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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

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

Drug Use and Abuse among Orthopedic Ward Patients—A Revolving Cycle of Menace in Atbuth, Bauchi

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Journal of Biosciences and Medicines 2024年第9期12卷 13-20页

作者： Yusuf Stephen Shaphat Shuaibu Ibrahim Timothy Emuan Buhari Abdullahi Zailani Bukar Shehu Aminu Umar Shirama Yakubu Bababa Ibrahim Babangida Hussaini Blessing Eneh Vincent Department of Orthoepaedics and Trauma Abubakar Tafawa Balewa University Teaching Hospital Bauchi Nigeria Department of Radiology Abubakar Tafawa Balewa University Teaching Hospital Bauchi Nigeria Department of Nursing Abubakar Tafawa Balewa University Teaching Hospital Bauchi Nigeria

Background: The use of drugs for purposes other than those for which they are meant to be used or in excess amounts. Psychoactive drugs are some of the drugs more commonly abused, also, antibiotics and other medications too can be misused. Drug abuse and misuse can lead to serious social, medical and emotional harm to the patients, and antibiotic resistance that makes treatment harder are also likely complications. Method: Patients in both male and female wards of the Orthoepaedics Department of ATBUTH, Bauchi were interviewed using a structured questionnaire and their responses were recorded and data were analyzed using the SPSS version 29. Results: A total of 112 patients were interviewed, 76 males and 36 females. Thirty-two (28.6%) patients had taken various kinds of unprescribed medications while on admission: 9 patients had taken unprescribed tramadol, 4 patients had taken codeine, 6 Ampiclox, 5 flagyl and about 8 patients had taken different kinds of traditional medications while on admission. Among the 32 patients, 23 (72%) are aged less than 30 years, 5 (16%) are aged between 30 and 50 years and 4 (12%) are aged above 50 years. Sixteen (50%) had such medications brought to them by relatives or friends, 10 (30%) were given by other patients on admission, 5 (15%) brought or bought the drugs by themselves while 1 (5%) were given by a non-clinical staff of the hospital. Conclusion: Drug misuse and abuse is a very serious, deleterious practice with destructive consequences in its wake, such consequences as drug dependency with all its antecedent effects, antibiotic resistance and difficulties in controlling/managing infections are but a few. So, it’s very important to both educate patients about these terrible practices and cope with the spread of them in our wards and hospitals.

关键词： Drug Abuse Misuse Dependency Resistance

Clinical Versus Doppler Based Assessment in Determining Amputation Level in Diabetic Foot Gangrene;A Prospective Cross-Sectional Study at Atbuth, Bauchi

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Open Journal of Orthopedics 2024年第8期14卷 366-373页

作者： Shaphat Shuaibu Ibrahim Stephen Yusuf Abubakar Musa Shirama Yakubu Bababa Yusuf Aliyu Salihu Makama Baje Salihu Bukar Shehu Department of Orthoepaedics and Trauma Abubakar Tafawa-Balewa University Teaching Hospital Bauchi Nigeria Department of Radiology Abubakar Tafawa-Balewa University Teaching Hospital Bauchi Nigeria Department of Surgery Abubakar Tafawa-Balewa University Teaching Hospital Bauchi Nigeria

Background: Amputation is defined as the surgical removal of a limb or part of a limb through the bone. If the amputation is done above or below the knee, they are termed major while minor amputations involve the partial removal of foot including forefoot resections, ray amputation of the digits or parts of the digits. Significant number of patients with diabetic foot ulcers end with amputations. In the past the amputation level was decided by clinical assessment alone, such as physical examination using color, temperature, peripheral pulses and wound bleeding during surgical procedure. The use of Doppler ultrasound to measure arterial blood pressure at the proposed amputation site has been advocated as a predictor of amputation success. An optimal choice of the level of amputation can reduce amputation complications. Methodology: A Prospective comparative randomized cross-sectional study carried out between 1st January 2022 and 1st January 2024 in ATBUTH, Bauchi amongst patients with diabetic foot Wagener stage IV and V scheduled for amputation. Outcome measures of wound break down, flap necrosis and re-amputation were assessed amongst the clinical based level assessment group and the doppler based level assessment group. Results: A total of 171 patients were recruited into the study. Males 103 and 68 are females, giving a male to female ratio of 1.5:1. mean age 47 years. There were 84 patients in the clinical based level assessment group and 87 patients in the doppler based level assessment. Conclusion: Diabetes mellitus foot disease is a significant risk factor for non-traumatic lower limb amputation and doppler level assessment is superior to clinical level in determining amputation level among diabetic patients scheduled for amputation. P-value 0.003.

关键词： Diabetics Amputation Foot Gangrene Doppler Clinical

Advances in immunotherapy for hepatitis B virus associated hepatocellular carcinoma patients

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World Journal of Hepatology 2024年第10期16卷 1158-1168页

作者： Wei-Hua Cao Ya-Qin Zhang Xin-Xin Li Zi-Yu Zhang Ming-Hui Li Department of Hepatology Division 2 Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China Department of Hepatology Division 2 Beijing Ditan HospitalCapital Medical UniversityPeking University Ditan Teaching HospitalBeijing 100015China

Hepatitis B virus(HBV)infection plays an important role in the occurrence and development of hepatocellular carcinoma(HCC),and the rate of HBV infection in liver cancer patients in China is as high as 92.05%.Due to long-term exposure to chronic antigens from the gut,the liver needs to maintain a certain level of immune tolerance,both to avoid severe inflammation caused by non-pathogenic antigens and to maintain the possibility of rapid and violent responses to infection and ***,HBV infection interacts with the tumor microenvironment(TME)through a highly complex and intertwined signaling pathway,which results in a special TME in *** to changes in the TME,tumor cells can evade immune surveillance by inhibiting tumor-specific T cell function through cytotoxic T-lymphocy-associated protein-4(CTLA-4)and programmed cell death 1(PD-1)/programmed cell death ligand 1(PD-L1).Interferons,as a class of immune factors with strong biological activity,can improve the TME of HBV-HCC through various *** recent years,the systematic treatment of HCC has gradually come out of the *** addition to the continuous emergence of new multi-target anti-vascular tyrosine kinase inhibitor drugs,immune checkpoint inhibitors have opened up a new avenue for the systematic treatment of *** present,immunotherapy based on PD-1/L1 inhibitors has gradually become a new direction of systematic treatment for HCC,and the disease charac-teristics of patients included in global clinical studies are different from those of Chinese ***,whether a group of HCC patients with HBV background and poor prognosis in China can also benefit from immunotherapy is an issue of wide *** review aims to elucidate the advances of immuno-therapy for HBV related HCC patients with regard to:(1)Immunotherapy based on interferons;(2)Immunotherapy based on PD-1/L1 inhibitors;(3)Immunotherapy based on CTLA4 inhibitors;(4)Adoptive cell transfer;(5)Combination immunotherapy str

关键词： Hepatitis B virus Hepatocellular carcinoma Immune checkpoint inhibitors Peginterferon alpha Systematic treatment

Congenital Mesoblastic Nephroma: A Case Report

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Open Journal of Pediatrics 2024年第5期14卷 834-840页

作者： E. A. Alinnor O. C. Ugwa I. O. Nnamani Department of Paediatrics University of Port Harcourt Teaching Hospital Port Harcourt Nigeria Department of Anatomical Pathology University of Port Harcourt Teaching Hospital Port Harcourt Nigeria

Background: Congenital Mesoblastic Nephroma (CMN) is a mesenchymal renal tumour of early life. With a median diagnosis of two months and over 90% of cases occurring within the first year of life, it is the most prevalent non-Wilms’ renal tumour. Even though imaging can be used as a diagnosing tool, it is frequently identified in the neonatal period when the baby has an abdominal mass. There are three different histologic types: mixed, cellular, and classic. Radical nephrectomy is the usual mode of treatment, though adjuvant chemotherapy may be necessary for the cellular type, which may be aggressive. Case presentation: We report on a case of a 2-day-old term male neonate born to a 27-year-old mother through spontaneous vertex delivery (SVD). He presented with a right-sided abdominal mass from birth. An abdominal ultrasound scan revealed a huge, well-circumscribed heterogeneous soft tissue mass in the right hemi-abdomen extending to the left side, measuring 10.2 cm by 8.0 cm. He underwent a right radical nephrectomy with a tumour weight of 450 g and a size of 18 cm × 15 cm × 6 cm. Histopathological diagnosis was Congenital Mesoblastic Nephroma (cellular type) Stage 1. Conclusion: Any infant with a renal tumour should be evaluated for congenital mesoblastic nephroma. Detailed investigation and complete resection are fundamental for ensuring an excellent outcome.

关键词： Congenital Mesoblastic Nephroma Nephrectomy Neonate

Diagnosis and management of malaria in the intensive care unit

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Journal of Intensive Medicine 2024年第1期4卷 3-15页

作者： George Akafity Nicholas Kumi Joyce Ashong Department of Research Monitoringand EvaluationCape Coast Teaching HospitalCape CoastGhana Intensive Care Unit Department of Critical Care and AnesthesiaCape Coast Teaching HospitalCape Coast Department of Paediatrics and Child Health Cape Coast Teaching HospitalCape CoastGhana

Malaria is responsible for approximately three-quarters of a million deaths in humans globally each *** of the morbidity and mortality reported are from Sub-Saharan Africa and Asia,where the disease is *** non-endemic areas,malaria is the most common cause of imported infection and is associated with significant mortality despite recent advancements and investments in elimination *** malaria often requires intensive care unit admission and can be complicated by cerebral malaria,respiratory distress,acute kidney injury,bleeding complications,and *** care management includes prompt diagnosis and early initiation of effective antimalarial therapy,recognition of complications,and appropriate supportive ***,the lack of diagnostic capacities due to limited advances in equipment,personnel,and infrastructure presents a challenge to the effective diagnosis and management of *** article reviews the clinical classification,diagnosis,and management of malaria as relevant to critical care clinicians,highlighting the role of diagnostic capacity,treatment options,and supportive care.

关键词： Malaria Intensive care unit Severe malaria Antimicrobial resistance Antimalarials Artemisinin-based combination therapy

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

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