Pub Date : 2023-08-14DOI: 10.24018/ejmed.2023.5.4.1817
Anmol Narang, L. Arora, Reena Arora
Objective: To compare the effects of Motor Relearning Programme and Mirror Therapy on upper extremity functions in Post-Stroke patients.Design: Parallel group, randomized controlled trial.Settings: The present research investigation was carried out in the outpatient department (OPD) of the University College of Physiotherapy in Faridkot, as well as in the IPD and OPD of the Department of Neurology and Neurosurgery of Guru Gobind Singh Medical College and Hospital in Faridkot, Punjab.Methods: A total of 45 post-stroke patients with upper limb disability were divided randomly into three equal groups comprises 15 patients each. Group A received Motor Relearning Programme (MRP) along with Conventional Physiotherapy (CPT), whereas Group B received Mirror Therapy (MT) along with CPT and Group C received CPT only. The total duration of intervention was 1 hour per session and frequency of 8 weeks, with 5 sessions per week.Main Outcome Measures: The outcome measures included were Motor Assessment Scale (MAS), Chedoke Arm And Hand Activity Inventory Scale (CAHAI), Fugl Meyer Assessment of physical performance of Upper Extremity (FMA-UE) Scale.Results: The present study revealed that all the parameters within the groups had significantly improved in the pre-intervention analysis. However, postintervention scores of all the parameters of Group A revealed considerable high improvement at a significant level of (p < 0.0001) when compared to the other two groups i.e., Group B and Group C.Conclusion: In light of the study’s findings, it is concluded that the MRP along with CPT is more effective than MT along with CPT and CPT alone.
{"title":"Comparison of Effects of Motor Relearning Programme and Mirror Therapy on Upper Extremity Functions in Post-Stroke Patients–A Randomized Control Trial","authors":"Anmol Narang, L. Arora, Reena Arora","doi":"10.24018/ejmed.2023.5.4.1817","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.4.1817","url":null,"abstract":"Objective: To compare the effects of Motor Relearning Programme and Mirror Therapy on upper extremity functions in Post-Stroke patients.Design: Parallel group, randomized controlled trial.Settings: The present research investigation was carried out in the outpatient department (OPD) of the University College of Physiotherapy in Faridkot, as well as in the IPD and OPD of the Department of Neurology and Neurosurgery of Guru Gobind Singh Medical College and Hospital in Faridkot, Punjab.Methods: A total of 45 post-stroke patients with upper limb disability were divided randomly into three equal groups comprises 15 patients each. Group A received Motor Relearning Programme (MRP) along with Conventional Physiotherapy (CPT), whereas Group B received Mirror Therapy (MT) along with CPT and Group C received CPT only. The total duration of intervention was 1 hour per session and frequency of 8 weeks, with 5 sessions per week.Main Outcome Measures: The outcome measures included were Motor Assessment Scale (MAS), Chedoke Arm And Hand Activity Inventory Scale (CAHAI), Fugl Meyer Assessment of physical performance of Upper Extremity (FMA-UE) Scale.Results: The present study revealed that all the parameters within the groups had significantly improved in the pre-intervention analysis. However, postintervention scores of all the parameters of Group A revealed considerable high improvement at a significant level of (p < 0.0001) when compared to the other two groups i.e., Group B and Group C.Conclusion: In light of the study’s findings, it is concluded that the MRP along with CPT is more effective than MT along with CPT and CPT alone.","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131415480","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 : 2023-08-11DOI: 10.24018/ejmed.2023.5.4.1857
Jihad Echnin, Mohamed Daghi, A. Laaidi, Henri Malaizé, A. Nouet, A. Carpentier, A. Lakhdar
Introduction: The simultaneous occurrence of ependymoma and glioblastoma in a single patient is an exceptionally rare phenomenon, with limited documented cases in the medical literature.Case Report: This article presents a compelling case study of a 53-yearold female who sequentially developed these two distinct primary brain tumors. The patient initially underwent neurosurgery for a subependymoma in 2010 and later presented with motor and sensory symptoms, leading to the diagnosis of glioblastoma. A diagnostic stereotactic brain biopsy confirmed the presence of a high-grade oligodendroglioma. Despite postoperative complications, the patient’s recovery has been favorable with no epileptic recurrence. The discussion highlights the distinct molecular and clinical heterogeneity of ependymoma and glioblastoma and the lack of reported cases featuring their consecutive occurrence. The underlying mechanisms behind such occurrences remain poorly understood and warrant further investigation.Conclusion: This case underscores the importance of deepening our comprehension of consecutive primary brain tumors to optimize diagnosis, treatment planning, and patient outcomes.
{"title":"Consecutive Development of Ependymoma and Glioblastoma in a Single Patient: A Case Report","authors":"Jihad Echnin, Mohamed Daghi, A. Laaidi, Henri Malaizé, A. Nouet, A. Carpentier, A. Lakhdar","doi":"10.24018/ejmed.2023.5.4.1857","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.4.1857","url":null,"abstract":"Introduction: The simultaneous occurrence of ependymoma and glioblastoma in a single patient is an exceptionally rare phenomenon, with limited documented cases in the medical literature.Case Report: This article presents a compelling case study of a 53-yearold female who sequentially developed these two distinct primary brain tumors. The patient initially underwent neurosurgery for a subependymoma in 2010 and later presented with motor and sensory symptoms, leading to the diagnosis of glioblastoma. A diagnostic stereotactic brain biopsy confirmed the presence of a high-grade oligodendroglioma. Despite postoperative complications, the patient’s recovery has been favorable with no epileptic recurrence. The discussion highlights the distinct molecular and clinical heterogeneity of ependymoma and glioblastoma and the lack of reported cases featuring their consecutive occurrence. The underlying mechanisms behind such occurrences remain poorly understood and warrant further investigation.Conclusion: This case underscores the importance of deepening our comprehension of consecutive primary brain tumors to optimize diagnosis, treatment planning, and patient outcomes.","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"119 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124377735","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 : 2023-08-06DOI: 10.34104/ejmhs.023.086092
Radiation therapy is a widely used cancer treatment that utilizes high-energy radiation to target and destroy cancer cells. However, challenges such as resistance to radiation and exposure of healthy tissue to the radiation can limit its effectiveness. In this article, we explore various methods that have been developed to increase the effectiveness of radiation therapy in cancer treatment. These methods include fractionation, image-guided radiation therapy (IGRT), radio sensitizers, hyper fractionation, and immunotherapy. By using these techniques, healthcare professionals can precisely target cancer cells while minimizing damage to healthy tissue. Understanding these methods and their benefits can lead to the development of more effective treatment plans for cancer patients. This article provides insights into how to optimize radiation therapy for improved outcomes in cancer treatment.
{"title":"Methods of increasing the Effectiveness of Radiotherapy in Destroying Cancer Cells","authors":"","doi":"10.34104/ejmhs.023.086092","DOIUrl":"https://doi.org/10.34104/ejmhs.023.086092","url":null,"abstract":"Radiation therapy is a widely used cancer treatment that utilizes high-energy radiation to target and destroy cancer cells. However, challenges such as resistance to radiation and exposure of healthy tissue to the radiation can limit its effectiveness. In this article, we explore various methods that have been developed to increase the effectiveness of radiation therapy in cancer treatment. These methods include fractionation, image-guided radiation therapy (IGRT), radio sensitizers, hyper fractionation, and immunotherapy. By using these techniques, healthcare professionals can precisely target cancer cells while minimizing damage to healthy tissue. Understanding these methods and their benefits can lead to the development of more effective treatment plans for cancer patients. This article provides insights into how to optimize radiation therapy for improved outcomes in cancer treatment.","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116950214","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 : 2023-08-01DOI: 10.24018/ejmed.2023.5.4.1872
S. Ito, T. Koike, Yoshio Matsushige, Koji Takasugi, S. Kato
Heart failure (HF) with preserved ejection function (HFpEF) has a high prevalence in older adults. HF in the elderly tends to be complicated by renal failure and anemia, known as cardio-renal anemia syndrome (CRAS), with each pathology adversely affecting the other, leading to a negative spiral. The temporal evolution from the onset of HFpEF in CRAS is not well understood. We experienced an elderly case in which the initial onset of CRAS was followed by repeated exacerbations with HFpEF. Multiple medications, including a sodium-glucose cotransporter-2 inhibitor and an angiotensin receptor neprilysin inhibitor, were effective in conjunction with extensive cardiac rehabilitation. Our case highlights the difficulty of treating HFpEF with CRAS.
{"title":"Fluctuation of Heart Failure with Preserved Ejection Fraction During the Course of Cardiorenal Anemia Syndrome: A Case Report","authors":"S. Ito, T. Koike, Yoshio Matsushige, Koji Takasugi, S. Kato","doi":"10.24018/ejmed.2023.5.4.1872","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.4.1872","url":null,"abstract":"Heart failure (HF) with preserved ejection function (HFpEF) has a high prevalence in older adults. HF in the elderly tends to be complicated by renal failure and anemia, known as cardio-renal anemia syndrome (CRAS), with each pathology adversely affecting the other, leading to a negative spiral. The temporal evolution from the onset of HFpEF in CRAS is not well understood. We experienced an elderly case in which the initial onset of CRAS was followed by repeated exacerbations with HFpEF. Multiple medications, including a sodium-glucose cotransporter-2 inhibitor and an angiotensin receptor neprilysin inhibitor, were effective in conjunction with extensive cardiac rehabilitation. Our case highlights the difficulty of treating HFpEF with CRAS.","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116581117","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 : 2023-07-29DOI: 10.24018/ejmed.2023.5.4.1865
M. Bolarinwa, A. O. Kumapayi
Educators often spend a lot of time carrying out repetitive motions of the upper limbs and prolonged standing on a daily basis, exposing them to hours of ergonomic risks. This is due to awkward postures, caused by significant deviation of some major body members from the normal neutral positions. Poor ergonomics can lead to various Musculoskeletal Disorders (MSDs), which are of serious concern for workplace safety, especially in jobs that require repetitive motions. It thus became necessary to assess the stress level associated with teaching postures and the prevalent musculoskeletal discomfort in different parts of the body. In this study, ergonomic assessment of teaching personnel at an International Secondary School and University of Ibadan, Nigeria was conducted to determine the prevalent musculoskeletal discomfort in different parts of the body. The study utilised two ergonomic assessment tools- Rapid Entire Body Assessment (REBA) and Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) to gather qualitative and quantitative data about posture and motions during teaching activities. It was discovered that both university lecturers and secondary school teachers in Nigeria face significant ergonomic risks, primarily in the neck, shoulders, and lower back. Further comparison revealed that educators in the secondary school experienced higher severity of musculoskeletal discomfort and exposure to MSD risks, compared to those in the tertiary institution. The educators of the International School had an average REBA score of 4.57, while those at the University of Ibadan had a score of 3.73. These scores indicated a medium level of MSD risk for both groups, but the educators of the International School were at a higher risk. On comparing the CMDQ outcome, it was discovered that there were major differences in the regions where discomforts were reported. While secondary school revealed higher average scores in the neck, right shoulder, and left shoulder regions, and with the neck region having a mean score of 7.003; right shoulder having a mean score of 4.550; and left shoulder having a mean score of 1.600; outcome from University of Ibadan revealed higher mean scores in the lower back and left wrist regions, with the lower back region having a mean score of 7.450 and left wrist region having a mean score of 1.030. These scores indicated a mild to moderate level of discomfort for both groups, with each facing major discomfort in unique body regions. This research highlights the significance of ergonomic evaluation and the combination of quantitative and qualitative data to identify potential interventions.
{"title":"Ergonomic Risk Assessment of Nigerian Teaching Personnel: Cases of a Secondary School and a Tertiary Institution in Ibadan, Nigeria","authors":"M. Bolarinwa, A. O. Kumapayi","doi":"10.24018/ejmed.2023.5.4.1865","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.4.1865","url":null,"abstract":"\u0000Educators often spend a lot of time carrying out repetitive motions of the upper limbs and prolonged standing on a daily basis, exposing them to hours of ergonomic risks. This is due to awkward postures, caused by significant deviation of some major body members from the normal neutral positions. Poor ergonomics can lead to various Musculoskeletal Disorders (MSDs), which are of serious concern for workplace safety, especially in jobs that require repetitive motions. It thus became necessary to assess the stress level associated with teaching postures and the prevalent musculoskeletal discomfort in different parts of the body. In this study, ergonomic assessment of teaching personnel at an International Secondary School and University of Ibadan, Nigeria was conducted to determine the prevalent musculoskeletal discomfort in different parts of the body. The study utilised two ergonomic assessment tools- Rapid Entire Body Assessment (REBA) and Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) to gather qualitative and quantitative data about posture and motions during teaching activities. It was discovered that both university lecturers and secondary school teachers in Nigeria face significant ergonomic risks, primarily in the neck, shoulders, and lower back. Further comparison revealed that educators in the secondary school experienced higher severity of musculoskeletal discomfort and exposure to MSD risks, compared to those in the tertiary institution. The educators of the International School had an average REBA score of 4.57, while those at the University of Ibadan had a score of 3.73. These scores indicated a medium level of MSD risk for both groups, but the educators of the International School were at a higher risk. On comparing the CMDQ outcome, it was discovered that there were major differences in the regions where discomforts were reported. While secondary school revealed higher average scores in the neck, right shoulder, and left shoulder regions, and with the neck region having a mean score of 7.003; right shoulder having a mean score of 4.550; and left shoulder having a mean score of 1.600; outcome from University of Ibadan revealed higher mean scores in the lower back and left wrist regions, with the lower back region having a mean score of 7.450 and left wrist region having a mean score of 1.030. These scores indicated a mild to moderate level of discomfort for both groups, with each facing major discomfort in unique body regions. This research highlights the significance of ergonomic evaluation and the combination of quantitative and qualitative data to identify potential interventions.\u0000","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116281336","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 : 2023-07-29DOI: 10.24018/ejmed.2023.5.4.1823
Damilola E. Adeteye, C. Ndikom, M. Akinwaare, T. O. Dosunmu
Background: Birth preparedness and complication readiness is a strategic intervention to achieve a reduction in the rate of maternal mortality. However, despite the importance and ease of use of this intervention, it has been observed that several factors have hindered the practice. Hence, the need to consider the knowledge, attitude, practice, and factors that influences Birth preparedness and Complication readiness among post-natal women. Method: This descriptive cross-sectional study used a multi-stage sampling technique to select 116 post-natal women in selected primary health centers in Ibadan North Local Government Area, Oyo state. An adapted structured questionnaire was used to assess the knowledge, attitude, practice and factors influencing the practice of birth preparedness and complication readiness. Statistical analysis was done using Statistical Package for the social science (SPSS) version 21.0 software. Descriptive data were presented as frequency and percentages while the chi-square test was used to test the hypotheses at P value < 0.05. Result: The majority of respondents were highly knowledgeable (86.2%). The respondents had a positive attitude towards birth preparedness and complication readiness (75%). The practice level was high among the respondents (71.6%). However, the factors that influenced practice were lack of adequate knowledge (X2=4.578, P =0.032), pre-mature delivery (X2=19.929, P=0.000) and environmental insecurities (X2=6.556, P=0.010). Conclusion: There is a relationship between factors (lack of adequate knowledge, premature delivery and environmental insecurities) and the practice of birth preparedness and complication readiness. Hence, measures should be employed to address the identified factors to improve the practice of birth preparedness and complication readiness.
{"title":"Factors Influencing Birth Preparedness and Complication Readiness among Post-Natal Women in Selected Primary Health Centers in Ibadan, Nigeria","authors":"Damilola E. Adeteye, C. Ndikom, M. Akinwaare, T. O. Dosunmu","doi":"10.24018/ejmed.2023.5.4.1823","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.4.1823","url":null,"abstract":"\u0000Background: Birth preparedness and complication readiness is a strategic intervention to achieve a reduction in the rate of maternal mortality. However, despite the importance and ease of use of this intervention, it has been observed that several factors have hindered the practice. Hence, the need to consider the knowledge, attitude, practice, and factors that influences Birth preparedness and Complication readiness among post-natal women. \u0000\u0000\u0000Method: This descriptive cross-sectional study used a multi-stage sampling technique to select 116 post-natal women in selected primary health centers in Ibadan North Local Government Area, Oyo state. An adapted structured questionnaire was used to assess the knowledge, attitude, practice and factors influencing the practice of birth preparedness and complication readiness. Statistical analysis was done using Statistical Package for the social science (SPSS) version 21.0 software. Descriptive data were presented as frequency and percentages while the chi-square test was used to test the hypotheses at P value < 0.05.\u0000\u0000\u0000Result: The majority of respondents were highly knowledgeable (86.2%). The respondents had a positive attitude towards birth preparedness and complication readiness (75%). The practice level was high among the respondents (71.6%). However, the factors that influenced practice were lack of adequate knowledge (X2=4.578, P =0.032), pre-mature delivery (X2=19.929, P=0.000) and environmental insecurities (X2=6.556, P=0.010). \u0000\u0000\u0000Conclusion: There is a relationship between factors (lack of adequate knowledge, premature delivery and environmental insecurities) and the practice of birth preparedness and complication readiness. Hence, measures should be employed to address the identified factors to improve the practice of birth preparedness and complication readiness.\u0000","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117003737","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 : 2023-07-26DOI: 10.24018/ejmed.2023.5.4.1816
H. Hamdani, N. Mtalai, R. Chahir, G. Daghouj, L. El maaloum, B. Allali, A. EL kettani
Ocular cystinosis is a rare autosomal recessive disorder caused by mutations in the CTNS gene, which encodes a lysosomal cystine transporter protein. This results in the accumulation of cystine crystals in various ocular structures, leading to a range of ocular manifestations. The incidence of cystinosis is estimated to be 1 in 100,000 to 200,000 live births, with a higher prevalence in certain populations such as those of European descent. We report the case of a 5-year-old child with ocular cystinosis. The ophthalmological examination revealed a photophobic child with a visual acuity of 3/10 in both eyes (Pigassou scale), and diffuse stromal crystal deposits over the entire cornea in both eyes. The rest of the examination was unremarkable. The patient was referred to pediatrics for work-up of storage disease and was diagnosed with ocular and nephrological cystinosis. The patient was able to start general treatment with Mercaptamine with improvement in renal function, but was unable to obtain local treatment due to lack of funds. The patient is still being followed in our clinic with stable corneal involvement. Ocular cystinosis is a very rare genetic disorder. There are three main types of cystinosis: nephropathic cystinosis and non-nephropathic cystinosis. Nephropathic cystinosis divides further on infantile and intermediate. The most common ocular manifestation of cystinosis is corneal cystine crystal deposit, which typically presents in the first year of life and can lead to photophobia, tearing, and decreased visual acuity. The corneal crystals can also cause recurrent erosions, which can be very painful. The severity of corneal involvement can range from mild punctate deposition to severe confluent crystal accumulation that can lead to corneal scarring and vision loss. Cysteamine drops, which are a form of cysteamine hydrochloride, can help dissolve the cystine crystals and improve corneal clarity, prevent further vision loss, and reduce the frequency of recurrent erosions. Early diagnosis and treatment are crucial in preventing further ocular damage in individuals with cystinosis. Regular ophthalmologic examinations should be conducted to monitor for ocular manifestations and initiate treatment as early as possible. A multidisciplinary approach is necessary, involving ophthalmologists, nephrologists, and other specialists, to manage the systemic manifestations of cystinosis.
{"title":"Starry-like Cornea: A Case of Ocular Cystinosis","authors":"H. Hamdani, N. Mtalai, R. Chahir, G. Daghouj, L. El maaloum, B. Allali, A. EL kettani","doi":"10.24018/ejmed.2023.5.4.1816","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.4.1816","url":null,"abstract":"Ocular cystinosis is a rare autosomal recessive disorder caused by mutations in the CTNS gene, which encodes a lysosomal cystine transporter protein. This results in the accumulation of cystine crystals in various ocular structures, leading to a range of ocular manifestations. The incidence of cystinosis is estimated to be 1 in 100,000 to 200,000 live births, with a higher prevalence in certain populations such as those of European descent. We report the case of a 5-year-old child with ocular cystinosis. The ophthalmological examination revealed a photophobic child with a visual acuity of 3/10 in both eyes (Pigassou scale), and diffuse stromal crystal deposits over the entire cornea in both eyes. The rest of the examination was unremarkable. The patient was referred to pediatrics for work-up of storage disease and was diagnosed with ocular and nephrological cystinosis. The patient was able to start general treatment with Mercaptamine with improvement in renal function, but was unable to obtain local treatment due to lack of funds. The patient is still being followed in our clinic with stable corneal involvement. Ocular cystinosis is a very rare genetic disorder. There are three main types of cystinosis: nephropathic cystinosis and non-nephropathic cystinosis. Nephropathic cystinosis divides further on infantile and intermediate. The most common ocular manifestation of cystinosis is corneal cystine crystal deposit, which typically presents in the first year of life and can lead to photophobia, tearing, and decreased visual acuity. The corneal crystals can also cause recurrent erosions, which can be very painful. The severity of corneal involvement can range from mild punctate deposition to severe confluent crystal accumulation that can lead to corneal scarring and vision loss. Cysteamine drops, which are a form of cysteamine hydrochloride, can help dissolve the cystine crystals and improve corneal clarity, prevent further vision loss, and reduce the frequency of recurrent erosions.\u0000Early diagnosis and treatment are crucial in preventing further ocular damage in individuals with cystinosis. Regular ophthalmologic examinations should be conducted to monitor for ocular manifestations and initiate treatment as early as possible. A multidisciplinary approach is necessary, involving ophthalmologists, nephrologists, and other specialists, to manage the systemic manifestations of cystinosis.","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"54 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134106339","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 : 2023-07-26DOI: 10.24018/ejmed.2023.5.4.1782
H. Hamdani, N. Mtalai, Sara Ennaki, G. Daghouj, L. E. Maaloum, B. Allali, A. Kettani, L. E. Maaloum
Congenital insensitivity to pain or more scientifically Hereditary sensory and autonomic neuropathies (HSAN) is a rare genetic disorder which associates a sensory dysfunction with a varying degree of autonomic dysfunction. Due to the peripheral neuropathy, a decreased sensitivity or even complete anesthesia may be present resulting in, on the ophthalmological level, neurotrophic ulcers. We report the case of 2 sisters (JM and KM) presenting with HSAN with recurrent corneal ulcers. Unfortunately, genetic testing couldn’t be performed due to lack of means, but the clinical presentation and features were very favourable or even pathognomonic of this syndrome. The first cases or reported individuals presenting with congenital insensitivity to pain goes back to 1930’s. Five types of hereditary sensory and autonomic neuropathy have been identified according to age of onset of symptoms, clinical features and affected gene. HSAN type IV also known as congenital insensitivity to pain with anhidrosis (CIPA) is the second most common HSAN. It is caused by mutation in the NTRK1(Neurotrophic tyrosine kinase receptor type 1) (TRKA) gene located in chromosome 1 (1q21-q22). It is characterized by repetitive hyperthermic episodes in infancy, and mental retardation is usually present, as reported in our case. Clinical symptoms of pain insensitivity manifest as tongue, lip and fingers biting, and self-inflicted injuries. Congenital insensitivity to pain is a rare genetic syndrome characterized by an absence or an altered response to pain. Individuals with this syndrome can presented self-inflicted injuries and auto-mutilation leading in some cases to severe disabilities. Long-term visual prognosis in CIPA patients is not assessed and there’s an important lack of data regarding ocular manifestation of CIP syndrome.
{"title":"Congenital Insensitivity TO Pain: A Case Report","authors":"H. Hamdani, N. Mtalai, Sara Ennaki, G. Daghouj, L. E. Maaloum, B. Allali, A. Kettani, L. E. Maaloum","doi":"10.24018/ejmed.2023.5.4.1782","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.4.1782","url":null,"abstract":"Congenital insensitivity to pain or more scientifically Hereditary sensory and autonomic neuropathies (HSAN) is a rare genetic disorder which associates a sensory dysfunction with a varying degree of autonomic dysfunction. Due to the peripheral neuropathy, a decreased sensitivity or even complete anesthesia may be present resulting in, on the ophthalmological level, neurotrophic ulcers. We report the case of 2 sisters (JM and KM) presenting with HSAN with recurrent corneal ulcers. Unfortunately, genetic testing couldn’t be performed due to lack of means, but the clinical presentation and features were very favourable or even pathognomonic of this syndrome. The first cases or reported individuals presenting with congenital insensitivity to pain goes back to 1930’s. Five types of hereditary sensory and autonomic neuropathy have been identified according to age of onset of symptoms, clinical features and affected gene. HSAN type IV also known as congenital insensitivity to pain with anhidrosis (CIPA) is the second most common HSAN. It is caused by mutation in the NTRK1(Neurotrophic tyrosine kinase receptor type 1) (TRKA) gene located in chromosome 1 (1q21-q22). It is characterized by repetitive hyperthermic episodes in infancy, and mental retardation is usually present, as reported in our case. Clinical symptoms of pain insensitivity manifest as tongue, lip and fingers biting, and self-inflicted injuries. Congenital insensitivity to pain is a rare genetic syndrome characterized by an absence or an altered response to pain. Individuals with this syndrome can presented self-inflicted injuries and auto-mutilation leading in some cases to severe disabilities. Long-term visual prognosis in CIPA patients is not assessed and there’s an important lack of data regarding ocular manifestation of CIP syndrome.","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130981034","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 : 2023-07-26DOI: 10.24018/ejmed.2023.5.4.1815
H. Hamdani, N. Mtalai, Kawtar El, Ghizlane Hadi, Daghouj Loubna El, Bouchra Maaloum, Allali Asmaa El, Kettani, K. E. Hadi, G. Daghouj, L. E. Maaloum, B. Allali, A. Kettani
Brain-stem anesthesia is a serious and rare complication of orbital regional anesthesia that may occur when the local anesthetic agent gains access to the central nervous system via a direct spread from the apex of the orbit or the submeningeal pathways. We report the case of a 66 -year-old man who developed, after a retro-bulbar block for cataract surgery, a tonico-clonic seizures, hypotension and bradycardia-features of brainstem anesthesia. We present the clinical features, treatment and comments on how to prevent the problem. Although it is rare, and because it may be life-threatening in some cases, physicians who perform retrobulbar block should be aware of its features and various clinical manifestation in order to recognize and treat it. Also, facilities where ophtalmic surgery under local anesthesia are performed should be properly equiped in order to manage this complication.
{"title":"Brainstem Anesthesia after Retrobulbar Anesthesia in Cataract Surgery: A Case Report","authors":"H. Hamdani, N. Mtalai, Kawtar El, Ghizlane Hadi, Daghouj Loubna El, Bouchra Maaloum, Allali Asmaa El, Kettani, K. E. Hadi, G. Daghouj, L. E. Maaloum, B. Allali, A. Kettani","doi":"10.24018/ejmed.2023.5.4.1815","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.4.1815","url":null,"abstract":"Brain-stem anesthesia is a serious and rare complication of orbital regional anesthesia that may occur when the local anesthetic agent gains access to the central nervous system via a direct spread from the apex of the orbit or the submeningeal pathways. We report the case of a 66 -year-old man who developed, after a retro-bulbar block for cataract surgery, a tonico-clonic seizures, hypotension and bradycardia-features of brainstem anesthesia. We present the clinical features, treatment and comments on how to prevent the problem. Although it is rare, and because it may be life-threatening in some cases, physicians who perform retrobulbar block should be aware of its features and various clinical manifestation in order to recognize and treat it. Also, facilities where ophtalmic surgery under local anesthesia are performed should be properly equiped in order to manage this complication.","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125552698","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 : 2023-07-25DOI: 10.24018/ejmed.2023.5.4.1501
Rania Rebai, Iman Sebai
The COVID-19 pandemic has overwhelmed healthcare systems particularly the training curriculum for post-graduate medical students. Our aim was to assess family medicine residents’ perceived impact of the COVID-19 pandemic on training and medical education in Tunisia. Methods: We conducted a cross-sectional survey among all Tunisian family medicine residents who were in training during the year 2020. Residents starting their first-year residency studies in 2021 were excluded. A structured questionnaire was created and shared via Google Forms. Residents' anonymity and consent were respected. Results: We included 107 residents (85% females). During the first semester of 2020, a significant reduction in workload was reported including working hours (58.9%), patient's flow (65.1%) and elective admission (83%). The workload tended to partially normalize during the second half of the year. The restriction of academic activities (staff, grand rounds, and congresses) was considered the major obstacle (73.8%) hindering residents’ training. About 72% benefited from E-learning during the second period. By the end of 2020, 48.6% of participants reported being infected by the virus. The majority (97.2%) reported feeling anxious, irritable and/or depressed. The pandemic significantly decreased residents' satisfaction with their medical training (4.22±2.15 before the crisis versus 2.78±1.18 during COVID-19) (p<10-3). Conclusion: The COVID-19 pandemic had decreased residents' level of satisfaction with their training and had negatively affected their mental health. The key findings of the present research can be a starting point to provide high quality residency training and to avoid bypassing their weaknesses in the upcoming outbreaks.
{"title":"The Experience of Family Medicine Residents during the Early Phase of COVID-19 Pandemic in Tunisia","authors":"Rania Rebai, Iman Sebai","doi":"10.24018/ejmed.2023.5.4.1501","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.4.1501","url":null,"abstract":"The COVID-19 pandemic has overwhelmed healthcare systems particularly the training curriculum for post-graduate medical students. Our aim was to assess family medicine residents’ perceived impact of the COVID-19 pandemic on training and medical education in Tunisia. Methods: We conducted a cross-sectional survey among all Tunisian family medicine residents who were in training during the year 2020. Residents starting their first-year residency studies in 2021 were excluded. A structured questionnaire was created and shared via Google Forms. Residents' anonymity and consent were respected. Results: We included 107 residents (85% females). During the first semester of 2020, a significant reduction in workload was reported including working hours (58.9%), patient's flow (65.1%) and elective admission (83%). The workload tended to partially normalize during the second half of the year. The restriction of academic activities (staff, grand rounds, and congresses) was considered the major obstacle (73.8%) hindering residents’ training. About 72% benefited from E-learning during the second period. By the end of 2020, 48.6% of participants reported being infected by the virus. The majority (97.2%) reported feeling anxious, irritable and/or depressed. The pandemic significantly decreased residents' satisfaction with their medical training (4.22±2.15 before the crisis versus 2.78±1.18 during COVID-19) (p<10-3). Conclusion: The COVID-19 pandemic had decreased residents' level of satisfaction with their training and had negatively affected their mental health. The key findings of the present research can be a starting point to provide high quality residency training and to avoid bypassing their weaknesses in the upcoming outbreaks.","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131008453","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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