Intracholecystic papillary neoplasm was a newly proposed term in the 2019 World Health Organization classification of tumors of the digestive system, as a preinvasive neoplasm of the gallbladder. We report a case of intra-cholecystic papillary neoplasm, biliary type with high-grade dysplasia presenting as a polypoidal mass in the fundus of the gallbladder, in a 47-year-old man with a history of periodic abdominal pain and dyspepsia of 6-month duration. As the term for the pathological classification in itself is new, we wish to report this case for record storing purposes that may be imperative if any further study on the said topic is planned in the future.
{"title":"A case report of intracholecystic papillary neoplasm presenting as gallbladder polyp","authors":"J. Thiek, Lachit Kalita, Kiran Kamalasanan","doi":"10.4103/ijmh.ijmh_70_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_70_22","url":null,"abstract":"Intracholecystic papillary neoplasm was a newly proposed term in the 2019 World Health Organization classification of tumors of the digestive system, as a preinvasive neoplasm of the gallbladder. We report a case of intra-cholecystic papillary neoplasm, biliary type with high-grade dysplasia presenting as a polypoidal mass in the fundus of the gallbladder, in a 47-year-old man with a history of periodic abdominal pain and dyspepsia of 6-month duration. As the term for the pathological classification in itself is new, we wish to report this case for record storing purposes that may be imperative if any further study on the said topic is planned in the future.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79923778","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}
Vinayak Pai, Suyash Ambekar, M. Nadkar, Alhad Mulkalwar, Priyadarshi Prajjwal
Background: Venous thromboembolism is a major contributor to the global disease burden, with an incidence of around 10 million cases per year and substantially associated morbidity and mortality. Objectives: The study aimed to assess the clinical, laboratory, and radiological profile along with electrocardiogram and echocardiogram changes and the treatment and outcomes in patients admitted with acute pulmonary embolism (PE) in a tertiary care centre. The etiologies and risk factors of the same were also evaluated. Materials and Methods: This was a hospital-based prospective observational study conducted among 31 patients over a period of 18 months. The study was conducted at a tertiary care centre in the Department of General Medicine. Patients of age more than 12 years, admitted with a confirmed diagnosis of acute PE based on computed tomography pulmonary angiography (CTPA), were included in the study. Results: Thrombolysis was done in 12.9% cases, while anticoagulants were given in 87.1% cases. Oxygen therapy was required in 74.2% cases on day 1 while in 9.7% on day 30. Secondary pulmonary hypertension was the commonest complication observed in the study, in 54.8% cases. Severe hypoxia was seen in 35.4% cases. No complications were seen in 6.4% cases. Mortality was recorded in 9.6% of the cases. Conclusion: Since PE is among the leading causes of death and disability, there should be a high degree of suspicion in all clinical settings. And since prolonged immobilisation is a strong risk factor for PE patients at risk, they should be offered prophylactic anticoagulation.
{"title":"Clinical profile and short-term outcomes of patients admitted with acute pulmonary embolism in a tertiary care centre","authors":"Vinayak Pai, Suyash Ambekar, M. Nadkar, Alhad Mulkalwar, Priyadarshi Prajjwal","doi":"10.4103/ijmh.ijmh_1_23","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_1_23","url":null,"abstract":"Background: Venous thromboembolism is a major contributor to the global disease burden, with an incidence of around 10 million cases per year and substantially associated morbidity and mortality. Objectives: The study aimed to assess the clinical, laboratory, and radiological profile along with electrocardiogram and echocardiogram changes and the treatment and outcomes in patients admitted with acute pulmonary embolism (PE) in a tertiary care centre. The etiologies and risk factors of the same were also evaluated. Materials and Methods: This was a hospital-based prospective observational study conducted among 31 patients over a period of 18 months. The study was conducted at a tertiary care centre in the Department of General Medicine. Patients of age more than 12 years, admitted with a confirmed diagnosis of acute PE based on computed tomography pulmonary angiography (CTPA), were included in the study. Results: Thrombolysis was done in 12.9% cases, while anticoagulants were given in 87.1% cases. Oxygen therapy was required in 74.2% cases on day 1 while in 9.7% on day 30. Secondary pulmonary hypertension was the commonest complication observed in the study, in 54.8% cases. Severe hypoxia was seen in 35.4% cases. No complications were seen in 6.4% cases. Mortality was recorded in 9.6% of the cases. Conclusion: Since PE is among the leading causes of death and disability, there should be a high degree of suspicion in all clinical settings. And since prolonged immobilisation is a strong risk factor for PE patients at risk, they should be offered prophylactic anticoagulation.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86715331","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}
Arnav Tongaonkar, K. Joshi, Alhad Mulkalwar, Shweta Gajare
Background: Anticoagulants are among the most commonly used drugs in hospitalized patients known to cause adverse drug reactions (ADRs). They have commonly been used as standard therapy in venous thromboembolism, stroke prevention, etc. Objectives: The authors aimed to assess the incidence of ADRs, clinical profile, severity and causality among the admitted patients taking anticoagulants in a tertiary care hospital. Materials and Methods: This was a hospital-based, prospective, observational, non-interventional cohort study undertaken in the General Medicine Wards of King Edward Memorial Hospital, Mumbai from June 2017 to December 2018. Every patient’s data was recorded using a structured ADR reporting form. The baseline parameters, medical history and underlying diseases, clinical data, characteristics of ADRs, and details of medication responsible for ADRs, as well as details of the drugs used for treatment of ADRs were recorded. The data was analyzed using descriptive statistics with the Statistical Packages for the Social Sciences (SPSS) version 26.0 software. Results: Out of the 164 patients admitted due to ADRs within the study period, 32 (19.5%) had developed ADRs due to anticoagulant treatment. Most anticoagulant-related ADRs involved the vascular system (n = 32). The severity of ADR was found to be mild in one patient (3.1%), moderate in 22 patients (68.8%), and severe in nine patients (28.1%). Twenty (62.5%) patients completely recovered, nine (28.1%) patients were still recovering (at the time of the analysis of the data), and three (9.4%) patients had a fatal outcome. Presence of systemic comorbidities and polypharmacy were found to be significant risk factors associated with anticoagulant-associated ADRs. Conclusion: Anticoagulants commonly cause ADRs in the study population. Patient education at the time of prescription can prevent many ADRs due to medication error or poor compliance. In addition, installing a better surveillance system in hospitals could alleviate the prevalence of ADRs.
{"title":"Analysis of burden and outcomes of anticoagulant induced adverse drug effects at a tertiary care centre","authors":"Arnav Tongaonkar, K. Joshi, Alhad Mulkalwar, Shweta Gajare","doi":"10.4103/ijmh.ijmh_76_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_76_22","url":null,"abstract":"Background: Anticoagulants are among the most commonly used drugs in hospitalized patients known to cause adverse drug reactions (ADRs). They have commonly been used as standard therapy in venous thromboembolism, stroke prevention, etc. Objectives: The authors aimed to assess the incidence of ADRs, clinical profile, severity and causality among the admitted patients taking anticoagulants in a tertiary care hospital. Materials and Methods: This was a hospital-based, prospective, observational, non-interventional cohort study undertaken in the General Medicine Wards of King Edward Memorial Hospital, Mumbai from June 2017 to December 2018. Every patient’s data was recorded using a structured ADR reporting form. The baseline parameters, medical history and underlying diseases, clinical data, characteristics of ADRs, and details of medication responsible for ADRs, as well as details of the drugs used for treatment of ADRs were recorded. The data was analyzed using descriptive statistics with the Statistical Packages for the Social Sciences (SPSS) version 26.0 software. Results: Out of the 164 patients admitted due to ADRs within the study period, 32 (19.5%) had developed ADRs due to anticoagulant treatment. Most anticoagulant-related ADRs involved the vascular system (n = 32). The severity of ADR was found to be mild in one patient (3.1%), moderate in 22 patients (68.8%), and severe in nine patients (28.1%). Twenty (62.5%) patients completely recovered, nine (28.1%) patients were still recovering (at the time of the analysis of the data), and three (9.4%) patients had a fatal outcome. Presence of systemic comorbidities and polypharmacy were found to be significant risk factors associated with anticoagulant-associated ADRs. Conclusion: Anticoagulants commonly cause ADRs in the study population. Patient education at the time of prescription can prevent many ADRs due to medication error or poor compliance. In addition, installing a better surveillance system in hospitals could alleviate the prevalence of ADRs.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86844221","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}
N. Ibiok, C. Onyedinma, Olanike Agwu-Umahi, C. Kassy, I. Obionu, O. Chime, I. Ogugua, C. Ochie, S. Arinze-onyia, A. Ndu, E. Aguwa, AdaezeTheodore Okeke
Background: The Ebola virus disease (EVD) outbreak of 2014–2016 in West Africa was the world’s deadliest to date, and the World Health Organization declared it an international health emergency. It adversely affected the health system with many healthcare workers (HCWs) being worried about going to work. Objective: This study therefore aimed at determining the willingness of HCWs to report to work in an outbreak of EVD. Materials and Methods: A semi-structured, self-administered, questionnaire-based cross-sectional study was conducted among 360 doctors, nurses, and medical laboratory workers in public and private health facilities in Enugu Metropolis. Results: Seventy-three percent (73%) of our respondents were willing to report to work during an outbreak of EVD. Nurses were about five times more likely to be willing to work than other categories of staff [odd ratio (OR) = 4.999; confidence interval (CI)= 2.15–11.597; P < 0.001] and female HCWs were about 1.3 times more likely to be willing to work than males during an EVD outbreak (OR =1.275; CI=0.743–2.815; P = 0.049). Availability of vaccination for healthcare staff (88.6%) and family members (79.2%) were the greatest personal and family-related motivating factors for willingness to work, whereas the provision of antiviral treatment for staff with unprotected exposure to an ill patient (78.1%) was the greatest work motivating factor. However, passion for work surpassed increased remuneration (61.4%) as a personal motivating factor for HCWs willingness to report to work during an EVD outbreak. Conclusion: Our study showed that HCWs were largely willing to work during an EVD outbreak. Personal vaccination for staff and family members and provision of antivirals were the major motivating factors.
{"title":"Healthcare workers’ willingness to report to work during a pandemic in southeastern Nigeria: A hypothetical case using Ebola virus disease","authors":"N. Ibiok, C. Onyedinma, Olanike Agwu-Umahi, C. Kassy, I. Obionu, O. Chime, I. Ogugua, C. Ochie, S. Arinze-onyia, A. Ndu, E. Aguwa, AdaezeTheodore Okeke","doi":"10.4103/ijmh.ijmh_63_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_63_22","url":null,"abstract":"Background: The Ebola virus disease (EVD) outbreak of 2014–2016 in West Africa was the world’s deadliest to date, and the World Health Organization declared it an international health emergency. It adversely affected the health system with many healthcare workers (HCWs) being worried about going to work. Objective: This study therefore aimed at determining the willingness of HCWs to report to work in an outbreak of EVD. Materials and Methods: A semi-structured, self-administered, questionnaire-based cross-sectional study was conducted among 360 doctors, nurses, and medical laboratory workers in public and private health facilities in Enugu Metropolis. Results: Seventy-three percent (73%) of our respondents were willing to report to work during an outbreak of EVD. Nurses were about five times more likely to be willing to work than other categories of staff [odd ratio (OR) = 4.999; confidence interval (CI)= 2.15–11.597; P < 0.001] and female HCWs were about 1.3 times more likely to be willing to work than males during an EVD outbreak (OR =1.275; CI=0.743–2.815; P = 0.049). Availability of vaccination for healthcare staff (88.6%) and family members (79.2%) were the greatest personal and family-related motivating factors for willingness to work, whereas the provision of antiviral treatment for staff with unprotected exposure to an ill patient (78.1%) was the greatest work motivating factor. However, passion for work surpassed increased remuneration (61.4%) as a personal motivating factor for HCWs willingness to report to work during an EVD outbreak. Conclusion: Our study showed that HCWs were largely willing to work during an EVD outbreak. Personal vaccination for staff and family members and provision of antivirals were the major motivating factors.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78143336","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}
P. Ezechukwu, E. Ugwu, S. Obi, G. Eleje, P. Agu, E. Iloghalu, K. Obioha, C. Onwuka, A. Ugwu, O. Onodugo, B. Ozumba
Background: Preeclampsia is one of the leading causes of maternal and perinatal morbidity and mortality in Nigeria and worldwide. It is not yet concluded as to whether or not elevated levels of serum creatinine and/or uric acid could be regarded as a predictive indicator for the severity of the disease. Objectives: To compare the mean serum levels of uric acid and creatinine in preeclamptic and normotensive pregnant women and assess for any associations between these renal biomarkers and the severity of preeclampsia in Nigeria. Materials and Methods: It was a cross-sectional analytical study of 132 women with preeclampsia (n = 61) and normotensive pregnant women (n = 61). The study group comprised eligible consecutive women diagnosed with preeclampsia, whereas the control group comprised appropriately matched normotensive pregnant women. Main outcome measures included the mean serum levels of uric acid and creatinine in both groups, and their levels in cases with mild and severe degrees of preeclampsia. Results: The mean serum levels of uric acid and creatinine were significantly higher in women with preeclampsia than in normotensive pregnant women (7.67 ± 2.9 versus 4.56 ± 1.1; P < 0.001, and 0.76 ± 0.3 versus 0.53 ± 0.1; P < 0.001, respectively). There was no significant difference in the mean serum levels of uric acid and creatinine in women with mild and severe degrees of preeclampsia (6.66 ± 2.3 versus 7.77 ± 2.9; P = 0.37, and 0.56 ± 0.2 versus 0.79 ± 0.4; P = 0.12, respectively). Conclusions: This study has demonstrated that serum uric acid and serum creatinine levels are elevated in pregnancies complicated by preeclampsia. However, there is no significant association between serum levels of these renal biomarkers and the severity of preeclampsia. The studied renal biomarkers are therefore important in the diagnostic workup of preeclampsia but of limited value in the disease prognostication.
背景:先兆子痫是尼日利亚和全世界孕产妇和围产期发病率和死亡率的主要原因之一。血清肌酐和/或尿酸水平升高是否可作为疾病严重程度的预测指标，目前尚未得出结论。目的:比较尼日利亚子痫前期和血压正常孕妇的尿酸和肌酐的平均血清水平，并评估这些肾脏生物标志物与子痫前期严重程度之间的任何关联。材料和方法:对132例先兆子痫妇女(n = 61)和血压正常的孕妇(n = 61)进行横断面分析研究。研究组由连续诊断为子痫前期的符合条件的妇女组成，而对照组由适当匹配的血压正常的孕妇组成。主要结局指标包括两组患者的平均血清尿酸和肌酐水平，以及轻度和重度子痫前期患者的尿酸和肌酐水平。结果:子痫前期孕妇尿酸和肌酐的平均水平明显高于正常孕妇(7.67±2.9 vs 4.56±1.1;P < 0.001, 0.76±0.3 vs 0.53±0.1;P < 0.001)。轻度和重度子痫前期妇女的尿酸和肌酐平均血清水平无显著差异(6.66±2.3 vs 7.77±2.9;P = 0.37，分别为0.56±0.2和0.79±0.4;P = 0.12)。结论:本研究表明妊娠合并子痫前期患者血清尿酸和血清肌酐水平升高。然而，这些肾脏生物标志物的血清水平与子痫前期的严重程度之间没有显著的关联。因此，所研究的肾脏生物标志物在先兆子痫的诊断工作中很重要，但在疾病预后方面价值有限。
{"title":"Renal biomarkers in pre-eclampsia and their associations with severity of pre-eclampsia","authors":"P. Ezechukwu, E. Ugwu, S. Obi, G. Eleje, P. Agu, E. Iloghalu, K. Obioha, C. Onwuka, A. Ugwu, O. Onodugo, B. Ozumba","doi":"10.4103/ijmh.ijmh_11_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_11_22","url":null,"abstract":"Background: Preeclampsia is one of the leading causes of maternal and perinatal morbidity and mortality in Nigeria and worldwide. It is not yet concluded as to whether or not elevated levels of serum creatinine and/or uric acid could be regarded as a predictive indicator for the severity of the disease. Objectives: To compare the mean serum levels of uric acid and creatinine in preeclamptic and normotensive pregnant women and assess for any associations between these renal biomarkers and the severity of preeclampsia in Nigeria. Materials and Methods: It was a cross-sectional analytical study of 132 women with preeclampsia (n = 61) and normotensive pregnant women (n = 61). The study group comprised eligible consecutive women diagnosed with preeclampsia, whereas the control group comprised appropriately matched normotensive pregnant women. Main outcome measures included the mean serum levels of uric acid and creatinine in both groups, and their levels in cases with mild and severe degrees of preeclampsia. Results: The mean serum levels of uric acid and creatinine were significantly higher in women with preeclampsia than in normotensive pregnant women (7.67 ± 2.9 versus 4.56 ± 1.1; P < 0.001, and 0.76 ± 0.3 versus 0.53 ± 0.1; P < 0.001, respectively). There was no significant difference in the mean serum levels of uric acid and creatinine in women with mild and severe degrees of preeclampsia (6.66 ± 2.3 versus 7.77 ± 2.9; P = 0.37, and 0.56 ± 0.2 versus 0.79 ± 0.4; P = 0.12, respectively). Conclusions: This study has demonstrated that serum uric acid and serum creatinine levels are elevated in pregnancies complicated by preeclampsia. However, there is no significant association between serum levels of these renal biomarkers and the severity of preeclampsia. The studied renal biomarkers are therefore important in the diagnostic workup of preeclampsia but of limited value in the disease prognostication.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76356935","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}
Adenomatoid odontogenic tumors (AOTs) are very rare. We present a case series of eight AOTs seen and managed at University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu State, Nigeria over a 10-year period, from 2012 to 2021. Their epidemiological data and clinic-pathological information were obtained from the biopsy forms, histopathology reports, and case files archived in the Records Department of the hospital. The AOTs were diagnosed in 8 patients out of the 225 odontogenic tumors seen during the period giving a prevalence of 3.6%. Five patients (62.5%) were males, whereas three (37.5%) were females giving a male-to-female ratio of 1.7:1. The mean (SD) age at onset of lesion was 12.4 (5.4) years with a range of 5–21 years. The location of the tumors was anterior in 62.5% of the jaw cases. A maxillary location was observed in 62.5% of the cases. Pain complaint was reported in 25% of the subjects. Tumor fluid was aspirated in 75.0% (n = 6) of the lesions: straw aspirate (83.3%),and dark-brown aspirate (16.7%). A tooth was associated with the tumor in 87.5% (n = 7) of the cases, with the canine impacted in 85.7% (n = 6) of these. Only one case (12.5%) was extrafollicular. The AOTs are uncommon and differed from other Nigerian studies by exhibiting a male gender prevalence, lower mean age, and frequent straw aspirates.
{"title":"Adenomatoid odontogenic tumors: Rare cases in Enugu, Eastern Nigeria","authors":"M. Nwoga","doi":"10.4103/ijmh.ijmh_32_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_32_22","url":null,"abstract":"Adenomatoid odontogenic tumors (AOTs) are very rare. We present a case series of eight AOTs seen and managed at University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu State, Nigeria over a 10-year period, from 2012 to 2021. Their epidemiological data and clinic-pathological information were obtained from the biopsy forms, histopathology reports, and case files archived in the Records Department of the hospital. The AOTs were diagnosed in 8 patients out of the 225 odontogenic tumors seen during the period giving a prevalence of 3.6%. Five patients (62.5%) were males, whereas three (37.5%) were females giving a male-to-female ratio of 1.7:1. The mean (SD) age at onset of lesion was 12.4 (5.4) years with a range of 5–21 years. The location of the tumors was anterior in 62.5% of the jaw cases. A maxillary location was observed in 62.5% of the cases. Pain complaint was reported in 25% of the subjects. Tumor fluid was aspirated in 75.0% (n = 6) of the lesions: straw aspirate (83.3%),and dark-brown aspirate (16.7%). A tooth was associated with the tumor in 87.5% (n = 7) of the cases, with the canine impacted in 85.7% (n = 6) of these. Only one case (12.5%) was extrafollicular. The AOTs are uncommon and differed from other Nigerian studies by exhibiting a male gender prevalence, lower mean age, and frequent straw aspirates.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86516114","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}
Johnson Achebe, Obinna Remigius Okwesili, C. Adiri, E. Asimadu
Acquired gynatresia resulting from traumatic vaginal delivery is rare. The use of bilateral pudendal flaps for reconstruction provides sensate tissue for a functional neovagina. Reconstruction of the vagina after complete stenosis from birth trauma has not widely been reported. We present a 29-year-old woman who developed vaginal stenosis within 2 months after vaginal delivery of a stillbirth baby. There was a failure of coitus for approximately 5 months before presentation. She had successful vaginal reconstruction with pudendal flaps and became pregnant twice through coitus after surgery. Her baby was delivered via Caesarean section. We have reported a case where the vagina was successfully reconstructed with bilateral pudendal thigh flaps which resulted in subsequent spontaneous (unassisted) pregnancies.
{"title":"Successful pregnancies after vaginal reconstruction following acquired gynatresia with pudendal thigh (Singapore) flaps","authors":"Johnson Achebe, Obinna Remigius Okwesili, C. Adiri, E. Asimadu","doi":"10.4103/ijmh.ijmh_57_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_57_22","url":null,"abstract":"Acquired gynatresia resulting from traumatic vaginal delivery is rare. The use of bilateral pudendal flaps for reconstruction provides sensate tissue for a functional neovagina. Reconstruction of the vagina after complete stenosis from birth trauma has not widely been reported. We present a 29-year-old woman who developed vaginal stenosis within 2 months after vaginal delivery of a stillbirth baby. There was a failure of coitus for approximately 5 months before presentation. She had successful vaginal reconstruction with pudendal flaps and became pregnant twice through coitus after surgery. Her baby was delivered via Caesarean section. We have reported a case where the vagina was successfully reconstructed with bilateral pudendal thigh flaps which resulted in subsequent spontaneous (unassisted) pregnancies.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81496896","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}
Waliu Oladosu, AdewaleMukaila Alayo, A. Ahmed, O. Jimoh, Sekinat Olarinoye-Raji, Basirat Egbeyemi, Taofeek Ajadi
Background: Increasing prevalence of overweight and obesity has profound impacts on health generally, including the reproductive system. Traditionally, pear body shapes, from narrow waist and wide hip circumferences, have been associated with high fecundability among females. Although this has been scientifically demonstrated by a number of researches only a few of these investigations were conducted with black women in Africa who were of reproductive age. Objectives: The objectives of the study were to compare the mean reproductive hormone levels between the different waist-to-hip ratio (WHR) and body mass index (BMI) categories and also to determine the correlations between the two anthropometric measurements and the reproductive hormones in a black African population. Materials and Methods: It was an analytical cross-sectional study of 180 females of a childbearing age. The WHR and BMI were measured as per standard recommendations. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, estradiol, day-21 progesterone, and testosterone were assayed. Results: A majority of the research participants were within the age group 21–30 years. Thirty three percent (33%) and 28.9% of participants were overweight and obese, respectively, using BMI compared with 26.7% and 20%, respectively, using WHR. Seventy six point nine percent (76.9%) of participants with an optimal BMI range ovulated with 61.5% having adequate luteal phase support compared with 75% and 54.2%, respectively, using WHR. Day-21 serum progesterone and serum estradiol were significantly negatively correlated with WHR and BMI (P < 0.05). BMI, however, showed a better correlation than WHR (r = -0.535 vs. -0.397; P = 0.001 vs. 0.008, respectively). Gonadotropins were significantly lower among overweight and obese groups for both BMI and WHR (P < 0.05), but only WHR showed moderately positive significant correlation with gonadotropins (LH: r = 0.050 vs. r = 0.215, P = 0.003, respectively; FSH: r = 0.159 vs. r = 0.431, P = 0.001, respectively), same as serum testosterone (r = 0.580 vs. r = 0.611, P = 0.002, respectively). Conclusions: Anthropometric measurements can serve as objective clues to functionality and optimal concentrations of reproductive hormones. Weight control should therefore aid the optimization of reproductive hormones and fertility among females of reproductive age.
背景:超重和肥胖的日益流行对包括生殖系统在内的健康产生了深远的影响。传统上，梨形身材，从窄腰到宽臀，一直与女性的高生育能力联系在一起。虽然一些研究已经科学地证明了这一点，但这些调查中只有少数是对非洲育龄黑人妇女进行的。目的:本研究的目的是比较不同腰臀比(WHR)和身体质量指数(BMI)类别之间的平均生殖激素水平，并确定两种人体测量值与非洲黑人人口生殖激素之间的相关性。材料与方法:对180名育龄妇女进行横断面分析研究。WHR和BMI是按照标准建议测量的。测定血清促卵泡激素(FSH)、黄体生成素(LH)、催乳素、雌二醇、第21天孕酮和睾酮水平。结果:大多数研究参与者年龄在21-30岁之间。用BMI来衡量，分别有33%和28.9%的参与者超重和肥胖，而用WHR来衡量，分别有26.7%和20%的参与者超重和肥胖。76.9%(76.9%)具有最佳BMI范围的参与者排卵，61.5%具有足够的黄体期支持，而使用WHR的参与者分别为75%和54.2%。第21天血清黄体酮、雌二醇与WHR、BMI呈显著负相关(P < 0.05)。BMI的相关性优于WHR (r = -0.535 vs. -0.397;P = 0.001 vs. 0.008)。超重组和肥胖组的BMI和腰高比与促性腺激素均显著降低(P < 0.05)，但腰高比与促性腺激素呈正相关(LH: r = 0.050比r = 0.215, P = 0.003;FSH: r = 0.159 vs. r = 0.431, P = 0.001)，血清睾酮(r = 0.580 vs. r = 0.611, P = 0.002)。结论:人体测量可以作为生殖激素功能和最佳浓度的客观线索。因此，控制体重应有助于优化生殖激素和育龄妇女的生育能力。
{"title":"Assessment of relationship between anthropometric measurements and reproductive hormonal profiles, among females of childbearing age at a tertiary health facility in Nigeria","authors":"Waliu Oladosu, AdewaleMukaila Alayo, A. Ahmed, O. Jimoh, Sekinat Olarinoye-Raji, Basirat Egbeyemi, Taofeek Ajadi","doi":"10.4103/ijmh.ijmh_47_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_47_22","url":null,"abstract":"Background: Increasing prevalence of overweight and obesity has profound impacts on health generally, including the reproductive system. Traditionally, pear body shapes, from narrow waist and wide hip circumferences, have been associated with high fecundability among females. Although this has been scientifically demonstrated by a number of researches only a few of these investigations were conducted with black women in Africa who were of reproductive age. Objectives: The objectives of the study were to compare the mean reproductive hormone levels between the different waist-to-hip ratio (WHR) and body mass index (BMI) categories and also to determine the correlations between the two anthropometric measurements and the reproductive hormones in a black African population. Materials and Methods: It was an analytical cross-sectional study of 180 females of a childbearing age. The WHR and BMI were measured as per standard recommendations. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, estradiol, day-21 progesterone, and testosterone were assayed. Results: A majority of the research participants were within the age group 21–30 years. Thirty three percent (33%) and 28.9% of participants were overweight and obese, respectively, using BMI compared with 26.7% and 20%, respectively, using WHR. Seventy six point nine percent (76.9%) of participants with an optimal BMI range ovulated with 61.5% having adequate luteal phase support compared with 75% and 54.2%, respectively, using WHR. Day-21 serum progesterone and serum estradiol were significantly negatively correlated with WHR and BMI (P < 0.05). BMI, however, showed a better correlation than WHR (r = -0.535 vs. -0.397; P = 0.001 vs. 0.008, respectively). Gonadotropins were significantly lower among overweight and obese groups for both BMI and WHR (P < 0.05), but only WHR showed moderately positive significant correlation with gonadotropins (LH: r = 0.050 vs. r = 0.215, P = 0.003, respectively; FSH: r = 0.159 vs. r = 0.431, P = 0.001, respectively), same as serum testosterone (r = 0.580 vs. r = 0.611, P = 0.002, respectively). Conclusions: Anthropometric measurements can serve as objective clues to functionality and optimal concentrations of reproductive hormones. Weight control should therefore aid the optimization of reproductive hormones and fertility among females of reproductive age.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81148179","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}
R. Okonkwo, A. Onyeabochukwu, E. Izuka, O. Onyegbule, C. Duke-Onyeabo, C. Obiora-Izuka, U. Nwagha
Background: Vaginal misoprostol is a highly effective method of cervical ripening and induction of labor; however, it is associated with some complications. Therefore, there is need to explore other routes of administration that may be safer, acceptable, and also effective. Objective: The aim of this study was to compare the effectiveness and safety of vaginal versus sublingual misoprostol for cervical ripening and induction of labor. Materials and Methods: This was a randomized controlled trial conducted among booked antenatal women in Owerri, South-East Nigeria. The eligible participants were randomized to receive either 25 μg of misoprostol vaginally (n = 90) or 25 μg sublingually (n = 90). Outcome measures included delivery within 24 h, induction to delivery interval, cesarean section rate, side effects of misoprostol, Apgar Score at birth, and admission into the Neonatal Intensive Care Unit. Results: There was no significant difference in the effectiveness and side effects of both routes of administration (p > 0.05). The results were comparable in both groups, except for the time to reach the active phase of labor (vaginal route 16.64 ± 9.12 vs. sublingual route 13.78 ± 7.47, P = 0.023) and the number of doses of misoprostol used (vaginal route 2.81 ± 1.53 vs. sublingual route 2.34 ± 1.49, P = 0.040). Conclusion: The effectiveness of cervical ripening and induction of labor is comparable in both groups and the side effect profile is also similar. Hence, the sublingual route is as effective and as safe as the vaginal route but with added advantage of shortening the duration of active phase of labor and requiring less doses for induction of labor.
{"title":"Effectiveness and safety of vaginal versus sublingual misoprostol for cervical ripening and induction of labor: A randomized controlled trial","authors":"R. Okonkwo, A. Onyeabochukwu, E. Izuka, O. Onyegbule, C. Duke-Onyeabo, C. Obiora-Izuka, U. Nwagha","doi":"10.4103/ijmh.ijmh_59_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_59_22","url":null,"abstract":"Background: Vaginal misoprostol is a highly effective method of cervical ripening and induction of labor; however, it is associated with some complications. Therefore, there is need to explore other routes of administration that may be safer, acceptable, and also effective. Objective: The aim of this study was to compare the effectiveness and safety of vaginal versus sublingual misoprostol for cervical ripening and induction of labor. Materials and Methods: This was a randomized controlled trial conducted among booked antenatal women in Owerri, South-East Nigeria. The eligible participants were randomized to receive either 25 μg of misoprostol vaginally (n = 90) or 25 μg sublingually (n = 90). Outcome measures included delivery within 24 h, induction to delivery interval, cesarean section rate, side effects of misoprostol, Apgar Score at birth, and admission into the Neonatal Intensive Care Unit. Results: There was no significant difference in the effectiveness and side effects of both routes of administration (p > 0.05). The results were comparable in both groups, except for the time to reach the active phase of labor (vaginal route 16.64 ± 9.12 vs. sublingual route 13.78 ± 7.47, P = 0.023) and the number of doses of misoprostol used (vaginal route 2.81 ± 1.53 vs. sublingual route 2.34 ± 1.49, P = 0.040). Conclusion: The effectiveness of cervical ripening and induction of labor is comparable in both groups and the side effect profile is also similar. Hence, the sublingual route is as effective and as safe as the vaginal route but with added advantage of shortening the duration of active phase of labor and requiring less doses for induction of labor.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79454743","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}
I. Ezejiofor, Olaniyi Olaofe, O. Ezejiofor, N. Ozor, Nonyelum Osonwa
Background: Soft tissue lesions are remarkably diverse and range from inflammatory, self-limited lesions to neoplasm. The diversity of these lesions frequently poses a diagnostic challenge to pathologists and remains a subject of interests. Lack of research on soft tissues in our setting has prompted the need to study them. Objectives: The aim of this study was to determine the benign lesions of soft tissues with respect to age, sex, anatomic site, and histologic types. It also aimed to determine the baseline data of benign soft tissue lesions in Nnewi, Nigeria. Materials and Methods: This study reviewed all histologically diagnosed benign soft tissue lesions at the Histopathology Department of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria from 2011 to 2019 and classified the tumors using the 2020 WHO Classification of Soft Tissue Tumours. Results: A total of 351 cases of soft tissue lesions were diagnosed during the study period, out of which 251 were benign lesions and accounted for 71.5% (251/351) of all soft tissue lesions, whereas 28.5% (100/351) of the cases were malignant. The benign lesions included inflammatory and benign neoplasm, of which neoplasm accounted for the majority of the cases with a frequency of 94.0% (236/251), whereas inflammatory lesions accounted for 5.9% (15/251). The 236 benign soft tissue tumors diagnosed had a male-to-female ratio of 1: 1.4 with a mean age (SD) of 37.5 (19.5) years. The most frequent occurrence of benign tumors was seen in the fourth decade with 52 cases (21.0%), followed by fifth decade with 42 cases (16.7%). Adipocytic tumors were the commonest with a frequency of 54.0% (135/251), followed by peripheral nerve sheath tumors (PNSTs) with 12.4% (31/251) and then vascular and fibroblastic/myofibroblastic tumors with 10.8% (27/251) and 5.6% (14/251), respectively. Lipoma is the most common histologic type of benign soft tissue tumor and the only benign adipocytic tumor. This is followed by hemangioma 9.6% (24/251) and then neurofibroma 7.6% (19/251). Lipoma accounted for 37.09% (135/351) of all soft tissue lesions and the majority of them were seen in the fourth decade, whereas hemagioma and neurofibroma occurred more at the first decade. The most common anatomic distributions of these benign tumors were lower extremities with 23.5% (n = 59/251), followed by trunk 21.1% (n = 53). The major inflammatory lesions were tuberculoid granulomatous inflammation and panniculitis with 2.3% (6/251) of cases each. Others were necrotizing fasciitis (n = 2) and eosinophilic myositis (n = 1). Conclusion: Benign soft tissue tumors had a slight female preponderance. Lipoma is the single most common benign soft tissue neoplasm, whereas tuberculosis and panniculitis were the two most common inflammatory soft tissue lesions. Histopathological evaluation of these lesions still stands as a gold standard in their diagnosis.
{"title":"Histopathological evaluation of benign soft tissue lesions at Nnamdi Azikiwe University teaching hospital, Nnewi, south-east Nigeria: A 9-year review","authors":"I. Ezejiofor, Olaniyi Olaofe, O. Ezejiofor, N. Ozor, Nonyelum Osonwa","doi":"10.4103/ijmh.ijmh_49_22","DOIUrl":"https://doi.org/10.4103/ijmh.ijmh_49_22","url":null,"abstract":"Background: Soft tissue lesions are remarkably diverse and range from inflammatory, self-limited lesions to neoplasm. The diversity of these lesions frequently poses a diagnostic challenge to pathologists and remains a subject of interests. Lack of research on soft tissues in our setting has prompted the need to study them. Objectives: The aim of this study was to determine the benign lesions of soft tissues with respect to age, sex, anatomic site, and histologic types. It also aimed to determine the baseline data of benign soft tissue lesions in Nnewi, Nigeria. Materials and Methods: This study reviewed all histologically diagnosed benign soft tissue lesions at the Histopathology Department of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria from 2011 to 2019 and classified the tumors using the 2020 WHO Classification of Soft Tissue Tumours. Results: A total of 351 cases of soft tissue lesions were diagnosed during the study period, out of which 251 were benign lesions and accounted for 71.5% (251/351) of all soft tissue lesions, whereas 28.5% (100/351) of the cases were malignant. The benign lesions included inflammatory and benign neoplasm, of which neoplasm accounted for the majority of the cases with a frequency of 94.0% (236/251), whereas inflammatory lesions accounted for 5.9% (15/251). The 236 benign soft tissue tumors diagnosed had a male-to-female ratio of 1: 1.4 with a mean age (SD) of 37.5 (19.5) years. The most frequent occurrence of benign tumors was seen in the fourth decade with 52 cases (21.0%), followed by fifth decade with 42 cases (16.7%). Adipocytic tumors were the commonest with a frequency of 54.0% (135/251), followed by peripheral nerve sheath tumors (PNSTs) with 12.4% (31/251) and then vascular and fibroblastic/myofibroblastic tumors with 10.8% (27/251) and 5.6% (14/251), respectively. Lipoma is the most common histologic type of benign soft tissue tumor and the only benign adipocytic tumor. This is followed by hemangioma 9.6% (24/251) and then neurofibroma 7.6% (19/251). Lipoma accounted for 37.09% (135/351) of all soft tissue lesions and the majority of them were seen in the fourth decade, whereas hemagioma and neurofibroma occurred more at the first decade. The most common anatomic distributions of these benign tumors were lower extremities with 23.5% (n = 59/251), followed by trunk 21.1% (n = 53). The major inflammatory lesions were tuberculoid granulomatous inflammation and panniculitis with 2.3% (6/251) of cases each. Others were necrotizing fasciitis (n = 2) and eosinophilic myositis (n = 1). Conclusion: Benign soft tissue tumors had a slight female preponderance. Lipoma is the single most common benign soft tissue neoplasm, whereas tuberculosis and panniculitis were the two most common inflammatory soft tissue lesions. Histopathological evaluation of these lesions still stands as a gold standard in their diagnosis.","PeriodicalId":14106,"journal":{"name":"International Journal of Medicine and Health Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85514738","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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