Pub Date : 2023-06-02DOI: 10.24018/ejmed.2023.5.3.1528
Rajesh Kumar, S. Naik, A. Prakash, Sukhdeep Singh
Nature and magnitude of medico-legal cases vary from hospital to hospital and from area to area and from time to time. Analysis of medico-legal cases can give an insight into the behaviours and activities of the people in and around the area. The present study was conducted at SSKH, Lady Hardinge Medical College, New Delhi from 1st January, 2021 till 31st June, 2022 to evaluate the impact of Covid-19 pandemic on the magnitude and nature of medico-legal cases. The number of MLCs were found reduced by 24% in the year 2020 (due to Omicron variant of Covid virus) and reduced further by 54% in the year 2021 (due to deadlier Delta variant of Covid virus) than the year 2019. In the year 2019, daily average of MLCs was 7.07. During the Covid-19 pandemic years 2020 and 2021, the daily average of the MLCs was dropped to 5.34. and 3.19 respectively. During the nation-wide complete lockdown in India from 24th March, 2020 till 14th April, 2020, the daily average of the MLCs had dropped to the minimum i.e. 1.5. Though the magnitude of MLCs reduced to great extent during lockdown days and pandemic years, however, no significant variations were noticed in nature (cause and manner) of medico-legal cases. Homicidal blunt force trauma, accidental road traffic collision and suicidal poisoning remained three major causes of medico-legal cases respectively in the years 2019, 2020 and 2021, almost in same proportions.
{"title":"Impact of COVID-19 Pandemic on Magnitude, Cause and Manner of Medico-legal Cases in A Tertiary Care Hospital, New Delhi","authors":"Rajesh Kumar, S. Naik, A. Prakash, Sukhdeep Singh","doi":"10.24018/ejmed.2023.5.3.1528","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.3.1528","url":null,"abstract":"Nature and magnitude of medico-legal cases vary from hospital to hospital and from area to area and from time to time. Analysis of medico-legal cases can give an insight into the behaviours and activities of the people in and around the area. The present study was conducted at SSKH, Lady Hardinge Medical College, New Delhi from 1st January, 2021 till 31st June, 2022 to evaluate the impact of Covid-19 pandemic on the magnitude and nature of medico-legal cases. The number of MLCs were found reduced by 24% in the year 2020 (due to Omicron variant of Covid virus) and reduced further by 54% in the year 2021 (due to deadlier Delta variant of Covid virus) than the year 2019. In the year 2019, daily average of MLCs was 7.07. During the Covid-19 pandemic years 2020 and 2021, the daily average of the MLCs was dropped to 5.34. and 3.19 respectively. During the nation-wide complete lockdown in India from 24th March, 2020 till 14th April, 2020, the daily average of the MLCs had dropped to the minimum i.e. 1.5. Though the magnitude of MLCs reduced to great extent during lockdown days and pandemic years, however, no significant variations were noticed in nature (cause and manner) of medico-legal cases. Homicidal blunt force trauma, accidental road traffic collision and suicidal poisoning remained three major causes of medico-legal cases respectively in the years 2019, 2020 and 2021, almost in same proportions.","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128172230","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 : 2023-06-02DOI: 10.24018/ejmed.2023.5.3.1669
E. S. Pangkahila, Luh Putu Widya Saraswati Tangkas
Due to structural similarities between HCG and thyroid-stimulating hormone, thyroid stimulation during pregnancy starts in the first trimester (TSH). The volume of thyroid hormone distribution increases along with placental metabolism, maternal thyroxine transport, and estrogen-mediated changes in thyroxine-binding globulin (TBG), all of which cause a 20–40% rise in early pregnancy thyroid hormone demand. Due to the human chorionic gonadotropin alpha subunit's cross-reactivity with the TSH receptor, the reference range of laboratory values for TSH is lower. High serum protein levels may alter estimates rather than direct measurements of free thyroxine (FT4), leading to reported results that are inaccurate. The clinical range of thyroid dysfunction during pregnancy can include both hyperthyroidism (Graves' disease and transitory gestational thyrotoxicosis) and hypothyroidism (overt hypothyroidism, subclinical hypothyroidism, and autoimmune thyroid disease). The risk of preterm and infant respiratory distress syndrome is increased by this malfunction.
{"title":"Thyroid Dysfunction in Pregnancy: A Literature Review","authors":"E. S. Pangkahila, Luh Putu Widya Saraswati Tangkas","doi":"10.24018/ejmed.2023.5.3.1669","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.3.1669","url":null,"abstract":"Due to structural similarities between HCG and thyroid-stimulating hormone, thyroid stimulation during pregnancy starts in the first trimester (TSH). The volume of thyroid hormone distribution increases along with placental metabolism, maternal thyroxine transport, and estrogen-mediated changes in thyroxine-binding globulin (TBG), all of which cause a 20–40% rise in early pregnancy thyroid hormone demand. Due to the human chorionic gonadotropin alpha subunit's cross-reactivity with the TSH receptor, the reference range of laboratory values for TSH is lower. High serum protein levels may alter estimates rather than direct measurements of free thyroxine (FT4), leading to reported results that are inaccurate. The clinical range of thyroid dysfunction during pregnancy can include both hyperthyroidism (Graves' disease and transitory gestational thyrotoxicosis) and hypothyroidism (overt hypothyroidism, subclinical hypothyroidism, and autoimmune thyroid disease). The risk of preterm and infant respiratory distress syndrome is increased by this malfunction.","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133738728","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 : 2023-06-02DOI: 10.24018/ejmed.2023.5.3.1672
S. de Dios, Eduardo Fernandez Carrion, Miguel Florido, M. Navarro, Rocio Gomez Gil, Fernando De Arriba Frade, Emilio Perez Anchia, Juan Sterling-Duarte, A. Yoldi, J. Z. Zamorano Gómez
Prevention has become a main factor in the management of cardiovascular diseases. There are many options to control the LDL-Cholesterol levels, which reduction has been widely proved to diminish cardiovascular events rate. Despite the many pharmacological options, an important percentage of the patients do not reach the control target. Among other factors, the available drugs present tolerance problems that limit their use, emerging the necessity to develop new options of treatment that combine efficacy and security. In this field arise the nutraceuticals, which may become an alternative, in selected patients, especially in primary prevention, where the necessity of LDL-cholesterol reduction is not so ambitious, and tolerance and security are essential to achieve the patient adherence to the treatment. The objective of the study is to demonstrate that the new formulation of Lipok®(a nutraceutical based in red yeast rice and berberine) adapting the concentration of monacolines to the new European regulation, is effective in the lipidic profile control. 97 patients in primary prevention that present LDL-Cholesterol levels over the guidelines objective (116mg/dL) where included. Security and effectiveness of adding Lipok® 6 months to the treatment was evaluated. We observed a statistically significant reduction in the TCH values (-34.3mg/dL), LDL-C (-33,8mg/dL) and triglycerides (-29,3mg/dL) at 6 months’ treatment. No variation in the levels of HDL-C was observed. No relevant side effects were reported (constipation <2%, no myalgias). There were mild reductions (that even reached statistical significance) in creatinine, GPT and glycosylated hemoglobin. No patient discontinued treatment in the 6 months. NO patient discontinued the treatment during the study. New formulation of Lipok® has proved to be effective in the control of the LDL-Cholesterol levels without relevant side effects. Considering the significant reduction shown in this study, it may become an alternative to other pharmacological treatments in the management of dyslipidaemia in primary prevention where adherence to the treatment is fundamental.
{"title":"Evaluationg the role of Nutraceuticals in Primary Prevention","authors":"S. de Dios, Eduardo Fernandez Carrion, Miguel Florido, M. Navarro, Rocio Gomez Gil, Fernando De Arriba Frade, Emilio Perez Anchia, Juan Sterling-Duarte, A. Yoldi, J. Z. Zamorano Gómez","doi":"10.24018/ejmed.2023.5.3.1672","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.3.1672","url":null,"abstract":"Prevention has become a main factor in the management of cardiovascular diseases. There are many options to control the LDL-Cholesterol levels, which reduction has been widely proved to diminish cardiovascular events rate. Despite the many pharmacological options, an important percentage of the patients do not reach the control target. Among other factors, the available drugs present tolerance problems that limit their use, emerging the necessity to develop new options of treatment that combine efficacy and security. In this field arise the nutraceuticals, which may become an alternative, in selected patients, especially in primary prevention, where the necessity of LDL-cholesterol reduction is not so ambitious, and tolerance and security are essential to achieve the patient adherence to the treatment. \u0000The objective of the study is to demonstrate that the new formulation of Lipok®(a nutraceutical based in red yeast rice and berberine) adapting the concentration of monacolines to the new European regulation, is effective in the lipidic profile control. \u000097 patients in primary prevention that present LDL-Cholesterol levels over the guidelines objective (116mg/dL) where included. Security and effectiveness of adding Lipok® 6 months to the treatment was evaluated. We observed a statistically significant reduction in the TCH values (-34.3mg/dL), LDL-C (-33,8mg/dL) and triglycerides (-29,3mg/dL) at 6 months’ treatment. No variation in the levels of HDL-C was observed. No relevant side effects were reported (constipation <2%, no myalgias). There were mild reductions (that even reached statistical significance) in creatinine, GPT and glycosylated hemoglobin. No patient discontinued treatment in the 6 months. NO patient discontinued the treatment during the study. \u0000New formulation of Lipok® has proved to be effective in the control of the LDL-Cholesterol levels without relevant side effects. Considering the significant reduction shown in this study, it may become an alternative to other pharmacological treatments in the management of dyslipidaemia in primary prevention where adherence to the treatment is fundamental.","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134332698","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 : 2023-06-02DOI: 10.24018/ejmed.2023.5.3.1687
Pande Made Ngurah Geriawan, Pande Made Angger Parameswara
Pre-cancerous lesions are cell changes that start on the surface of the cervix near the squamocolumnar junction (SCJ). Cervical cancer can be prevented through early identification and treatment. These pre-cancerous lesions can be identified through methods such as pap smears, visual inspection with acetic acid (VIA), and human papillomavirus (HPV) DNA tests. This study aims to determine the characteristics of cervical pre-cancerous lesions at Sanjiwani General Hospital. This is a descriptive observational study design with a cross-sectional approach at Sanjiwani General Hospital from January to December 2022. The inclusion criteria were patients who had pap smear screening and were recorded entirely in the examination data archive at the Anatomical Pathology Laboratory of Sanjiwani General Hospital in 2022. The exclusion criteria were Pap smear results with inadequate pap smears to be evaluated. The result was obtained from secondary data from patient medical records, determined by the total sampling technique, and will be processed using the IBM SPSS Statistics Version 26 application. In total, 35 samples met the research criteria. All samples (100%) showed positive findings on the VIA test. The most found on the pap smear screening was 15 samples (42.9%) with NILM and followed in succession by eight samples (22.9%) with ASC-US, seven samples (20%) with ASC-H, three samples (8.5%) LSIL, and two samples (5.7%) with findings of HSIL. Most patients with Pap smears at Sanjiwani General Hospital in 2022 will be in the age group of 41-50. Based on obstetric and gynecological history, most respondents had parity ≥ 3, age at sexual intercourse ≥20 years, number of sexual partners was only one, and had not experienced menopause. Most patients use hormonal contraception, have no family history of cervical cancer, and have never been vaccinated or screened for HPV. Most of the pap smear findings were NILM, with the most abnormalities found being ASCUS.
{"title":"Characteristics of Cervical Pre-Cancerous Lesions at Sanjiwani General Hospital in January-December 2022","authors":"Pande Made Ngurah Geriawan, Pande Made Angger Parameswara","doi":"10.24018/ejmed.2023.5.3.1687","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.3.1687","url":null,"abstract":"\u0000Pre-cancerous lesions are cell changes that start on the surface of the cervix near the squamocolumnar junction (SCJ). Cervical cancer can be prevented through early identification and treatment. These pre-cancerous lesions can be identified through methods such as pap smears, visual inspection with acetic acid (VIA), and human papillomavirus (HPV) DNA tests. This study aims to determine the characteristics of cervical pre-cancerous lesions at Sanjiwani General Hospital. This is a descriptive observational study design with a cross-sectional approach at Sanjiwani General Hospital from January to December 2022. The inclusion criteria were patients who had pap smear screening and were recorded entirely in the examination data archive at the Anatomical Pathology Laboratory of Sanjiwani General Hospital in 2022. The exclusion criteria were Pap smear results with inadequate pap smears to be evaluated. The result was obtained from secondary data from patient medical records, determined by the total sampling technique, and will be processed using the IBM SPSS Statistics Version 26 application. In total, 35 samples met the research criteria. All samples (100%) showed positive findings on the VIA test. The most found on the pap smear screening was 15 samples (42.9%) with NILM and followed in succession by eight samples (22.9%) with ASC-US, seven samples (20%) with ASC-H, three samples (8.5%) LSIL, and two samples (5.7%) with findings of HSIL. Most patients with Pap smears at Sanjiwani General Hospital in 2022 will be in the age group of 41-50. Based on obstetric and gynecological history, most respondents had parity ≥ 3, age at sexual intercourse ≥20 years, number of sexual partners was only one, and had not experienced menopause. Most patients use hormonal contraception, have no family history of cervical cancer, and have never been vaccinated or screened for HPV. Most of the pap smear findings were NILM, with the most abnormalities found being ASCUS.\u0000","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115726880","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 : 2023-06-02DOI: 10.24018/ejmed.2023.5.3.1205
A. Sabrá, Ana Muñoz, Aderbal Sabrá-Filho, S. Sabrá
Background: Gastrointestinal malabsorption of proteins from the diet of the mother can induce diseases in breast fed infants. The malfunction of the gastrointestinal tract (GI) of the mother is the basic process causing this disease. This new entity is under the scope of “diseases of the entero-mammary circle” (DEMC). Proteins different from homologues proteins of the breast milk, present in breast milk offered to the infant develops food allergy with clinical manifestation in different organs of the newborn and infant. Here we describe the most relevant clinical symptoms associated to this new entity the DEMC. Methods: From January 2015 to January 2021, 100 charts from infants, age 0 to 6 months, were randomly selected from our clinic of Pediatric Gastroenterology and Food Allergy at Santa Casa da Misericordia do Rio de Janeiro, Rio de Janeiro, Brazil. The inclusion criteria were: 1) To be exclusively breast fed since birth and 2) Diagnosis of food allergy through strict diet to the mother without cow's milk, egg, soy and wheat protein and subsequent oral challenge with ingestion of the seafood by the mothers and recurrence of gastrointestinal, respiratory or dermal symptoms by oral challenge positive. The exclusion criteria were the use of other any food besides the breast milk. Results: The onset of symptoms in the patients studied starts early in life. In the GI system the prevalent clinical symptoms were blood in stool, gastro-esophageal reflux, abdominal distention, abdominal pain, diarrhea, constipation, bulky stools, flatus and vomiting, colic’s and nauseas and hiccups. In the respiratory system of the patients, the clinical disturbance was snoring and rhinitis, sinusitis, excess of mucus, chronic cough, and asthma. In the skin system, was prevalent the pallor, atopic eczema, eczema of folds, erythema of the cheeks, per oral erythema and seborrheic dermatitis. Related to the central nervous system we found sleep disorder, insomnia, irritability, and lethargy. Conclusion: The present study was developed to explore the broad spectrum of the DEMC, presented as different clinical pictures in infants, exclusively breast fed, compromising all systems such the GI tract, the skin, the respiratory system, and the central nervous system.
背景:母亲饮食中蛋白质的胃肠道吸收不良可诱发母乳喂养婴儿的疾病。母体胃肠道功能障碍是导致本病的基本过程。这一新实体属于"肠-乳腺圈疾病" (DEMC)的范畴。提供给婴儿的母乳中存在的不同于母乳同源蛋白的蛋白质产生食物过敏，在新生儿和婴儿的不同器官中出现临床表现。在这里，我们描述了与这种新实体- DEMC相关的最相关的临床症状。方法:选取2015年1月至2021年1月在巴西里约热内卢Santa Casa da Misericordia do Rio de Janeiro儿科胃肠病学和食物过敏门诊随机抽取的100例0 ~ 6个月婴儿病历。纳入标准为:1)出生后全母乳喂养;2)母亲严格饮食诊断为食物过敏，不含牛奶、鸡蛋、大豆和小麦蛋白，母亲食用海鲜后进行口腔攻毒，口腔攻毒阳性后胃肠道、呼吸道或皮肤症状复发。排除标准是使用母乳以外的任何其他食物。结果:所研究的患者在生命早期就开始出现症状。在胃肠道系统中，常见的临床症状是便血、胃食管反流、腹胀、腹痛、腹泻、便秘、大便臃肿、肠胃胀气、呕吐、绞痛、恶心和打嗝。在呼吸系统方面，患者的临床障碍为打鼾和鼻炎、鼻窦炎、粘液过多、慢性咳嗽和哮喘。在皮肤系统中，普遍存在苍白，特应性湿疹，褶皱湿疹，脸颊红斑，口腔红斑和脂溢性皮炎。与中枢神经系统有关，我们发现睡眠障碍、失眠、易怒和嗜睡。结论:本研究旨在探索DEMC的广谱性，在纯母乳喂养的婴儿中表现为不同的临床表现，损害所有系统，如胃肠道，皮肤，呼吸系统和中枢神经系统。
{"title":"Diseases of the Entero-Mammary Circle: A New Clinical Entity","authors":"A. Sabrá, Ana Muñoz, Aderbal Sabrá-Filho, S. Sabrá","doi":"10.24018/ejmed.2023.5.3.1205","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.3.1205","url":null,"abstract":"Background: Gastrointestinal malabsorption of proteins from the diet of the mother can induce diseases in breast fed infants. The malfunction of the gastrointestinal tract (GI) of the mother is the basic process causing this disease. This new entity is under the scope of “diseases of the entero-mammary circle” (DEMC). Proteins different from homologues proteins of the breast milk, present in breast milk offered to the infant develops food allergy with clinical manifestation in different organs of the newborn and infant. Here we describe the most relevant clinical symptoms associated to this new entity the DEMC.\u0000Methods: From January 2015 to January 2021, 100 charts from infants, age 0 to 6 months, were randomly selected from our clinic of Pediatric Gastroenterology and Food Allergy at Santa Casa da Misericordia do Rio de Janeiro, Rio de Janeiro, Brazil. The inclusion criteria were: 1) To be exclusively breast fed since birth and 2) Diagnosis of food allergy through strict diet to the mother without cow's milk, egg, soy and wheat protein and subsequent oral challenge with ingestion of the seafood by the mothers and recurrence of gastrointestinal, respiratory or dermal symptoms by oral challenge positive. The exclusion criteria were the use of other any food besides the breast milk.\u0000Results: The onset of symptoms in the patients studied starts early in life. In the GI system the prevalent clinical symptoms were blood in stool, gastro-esophageal reflux, abdominal distention, abdominal pain, diarrhea, constipation, bulky stools, flatus and vomiting, colic’s and nauseas and hiccups. In the respiratory system of the patients, the clinical disturbance was snoring and rhinitis, sinusitis, excess of mucus, chronic cough, and asthma. In the skin system, was prevalent the pallor, atopic eczema, eczema of folds, erythema of the cheeks, per oral erythema and seborrheic dermatitis. Related to the central nervous system we found sleep disorder, insomnia, irritability, and lethargy.\u0000Conclusion: The present study was developed to explore the broad spectrum of the DEMC, presented as different clinical pictures in infants, exclusively breast fed, compromising all systems such the GI tract, the skin, the respiratory system, and the central nervous system.","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"1259 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122698157","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 : 2023-06-02DOI: 10.24018/ejmed.2023.5.3.1627
I. Subawa, I. Pramana, I. Pratama
Introduction: Talus fractures are rare injuries to the hindfoot that still challenging in treatment. Accounting for <1% of foot and ankle fractures, and approximately 50% of them occur at the level of the neck. The anastomotic ring of blood supply is likely to be damaged in neck talus fractures, which disrupt the blood flow and cause significant problems affecting fracture healing and its complication. Case Illustration: We follow the progress of the illness from a 47 years old female complain pain on her left ankle after falling down 6 months before outpatient. Patient diagnosed as neglected close fracture left neck talus Hawkins type IV. Then patient undergo an ankle arthroscopy to evaluate the ankle joint in decision to preserve the tibiotalar joint, while arthrodesis performed in subtalar and talonavicular joints in this patient. This procedure achieved a good result in preserve ankle alignment, stability and soft tissue damage reduction. Improvement of VAS and AOFAS Score from 5 and 39 preoperative to 0 and 81 in follow-up of 3 months after surgery with good compliance of the patient. Discussion: Arthroscopy is safe procedure obtaining anatomical joint surface and reduce tissue damage. Therefore, a clear articular surface must be found during arthroscopy in deciding to preserve the joint function. While subtalar arthrodesis also another option that can enhance blood supply to encourage union, although loss of some ankle motion has significant effect on ambulation.
{"title":"Decision on Preserving Ankle Joint Function in Neglected Neck Talus Fracture Hawkins Type IV","authors":"I. Subawa, I. Pramana, I. Pratama","doi":"10.24018/ejmed.2023.5.3.1627","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.3.1627","url":null,"abstract":"Introduction: Talus fractures are rare injuries to the hindfoot that still challenging in treatment. Accounting for <1% of foot and ankle fractures, and approximately 50% of them occur at the level of the neck. The anastomotic ring of blood supply is likely to be damaged in neck talus fractures, which disrupt the blood flow and cause significant problems affecting fracture healing and its complication.\u0000Case Illustration: We follow the progress of the illness from a 47 years old female complain pain on her left ankle after falling down 6 months before outpatient. Patient diagnosed as neglected close fracture left neck talus Hawkins type IV. Then patient undergo an ankle arthroscopy to evaluate the ankle joint in decision to preserve the tibiotalar joint, while arthrodesis performed in subtalar and talonavicular joints in this patient. This procedure achieved a good result in preserve ankle alignment, stability and soft tissue damage reduction. Improvement of VAS and AOFAS Score from 5 and 39 preoperative to 0 and 81 in follow-up of 3 months after surgery with good compliance of the patient.\u0000Discussion: Arthroscopy is safe procedure obtaining anatomical joint surface and reduce tissue damage. Therefore, a clear articular surface must be found during arthroscopy in deciding to preserve the joint function. While subtalar arthrodesis also another option that can enhance blood supply to encourage union, although loss of some ankle motion has significant effect on ambulation.","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"136 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116336933","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 : 2023-05-31DOI: 10.24018/ejmed.2023.5.3.1726
A. El Bakouri, Abdelhak Ettaoussi, M. Bouali, F. Bensardi, K. El Hattabi, A. Fadil
Idiopathic small bowel volvulus is a rare cause of acute intestinal obstruction by strangulation in adults and is defined by the twisting of a segment of the small bowel around its mesenteric axis with no obvious underlying congenital or acquired cause. This article reports the case of a 56-year-old patient, chronic smoker and cannabis user, who was admitted with febrile occlusive syndrome and generalized abdominal contracture. The abdominal CT scan showed a distension of the small intestines upstream of a probable small bowel volvulus, associated with signs of digestive distress. Surgical exploration revealed a large peritoneal effusion of distressed fluid, with a volvulus of the distal small bowel causing 1.80 m of small bowel and coecum necrosis from 2.20 ADJ without rotational abnormality or docking defect.
{"title":"Idiopathic Small Bowel Volvulus: A Case Report","authors":"A. El Bakouri, Abdelhak Ettaoussi, M. Bouali, F. Bensardi, K. El Hattabi, A. Fadil","doi":"10.24018/ejmed.2023.5.3.1726","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.3.1726","url":null,"abstract":"Idiopathic small bowel volvulus is a rare cause of acute intestinal obstruction by strangulation in adults and is defined by the twisting of a segment of the small bowel around its mesenteric axis with no obvious underlying congenital or acquired cause. \u0000This article reports the case of a 56-year-old patient, chronic smoker and cannabis user, who was admitted with febrile occlusive syndrome and generalized abdominal contracture. \u0000The abdominal CT scan showed a distension of the small intestines upstream of a probable small bowel volvulus, associated with signs of digestive distress. \u0000Surgical exploration revealed a large peritoneal effusion of distressed fluid, with a volvulus of the distal small bowel causing 1.80 m of small bowel and coecum necrosis from 2.20 ADJ without rotational abnormality or docking defect.","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"70 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130528992","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 : 2023-05-26DOI: 10.24018/ejmed.2023.5.3.1732
A. Tall, A. Diallo, Augustin Diegane Tine, A. Ndiaye, A. Faye, P. G. Sow
Introduction: The ANC plays an important role in monitoring the health status of the fetus but also in the monitoring of the mother, by allowing the tracking of several conditions. It makes it possible to retain the woman with the health structure, thus promoting childbirth in ideal conditions. The objective of this study was to identify the determinants of ANC in the Kolda and Sédhiou regions. Method: It was a descriptive and analytical cross-sectional survey. The study focused on women who gave birth between February 2013 and January 2014. Sampling was two-stage random. The data collected during an individual interview focused on the socio-demographic characteristics, knowledge and practices of the women surveyed. The data was analyzed using the R software. Results: A total of 1216 women were surveyed. The results of the study show that 62.3% had no level of education, 48% had no IGA, 57.6% were within 5 km of a health facility and 44.1% were multiparous. Participation in awareness-raising activities involved 53% of women. The percentage of women who had completed their ANC was 24% while 34% had completed ANC1 on time. The results of the multivariate analysis showed that timely ANC1 practice was related to proximity to the health facility (1.7 [1.31-2.2)], simple multiparity (1.46 [1.14-1.89]) and participation in the awareness programme (1.4 [1.08-1.81]). Completion of all ANCs was associated with schooling (79 [1.34-2.39]), knowledge of the number and importance of ANC and the fact that the woman lived within 15 minutes of the structure (1.52 [1.14-2.04]). Conclusion: The results of the study show that the useof reproductive health services for ANC was linked to environmental, economic, cultural and structural factors. Improving the accessibility of these services requires joint actions by the government, NGOs, community actors and the involvement of the population.
{"title":"Determinants of Antenatal Consultation in The Health Districts of Kolda and Sédhiou (Senegal)","authors":"A. Tall, A. Diallo, Augustin Diegane Tine, A. Ndiaye, A. Faye, P. G. Sow","doi":"10.24018/ejmed.2023.5.3.1732","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.3.1732","url":null,"abstract":"\u0000Introduction: The ANC plays an important role in monitoring the health status of the fetus but also in the monitoring of the mother, by allowing the tracking of several conditions. It makes it possible to retain the woman with the health structure, thus promoting childbirth in ideal conditions. The objective of this study was to identify the determinants of ANC in the Kolda and Sédhiou regions.\u0000\u0000\u0000Method: It was a descriptive and analytical cross-sectional survey. The study focused on women who gave birth between February 2013 and January 2014. Sampling was two-stage random. The data collected during an individual interview focused on the socio-demographic characteristics, knowledge and practices of the women surveyed. The data was analyzed using the R software.\u0000\u0000\u0000Results: A total of 1216 women were surveyed. The results of the study show that 62.3% had no level of education, 48% had no IGA, 57.6% were within 5 km of a health facility and 44.1% were multiparous. Participation in awareness-raising activities involved 53% of women. The percentage of women who had completed their ANC was 24% while 34% had completed ANC1 on time. The results of the multivariate analysis showed that timely ANC1 practice was related to proximity to the health facility (1.7 [1.31-2.2)], simple multiparity (1.46 [1.14-1.89]) and participation in the awareness programme (1.4 [1.08-1.81]). Completion of all ANCs was associated with schooling (79 [1.34-2.39]), knowledge of the number and importance of ANC and the fact that the woman lived within 15 minutes of the structure (1.52 [1.14-2.04]).\u0000\u0000\u0000Conclusion: The results of the study show that the useof reproductive health services for ANC was linked to environmental, economic, cultural and structural factors. Improving the accessibility of these services requires joint actions by the government, NGOs, community actors and the involvement of the population.\u0000","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114082126","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 : 2023-05-26DOI: 10.24018/ejmed.2023.5.3.1743
E. Mazokopakis
Introduction/Background: Drug-induced hypothyroidism is well established in the literature. I describe the first case of symptomatic subclinical hypothyroidism (SCH) in a thyroidectomy woman with diabetes mellitus 2 receiving therapy with per os levothyroxine and sc semaglutide (Ozempic). Case Presentation: A 37-year-old overweight and thyroidectomy woman with diabetes mellitus 2 was admitted to our hospital with complaints of increasing fatigue, weakness and shortness of breath. She received levothyroxine (150 μcg per day), sc semaglutide (1 mg per week the last six months), and rosuvastatin (20 mg per day). A detailed clinical examination and laboratory tests revealed, among others, an elevated TSH serum level (92-98 mIU/L) with normal serum FT3 and FT4 levels on first and next measurements. Based on the possible diagnosis of semaglutide-induced SCH, semaglutide was withdrawn. Thyroid dysfunction was restored (serum TSH: 1.8 mIU/L) after two months with a significant improvement in symptoms. Conclusion: An influence of sc semaglutide on thyroid function is possible. Thyroid function tests are suggested in patients receiving both per os levothyroxine and sc semaglutide.
{"title":"Semaglutide-induced Subclinical Hypothyroidism: A Case Report","authors":"E. Mazokopakis","doi":"10.24018/ejmed.2023.5.3.1743","DOIUrl":"https://doi.org/10.24018/ejmed.2023.5.3.1743","url":null,"abstract":"\u0000Introduction/Background: Drug-induced hypothyroidism is well established in the literature. I describe the first case of symptomatic subclinical hypothyroidism (SCH) in a thyroidectomy woman with diabetes mellitus 2 receiving therapy with per os levothyroxine and sc semaglutide (Ozempic).\u0000\u0000\u0000Case Presentation: A 37-year-old overweight and thyroidectomy woman with diabetes mellitus 2 was admitted to our hospital with complaints of increasing fatigue, weakness and shortness of breath. She received levothyroxine (150 μcg per day), sc semaglutide (1 mg per week the last six months), and rosuvastatin (20 mg per day). A detailed clinical examination and laboratory tests revealed, among others, an elevated TSH serum level (92-98 mIU/L) with normal serum FT3 and FT4 levels on first and next measurements. Based on the possible diagnosis of semaglutide-induced SCH, semaglutide was withdrawn. Thyroid dysfunction was restored (serum TSH: 1.8 mIU/L) after two months with a significant improvement in symptoms.\u0000\u0000\u0000Conclusion: An influence of sc semaglutide on thyroid function is possible. Thyroid function tests are suggested in patients receiving both per os levothyroxine and sc semaglutide.\u0000","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120953869","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 : 2023-05-19DOI: 10.34104/ejmhs.023.063073
Hani Moubasher, Amira Mohamed Abu-Taleb, A. El-Kholy, Shaimaa Ali El-Salmy, Shaimaa Ali
Acinetobacter baumannii is a bacterial pathogen, associated with hospital and community acquired infections. It is one of the most common, opportunistic, and serious multidrug resistant bacteria (MDR). It is considered a global problem. The use of natural compounds such as fungal metabolites as an alternative to antibiotics is being explored to overcome the issue of antimicrobial resistance. Among fifty fungal spp. isolated from different sources, only Aspergillus terreus showed an antibacterial effect against A. baumannii. Co-culture is applied to produce bioactive compounds in higher amounts and/or to induce the production of new secondary metabolites. Several solvents and chromatographic techniques were used to isolate, fractionate, and purify Aspergillus terreus/ Acinetobacter baumannii co-culture secondary metabolites. Ethyl acetate extract was the most potent extract against MDR A. baumannii, in comparison to chloroform and methanol extracts. Characterization and structure elucidation of the purified compound isolated from ethyl acetate extract were performed using LC-MS, 1H NMR, and IR. The compound was identified as terreusinone A with a minimum inhibitory concentration of 160 µg.µl-1against MDR A. baumannii. This is the first record to determine the antibacterial effect of terreusinone A particularly against MDR A. baumannii.
{"title":"Production of Antibacterial Compounds from Aspergillus terreus Against MDR Acinetobacter baumannii Using Co-culture","authors":"Hani Moubasher, Amira Mohamed Abu-Taleb, A. El-Kholy, Shaimaa Ali El-Salmy, Shaimaa Ali","doi":"10.34104/ejmhs.023.063073","DOIUrl":"https://doi.org/10.34104/ejmhs.023.063073","url":null,"abstract":"Acinetobacter baumannii is a bacterial pathogen, associated with hospital and community acquired infections. It is one of the most common, opportunistic, and serious multidrug resistant bacteria (MDR). It is considered a global problem. The use of natural compounds such as fungal metabolites as an alternative to antibiotics is being explored to overcome the issue of antimicrobial resistance. Among fifty fungal spp. isolated from different sources, only Aspergillus terreus showed an antibacterial effect against A. baumannii. Co-culture is applied to produce bioactive compounds in higher amounts and/or to induce the production of new secondary metabolites. Several solvents and chromatographic techniques were used to isolate, fractionate, and purify Aspergillus terreus/ Acinetobacter baumannii co-culture secondary metabolites. Ethyl acetate extract was the most potent extract against MDR A. baumannii, in comparison to chloroform and methanol extracts. Characterization and structure elucidation of the purified compound isolated from ethyl acetate extract were performed using LC-MS, 1H NMR, and IR. The compound was identified as terreusinone A with a minimum inhibitory concentration of 160 µg.µl-1against MDR A. baumannii. This is the first record to determine the antibacterial effect of terreusinone A particularly against MDR A. baumannii.","PeriodicalId":113708,"journal":{"name":"European Journal of Medical and Health Sciences","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133571186","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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