O. O. Oladosu, B. Bolaji, O. Ige, I. I. Enaworu, A. Alawode
INTRODUCTION: Laryngoscopy and endotracheal intubation at induction of anaesthesia have been associated with awareness and haemodynamic fluctuations. Agents that can mitigate these effects should create better anaesthetic conditions. This study aimed to compare the effects of intravenous esmolol and lidocaine on the bispectral index (BIS) and haemodynamic responses during induction of general anaesthesia with propofol/fentanyl in adult patients scheduled for elective surgical procedures. METHODS: This was a prospective randomized controlled study in ninety patients aged 18-65 years who were randomized into three groups to receive either IV esmolol 0.5 mg/kg, IV lidocaine 1.5 mg/kg or normal saline prior to induction of general anaesthesia. RESULTS: The esmolol group had a significantly shorter induction time (p<0.0001) and a lower dose of propofol consumed (p<0.0001) than the lidocaine group. The mean pulse rate was significantly lower at the 1st min to 4th min post-intubation in esmolol and lidocaine groups compared to the control group (p values; 1 min= 0.005, 2 min= 0.008, 3 min= 0.023, 4 min= 0.018). There was a significant difference in the systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) in the three groups at 2 min post-intubation. CONCLUSION: Pre-induction intravenous esmolol 0.5 mg/kg was more effective than intravenous lidocaine 1.5 mg/kg in reducing the induction dose of propofol and the induction time. Esmolol also prevented increases in BIS better than lidocaine following endotracheal intubation but both agents were equally effective in attenuating the haemodynamic changes associated with laryngoscopy and endotracheal intubation.
{"title":"Comparative effects of intravenous esmolol and lidocaine on bispectral index during propofol-fentanyl induction in patients scheduled for elective surgeries under general anaesthesia","authors":"O. O. Oladosu, B. Bolaji, O. Ige, I. I. Enaworu, A. Alawode","doi":"10.4314/rmj.v80i4.8","DOIUrl":"https://doi.org/10.4314/rmj.v80i4.8","url":null,"abstract":"INTRODUCTION: Laryngoscopy and endotracheal intubation at induction of anaesthesia have been associated with awareness and haemodynamic fluctuations. Agents that can mitigate these effects should create better anaesthetic conditions. This study aimed to compare the effects of intravenous esmolol and lidocaine on the bispectral index (BIS) and haemodynamic responses during induction of general anaesthesia with propofol/fentanyl in adult patients scheduled for elective surgical procedures. \u0000METHODS: This was a prospective randomized controlled study in ninety patients aged 18-65 years who were randomized into three groups to receive either IV esmolol 0.5 mg/kg, IV lidocaine 1.5 mg/kg or normal saline prior to induction of general anaesthesia. \u0000RESULTS: The esmolol group had a significantly shorter induction time (p<0.0001) and a lower dose of propofol consumed (p<0.0001) than the lidocaine group. The mean pulse rate was significantly lower at the 1st min to 4th min post-intubation in esmolol and lidocaine groups compared to the control group (p values; 1 min= 0.005, 2 min= 0.008, 3 min= 0.023, 4 min= 0.018). There was a significant difference in the systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) in the three groups at 2 min post-intubation. \u0000CONCLUSION: Pre-induction intravenous esmolol 0.5 mg/kg was more effective than intravenous lidocaine 1.5 mg/kg in reducing the induction dose of propofol and the induction time. Esmolol also prevented increases in BIS better than lidocaine following endotracheal intubation but both agents were equally effective in attenuating the haemodynamic changes associated with laryngoscopy and endotracheal intubation.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"385 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140490803","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: Thrower’s Ten program is a thrower-specific workout program that increases upper-extremity strength, power, and endurance, especially in overhead athletes. The study compares the thrower's ten-exercise program to the regular warm-up program in recreational cricket bowlers' posterior capsule tightness, internal rotator strength, upper extremity stability, and explosive power. METHODS: Based on inclusion and exclusion criteria, 82 recreational cricket bowlers were divided into experimental (n=41) and control (n=41) groups. The experimental group received Thrower's ten warm-up programs three times a week for six weeks, along with the standard warm-up. Control maintained its warm-up routine. Before and after six weeks, participants were tested for shoulder internal rotator strength, posterior capsule tightness, stability, and explosive power. SPSS software was used to calculate outcome measures mean, standard deviation, independent t-test, and paired t-test. RESULTS: After six weeks, all outcome measures exhibited a significant difference (p<0.05) within the experimental group, whereas none of the outcome measures depicted a significant difference (p>0.05) within the control group. A significant difference (p<0.05) was seen between the groups for post-test strength and upper extremity stability measures. However, a non-significant difference (p>0.05) was noted between groups for posterior capsule tightness and upper extremity explosive power. CONCLUSION: Compared to the usual warm-up program used by recreational cricket bowlers, the thrower’s customized warm-up routine is more successful in improving internal rotator strength and upper extremity stability. Both warm-up programs enhance posterior capsule tightness and upper extremity explosive power.
简介："投手十式 "训练计划是一项针对投手的训练计划，可增强上肢力量、力量和耐力，尤其是高空运动员的上肢力量、力量和耐力。本研究比较了 "投手十式 "锻炼计划和常规热身计划对休闲板球运动员后关节囊紧绷度、内旋肌力量、上肢稳定性和爆发力的影响。方法：根据纳入和排除标准，82 名休闲板球保龄球运动员被分为实验组（41 人）和对照组（41 人）。实验组接受 Thrower 的十项热身计划，每周三次，为期六周，同时进行标准热身。对照组保持热身常规。在六周前和六周后，参与者接受了肩关节内旋肌力量、后囊紧绷度、稳定性和爆发力测试。使用 SPSS 软件计算结果指标的平均值、标准差、独立 t 检验和配对 t 检验。结果：六周后，对照组的所有结果指标均有显著差异（P0.05）。组间在后囊紧缩度和上肢爆发力方面有明显差异（P0.05）。结论：与休闲板球保龄球运动员通常使用的热身计划相比，投掷手定制的热身程序在改善内旋肌力量和上肢稳定性方面更为成功。两种热身计划都能增强后关节囊的紧实度和上肢爆发力。
{"title":"Comparing the effectiveness of thrower’s specific exercise program with regular warm-up program in recreational cricket bowlers","authors":"P. S. Timothy, S. Subramanian","doi":"10.4314/rmj.v80i4.7","DOIUrl":"https://doi.org/10.4314/rmj.v80i4.7","url":null,"abstract":"INTRODUCTION: Thrower’s Ten program is a thrower-specific workout program that increases upper-extremity strength, power, and endurance, especially in overhead athletes. The study compares the thrower's ten-exercise program to the regular warm-up program in recreational cricket bowlers' posterior capsule tightness, internal rotator strength, upper extremity stability, and explosive power. \u0000METHODS: Based on inclusion and exclusion criteria, 82 recreational cricket bowlers were divided into experimental (n=41) and control (n=41) groups. The experimental group received Thrower's ten warm-up programs three times a week for six weeks, along with the standard warm-up. Control maintained its warm-up routine. Before and after six weeks, participants were tested for shoulder internal rotator strength, posterior capsule tightness, stability, and explosive power. SPSS software was used to calculate outcome measures mean, standard deviation, independent t-test, and paired t-test. \u0000RESULTS: After six weeks, all outcome measures exhibited a significant difference (p<0.05) within the experimental group, whereas none of the outcome measures depicted a significant difference (p>0.05) within the control group. A significant difference (p<0.05) was seen between the groups for post-test strength and upper extremity stability measures. However, a non-significant difference (p>0.05) was noted between groups for posterior capsule tightness and upper extremity explosive power. \u0000CONCLUSION: Compared to the usual warm-up program used by recreational cricket bowlers, the thrower’s customized warm-up routine is more successful in improving internal rotator strength and upper extremity stability. Both warm-up programs enhance posterior capsule tightness and upper extremity explosive power.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"199 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140491538","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. E. Nirmala Dewi, M. Octavia, W. Himawan, D. Sugiyo
INTRODUCTION: Toxic agents from cigarette smoke can affect the cardiovascular system, especially coronary heart disease (CHD). The implication to the second-hand smoker was 80%–90%, similar to the first-hand smoker. This study aimed to provide preliminary data on the smoking effect among first- and second-hand smokers according to cardiac diseases in Yogyakarta, Indonesia. METHODS: This descriptive cross-sectional study was conducted by prospectively collecting data from two secondary hospitals in Yogyakarta, Indonesia. The collected data were descriptively analyzed to compare the first- and second-hand smokers to the variables. ANOVA or the Mann- Whitney Test, was also used to obtain the correlation of each variable across both smoking groups. RESULTS: Among the 101 participants, we found that smoking habits can have a similar or even higher impact among second-hand smokers compared to first-hand smokers with respect to congestive heart failure (CHF) diagnoses (48% vs. 56%), IHD diagnoses (36% vs. 27.9%), suffering chest pain (39.3% vs. 27.8%), and shortness of breath (38.7% vs. 33.3%). CONCLUSION: Smoking habits can increase the risk of CHD, especially CHF, and IHD, among first- and second-hand smokers. Indonesia's government should protect second-hand smokers and limit the exposure of first-hand smokers to cigarettes.
{"title":"Impact of first- and second-hand smoking on cardiac diseases in Yogyakarta, Indonesia: a preliminary cross-sectional study","authors":"P. E. Nirmala Dewi, M. Octavia, W. Himawan, D. Sugiyo","doi":"10.4314/rmj.v80i4.4","DOIUrl":"https://doi.org/10.4314/rmj.v80i4.4","url":null,"abstract":"INTRODUCTION: Toxic agents from cigarette smoke can affect the cardiovascular system, especially coronary heart disease (CHD). The implication to the second-hand smoker was 80%–90%, similar to the first-hand smoker. This study aimed to provide preliminary data on the smoking effect among first- and second-hand smokers according to cardiac diseases in Yogyakarta, Indonesia. \u0000METHODS: This descriptive cross-sectional study was conducted by prospectively collecting data from two secondary hospitals in Yogyakarta, Indonesia. The collected data were descriptively analyzed to compare the first- and second-hand smokers to the variables. ANOVA or the Mann- Whitney Test, was also used to obtain the correlation of each variable across both smoking groups. \u0000RESULTS: Among the 101 participants, we found that smoking habits can have a similar or even higher impact among second-hand smokers compared to first-hand smokers with respect to congestive heart failure (CHF) diagnoses (48% vs. 56%), IHD diagnoses (36% vs. 27.9%), suffering chest pain (39.3% vs. 27.8%), and shortness of breath (38.7% vs. 33.3%). \u0000CONCLUSION: Smoking habits can increase the risk of CHD, especially CHF, and IHD, among first- and second-hand smokers. Indonesia's government should protect second-hand smokers and limit the exposure of first-hand smokers to cigarettes.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"149 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140491551","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. A. Omotoso, J. Ojo, T. Ipinnimo, T. Alao, M. Chimah, E. Uchuno, H. Mohammed, A. Etuk, B. Osho, O. Olasehinde
NTRODUCTION: Depression is among the most common mental and public health problems globally. Depression is generally common among university students and is especially high among undergraduates on clinical postings. Clinical students are exposed to varying kinds of stressors ensuing from difficulties integrating into the hospital system and implicated in causing academic failure, disability, and poor quality of life. This study aimed to assess the knowledge and the socio-demographic factors associated with depression among clinical undergraduates in a private university. METHODS: This was a cross-sectional study conducted among 242 students of the College of Medicine and Health Sciences of a private university who were undergoing their clinical rotations. Data was collected on the socio-demographic variable and knowledge of depression. The proportion of students with depression was determined with the 20-itemZung self-rating depression scale. RESULTS: Less than half (43.0%) of the respondents had good knowledge of depression, with the majority using social media (82.6%) and one-third of Journals/textbooks (34.3%) as sources of information. The identified predictors of depression were being female (AOR:2.624; 95%CI:1.006-7.600) and having poor knowledge of depression (AOR:2.806; 95%CI:1.121-3.975). CONCLUSION: This study revealed that less than half of the students had good knowledge of depression. Poor knowledge and female gender were identified as positive predictors of depression. Therefore, more effort should also be taken by the school authority to educate these students on depression.
{"title":"Knowledge and socio-demographic factors associated with depression among students on clinical rotation in a private university in Ekiti state, Nigeria","authors":"A. A. Omotoso, J. Ojo, T. Ipinnimo, T. Alao, M. Chimah, E. Uchuno, H. Mohammed, A. Etuk, B. Osho, O. Olasehinde","doi":"10.4314/rmj.v80i4.3","DOIUrl":"https://doi.org/10.4314/rmj.v80i4.3","url":null,"abstract":"NTRODUCTION: Depression is among the most common mental and public health problems globally. Depression is generally common among university students and is especially high among undergraduates on clinical postings. Clinical students are exposed to varying kinds of stressors ensuing from difficulties integrating into the hospital system and implicated in causing academic failure, disability, and poor quality of life. This study aimed to assess the knowledge and the socio-demographic factors associated with depression among clinical undergraduates in a private university. \u0000METHODS: This was a cross-sectional study conducted among 242 students of the College of Medicine and Health Sciences of a private university who were undergoing their clinical rotations. Data was collected on the socio-demographic variable and knowledge of depression. The proportion of students with depression was determined with the 20-itemZung self-rating depression scale. \u0000RESULTS: Less than half (43.0%) of the respondents had good knowledge of depression, with the majority using social media (82.6%) and one-third of Journals/textbooks (34.3%) as sources of information. The identified predictors of depression were being female (AOR:2.624; 95%CI:1.006-7.600) and having poor knowledge of depression (AOR:2.806; 95%CI:1.121-3.975). \u0000CONCLUSION: This study revealed that less than half of the students had good knowledge of depression. Poor knowledge and female gender were identified as positive predictors of depression. Therefore, more effort should also be taken by the school authority to educate these students on depression.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"406 28","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140490533","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: Malaria in pregnancy is associated with a high rate of maternal and perinatal morbidity and mortality. Utilization of preventive strategies during pregnancy is an integral part of controlling the burden of malaria in pregnancy. This study evaluated the malaria preventive strategies utilized and the prevalence of asymptomatic malaria among pregnant women at Adeoyo Maternity Teaching Hospital (AMTH), Ibadan, Nigeria. METHODS: A facility-based descriptive cross-sectional study among 223 pregnant women in Adeoyo Maternity Teaching Hospital, Ibadan, Nigeria. Information on socio-demographic and obstetric characteristics, malaria symptoms, and the preventive strategies utilized were obtained using a structured questionnaire. Descriptive and bivariate analysis using chi-square test and multivariate analysis at 95% confidence interval and p< 0.05 was used to determine the predictors of asymptomatic malaria infection in relation to socio-demographic characteristics and malaria preventive strategies utilized. RESULTS: The mean age was 30±5 years. More than half (53.4%) of them used insecticide-treated nets consistently, 49.3% sprayed the room regularly with insecticides, while the majority (88.3%) reported they maintained a clean environment. However, 11.7% tested positive for the malaria parasite. Consistency in the use of insecticide-treated net (ITN) and participants age were factors associated with malaria occurrence (p=0.01). The use of ITN and being >30 years of age are protective factors against having malaria infection among pregnant women (AOR= 0.34; 95%, CI=0.14-0.84) and (AOR=0.31; 95% CI=0.13-0.76) respectively. CONCLUSION: Irrespective of all other malaria preventive strategies adopted by pregnant women, consistent use of ITN was independently a protective factor against developing malaria in pregnancy.
{"title":"Utilization of malaria preventive strategies among pregnant women at Adeoyo Maternity Teaching Hospital, Ibadan, Nigeria","authors":"Olaolu O. Oni, O. Bello","doi":"10.4314/rmj.v80i4.6","DOIUrl":"https://doi.org/10.4314/rmj.v80i4.6","url":null,"abstract":"INTRODUCTION: Malaria in pregnancy is associated with a high rate of maternal and perinatal morbidity and mortality. Utilization of preventive strategies during pregnancy is an integral part of controlling the burden of malaria in pregnancy. This study evaluated the malaria preventive strategies utilized and the prevalence of asymptomatic malaria among pregnant women at Adeoyo Maternity Teaching Hospital (AMTH), Ibadan, Nigeria. \u0000METHODS: A facility-based descriptive cross-sectional study among 223 pregnant women in Adeoyo Maternity Teaching Hospital, Ibadan, Nigeria. Information on socio-demographic and obstetric characteristics, malaria symptoms, and the preventive strategies utilized were obtained using a structured questionnaire. Descriptive and bivariate analysis using chi-square test and multivariate analysis at 95% confidence interval and p< 0.05 was used to determine the predictors of asymptomatic malaria infection in relation to socio-demographic characteristics and malaria preventive strategies utilized. \u0000RESULTS: The mean age was 30±5 years. More than half (53.4%) of them used insecticide-treated nets consistently, 49.3% sprayed the room regularly with insecticides, while the majority (88.3%) reported they maintained a clean environment. However, 11.7% tested positive for the malaria parasite. Consistency in the use of insecticide-treated net (ITN) and participants age were factors associated with malaria occurrence (p=0.01). The use of ITN and being >30 years of age are protective factors against having malaria infection among pregnant women (AOR= 0.34; 95%, CI=0.14-0.84) and (AOR=0.31; 95% CI=0.13-0.76) respectively. \u0000CONCLUSION: Irrespective of all other malaria preventive strategies adopted by pregnant women, consistent use of ITN was independently a protective factor against developing malaria in pregnancy.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"397 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140490686","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: Erectile dysfunction has adverse effects on the marital harmony and self-esteem of affected persons. It is shrouded in shame in our environment, hence affecting self-reporting of the condition. It is linked to CVDs in its etiology. The objective was to determine the relationship between erectile dysfunction (ED) and cardiovascular risk factors to recommend them as indicators for screening for ED in our environment. METHODS: This was a cross-sectional analytical study of 243 men at a tertiary hospital in Nigeria. Participants were recruited by systematic random sampling, excluding those on aphrodisiacs. Erectile dysfunction was measured using the International Index of Erectile Function (IIEF-5), and ED was defined as a score <17. CVD risk factors were obtained from history and examination. Univariate analysis and logistic regressions were used to elicit associations between ED and cardiovascular risk factors. RESULTS: The prevalence of ED was 47.3%. Erectile dysfunction was associated with increasing age (χ2=27, p<0.01), harmful alcohol use (χ2=3.08, p= 0.079), diabetes (χ2=8.29, p=0.04), and hypertension (χ2=12.28, p =0.01) following bivariate analysis. However, only advanced age (aOR=0.04, 95% CI: 0.00-0.54, p = 0.014) and harmful alcohol use (aOR = 0.37, 95% CI: 0.04-0.97, p=0.043) were independently associated with ED after binary logistic regression. CONCLUSION: The prevalence of ED is high high. It is associated with age, harmful alcohol use, diabetes mellitus, and hypertension, hence the need to screen for ED, especially in the presence of these factors.
导言：勃起功能障碍会对患者的婚姻和谐和自尊心造成不利影响。在我们的环境中，勃起功能障碍被蒙上了一层羞耻的阴影，因此影响了患者对病情的自我报告。其病因与心血管疾病有关。本研究旨在确定勃起功能障碍（ED）与心血管风险因素之间的关系，并建议将其作为在我们的环境中筛查 ED 的指标。方法：这是一项横断面分析研究，对象是尼日利亚一家三级医院的 243 名男性。研究人员通过系统随机抽样的方式招募，不包括服用壮阳药的男性。勃起功能障碍采用国际勃起功能指数（IIEF-5）进行测量，得分小于17分定义为ED。心血管疾病风险因素通过病史和检查获得。采用单变量分析和逻辑回归找出 ED 与心血管风险因素之间的关联。结果：ED的发病率为47.3%。经二变量分析，勃起功能障碍与年龄增加（χ2=27，P<0.01）、有害饮酒（χ2=3.08，P= 0.079）、糖尿病（χ2=8.29，P=0.04）和高血压（χ2=12.28，P=0.01）有关。然而，在二元逻辑回归后，只有高龄（aOR=0.04，95% CI：0.00-0.54，p=0.014）和有害饮酒（aOR=0.37，95% CI：0.04-0.97，p=0.043）与 ED 独立相关。结论：ED 的发病率很高。它与年龄、酗酒、糖尿病和高血压有关，因此有必要对 ED 进行筛查，尤其是在存在这些因素的情况下。
{"title":"Association between erectile dysfunction and cardiovascular risk factors in a Nigeria tertiary hospital","authors":"I. Tor-Anyiin, O. E. Omokhua, L. T. Swende","doi":"10.4314/rmj.v80i4.2","DOIUrl":"https://doi.org/10.4314/rmj.v80i4.2","url":null,"abstract":"INTRODUCTION: Erectile dysfunction has adverse effects on the marital harmony and self-esteem of affected persons. It is shrouded in shame in our environment, hence affecting self-reporting of the condition. It is linked to CVDs in its etiology. The objective was to determine the relationship between erectile dysfunction (ED) and cardiovascular risk factors to recommend them as indicators for screening for ED in our environment. \u0000METHODS: This was a cross-sectional analytical study of 243 men at a tertiary hospital in Nigeria. Participants were recruited by systematic random sampling, excluding those on aphrodisiacs. Erectile dysfunction was measured using the International Index of Erectile Function (IIEF-5), and ED was defined as a score <17. CVD risk factors were obtained from history and examination. Univariate analysis and logistic regressions were used to elicit associations between ED and cardiovascular risk factors. \u0000RESULTS: The prevalence of ED was 47.3%. Erectile dysfunction was associated with increasing age (χ2=27, p<0.01), harmful alcohol use (χ2=3.08, p= 0.079), diabetes (χ2=8.29, p=0.04), and hypertension (χ2=12.28, p =0.01) following bivariate analysis. However, only advanced age (aOR=0.04, 95% CI: 0.00-0.54, p = 0.014) and harmful alcohol use (aOR = 0.37, 95% CI: 0.04-0.97, p=0.043) were independently associated with ED after binary logistic regression. \u0000CONCLUSION: The prevalence of ED is high high. It is associated with age, harmful alcohol use, diabetes mellitus, and hypertension, hence the need to screen for ED, especially in the presence of these factors.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"130 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140491717","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. Nzabandora, S. Bilal, L. Jing, M. B. Henry, A. Beeman, G. Mbanjumucyo, N. Rosenberg, J. Nyinawankusi, V. Sharma, V. Ndebwanimana, J. Muaragizi, E. Odoom, A. Aluisio
INTRODUCTION: The burden of injuries is high in low- and middle-income countries where pre-hospital systems are being developed to improve acute injury care. This study compares the characteristics and outcomes between trauma patients transported by formal emergency medical services (EMS) and by private transport to the emergency department (ED) of the Centre Hospitalier Universitaire de Kigali (CHUK) in Rwanda. METHODS: This retrospective cohort study analyzed a random sample of trauma patients presenting between 1 August 2015 and 30 July 2016. Descriptive analyses were performed, and differences in outcomes were assessed based on transport modalities via Pearson Chi-Squared or Fisher’s Exact tests. RESULTS: Of the 556 trauma patients analyzed, 87.1% were transported by private transport and the remainder by EMS. The median inpatient length of stay for private transport patients was 7 days (IQR:3-16 days), compared to 9.5 days for EMS patients (IQR:4-18 days) (p=0.301). More EMS-transported patients died in the ED (p=0.005), and more were admitted to the hospital. There was a higher mortality rate among patients admitted to the hospital who arrived by private transport, but the difference was not statistically significant. CONCLUSION: The higher ED death rate among EMS-transported patients and the higher in-hospital death rate among private transport patients suggest that major differences in the two groups may or may not be related to how trauma patients are brought to the ED.
{"title":"Comparative epidemiology and outcomes among trauma patients transported by private and formal pre-hospital care modes in Kigali, Rwanda","authors":"J. Nzabandora, S. Bilal, L. Jing, M. B. Henry, A. Beeman, G. Mbanjumucyo, N. Rosenberg, J. Nyinawankusi, V. Sharma, V. Ndebwanimana, J. Muaragizi, E. Odoom, A. Aluisio","doi":"10.4314/rmj.v80i4.1","DOIUrl":"https://doi.org/10.4314/rmj.v80i4.1","url":null,"abstract":"INTRODUCTION: The burden of injuries is high in low- and middle-income countries where pre-hospital systems are being developed to improve acute injury care. This study compares the characteristics and outcomes between trauma patients transported by formal emergency medical services (EMS) and by private transport to the emergency department (ED) of the Centre Hospitalier Universitaire de Kigali (CHUK) in Rwanda. \u0000METHODS: This retrospective cohort study analyzed a random sample of trauma patients presenting between 1 August 2015 and 30 July 2016. Descriptive analyses were performed, and differences in outcomes were assessed based on transport modalities via Pearson Chi-Squared or Fisher’s Exact tests. \u0000RESULTS: Of the 556 trauma patients analyzed, 87.1% were transported by private transport and the remainder by EMS. The median inpatient length of stay for private transport patients was 7 days (IQR:3-16 days), compared to 9.5 days for EMS patients (IQR:4-18 days) (p=0.301). More EMS-transported patients died in the ED (p=0.005), and more were admitted to the hospital. There was a higher mortality rate among patients admitted to the hospital who arrived by private transport, but the difference was not statistically significant. \u0000CONCLUSION: The higher ED death rate among EMS-transported patients and the higher in-hospital death rate among private transport patients suggest that major differences in the two groups may or may not be related to how trauma patients are brought to the ED.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"250 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140491149","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. S. Kabba, N. T. Onyishi, A. Kalawa, R. K. Adeyinka, B. M. Duduyemi
INTRODUCTION: Thyroid disorders are the second most common endocrine diseases in humans. There has been no study of thyroid masses in our setting in spite of recurrent presentations. We undertook a retrospective study of incident thyroidectomy cases in our anatomic pathology laboratory over one year to establish the frequency and clinico-pathologic features of thyroid masses. METHODS: All thyroid specimens submitted to the anatomic pathology laboratory of the University of Sierra Leone Teaching Hospital Connaught from January 1, 2021 to December 31, 2021, were included in the study. Data was extracted from archived request forms, pathology reports, and patient’s case notes retrieved from the records department. The data obtained was analyzed with SPSS software. RESULTS: Twenty-seven thyroidectomy specimens (4.5% of all surgical pathology cases) were seen over a one-year period. Ninety-two percent were from women, while 7.4% were from men. The age range of patients was 17 to 65 years; the median age (IQR) was 40 (35-48) years. Duration of mass before presentation ranged from 3 months to 50 years. About 75% of the resected thyroid masses weighed 5 to 21 times more than a normal thyroid gland. Multinodular goiter was the most common histology (70.4%). Twenty-two percent of the resected masses were malignant. CONCLUSION: Thyroid masses constitute about 4.5% of all surgical specimens in our laboratory. Most thyroid masses are borne for years with no serious consequences. Some of the resected masses were up to 20 times the size of a normal gland. The frequency of malignant diagnoses in thyroid masses was 22.5%.
{"title":"Thyroid masses in Sierra Leone: a one-year retrospective clinico- pathological study","authors":"M. S. Kabba, N. T. Onyishi, A. Kalawa, R. K. Adeyinka, B. M. Duduyemi","doi":"10.4314/rmj.v80i4.5","DOIUrl":"https://doi.org/10.4314/rmj.v80i4.5","url":null,"abstract":"INTRODUCTION: Thyroid disorders are the second most common endocrine diseases in humans. There has been no study of thyroid masses in our setting in spite of recurrent presentations. We undertook a retrospective study of incident thyroidectomy cases in our anatomic pathology laboratory over one year to establish the frequency and clinico-pathologic features of thyroid masses. \u0000METHODS: All thyroid specimens submitted to the anatomic pathology laboratory of the University of Sierra Leone Teaching Hospital Connaught from January 1, 2021 to December 31, 2021, were included in the study. Data was extracted from archived request forms, pathology reports, and patient’s case notes retrieved from the records department. The data obtained was analyzed with SPSS software. \u0000RESULTS: Twenty-seven thyroidectomy specimens (4.5% of all surgical pathology cases) were seen over a one-year period. Ninety-two percent were from women, while 7.4% were from men. The age range of patients was 17 to 65 years; the median age (IQR) was 40 (35-48) years. Duration of mass before presentation ranged from 3 months to 50 years. About 75% of the resected thyroid masses weighed 5 to 21 times more than a normal thyroid gland. Multinodular goiter was the most common histology (70.4%). Twenty-two percent of the resected masses were malignant. \u0000CONCLUSION: Thyroid masses constitute about 4.5% of all surgical specimens in our laboratory. Most thyroid masses are borne for years with no serious consequences. Some of the resected masses were up to 20 times the size of a normal gland. The frequency of malignant diagnoses in thyroid masses was 22.5%.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140490899","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. Dukuze, E. Uwibambe, P. Sesonga, J. Niyongere, B. Tuyishimire, A. Urungwiro, J. Ndinkabandi, A. Rwamatwara, S. Niyoyita, G. Isingizwe, J. Batamuliza, C. Nsanzabaganwa, J. Bukuru, F. Rutagarama, O. Karangwa, A. Ndatinya, C. Muhizi, L. Mutesa
Usher syndrome is a genetic, clinically heterogeneous condition characterized by sensorineural hearing loss, progressive retinal degeneration, and vestibular dysfunction. There are three phenotypically recognizable types of Usher syndrome. Individuals with Usher syndrome type 1 have no vestibular function and profound sensorineural hearing loss. Individuals with Usher syndrome type 2 have normal vestibular function and mild-to-severe hearing loss with visual impairment that is presented later in life. People with Usher syndrome type III experience hearing and vision loss beginning later in life. In this case report, we are reporting a 7-year-old boy consulted for progressive hearing loss and bilateral vision impairment, and fundus exam revealed mild bilateral retinal vessel attenuation and bone spicule deposits in both eyes. A molecular genetic test done by next-generation sequencing identified a homozygous pathogenic variant in the CDH23 gene (NM_022124.5:c.2255del variant coordinate with amino acid change of p.(Gly752Valfs*13)), confirming the diagnosis of autosomal recessive Usher syndrome type ID (USH1D). The patient had a remarkable improvement with visual and optical aids. Genetic counseling, including reproductive counseling, was provided to the parents. Clinical evaluation, visual hearing tests, and genetic workup confirmed Usher syndrome, which is a rare but dangerous cause of hearing loss and visual impairment that needs to be thoroughly evaluated by a multi-disciplinary team approach.
乌谢尔综合征是一种遗传性临床异质性疾病，其特征是感音神经性听力损失、进行性视网膜变性和前庭功能障碍。乌谢尔综合征有三种表型。1 型乌谢尔综合征患者没有前庭功能，并伴有深度感音神经性听力损失。乌谢尔综合征 2 型患者的前庭功能正常，听力轻度至重度受损，并伴有视力障碍，这种情况在晚期才会出现。乌谢尔综合征 III 型患者在晚年开始出现听力和视力损失。在本病例报告中，我们报告了一名因进行性听力损失和双侧视力受损而就诊的 7 岁男孩，眼底检查发现其双眼有轻度的双侧视网膜血管衰减和骨刺沉积。通过新一代测序进行分子遗传学检测，发现 CDH23 基因存在一个同卵致病变异（NM_022124.5:c.2255del 变异坐标，氨基酸变化为 p.(Gly752Valfs*13)），确诊为常染色体隐性遗传的 ID 型乌谢尔综合征（USH1D）。患者在使用视觉和光学辅助设备后病情明显好转。为其父母提供了遗传咨询，包括生育咨询。临床评估、视觉听力测试和遗传检查证实了乌谢尔综合征，这是一种罕见但危险的听力损失和视力损伤病因，需要通过多学科团队方法进行彻底评估。
{"title":"Genetic and phenotypic presentation of Usher syndrome - a case report","authors":"N. Dukuze, E. Uwibambe, P. Sesonga, J. Niyongere, B. Tuyishimire, A. Urungwiro, J. Ndinkabandi, A. Rwamatwara, S. Niyoyita, G. Isingizwe, J. Batamuliza, C. Nsanzabaganwa, J. Bukuru, F. Rutagarama, O. Karangwa, A. Ndatinya, C. Muhizi, L. Mutesa","doi":"10.4314/rmj.v80i4.10","DOIUrl":"https://doi.org/10.4314/rmj.v80i4.10","url":null,"abstract":"Usher syndrome is a genetic, clinically heterogeneous condition characterized by sensorineural hearing loss, progressive retinal degeneration, and vestibular dysfunction. There are three phenotypically recognizable types of Usher syndrome. Individuals with Usher syndrome type 1 have no vestibular function and profound sensorineural hearing loss. Individuals with Usher syndrome type 2 have normal vestibular function and mild-to-severe hearing loss with visual impairment that is presented later in life. People with Usher syndrome type III experience hearing and vision loss beginning later in life. In this case report, we are reporting a 7-year-old boy consulted for progressive hearing loss and bilateral vision impairment, and fundus exam revealed mild bilateral retinal vessel attenuation and bone spicule deposits in both eyes. A molecular genetic test done by next-generation sequencing identified a homozygous pathogenic variant in the CDH23 gene (NM_022124.5:c.2255del variant coordinate with amino acid change of p.(Gly752Valfs*13)), confirming the diagnosis of autosomal recessive Usher syndrome type ID (USH1D). The patient had a remarkable improvement with visual and optical aids. Genetic counseling, including reproductive counseling, was provided to the parents. Clinical evaluation, visual hearing tests, and genetic workup confirmed Usher syndrome, which is a rare but dangerous cause of hearing loss and visual impairment that needs to be thoroughly evaluated by a multi-disciplinary team approach.","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"142 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140491885","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: Insulin resistance plays a central role in type 2 diabetes mellitus (T2DM). Another possible cause of T2DM is a deficiency o f 25-hydroxy vitamin D [ 25(OH)D], although the underlying mechanism is not yet clearly understood. The most frequently used laboratory parameters for monitoring T2DM are fasting blood glucose (FBG) and HbA1c. Determining any association of vitamin D with HbA1c and FBG in T2DM.
METHODS: A cross-sectional study involving 100 T2DM patients with the following characteristics: 18-year and older persons of both genders, not having kidney and liver disease, not on insulin therapy, not pregnant or lactating, a nd n ot consuming vitamin D i n t he last three months. Spearman’s correlation coefficient was use d to test any association of 25(OH)D with HbA1 c and fasting blood glucose (FBG) (p<0.05).
RESULTS: Subjects comprised 74 females and 26 males with a median age of 56 years. Median HbA1c, 25(OH)D, and FBG were 8.05%, 11.2 ng/mL, and 127 mg/dL, respectively. The Spearman correlation coefficient for vitamin D and HbA1c was r=-0.217 (p=0.03), and for vitamin D and FBG,it was r =-0.153 (p=0.128).
CONCLUSION: There was a significant negative correlation of vitamin D with HbA1c but not with FBG. Administration of vitamin D should be considered for additional treatment of T2DM.
{"title":"25-hydroxy vitamin D concentrations negatively correlated with HbA1c in type 2 diabetes mellitus patients: a cross-sectional study in Mampang, South Jakarta","authors":"None Alvina, None Pusparini","doi":"10.4314/rmj.v80i3.3","DOIUrl":"https://doi.org/10.4314/rmj.v80i3.3","url":null,"abstract":"
 
 
 INTRODUCTION: Insulin resistance plays a central role in type 2 diabetes mellitus (T2DM). Another possible cause of T2DM is a deficiency o f 25-hydroxy vitamin D [ 25(OH)D], although the underlying mechanism is not yet clearly understood. The most frequently used laboratory parameters for monitoring T2DM are fasting blood glucose (FBG) and HbA1c. Determining any association of vitamin D with HbA1c and FBG in T2DM.
 METHODS: A cross-sectional study involving 100 T2DM patients with the following characteristics: 18-year and older persons of both genders, not having kidney and liver disease, not on insulin therapy, not pregnant or lactating, a nd n ot consuming vitamin D i n t he last three months. Spearman’s correlation coefficient was use d to test any association of 25(OH)D with HbA1 c and fasting blood glucose (FBG) (p<0.05).
 RESULTS: Subjects comprised 74 females and 26 males with a median age of 56 years. Median HbA1c, 25(OH)D, and FBG were 8.05%, 11.2 ng/mL, and 127 mg/dL, respectively. The Spearman correlation coefficient for vitamin D and HbA1c was r=-0.217 (p=0.03), and for vitamin D and FBG,it was r =-0.153 (p=0.128).
 CONCLUSION: There was a significant negative correlation of vitamin D with HbA1c but not with FBG. Administration of vitamin D should be considered for additional treatment of T2DM.
 
 
","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135923490","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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