Pub Date : 2025-09-27DOI: 10.1016/j.glmedi.2025.100216
Mohammad Habibur Rahman
Despite international efforts to promote inclusive development, women with disabilities still face substantial employment barriers. Even though vocational rehabilitation (VR) programs are intended to be beneficial, gender disparities, continue to be a significant obstacle. In order to fill this gap, this study uses a mixed-methods scoping review in accordance with PRISMA-ScR guidelines. The researcher conducted a thorough search of four significant scholarly databases to identify research on gender, employment, and empowerment outcomes published between 2000 and 2025, Consistent trends were found in the review: women with disabilities faced numerous, interlocking obstacles, whereas men with disabilities consistently experienced higher employment rates, improved job retention, and higher income following VR. These included caregiving duties, limited career advancement, gender bias in hiring, and limited access to skills training, all of which contributed to underemployment and a decline in self-efficacy. The results show how urgently gender-sensitive VR tactics—like adaptable training plans and mentorship programs—as well as laws that correct systemic injustices are needed. Developing equitable VR frameworks will require expanding research in underrepresented regions and bolstering the evidence base with gender-disaggregated data. The review concludes that improving employment equity and empowering individuals with disabilities, especially women with disabilities requires VR to be transformed into a truly inclusive system.
{"title":"Gender disparities in vocational rehabilitation: A scoping review on employment and empowerment among persons with disabilities","authors":"Mohammad Habibur Rahman","doi":"10.1016/j.glmedi.2025.100216","DOIUrl":"10.1016/j.glmedi.2025.100216","url":null,"abstract":"<div><div>Despite international efforts to promote inclusive development, women with disabilities still face substantial employment barriers. Even though vocational rehabilitation (VR) programs are intended to be beneficial, gender disparities, continue to be a significant obstacle. In order to fill this gap, this study uses a mixed-methods scoping review in accordance with PRISMA-ScR guidelines. The researcher conducted a thorough search of four significant scholarly databases to identify research on gender, employment, and empowerment outcomes published between 2000 and 2025, Consistent trends were found in the review: women with disabilities faced numerous, interlocking obstacles, whereas men with disabilities consistently experienced higher employment rates, improved job retention, and higher income following VR. These included caregiving duties, limited career advancement, gender bias in hiring, and limited access to skills training, all of which contributed to underemployment and a decline in self-efficacy. The results show how urgently gender-sensitive VR tactics—like adaptable training plans and mentorship programs—as well as laws that correct systemic injustices are needed. Developing equitable VR frameworks will require expanding research in underrepresented regions and bolstering the evidence base with gender-disaggregated data. The review concludes that improving employment equity and empowering individuals with disabilities, especially women with disabilities requires VR to be transformed into a truly inclusive system.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"7 ","pages":"Article 100216"},"PeriodicalIF":0.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-19DOI: 10.1016/j.glmedi.2025.100215
Haleigh Pine , Kyrillos Ayoub , Amber Batra , Peter G. Delaney , Muwaga Hannington , Jacob Ssentamu , Maxwell C. Klapow , Nathanael J. Smith , Krishnan Raghavendran , Zachary J. Eisner
Introduction
Road traffic injuries (RTIs) are a leading contributor to the disproportionate global injury burden in low- and middle-income countries (LMICs). Emergency medical services (EMS) could address up to 45 % of RTI-related mortality, yet 91.3 % of the African population lacks EMS access. With WHO recommending lay first responder (LFR) training, evaluating longitudinal applications of LFR models is critical for sustainable prehospital care development. This study assessed the efficacy of a pilot LFR program in Mukono, Uganda, over six months, focusing on knowledge retention, training prioritization, and financial feasibility for scale-up.
Methods
A longitudinal cohort of 225 motorcycle taxi drivers completed a 5.5-hour modular first aid course in June 2022, delivered in English and Luganda using a training-of-trainers model. In January 2023, 133 participants (59.1 %) attended a refresher session. Knowledge was assessed pre- and post-training at both timepoints with a validated 25-question test. Wilcoxon tests examined knowledge acquisition and decay and a generalized linear mixed-effects model (GLMM) evaluated demographic predictors (time, education, age, income, dependents, prior experience). Real-world interventions were tracked via incident reports over six months, and costs were recorded to estimate scalability.
Results
Participants were all male, median age 30 years (IQR:25,35), with median five years of transportation provider experience (IQR:3,8). GLMM analysis indicated significant global effects for time, income, number of dependents, age, and education; however, pairwise comparisons of estimated marginal means revealed clear differences only for income (lowest vs. highest) and dependents (0 vs. 1–2 or 3–5). Age, education, and prior experience did not show significant pairwise differences. Knowledge scores improved significantly after initial training (pre-test: 33.4 %, post-test: 62.6 %; PPDI: 29.2 %, p < 0.001) and refresher training (pre-test: 46.3 %, post-test: 76.4 %; PPDI: 30.1 %, p < 0.001). Significant decay occurred between initial post-test and refresher pre-test (−16.3 %, p < 0.001), particularly in airway management. Refresher post-test scores exceeded initial post-test scores by 13.9 % (p < 0.001), indicating strong reinforcement. Forty-four responders (19.6 %) submitted 91 incident reports. RTIs comprised 61.5 % of cases, with 72.5 % transported by motorcycle. Lower extremity injuries were most common (51.6 %), and fracture splinting (37.4 %) and patient extrication (36.3 %) were the most frequent interventions. Program costs totaled $2888.31 USD ($12.84 per trainee), including first aid kits, venue, food, printing, and trainer stipends.
Conclusions
LFR participants demonstrate significant knowledge acquisition and decay, underscoring the need for regular refresher training, particularly in airway and
{"title":"Efficacy of a lay first responder program: Results from a pilot cohort in Uganda","authors":"Haleigh Pine , Kyrillos Ayoub , Amber Batra , Peter G. Delaney , Muwaga Hannington , Jacob Ssentamu , Maxwell C. Klapow , Nathanael J. Smith , Krishnan Raghavendran , Zachary J. Eisner","doi":"10.1016/j.glmedi.2025.100215","DOIUrl":"10.1016/j.glmedi.2025.100215","url":null,"abstract":"<div><h3>Introduction</h3><div>Road traffic injuries (RTIs) are a leading contributor to the disproportionate global injury burden in low- and middle-income countries (LMICs). Emergency medical services (EMS) could address up to 45 % of RTI-related mortality, yet 91.3 % of the African population lacks EMS access. With WHO recommending lay first responder (LFR) training, evaluating longitudinal applications of LFR models is critical for sustainable prehospital care development. This study assessed the efficacy of a pilot LFR program in Mukono, Uganda, over six months, focusing on knowledge retention, training prioritization, and financial feasibility for scale-up.</div></div><div><h3>Methods</h3><div>A longitudinal cohort of 225 motorcycle taxi drivers completed a 5.5-hour modular first aid course in June 2022, delivered in English and Luganda using a training-of-trainers model. In January 2023, 133 participants (59.1 %) attended a refresher session. Knowledge was assessed pre- and post-training at both timepoints with a validated 25-question test. Wilcoxon tests examined knowledge acquisition and decay and a generalized linear mixed-effects model (GLMM) evaluated demographic predictors (time, education, age, income, dependents, prior experience). Real-world interventions were tracked via incident reports over six months, and costs were recorded to estimate scalability.</div></div><div><h3>Results</h3><div>Participants were all male, median age 30 years (IQR:25,35), with median five years of transportation provider experience (IQR:3,8). GLMM analysis indicated significant global effects for time, income, number of dependents, age, and education; however, pairwise comparisons of estimated marginal means revealed clear differences only for income (lowest vs. highest) and dependents (0 vs. 1–2 or 3–5). Age, education, and prior experience did not show significant pairwise differences. Knowledge scores improved significantly after initial training (pre-test: 33.4 %, post-test: 62.6 %; PPDI: 29.2 %, p < 0.001) and refresher training (pre-test: 46.3 %, post-test: 76.4 %; PPDI: 30.1 %, p < 0.001). Significant decay occurred between initial post-test and refresher pre-test (−16.3 %, p < 0.001), particularly in airway management. Refresher post-test scores exceeded initial post-test scores by 13.9 % (p < 0.001), indicating strong reinforcement. Forty-four responders (19.6 %) submitted 91 incident reports. RTIs comprised 61.5 % of cases, with 72.5 % transported by motorcycle. Lower extremity injuries were most common (51.6 %), and fracture splinting (37.4 %) and patient extrication (36.3 %) were the most frequent interventions. Program costs totaled $2888.31 USD ($12.84 per trainee), including first aid kits, venue, food, printing, and trainer stipends.</div></div><div><h3>Conclusions</h3><div>LFR participants demonstrate significant knowledge acquisition and decay, underscoring the need for regular refresher training, particularly in airway and","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"7 ","pages":"Article 100215"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-11DOI: 10.1016/j.glmedi.2025.100214
Maryam Tariq , Muhammad Hussain Azhar , Kaleem ullah , Laveeza Fatima , Abdulqadir J. Nashwan
Acute lymphoblastic leukemia (ALL) is a cancer of lymphoid precursor cells, commonly affecting children. Symptoms include fever, pallor, bruising, and organ enlargement. Five-year survival rates exceed 85 %, though relapse outcomes are poor. Diagnosis involves bone marrow examination and flow cytometry. Treatments include steroids and chemotherapy. A 14-year-old Asian boy presented with fatigue, jaundice, pallor, and low-grade fever. He had no history of infections or any comorbidities. Initial labs showed pancytopenia, prompting admission. Examination revealed cervical lymphadenopathy, pallor, jaundice, and bicytopenia. Over the course of the hospital stay, further tests ruled out liver disease, Hepatitis, and HIV. Bone marrow-related causes such as aplastic anemia, myelofibrosis, and lymphoproliferative/myelodysplastic disorders were excluded based on CBC, peripheral film, and bone marrow aspiration results. Eventually, flow cytometry confirmed precursor B-cell acute lymphoblastic leukemia (ALL). Despite treatment, the patient succumbed to hypovolemic shock following severe hematemesis. This case highlights the importance of considering the genetic profile in diagnosis, as relying solely on CBC, peripheral smear, and bone marrow biopsy may not be sufficient to rule out conditions like ALL, which can mimic autoimmune hemolytic diseases.
{"title":"Acute lymphoblastic leukemia mimicking evan syndrome: A case report with review of literature","authors":"Maryam Tariq , Muhammad Hussain Azhar , Kaleem ullah , Laveeza Fatima , Abdulqadir J. Nashwan","doi":"10.1016/j.glmedi.2025.100214","DOIUrl":"10.1016/j.glmedi.2025.100214","url":null,"abstract":"<div><div>Acute lymphoblastic leukemia (ALL) is a cancer of lymphoid precursor cells, commonly affecting children. Symptoms include fever, pallor, bruising, and organ enlargement. Five-year survival rates exceed 85 %, though relapse outcomes are poor. Diagnosis involves bone marrow examination and flow cytometry. Treatments include steroids and chemotherapy. A 14-year-old Asian boy presented with fatigue, jaundice, pallor, and low-grade fever. He had no history of infections or any comorbidities. Initial labs showed pancytopenia, prompting admission. Examination revealed cervical lymphadenopathy, pallor, jaundice, and bicytopenia. Over the course of the hospital stay, further tests ruled out liver disease, Hepatitis, and HIV. Bone marrow-related causes such as aplastic anemia, myelofibrosis, and lymphoproliferative/myelodysplastic disorders were excluded based on CBC, peripheral film, and bone marrow aspiration results. Eventually, flow cytometry confirmed precursor B-cell acute lymphoblastic leukemia (ALL). Despite treatment, the patient succumbed to hypovolemic shock following severe hematemesis. This case highlights the importance of considering the genetic profile in diagnosis, as relying solely on CBC, peripheral smear, and bone marrow biopsy may not be sufficient to rule out conditions like ALL, which can mimic autoimmune hemolytic diseases.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"7 ","pages":"Article 100214"},"PeriodicalIF":0.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-25DOI: 10.1016/j.glmedi.2025.100213
R. Andrew Yockey
Severe mental illness (SMI) and co-occurring substance use disorders (SUDs) continue to pose a major global health challenge, contributing to high rates of mortality, disability, and economic strain. Ibogaine, a naturally occurring psychoactive compound derived from the Tabernanthe iboga plant, has shown promise in easing withdrawal symptoms, reducing cravings, and improving psychiatric symptoms linked to addiction. While early observational studies and a growing number of clinical trials are encouraging, concerns about safety—particularly its impact on heart function, such as QT interval prolongation and the risk of life-threatening arrhythmias—have limited its broader clinical use. Moving forward, key research priorities include conducting large-scale randomized controlled trials with personalized dosing strategies, developing safer synthetic alternatives, investigating the drug’s underlying neurobiological effects, and tracking long-term outcomes. Closing these gaps is crucial to fully understand and safely harness ibogaine’s potential for treating SMI and SUDs.
{"title":"Reconsidering Ibogaine for the treatment of severe mental illness and substance use disorders","authors":"R. Andrew Yockey","doi":"10.1016/j.glmedi.2025.100213","DOIUrl":"10.1016/j.glmedi.2025.100213","url":null,"abstract":"<div><div>Severe mental illness (SMI) and co-occurring substance use disorders (SUDs) continue to pose a major global health challenge, contributing to high rates of mortality, disability, and economic strain. Ibogaine, a naturally occurring psychoactive compound derived from the <em>Tabernanthe iboga</em> plant, has shown promise in easing withdrawal symptoms, reducing cravings, and improving psychiatric symptoms linked to addiction. While early observational studies and a growing number of clinical trials are encouraging, concerns about safety—particularly its impact on heart function, such as QT interval prolongation and the risk of life-threatening arrhythmias—have limited its broader clinical use. Moving forward, key research priorities include conducting large-scale randomized controlled trials with personalized dosing strategies, developing safer synthetic alternatives, investigating the drug’s underlying neurobiological effects, and tracking long-term outcomes. Closing these gaps is crucial to fully understand and safely harness ibogaine’s potential for treating SMI and SUDs.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"7 ","pages":"Article 100213"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-09DOI: 10.1016/j.glmedi.2025.100212
Guillaume Tcheutchoua Soh , Abdourahmane Ndong, Armel Franck Tene Nde, Jacques Noel Tendeng, Philippe Manyacka Ma Nyemb, Ibrahima Konate
Acute appendicitis is a frequent abdominal emergency and has a well-codified management. Its symptoms depend on the caeco-appendicular anatomy and the stage of the disease. In a subhepatic position, appendicitis poses a diagnostic and therapeutic problem. We report three paediatric patients, a 9-year-old boy and two 15-year-old girls, admitted with atypical acute abdominal pain. Ultrasound showed appendicitis in the two girls, but failed to conclude on the subhepatic position of appendicitis. In the boy, his computed tomography (CT) of the abdomen showed a subhepatic mass. The final diagnosis was acute subhepatic appendicitis for all the patients. All the patients were managed by open surgery. The first patient was initially managed via laparoscopic surgery but difficulties visualizing the appendix due to adhesions motivated a conversion. The postoperative course was uneventful for two patients and complicated by retroperitoneal abscess for one patient who was hospitalised for 10 days. Subhepatic location of appendicitis causes diagnostic delay and additional morbidity. The young age of the patient, the delay of the diagnostic and therapeutic resources available may contribute to greater difficulty managing this condition.
{"title":"Peculiarities of diagnosis and management for subhepatic appendicitis","authors":"Guillaume Tcheutchoua Soh , Abdourahmane Ndong, Armel Franck Tene Nde, Jacques Noel Tendeng, Philippe Manyacka Ma Nyemb, Ibrahima Konate","doi":"10.1016/j.glmedi.2025.100212","DOIUrl":"10.1016/j.glmedi.2025.100212","url":null,"abstract":"<div><div>Acute appendicitis is a frequent abdominal emergency and has a well-codified management. Its symptoms depend on the caeco-appendicular anatomy and the stage of the disease. In a subhepatic position, appendicitis poses a diagnostic and therapeutic problem. We report three paediatric patients, a 9-year-old boy and two 15-year-old girls, admitted with atypical acute abdominal pain. Ultrasound showed appendicitis in the two girls, but failed to conclude on the subhepatic position of appendicitis. In the boy, his computed tomography (CT) of the abdomen showed a subhepatic mass. The final diagnosis was acute subhepatic appendicitis for all the patients. All the patients were managed by open surgery. The first patient was initially managed via laparoscopic surgery but difficulties visualizing the appendix due to adhesions motivated a conversion. The postoperative course was uneventful for two patients and complicated by retroperitoneal abscess for one patient who was hospitalised for 10 days. Subhepatic location of appendicitis causes diagnostic delay and additional morbidity. The young age of the patient, the delay of the diagnostic and therapeutic resources available may contribute to greater difficulty managing this condition.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"7 ","pages":"Article 100212"},"PeriodicalIF":0.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic kidney disease (CKD) is becoming a significant area of concern in sub-Saharan Africa, as it is increasing in prevalence rates, deaths and has substantial economic and health costs. Even with the progress made in infectious disease control, CKD poses a danger of undoing health and economic progress, especially as the region grapples with weak health systems and limited resources. This is further burdened by the lack of standardized diagnostic criteria, weak epidemiological data, and inadequate recognition of CKD in primary care, which leads to late identification and unfavorable outcomes. There is an extreme economic burden as the cost of treatment is very high compared to average incomes, and out-of-pocket expenses are usually catastrophic. There is poor healthcare infrastructure, such as nephrology workforce, and dialysis capacity, which have contributed to health disparities, particularly in rural regions. Health policies at the national level rarely give priority to CKD, which also reduces access to healthcare and financial security. These challenges can only be solved through coordinated policy efforts, enhanced data systems, early detection policies, and the need to integrate the management of CKD with primary care.
{"title":"The public health impacts of chronic kidney disease in Sub-Saharan Africa: A call for action","authors":"Biruk Demisse Ayalew, Zemichael Getu Alemayehu, Yoseph Getu Tamrie, Bereket Alemayehu Admasu, Abenezer Shiferaw Keraga, Henok Wolde Nida, Temesgen Mamo Sharew, Brook Lelisa Sime, Yonatan Abbawa Zewdie, Yared Mezemir Tiruneh, Nathan Jibat","doi":"10.1016/j.glmedi.2025.100209","DOIUrl":"10.1016/j.glmedi.2025.100209","url":null,"abstract":"<div><div>Chronic kidney disease (CKD) is becoming a significant area of concern in sub-Saharan Africa, as it is increasing in prevalence rates, deaths and has substantial economic and health costs. Even with the progress made in infectious disease control, CKD poses a danger of undoing health and economic progress, especially as the region grapples with weak health systems and limited resources. This is further burdened by the lack of standardized diagnostic criteria, weak epidemiological data, and inadequate recognition of CKD in primary care, which leads to late identification and unfavorable outcomes. There is an extreme economic burden as the cost of treatment is very high compared to average incomes, and out-of-pocket expenses are usually catastrophic. There is poor healthcare infrastructure, such as nephrology workforce, and dialysis capacity, which have contributed to health disparities, particularly in rural regions. Health policies at the national level rarely give priority to CKD, which also reduces access to healthcare and financial security. These challenges can only be solved through coordinated policy efforts, enhanced data systems, early detection policies, and the need to integrate the management of CKD with primary care.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"7 ","pages":"Article 100209"},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-04DOI: 10.1016/j.glmedi.2025.100208
Osman M. Osman , Suaad Abdalla Abdu Seneen , Musab Hamed Ahmed Hamed , Abubker Elamin Mohamed Abdalla , Nazzar Atta Doka Aboali , Doaa Siralkhatim Mohamed Ahmed
Lumbar hernia is a rare condition characterized by protrusion of retroperitoneal contents through a defect in the posterolateral abdominal wall, with fewer than 400 cases reported. Bilateral lumbar hernia is exceedingly rare, and recurrence following surgical repair is even more uncommon. We report a case of a 44-year-old male laborer with recurrent bilateral lumbar hernia who initially presented with bilateral reducible lumbar swellings which were successfully diagnosed as bilateral lumbar hernia and underwent surgical repair using mesh reinforcement. The hernias recurred four months postoperatively, and the patient presented again 2.5 years later. This time, he also experienced lumbosacral back pain with radiation to the right foot. Clinical examination and imaging, including ultrasound and CT scan, confirmed bilateral lumbar hernia recurrence. The patient declined further surgical intervention, opting for conservative management. MRI of the spine also revealed L4/L5 and L5/S1 disc herniations, and a Tarlov cyst. This case highlights the diagnostic and management challenges posed by recurrent bilateral lumbar hernia, particularly in resource-constrained settings. It also highlights the potential coexistence of unrelated spinal pathology, which may complicate symptom interpretation. We review the existing literature and discuss potential risk factors for recurrence, including suboptimal mesh fixation, and the importance of individualized surgical planning. Awareness of this rare condition is crucial for prompt diagnosis and appropriate management.
{"title":"Recurrent bilateral lumbar hernia, a case report and literature review","authors":"Osman M. Osman , Suaad Abdalla Abdu Seneen , Musab Hamed Ahmed Hamed , Abubker Elamin Mohamed Abdalla , Nazzar Atta Doka Aboali , Doaa Siralkhatim Mohamed Ahmed","doi":"10.1016/j.glmedi.2025.100208","DOIUrl":"10.1016/j.glmedi.2025.100208","url":null,"abstract":"<div><div>Lumbar hernia is a rare condition characterized by protrusion of retroperitoneal contents through a defect in the posterolateral abdominal wall, with fewer than 400 cases reported. Bilateral lumbar hernia is exceedingly rare, and recurrence following surgical repair is even more uncommon. We report a case of a 44-year-old male laborer with recurrent bilateral lumbar hernia who initially presented with bilateral reducible lumbar swellings which were successfully diagnosed as bilateral lumbar hernia and underwent surgical repair using mesh reinforcement. The hernias recurred four months postoperatively, and the patient presented again 2.5 years later. This time, he also experienced lumbosacral back pain with radiation to the right foot. Clinical examination and imaging, including ultrasound and CT scan, confirmed bilateral lumbar hernia recurrence. The patient declined further surgical intervention, opting for conservative management. MRI of the spine also revealed L4/L5 and L5/S1 disc herniations, and a Tarlov cyst. This case highlights the diagnostic and management challenges posed by recurrent bilateral lumbar hernia, particularly in resource-constrained settings. It also highlights the potential coexistence of unrelated spinal pathology, which may complicate symptom interpretation. We review the existing literature and discuss potential risk factors for recurrence, including suboptimal mesh fixation, and the importance of individualized surgical planning. Awareness of this rare condition is crucial for prompt diagnosis and appropriate management.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"7 ","pages":"Article 100208"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144572792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-25DOI: 10.1016/j.glmedi.2025.100205
Nilesh Kumar
Pterygium excision with conjunctival autografting is the preferred surgical approach for preventing recurrence. However, the ideal method for graft fixation remains debatable. This study describes a novel technique using hemocoagulase (Botropase) for conjunctival autograft fixation in pterygium surgery. Botropase, derived from snake venom, facilitates fibrin matrix formation at the graft-host interface without the drawbacks of traditional methods. Our initial series demonstrated a mean surgical time of 18.3 min, significantly shorter than sutured techniques (32.42 min) and comparable to fibrin glue (20.17 min). The procedure showed excellent graft stability with minimal complications and no recurrences during the follow-up period. At approximately 3 USD per vial, Botropase offers a 95 % cost reduction compared to fibrin glue, making it particularly valuable for high-volume centers and developing economies. This technique represents a promising advancement in pterygium surgery by combining the precision of fibrin glue with the affordability of autologous blood while mitigating their respective limitations.
{"title":"Botropase optimized conjunctival tissue grafting (BOT-Graft): Bridging efficacy, safety, and affordability in primary Pterygium surgery","authors":"Nilesh Kumar","doi":"10.1016/j.glmedi.2025.100205","DOIUrl":"10.1016/j.glmedi.2025.100205","url":null,"abstract":"<div><div>Pterygium excision with conjunctival autografting is the preferred surgical approach for preventing recurrence. However, the ideal method for graft fixation remains debatable. This study describes a novel technique using hemocoagulase (Botropase) for conjunctival autograft fixation in pterygium surgery. Botropase, derived from snake venom, facilitates fibrin matrix formation at the graft-host interface without the drawbacks of traditional methods. Our initial series demonstrated a mean surgical time of 18.3 min, significantly shorter than sutured techniques (32.42 min) and comparable to fibrin glue (20.17 min). The procedure showed excellent graft stability with minimal complications and no recurrences during the follow-up period. At approximately 3 USD per vial, Botropase offers a 95 % cost reduction compared to fibrin glue, making it particularly valuable for high-volume centers and developing economies. This technique represents a promising advancement in pterygium surgery by combining the precision of fibrin glue with the affordability of autologous blood while mitigating their respective limitations.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"7 ","pages":"Article 100205"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-25DOI: 10.1016/j.glmedi.2025.100206
Muhammad Umar , Shahzeb Ali , Muhammad Farrukh Siddiqui , Almas Zafar , Saba Zaidi
Acute necrotizing encephalopathy (ANE) is a rare, rapidly progressive encephalopathy most commonly described in pediatric populations, with adult-onset cases being exceedingly rare. We report a case of a 24-year-old previously healthy male who developed ANE following a prodromal febrile diarrheal illness. The patient initially presented with generalized seizures and altered mental status, progressing rapidly to coma and requiring mechanical ventilation. Brain magnetic resonance imaging (MRI) demonstrated characteristic bilateral symmetrical T2 hyperintensities in the thalami, basal ganglia, brainstem, and cerebellum—findings strongly indicative of ANE. Despite early and aggressive treatment with high-dose corticosteroids, plasmapheresis, and intravenous immunoglobulins, the patient’s clinical course was complicated by refractory seizures and the onset of multidrug-resistant ventilator-associated pneumonia. Prolonged sedation, tracheostomy, and broad-spectrum antimicrobial therapy were necessary for ongoing management. Ultimately, the patient suffered persistent neurological deficits. This case underscores the diagnostic challenges of ANE in adults. It highlights the need for early recognition, multidisciplinary intervention, and vigilance for secondary complications to improve outcomes in this rare but severe encephalopathy.
{"title":"Adult-onset acute necrotizing encephalopathy following febrile diarrheal illness","authors":"Muhammad Umar , Shahzeb Ali , Muhammad Farrukh Siddiqui , Almas Zafar , Saba Zaidi","doi":"10.1016/j.glmedi.2025.100206","DOIUrl":"10.1016/j.glmedi.2025.100206","url":null,"abstract":"<div><div>Acute necrotizing encephalopathy (ANE) is a rare, rapidly progressive encephalopathy most commonly described in pediatric populations, with adult-onset cases being exceedingly rare. We report a case of a 24-year-old previously healthy male who developed ANE following a prodromal febrile diarrheal illness. The patient initially presented with generalized seizures and altered mental status, progressing rapidly to coma and requiring mechanical ventilation. Brain magnetic resonance imaging (MRI) demonstrated characteristic bilateral symmetrical T2 hyperintensities in the thalami, basal ganglia, brainstem, and cerebellum—findings strongly indicative of ANE. Despite early and aggressive treatment with high-dose corticosteroids, plasmapheresis, and intravenous immunoglobulins, the patient’s clinical course was complicated by refractory seizures and the onset of multidrug-resistant ventilator-associated pneumonia. Prolonged sedation, tracheostomy, and broad-spectrum antimicrobial therapy were necessary for ongoing management. Ultimately, the patient suffered persistent neurological deficits. This case underscores the diagnostic challenges of ANE in adults. It highlights the need for early recognition, multidisciplinary intervention, and vigilance for secondary complications to improve outcomes in this rare but severe encephalopathy.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"7 ","pages":"Article 100206"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144866479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dementia is becoming a major public health problem in Sub-Saharan Africa (SSA), with prevalence increasing due to demographic transitions, increasing life expectancy, and increasing prevalence of non-communicable diseases. This commentary synthesizes the latest data on the epidemiology, risk factors, public perception, and management approaches for dementia in SSA, noting that although worldwide rates of dementia are increasing, SSA will experience the highest growth, which, with the current rate of increase, is projected to triple by 2050. SSA prevalence rates vary widely from 2.3 % to as high as 20 %, predominantly because of methodological discrepancies, lack of identification, and limited access to medical care. Incidence figures are also weak and mostly restricted to a few countries, thus potentially underestimating the true regional burden. The identified risk factors include age, gender, low educational attainment, untreated hypertension, diabetes, infectious diseases, including causes of HIV and cerebral malaria, and specific genetic predispositions, with low educational status being the most powerful modifiable factor. Stigma and misconceptions often delay diagnosis and contribute to under-reporting, compounding the burden on affected families. The sub-optimal healthcare system, lack of culturally appropriate diagnostics, and national fragmentation of epidemiological data make the situation of SSA more complex. The commentary emphasizes the importance of raising awareness, data collection method refinement, and culturally informed approaches to guide policy-making, promote research, and enhance the prevention and management of dementia in SSA, to develop locally-suited interventions to address the growing dementia epidemic.
{"title":"Dementia in Sub-Saharan Africa: Risk factors, public perception, and management approaches","authors":"Zemichael Getu Alemayehu , Biruk Demisse Ayalew , Brook Lelisa Sime , Tsimona Dinku Bonger , Yonatan Abbawa Zewdie , Abenezer Shiferaw Keraga , Henok Wolde Nida , Temesgen Mamo Sharew , Beamlak Getachew Woldeselassie , Mateyas Yohannes Melaku , Biniyam Alemayehu Ayele","doi":"10.1016/j.glmedi.2025.100204","DOIUrl":"10.1016/j.glmedi.2025.100204","url":null,"abstract":"<div><div>Dementia is becoming a major public health problem in Sub-Saharan Africa (SSA), with prevalence increasing due to demographic transitions, increasing life expectancy, and increasing prevalence of non-communicable diseases. This commentary synthesizes the latest data on the epidemiology, risk factors, public perception, and management approaches for dementia in SSA, noting that although worldwide rates of dementia are increasing, SSA will experience the highest growth, which, with the current rate of increase, is projected to triple by 2050. SSA prevalence rates vary widely from 2.3 % to as high as 20 %, predominantly because of methodological discrepancies, lack of identification, and limited access to medical care. Incidence figures are also weak and mostly restricted to a few countries, thus potentially underestimating the true regional burden. The identified risk factors include age, gender, low educational attainment, untreated hypertension, diabetes, infectious diseases, including causes of HIV and cerebral malaria, and specific genetic predispositions, with low educational status being the most powerful modifiable factor. Stigma and misconceptions often delay diagnosis and contribute to under-reporting, compounding the burden on affected families. The sub-optimal healthcare system, lack of culturally appropriate diagnostics, and national fragmentation of epidemiological data make the situation of SSA more complex. The commentary emphasizes the importance of raising awareness, data collection method refinement, and culturally informed approaches to guide policy-making, promote research, and enhance the prevention and management of dementia in SSA, to develop locally-suited interventions to address the growing dementia epidemic.</div></div>","PeriodicalId":100804,"journal":{"name":"Journal of Medicine, Surgery, and Public Health","volume":"7 ","pages":"Article 100204"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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