A. A. Okesina, I. Nsubuga, O. O. Omoola, H. A. Okesina
INTRODUCTION: Lower limb amputation (LLA) is a global health issue affecting millions of people worldwide. Factors such as diabetes, peripheral vascular disease, infections, and improper medical practices also contribute to Lower limb amputation. The personal, family, and socio-economic costs associated with amputation are substantial, emphasizing the need for preventive measures, improved healthcare resources, and support for amputees. METHODS: A literature review of Lower limb amputation and its associated risk factors, which focuses on hypertension, hypercholesterolemia, smoking, diabetic complications, Indigenous ethnicity, and foot infections. RESULTS: It was revealed that the socio-economic impact of Lower limb amputation includes job loss and financial burdens. Also, access to rehabilitation services, stigma, and marginalization further complicate the lives of amputees. Furthermore, peripheral vascular disease is a significant risk factor, and chronic hyperglycemia in diabetes leads to diabetic foot syndrome and subsequent amputations. Lower limb amputation has a profound impact on quality of life and psychological well-being, particularly in rural areas where manual labor is prevalent. Strategies to address Lower limb amputation include prevention and management of diabetes-related complications, improved healthcare access, and awareness programs. Public health initiatives, health education campaigns, early detection, and affordable healthcare are also crucial in reducing amputation rates. Specific interventions for diabetic foot care, timely surgical intervention, and preserving limb length and function are important considerations. CONCLUSION: Multifaceted strategies are necessary for the effective management and prevention of lower limb amputation.
{"title":"Understanding Lower Limb Amputation: A Review of the Strategies for Healthcare Improvement, Prevention, and Management","authors":"A. A. Okesina, I. Nsubuga, O. O. Omoola, H. A. Okesina","doi":"10.4314/rmj.v81i1.13","DOIUrl":"https://doi.org/10.4314/rmj.v81i1.13","url":null,"abstract":"INTRODUCTION: Lower limb amputation (LLA) is a global health issue affecting millions of people worldwide. Factors such as diabetes, peripheral vascular disease, infections, and improper medical practices also contribute to Lower limb amputation. The personal, family, and socio-economic costs associated with amputation are substantial, emphasizing the need for preventive measures, improved healthcare resources, and support for amputees. METHODS: A literature review of Lower limb amputation and its associated risk factors, which focuses on hypertension, hypercholesterolemia, smoking, diabetic complications, Indigenous ethnicity, and foot infections. RESULTS: It was revealed that the socio-economic impact of Lower limb amputation includes job loss and financial burdens. Also, access to rehabilitation services, stigma, and marginalization further complicate the lives of amputees. Furthermore, peripheral vascular disease is a significant risk factor, and chronic hyperglycemia in diabetes leads to diabetic foot syndrome and subsequent amputations. Lower limb amputation has a profound impact on quality of life and psychological well-being, particularly in rural areas where manual labor is prevalent. Strategies to address Lower limb amputation include prevention and management of diabetes-related complications, improved healthcare access, and awareness programs. Public health initiatives, health education campaigns, early detection, and affordable healthcare are also crucial in reducing amputation rates. Specific interventions for diabetic foot care, timely surgical intervention, and preserving limb length and function are important considerations. CONCLUSION: Multifaceted strategies are necessary for the effective management and prevention of lower limb amputation.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"17 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140708648","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}
M. Umubonwa, T. Ndayishime, V. Archibong, A. Muhammed, S. Habumuremyi, C. Niyibigira, J. Gashegu
Embryological defects in the development of the kidney cause a unilateral duplicated ureter. It may predispose an individual to the formation of ureteric stones at the junction of the duplicated ureter due to the acute angle formed at the point of union, increasing the likelihood of the “yoyo reflux” phenomenon, urinary stasis, and recurrent urinary tract infections. The case report is a 39-year-old adult male cadaver who had a unilateral duplicated left ureter with a “V” shape at the vesicoureteral junction. The case was discovered during a routine dissection of the abdominal region at the gross anatomy laboratory of the College of Medicine and Health Sciences, University of Rwanda. Although a duplicated ureter may be asymptomatic, it is implicated in the development of ureteric calculi and ureteric infections and increases the susceptibility to potential iatrogenic injury during surgical procedures.
{"title":"Unilateral incomplete duplication of the left ureter: a case report","authors":"M. Umubonwa, T. Ndayishime, V. Archibong, A. Muhammed, S. Habumuremyi, C. Niyibigira, J. Gashegu","doi":"10.4314/rmj.v81i1.18","DOIUrl":"https://doi.org/10.4314/rmj.v81i1.18","url":null,"abstract":"Embryological defects in the development of the kidney cause a unilateral duplicated ureter. It may predispose an individual to the formation of ureteric stones at the junction of the duplicated ureter due to the acute angle formed at the point of union, increasing the likelihood of the “yoyo reflux” phenomenon, urinary stasis, and recurrent urinary tract infections. The case report is a 39-year-old adult male cadaver who had a unilateral duplicated left ureter with a “V” shape at the vesicoureteral junction. The case was discovered during a routine dissection of the abdominal region at the gross anatomy laboratory of the College of Medicine and Health Sciences, University of Rwanda. Although a duplicated ureter may be asymptomatic, it is implicated in the development of ureteric calculi and ureteric infections and increases the susceptibility to potential iatrogenic injury during surgical procedures.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"89 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140707819","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}
INTRODUCTION: Narrowing the gender gap and making education more inclusive are the primary objectives of the government of Rwanda and its stakeholders. However, women are underrepresented in science, technology, and engineering. Fortunately, female medical students have increased steadily in recent years. The objective was to investigate the difference between female and male performance in Anatomy METHODS: The marks of five academic years 2017-2018 to 2021-2022 were used. IBM SPSS Statistics 23 was used to analyze the data. Male and female performance was analyzed based on the general mean scores, then the mean scores of each module, and finally the grade ranges [<50%], [50-59%], [60-69%], [70-84%], [>85%] in five years. The standard deviation and P-values were calculated for difference analysis. RESULTS: 2433 records, 1534 (63.1%) males and 899 (36.9%) females, were pulled out, of which 35 students retook the modules; 19 females and 16 males. 41% of females and 39.6% of males scored between 60-69%, followed by 28.7% of females and 33.5% of males scored between 7084%, 22.5% of females and 20.4% of males scored between 50-59%, and then 6.7% of females and 6.0% of male failed by scoring <50%, while 0.4% of both female and male scored >85%. CONCLUSION: There is no significant difference between male and female students’ performances in Anatomy when compared (p>0.05). However, efforts should be made to determine the reasons for the gender gap in sciences and also to find means to attract more female students into science-based courses and professions.
{"title":"Gender-based performance in anatomy modules among students of the School of Medicine and Pharmacy, the University of Rwanda","authors":"S. Habumuremyi, K. Okesina, J. Gashegu","doi":"10.4314/rmj.v81i1.22","DOIUrl":"https://doi.org/10.4314/rmj.v81i1.22","url":null,"abstract":"INTRODUCTION: Narrowing the gender gap and making education more inclusive are the primary objectives of the government of Rwanda and its stakeholders. However, women are underrepresented in science, technology, and engineering. Fortunately, female medical students have increased steadily in recent years. The objective was to investigate the difference between female and male performance in Anatomy METHODS: The marks of five academic years 2017-2018 to 2021-2022 were used. IBM SPSS Statistics 23 was used to analyze the data. Male and female performance was analyzed based on the general mean scores, then the mean scores of each module, and finally the grade ranges [<50%], [50-59%], [60-69%], [70-84%], [>85%] in five years. The standard deviation and P-values were calculated for difference analysis. RESULTS: 2433 records, 1534 (63.1%) males and 899 (36.9%) females, were pulled out, of which 35 students retook the modules; 19 females and 16 males. 41% of females and 39.6% of males scored between 60-69%, followed by 28.7% of females and 33.5% of males scored between 7084%, 22.5% of females and 20.4% of males scored between 50-59%, and then 6.7% of females and 6.0% of male failed by scoring <50%, while 0.4% of both female and male scored >85%. CONCLUSION: There is no significant difference between male and female students’ performances in Anatomy when compared (p>0.05). However, efforts should be made to determine the reasons for the gender gap in sciences and also to find means to attract more female students into science-based courses and professions.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"69 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140708106","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}
C. Niyibigira, S. Habumuremyi, V. Archibong, J. Gashegu
The left renal vein drains the left kidney to the left lateral inferior vena cava, and it courses anteriorly to the abdominal aorta and posteriorly to the superior mesenteric artery. The case of two renal veins draining the kidneys was seen during a routine dissection of the left retroperitoneal space of a 36-year-old male cadaver. This unusual complex pattern of the left renal vein with an accessory tributary is useful, particularly for surgeons and urologists needing to access the retroperitoneal space. An awareness of such renal vascular variation can help reduce the risk of iatrogenic vascular injury when accessing this area.
{"title":"Accessory tributary of the left renal vein - a case report","authors":"C. Niyibigira, S. Habumuremyi, V. Archibong, J. Gashegu","doi":"10.4314/rmj.v81i1.8","DOIUrl":"https://doi.org/10.4314/rmj.v81i1.8","url":null,"abstract":"The left renal vein drains the left kidney to the left lateral inferior vena cava, and it courses anteriorly to the abdominal aorta and posteriorly to the superior mesenteric artery. The case of two renal veins draining the kidneys was seen during a routine dissection of the left retroperitoneal space of a 36-year-old male cadaver. This unusual complex pattern of the left renal vein with an accessory tributary is useful, particularly for surgeons and urologists needing to access the retroperitoneal space. An awareness of such renal vascular variation can help reduce the risk of iatrogenic vascular injury when accessing this area.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"75 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140707712","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}
E. Nubahumpatse, J. C. Kabayiza, Cliff O. Callahan, C. Umuhoza, M. Nsanzabera
INTRODUCTION: Helicobacter pylori infection (HPI) is a global public health problem, believed to cause more than 300,000 deaths each year. This study explores pediatricians' awareness, attitudes, and practices regarding diagnosing and managing helicobacter pylori infection (HPI) in Rwanda. METHODS: This descriptive cross-sectional study was conducted from May to June 2022 in Rwanda. Among eighty registered pediatricians, 66 were recruited based on a simple random sampling approach. The lead researcher distributed a self-administered questionnaire. Data were analyzed using SPSS software, and a p-value of ≤ 0.05 was considered significant. RESULTS: Among sixty-six recruited participants, more than half (57.6%) initiated testing from 5-12 years of child’s age, 86.4% treated the infection after investigation, and the most requested investigations were: stool antigen (90.6%), serology test (46.9%), and endoscopic exam (31.3%). Participants from public institutions were more likely to utilize stool antigen (90.0% vs 50.0%, OR:1.800, p=0.006) and less likely to utilize serology tests (40.0% vs 83.3%, OR:0.480, p=0.041).Participants with the rank of consultant or beyond were more adherent to a 14-day antibiotic regimen than junior consultants (55.0% vs 26.9%, OR:1.624, p=0.025). CONCLUSIONS: Rwandan pediatricians are aware of the current evidence on H. pylori and are willing to utilize evidence-based guidelines. The results express a need to institutionalize the existing evidence on HPI among the pediatric population and a need to promote continuous medical education for capacity building of the pediatricians. Where possible, hospitals should create and sustain the inter-facility agreement to utilize the existing minimum capacity to serve the maximum number of patients, as stated by Sustainable Development Goal 17.
{"title":"Awareness, attitude, and practice of pediatricians in relation to helicobacter pylori infection, diagnosis, and management in Rwanda","authors":"E. Nubahumpatse, J. C. Kabayiza, Cliff O. Callahan, C. Umuhoza, M. Nsanzabera","doi":"10.4314/rmj.v81i1.1","DOIUrl":"https://doi.org/10.4314/rmj.v81i1.1","url":null,"abstract":"INTRODUCTION: Helicobacter pylori infection (HPI) is a global public health problem, believed to cause more than 300,000 deaths each year. This study explores pediatricians' awareness, attitudes, and practices regarding diagnosing and managing helicobacter pylori infection (HPI) in Rwanda. \u0000METHODS: This descriptive cross-sectional study was conducted from May to June 2022 in Rwanda. Among eighty registered pediatricians, 66 were recruited based on a simple random sampling approach. The lead researcher distributed a self-administered questionnaire. Data were analyzed using SPSS software, and a p-value of ≤ 0.05 was considered significant. \u0000RESULTS: Among sixty-six recruited participants, more than half (57.6%) initiated testing from 5-12 years of child’s age, 86.4% treated the infection after investigation, and the most requested investigations were: stool antigen (90.6%), serology test (46.9%), and endoscopic exam (31.3%). Participants from public institutions were more likely to utilize stool antigen (90.0% vs 50.0%, OR:1.800, p=0.006) and less likely to utilize serology tests (40.0% vs 83.3%, OR:0.480, p=0.041).Participants with the rank of consultant or beyond were more adherent to a 14-day antibiotic regimen than junior consultants (55.0% vs 26.9%, OR:1.624, p=0.025). \u0000CONCLUSIONS: Rwandan pediatricians are aware of the current evidence on H. pylori and are willing to utilize evidence-based guidelines. The results express a need to institutionalize the existing evidence on HPI among the pediatric population and a need to promote continuous medical education for capacity building of the pediatricians. Where possible, hospitals should create and sustain the inter-facility agreement to utilize the existing minimum capacity to serve the maximum number of patients, as stated by Sustainable Development Goal 17.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"103 S5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140707391","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}
Theme: Anatomy for patients’ safety and professional growth It is with great honor that I welcome you to our 2nd anatomy annual congress. This year’s theme is “Anatomy for Patients’ Safety and Professional Growth.” Understanding anatomy is crucial for patient safety and professional development as it forms the cornerstone of healthcare practice. For accurate diagnosis and treatment, a solid understanding of anatomy is necessary in all areas, including the physical examination of a patient, the interpretation of symptoms, the interpretation of radiological images, and the comprehension of pathological illnesses. Thus, it may be claimed that a good healthcare worker is one who can use anatomical knowledge to give his or her patients high-quality care. Patient safety is a concern in healthcare practice not just in Rwanda but globally, as it directly impacts the quality of care, patient outcomes, and public trust in healthcare. Rwanda is a low- and middle-income country with a developing healthcare infrastructure, and it is important that patient safety is a priority. This is why the 2nd Anatomy Congress of S-CAR offers the ideal setting for professionals to collaborate and share experiences, learn from specialists, embrace ongoing advancements in anatomy education, and advance patient safety and professional development in Rwanda and Africa. Our participation in this S-CAR congress is a testament to our commitment to the well-being of our patients and our passion for professional growth. We will all promise to uphold not only the anatomy profession in Rwanda but also to support patient safety and carry the torch for our professional advancement. The 2nd Anatomy Annual Congress program offers an interesting package for both professionals and students, with 39 presentations subdivided into six sessions (medical education, learning assessment, anatomical study, anatomical variations, surgical anatomy, neuroanatomy, and neuroscience). This conference will help appreciate the beauty of the anatomy sciences and its importance in patient safety and professional growth in Rwanda. On behalf of S-CAR, I would like to express my gratitude to the sponsors of this congress, namely: UR, Operation Smile, and MMI.
{"title":"Second Anatomy Annual Congress in Rwanda - October 15, 2023","authors":"SOCIETY OF CLINICAL ANATOMY OF RWANDA (S-CAR)","doi":"10.4314/rmj.v81i1.6","DOIUrl":"https://doi.org/10.4314/rmj.v81i1.6","url":null,"abstract":"Theme: Anatomy for patients’ safety and professional growth \u0000It is with great honor that I welcome you to our 2nd anatomy annual congress. This year’s theme is “Anatomy for Patients’ Safety and Professional Growth.” Understanding anatomy is crucial for patient safety and professional development as it forms the cornerstone of healthcare practice. For accurate diagnosis and treatment, a solid understanding of anatomy is necessary in all areas, including the physical examination of a patient, the interpretation of symptoms, the interpretation of radiological images, and the comprehension of pathological illnesses. Thus, it may be claimed that a good healthcare worker is one who can use anatomical knowledge to give his or her patients high-quality care. \u0000Patient safety is a concern in healthcare practice not just in Rwanda but globally, as it directly impacts the quality of care, patient outcomes, and public trust in healthcare. Rwanda is a low- and middle-income country with a developing healthcare infrastructure, and it is important that patient safety is a priority. This is why the 2nd Anatomy Congress of S-CAR offers the ideal setting for professionals to collaborate and share experiences, learn from specialists, embrace ongoing advancements in anatomy education, and advance patient safety and professional development in Rwanda and Africa. \u0000Our participation in this S-CAR congress is a testament to our commitment to the well-being of our patients and our passion for professional growth. We will all promise to uphold not only the anatomy profession in Rwanda but also to support patient safety and carry the torch for our professional advancement. The 2nd Anatomy Annual Congress program offers an interesting package for both professionals and students, with 39 presentations subdivided into six sessions (medical education, learning assessment, anatomical study, anatomical variations, surgical anatomy, neuroanatomy, and neuroscience). This conference will help appreciate the beauty of the anatomy sciences and its importance in patient safety and professional growth in Rwanda. On behalf of S-CAR, I would like to express my gratitude to the sponsors of this congress, namely: UR, Operation Smile, and MMI.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"89 S1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140706937","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}
A. Mohammed, S. Olorunnado, V. Archibong, J. Gashegu
The greater saphenous vein (GSV) is a vital structure in the lower extremity with well-documented anatomical variations. This case report describes the unexpected discovery of an accessory GSV during a routine cadaveric dissection at the University of Rwanda's School of Medicine and Pharmacy. The accessory GSV ran parallel to the main GSV before rejoining it higher in the leg. This finding underscores the importance of recognizing anatomical variations like accessory GSVs, which can influence clinical procedures and outcomes. Increased awareness among clinicians and educators is crucial, and further research is needed to assess the prevalence and clinical implications of this rare anatomical variant.
{"title":"Discovery of an accessory greater saphenous vein - a case study","authors":"A. Mohammed, S. Olorunnado, V. Archibong, J. Gashegu","doi":"10.4314/rmj.v81i1.9","DOIUrl":"https://doi.org/10.4314/rmj.v81i1.9","url":null,"abstract":"The greater saphenous vein (GSV) is a vital structure in the lower extremity with well-documented anatomical variations. This case report describes the unexpected discovery of an accessory GSV during a routine cadaveric dissection at the University of Rwanda's School of Medicine and Pharmacy. The accessory GSV ran parallel to the main GSV before rejoining it higher in the leg. This finding underscores the importance of recognizing anatomical variations like accessory GSVs, which can influence clinical procedures and outcomes. Increased awareness among clinicians and educators is crucial, and further research is needed to assess the prevalence and clinical implications of this rare anatomical variant.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140708459","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}
J. Rugambwa, O. Kubwimana, F. Hirwa, E. Rafiki, S. Olorunnado, J. Gashegu
Anatomical variations in humans are widespread but highly complex. A thorough understanding of anatomy is essential for successful surgical and anesthetic procedures. Brachial plexus anatomical variations are prevalent and account for more than 50% of anatomical variations in cadaveric analyses of the human nervous system. Clinical outcomes may be unsatisfactory if specific brachial plexus anatomical variations are overlooked. In 22% of axillary blocks, the musculocutaneous nerve location was found to be irregular. It may be joined to the median nerve and extended distally before disconnecting from it or may be located close to the axillary artery more frequently. Hence, understanding the anatomy of the brachial plexus is necessary for excellent clinical outcomes in upper extremity surgical procedures. We identified a complex left brachial plexus anatomical variation during the upper limbs dissection course. From the lateral cord, two parallel nervous brands emerge as the musculocutaneous nerve and median nerve fusing into the median-musculocutaneous common trunk. Distally, this trunk forms the ansa brachii that gives the nerve to the biceps brachii muscle, the nerve to the brachialis muscle, and the lateral cutaneous nerve of the forearm. Four branches from the lateral cord, the musculocutaneous nerve, and the median-musculocutaneous trunk sequentially innervated the coracobrachialis muscle. Successful upper extremity surgery and anesthesia need a thorough understanding of the human brachial plexus anatomy and its variations. Additional research and dissections are encouraged to understand human anatomy and its variations.
{"title":"Ansa brachii from a median-musculocutaneous trunk: an anatomical variation - a case report","authors":"J. Rugambwa, O. Kubwimana, F. Hirwa, E. Rafiki, S. Olorunnado, J. Gashegu","doi":"10.4314/rmj.v81i1.19","DOIUrl":"https://doi.org/10.4314/rmj.v81i1.19","url":null,"abstract":"Anatomical variations in humans are widespread but highly complex. A thorough understanding of anatomy is essential for successful surgical and anesthetic procedures. Brachial plexus anatomical variations are prevalent and account for more than 50% of anatomical variations in cadaveric analyses of the human nervous system. Clinical outcomes may be unsatisfactory if specific brachial plexus anatomical variations are overlooked. In 22% of axillary blocks, the musculocutaneous nerve location was found to be irregular. It may be joined to the median nerve and extended distally before disconnecting from it or may be located close to the axillary artery more frequently. Hence, understanding the anatomy of the brachial plexus is necessary for excellent clinical outcomes in upper extremity surgical procedures. We identified a complex left brachial plexus anatomical variation during the upper limbs dissection course. From the lateral cord, two parallel nervous brands emerge as the musculocutaneous nerve and median nerve fusing into the median-musculocutaneous common trunk. Distally, this trunk forms the ansa brachii that gives the nerve to the biceps brachii muscle, the nerve to the brachialis muscle, and the lateral cutaneous nerve of the forearm. Four branches from the lateral cord, the musculocutaneous nerve, and the median-musculocutaneous trunk sequentially innervated the coracobrachialis muscle. Successful upper extremity surgery and anesthesia need a thorough understanding of the human brachial plexus anatomy and its variations. Additional research and dissections are encouraged to understand human anatomy and its variations.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"49 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140707311","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}
INTRODUCTION: Obesity has become a major public health issue worldwide. This study assessed knowledge and practices regarding various pharmacological and non-pharmacological weight loss approaches among 393 adults in Iraq. METHODS: A questionnaire captured data on weight methods used, knowledge of treatable conditions, adverse effects, safety, efficacy, and challenges with long-term adherence. RESULTS: Most participants were obese (64%), female (68%) with mainly being young age groups (18-29) and they were aware (93%) about their weight. Most participants were actively trying methods like fasting/intermittent fasting (20-26%), low-carbohydrates (36%), and exercise to lose weight (39%), driven by health and aesthetic concerns. Understanding of obesity-related diseases, reversible side effects, and medical supervision needs was reasonable. However, crucial knowledge gaps existed regarding nutritional adequacy and unrealistic expectations of sustained weight loss without professional support. The most well-known approaches were intermittent fasting (20-26%), reduced carbohydrate intake (36%) and increased exercise (38.9%). Key information sources were the internet (70%), nutrition specialists (33%), and family/friends (28-29%), rather than formal healthcare providers. Around 60% correctly identified weight reduction and comorbidity prevention as the main goals, though 15% wrongly assumed blood sugar control in non-diabetics. CONCLUSION: These participants were highly concerned about their weight with minimal knowledge and themselves trying different methods to minimise the health impact of obesity; mainly fasting and exercise and participants confirmed that these are safer than other options.
{"title":"Knowledge and practice of adults towards different weight loss methods","authors":"R. Aldabbagh, Marwah A. Alshorbaji, Y. Alsabbagh","doi":"10.4314/rmj.v81i1.5","DOIUrl":"https://doi.org/10.4314/rmj.v81i1.5","url":null,"abstract":"INTRODUCTION: Obesity has become a major public health issue worldwide. This study assessed knowledge and practices regarding various pharmacological and non-pharmacological weight loss approaches among 393 adults in Iraq. \u0000METHODS: A questionnaire captured data on weight methods used, knowledge of treatable conditions, adverse effects, safety, efficacy, and challenges with long-term adherence. \u0000RESULTS: Most participants were obese (64%), female (68%) with mainly being young age groups (18-29) and they were aware (93%) about their weight. Most participants were actively trying methods like fasting/intermittent fasting (20-26%), low-carbohydrates (36%), and exercise to lose weight (39%), driven by health and aesthetic concerns. Understanding of obesity-related diseases, reversible side effects, and medical supervision needs was reasonable. However, crucial knowledge gaps existed regarding nutritional adequacy and unrealistic expectations of sustained weight loss without professional support. The most well-known approaches were intermittent fasting (20-26%), reduced carbohydrate intake (36%) and increased exercise (38.9%). Key information sources were the internet (70%), nutrition specialists (33%), and family/friends (28-29%), rather than formal healthcare providers. Around 60% correctly identified weight reduction and comorbidity prevention as the main goals, though 15% wrongly assumed blood sugar control in non-diabetics. \u0000CONCLUSION: These participants were highly concerned about their weight with minimal knowledge and themselves trying different methods to minimise the health impact of obesity; mainly fasting and exercise and participants confirmed that these are safer than other options.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"23 s1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140707322","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}
D. Nyampinga, E. Rutaganda, F. Shikama, Z. Ingabire, S. Mukanumviye, S. Turikumwe, H. Aberra, B. Redae, B. Seminega, V. Dusabejambo, D. J. Van Leeuwen
INTRODUCTION: Upper gastrointestinal (GI) bleeding is a common emergency that results in significant morbidity and mortality. In Rwanda, data on causes and outcomes are lacking. The aim of this study was to identify the causes and outcomes of upper gastrointestinal bleeding in patients referred to tertiary referral centers. METHODS: This is an observational prospective study for which we enrolled all patients who presented with presumed upper gastrointestinal bleeding and underwent upper gastrointestinal endoscopy. We studied causes and outcomes during 3 months of follow-up after initial presentation from February 2019 to September 2019. RESULTS: We enrolled 194 participants. The mean age was 49.6 ± 17.66 years. The common causes of upper GI bleeding were peptic ulcer disease in 82 (43.3%) patients, esophageal varices 32 (16.5%), gastric malignancies 22 (11.3%), and gastritis 21 (10.8%). The upper GI endoscopy was reported to be normal in only 20 cases (10.3%). The mortality and rebleeding rates after 3 months were 37 (19.07%) and 70 (36%) respectively. The esophageal varices were associated with increased rebleeding (OR: 10.791, P value <0.001), while gastric cancer was associated with increased mortality (OR: 4.405, P value 0.008). CONCLUSION: Upper gastrointestinal bleeding is a considerable problem in Rwandan teaching hospitals. Our findings are in agreement with the reported causes of upper GI bleeding worldwide. From this study, we consider that variceal hemorrhage and peptic ulcer may have the potential to be better managed.
{"title":"Causes and outcomes of upper gastrointestinal bleeding in referral hospitals in Rwanda: a prospective study","authors":"D. Nyampinga, E. Rutaganda, F. Shikama, Z. Ingabire, S. Mukanumviye, S. Turikumwe, H. Aberra, B. Redae, B. Seminega, V. Dusabejambo, D. J. Van Leeuwen","doi":"10.4314/rmj.v80i4.9","DOIUrl":"https://doi.org/10.4314/rmj.v80i4.9","url":null,"abstract":"INTRODUCTION: Upper gastrointestinal (GI) bleeding is a common emergency that results in significant morbidity and mortality. In Rwanda, data on causes and outcomes are lacking. The aim of this study was to identify the causes and outcomes of upper gastrointestinal bleeding in patients referred to tertiary referral centers. \u0000METHODS: This is an observational prospective study for which we enrolled all patients who presented with presumed upper gastrointestinal bleeding and underwent upper gastrointestinal endoscopy. We studied causes and outcomes during 3 months of follow-up after initial presentation from February 2019 to September 2019. \u0000RESULTS: We enrolled 194 participants. The mean age was 49.6 ± 17.66 years. The common causes of upper GI bleeding were peptic ulcer disease in 82 (43.3%) patients, esophageal varices 32 (16.5%), gastric malignancies 22 (11.3%), and gastritis 21 (10.8%). The upper GI endoscopy was reported to be normal in only 20 cases (10.3%). The mortality and rebleeding rates after 3 months were 37 (19.07%) and 70 (36%) respectively. The esophageal varices were associated with increased rebleeding (OR: 10.791, P value <0.001), while gastric cancer was associated with increased mortality (OR: 4.405, P value 0.008). \u0000CONCLUSION: Upper gastrointestinal bleeding is a considerable problem in Rwandan teaching hospitals. Our findings are in agreement with the reported causes of upper GI bleeding worldwide. From this study, we consider that variceal hemorrhage and peptic ulcer may have the potential to be better managed.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"95 9-10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140491845","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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