ORIGINAL RESEARCH ARTICLE | July 6, 2023
Risk Assessment of Venous Thrombolic Disease in Hospitalized Advanced HIV Patients in a Resource-Limited Setting
Sylvano Tshingudi Tshingudi
Page no 377-380 |
DOI: 10.36348/sjm.2023.v08i07.001
HIV infection is known to be a factor associated with cardiovascular disease. The objective of this work is to draw the attention of clinicians working in a resource-limited environment to the risk run by these patients in hospitalization in order to be able to prevent and ensure early and adequate management allowing the reduction of thrombotic risk andits complications. This is a descriptive cross-sectional study from January 2022 to May 2023, all patients hospitalized for advanced HIV disease were assessed by the Padua score supported by the D-dimer test. The data was collected in strict confidentiality. Out of a total of 400 hospitalized patients 40 were identified as being at being at risk of developing venous thromboembolic disease (VTE). The average age was 33, 6 years, 28 patients were female (70%).Coma (37,5%) and dyspnea(30%) were the main reasons for consultation. Cellular immunosuppression was severe (CD4∠200 mm3) in 95% of patients disseminated tuberculosis(50%), pneumocystosis carini pneumonia(25%), sepsis(12,5%), neuromeningeal cryptococcosis(7,5%) and Kaposi’s sarcoma (5%) were the main associated opportunistic conditions. 28(70%) patients were naïve to antiretrovirals and 12(30%) had been on retroviral treatment for six months. 12(30%) patients died, 8(20%) patients progressed well, and 20(50%) were lost sight of for lack financed mean.
ORIGINAL RESEARCH ARTICLE | July 11, 2023
Predictors of Daily Utilization of Long-Lasting Insecticidal Nets for Malaria Prevention in Pregnancy among Antenatal Care Recipients in Southern Nigeria
Dr. Anyiekere Morgan Ekanem, Mbuotidem Ibanga Akpan, Charity Nkemjika Onwe, Chioma Purity Ibe, Bright Chukwunonye Okey, Abel Samuel Paul, Emaediong Ibong Akpanekpo
Page no 381-386 |
DOI: 10.36348/sjm.2023.v08i07.002
Malaria remains a significant public health concern, particularly among pregnant women in sub-Saharan Africa. Long Lasting Insecticidal Nets (LLINs) have been recognized as an effective preventive measure against malaria transmission. However, the utilization of LLINs among pregnant women remains suboptimal. This study aimed to assess the level of daily LLIN utilization and identify its predictors among pregnant women receiving antenatal care in a tertiary healthcare centre in Southern Nigeria. A cross-sectional study was conducted among antenatal recipients at the University of Uyo Teaching Hospital in Uyo, AkwaIbom State. A total of 323 respondents were recruited for the study. Data were collected using a pre-tested semi-structured questionnaire. Multivariable logistic regression analyses were performed to identify predictors of daily LLIN usage. One hundred and twenty seven (39.3%) of the respondents had ever slept inside a LLIN during the index pregnancy, while 22.6% reported daily usage. LLIN ownership was reported by 47.7% of the respondents, highlighting a discrepancy between ownership and consistent use. Predictors of daily LLIN usage included LLIN ownership (aOR 3.83, 95% CI 1.95-7.48), absence of discomfort during LLIN use (aOR 9.33,95%CI 4.32-20.17), non-use of other malaria preventive measures (aOR 3.7,95% CI 11.51-8.93) and presence of mosquitoes in home dwelling (aOR 3.56 95%CI 1.35-9.37). Health education campaigns should emphasize the benefits of daily LLIN usage during pregnancy. Policy interventions are warranted to increase LLIN distribution and availability to pregnant women through antenatal care clinics.
CASE REPORT | July 15, 2023
Primary Intestinal Lymphangiectasia Diagnosed by Capsule Endoscopy
Mouna Salihoun, Soumaya Merzouk, Ilham Serraj, Mohamed Acharki, Nawal Kabbaj
Page no 387-389 |
DOI: 10.36348/sjm.2023.v08i07.003
Primary intestinal lymphangiectasia (PIL) is a rare disorder in children and it is more exceptional in adults. PIL is caused by a diffuse or localized dilatation and/or rupture of intestinal lymphatic vessels in the mucosa, submucosa, or subserosa due to high pressure in lymphatic vessels. The diagnosis is made on clinical grounds with the support of small bowel biopsies. The following report present a case of intestinal lymphangiectasia revealed by capsule endoscopy examination. This work shows that standard EGD and colonoscopy may miss characteristic lesions of PIL, and capsule endoscopy (or enteroscopy) may be required for the diagnosis because lesions are typically located in distal duodenum/jejunoileum.
ORIGINAL RESEARCH ARTICLE | July 17, 2023
Musculoskeletal Problems among Third-Gender People in Dhaka
Dr. Anawarul Quader Nazim, S. M. Mustofa Kamal, Bishwajit Sarker, Mayesa Nujhat, Md. Soriful Islam, Sabrina Zaman Shova, Iffat Ara Ela
Page no 390-396 |
DOI: 10.36348/sjm.2023.v08i07.004
Purpose: The study aimed to identify the Musculoskeletal problem among the third-gender population in Dhaka. Objective: This study’s objective was to find out socio-demographic information, and Musculoskeletal problems among the third-gender population in Dhaka. Methodology: This study was performed in a cross-sectional study design. This study was conducted to determine the Musculoskeletal problem among the third-gender population. This study’s sample was collected through a convenience sampling procedure and a total sample of 62. The data was collected from the different areas across Dhaka. The data collection process was a questionnaire with a face-to-face interview. Data was analyzed with Microsoft Office, and Excel 2019 using the SPSS 25 version software program and test use of study chi- square test. Result: This study’s participant means and standard deviation of participant age where are Mean ±SD= 30.90±10.710; About (45%) third gender age 18-27 years; (32%) age 28-37 years; (12%) age 38-47 years; and 11% more than 47 years. 72.6% were male sex at birth and 27.4% were female sex at birth. Around (14.50%) of them live in rural areas, 4.80%) are semi-urban and (80.60%) are from urban areas. (53.2%) were experiencing pain in the different body parts. 21.2% neck pain, 15.2% shoulder pain, 6.1% elbow pain, 39.4% knee, and 39.4% hip pain. severity level was mild pain felt at 8.10%, moderate pain experienced at 27.40% and 17.70% suffered from severe pain. Conclusion: The database revealed a significant prevalence of musculoskeletal issues (53.2%), primarily affecting the hip and knee. To enhance accuracy, employing a standardized observation tool is recommended. Further research, including larger samples among the third gender in Bangladesh, is essential for robust decision-making and increased awareness.
CASE REPORT | July 21, 2023
An Atypical Clinical Presentation of Acute Inflammatory Demyelinating Polyradiculoneuropathy
Raed Gasemaltayeb
Page no 397-398 |
DOI: 10.36348/sjm.2023.v08i07.005
Acute inflammatory demyelinating polyradiculoneuropathy (AIDP), also known as Guillain-Barre syndrome (GBS), is an autoimmune disease that is typically present as a progressive ascending weakness, with subtle or no sensory findings, and reduced or absent deep tendon reflexes. In this case report I am presenting a patient who presented with an atypical clinical feature of AIDP in the form of a descending rather than ascending weakness, highlighting the importance of considering AIDP as a potential diagnosis in such atypical presentations.
ORIGINAL RESEARCH ARTICLE | July 21, 2023
Determination of Anxiety Levels and Factors Affecting Anxiety in Patients Undergoing Transcatheter Aortic Valve Implantation
Berna Dizer, Havva Kara, Erika Sivarajan Froelicher
Page no 399-406 |
DOI: 10.36348/sjm.2023.v08i07.006
Background/aim: Transcatheter Aortic Valve Implantation (TAVI) is an alternative treatment for patients with severe aortic stenosis who are considered high-risk for surgery. Determine the anxiety levels of patients, who will undergo TAVI surgery, and factors affecting anxiety in the pre- and postoperative period. Materials and methods: This cross-sectional study was conducted in Sifa hospital in Izmir, Turkey between September 2014 and June 2015. Data were collected in the cardiology outpatient clinic for preoperative data, and in the coronary intensive care unit and cardiology outpatient clinic for postoperative data. The data were collected by interviewing patients who presented with aortic stenosis or aortic insufficiency and underwent TAVI surgery. Stress status of the patients before and after TAVI was measured with the State-Trait Anxiety Inventory (STAI). Results: The mean age of 34 patients participating in the study was 78.21(±6.67), and 61.8 % of the patients were women. The mean state anxiety scores of all patients were 45.5(±12.1) before the surgery, 36.4(±10.6) after the surgery. The anxiety experienced before the operation was moderate to high; and after the operation was lower. Conclusion: The patients were experiencing moderate to high and levels of anxiety. The factors affecting the state anxiety scores in the preoperative period were the age of the patient and the presence of chronic diseases. The factors affecting the stress of the patients in the pre- and post-TAVI period were subjective fear felt due to the stressful situation in the preoperative period were found to be age and the presence of chronic disease.
ORIGINAL RESEARCH ARTICLE | July 31, 2023
Fine-Needle Aspiration Biopsy of Pancreatic Masses: Failure Factors
S. Belabess, M. Salihoun, M. Acherki, N. Kabbaj
Page no 407-412 |
DOI: 10.36348/sjm.2023.v08i07.007
Objectives: The main objective of this work is to determine the factors affecting the failure rate of pancreatic aspiration cytology, in particular the size, location, and nature of the mass as well as the size of the needle, the aspiration site, the number of passages, and realization of Fanning. Materials and methods: This is a retrospective study conducted in the EFD-HGE department at Ibn Sina Hospital in Rabat from March 2017 to May 2023. 138 patients with a solid or cystic pancreatic mass on imaging were included. A video-linear Pentax-type echoendoscope was used with needles of different gauges: 19G, 20G, 22G, and 25G. Statistical analysis was performed using R software and the level of significance was set at p < 0.05. Results: The sex ratio F/M was 1.35. The average age was 59 years old. The average tumor size was 40.5 mm. Fine needle aspiration (FNA) under ultrasound-endoscopy (EUS) was positive in 70% of cases: adenocarcinoma in 60% of cases, chronic pancreatitis in 9.33% of cases, neuroendocrine tumor in 8% of cases, solid and pseudo-papillary tumor of the pancreas in 4% of cases, mucinous cystadenoma with low-grade (LGD) in 1.33% of the cases, an intraductal papillary mucinous neoplasm (IPMN) in 2.66% of the cases, pancreatic tuberculosis in 1.33% of the cases. Normal pancreatic parenchyma without signs of malignancy in 13.33% of the cases. The failure rate of pancreatic fine-needle aspiration was estimated at 30% of cases (inconclusive result). By univariate analysis, we demonstrated that the risk of having an inconclusive fine needle aspiration increases on the one hand by the location of the mass at the head of the pancreas (p = 0.02), the presence of a cystic component (p = 0.01), the infiltrating character of the mass (p = 0.01), and on the other hand by the absence of Fanning (p = 0.03). However, this study did not show a significant correlation with the other factors, in particular the size of the mass, the size of the needle, the site of fine-needle aspiration, and the number of passages. No complications were noted. Conclusion: The failure rate of fine-needle aspiration biopsy was 30%. We demonstrated that it increases by the location of the mass at the head of the pancreas (p = 0.02), the presence of a cystic component (p = 0.01), the infiltrating character of the mass (p = 0.01), and the absence of fanning. An additional study with a larger sample or a multicenter study seems necessary to confirm our results.