopsy. The nasal, paranasal and nasopharyngeal masses had histologic confirmation of inflammatory nasal polyps and lymphoid (adenoid) hyperplasia respectively. Her condition improved remarkably with subsequent medical treatment. She was followed up for 8 months and no recurrence was observed. Conclusion: Sinonasal polyposis can coexist with adenoid hypertrophy and middle ear disease as a single pathological condition. Hence, a high index of suspicion and thorough evaluation become necessary for making timely diagnoses and instituting effective management.

关键词： Sino-Nasal Polyps Adenoid Enlargement Rhinosinusitis Otitis Media Endoscopic Sinus Surgery

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Cholecystokinin and cholecystokinin-A receptor: An attractive treatment strategy for biliary dyskinesia?

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World Journal of Gastroenterology 2024年第3期30卷 283-285页

作者： Jun Chang Yan Liu Ting-Can Jiang Lan Zhao Jian-Wei Liu Tianjin Institute of Acupuncture and Moxibustion The First Teaching Hospital of Tianjin University of Traditional Chinese MedicineTianjin 300381China Department of Gastroenterology Tianjin Hospital of Integrated Traditional Chinese and Western Medicine Nankai HospitalTianjin 300100China State Key Laboratory of Component-Based Chinese Medicine Tianjin University of Traditional Chinese MedicineTianjin 301617China School of Integrative Medicine Tianjin University of Traditional Chinese MedicineTianjin 301617China

Biliary dyskinesia is a relatively common gastrointestinal disease that is increas-ing in incidence as living standards ***,its underlying pathogenesis remains unclear,hindering the development of therapeutic ***,“Expression and functional study of cholecystokinin-A receptors on the interstitial Cajal-like cells of the guinea pig common bile duct”demonstrated that cholecystokinin(CCK)regulates the contractile function of the common bile duct through interaction with the CCK-A receptor in interstitial Cajal-like cells,contributing to improving the academic understanding of biliary tract dynamics and providing emerging directions for the pathogenesis and clinical management of biliary *** letter provides a brief overview of the role of CCK and CCK-A receptors in biliary dyskinesia from the perspective of animal experiments and clinical studies,and discusses prospects and challenges for the clinical application of CCK and CCK-A receptors as potential therapeutic targets.

关键词： Cholecystokinin Cholecystokinin-A receptor Biliary dyskinesia Interstitial Cajal-like cell Therapeutic target

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