Pan African Medical Journal最新文献

Telemedicine is the use of virtual space to provide much-needed healthcare services to consumers, with the potential to revolutionize the delivery of healthcare. As the number of challenges facing Somalia continues to grow including the prolonged war, natural disasters, and migration of skilled healthcare professionals, the federal government may be overwhelmed and unable to provide sufficient basic healthcare to its citizens. This review was undertaken to highlight the current state of healthcare services delivery, the benefits of telemedicine, its potential to address the currently strained healthcare services, and the challenges that may hamper its adoption in Somalia. The review results show that the introduction of telemedicine into Somalia's healthcare will go a long way in supporting the efforts of the government to significantly improve the quality of healthcare by increasing accessibility and efficiency. The review also identified potential challenges that may hamper the adoption of this technology including policy barriers, hospital facility and information technology infrastructure, lack of trained healthcare workers as well as lack of awareness among the public on the benefits of telemedicine. Hence, given the current humanitarian situation facing the country and the determination to provide quality healthcare services at an affordable rate to its citizens, policymakers should view telemedicine as an attractive alternative to achieve these targets.

There is a silent pandemic of suicides around the world, with an exponential increase in suicidality and chronic suicidal ideations. The exact global estimates cannot be accurately ascertained, but analysis will put it at more than a million annually. With countries like America having almost 50,000 and India alone reaching 200,000, annually. Countries like Bangladesh are nearly chronically suicidal. However, in Africa, Nigeria has a suicide rate of 17.3 per 100,000, which stands above the global 10.5 and Africa's 12.0. The rate of suicide is experiencing an exponential increase. As the world, regions, and countries work towards ways to combat the pandemic, scientists brainstorm on preventive modalities. Our team, "The Mending Mind" (Winners of the 2021 Innovation for Action Global Health Challenge) proposed a suicide-preventing innovation that actively works by pathologic stress level detection. The stress-detecting wristband. This innovation is feasible and the technology needed to invent it is available. Moreso, with the rise in Artificial Intelligence (AI) augmented devices, it can be modified over time to include other healthcare monitoring sequences.

Introduction: diabetes mellitus is a metabolic disease of the endocrine system characterized by elevated blood sugar levels due to disorders in insulin action, and secretion. This study aims to evaluate the antihyperglycemic and antihyperlipidemic effects of Trigonella foenum-graecum L and Coffea arabica L seeds in STZ (streptozotocin) induced diabetic mice: impact on kidney and liver functions.

Methods: twenty-six male mice aged 2 weeks, were divided into five groups: normal control, diabetic control (DC), positive control (PC), galactomannan-treated (GM), and chlorogenic acid-treated (CGA). Trigonella foenum-graecum L (TFL) seeds were bought from the local market. Similarly, Coffea arabica L (CAL) seeds were collected from the Ethiopian Commodity Exchange. After a 28-day treatment period TFL and CAL, Fasting Blood Glucose diabetic control (FBG], Oral Glucose Tolerance (OGT), lipid profile, and kidney and liver function tests were conducted. Statistical analysis was performed using R software, with the significance level set at a P-value < 0.05.

Results: galactomannan-treated and CGA significantly reduced FBG by -176.8 and -252.4 (p<0.01), respectively, and improved OGT (AUC of CGA-7449 and GM-14754) in comparison to DC (52452] (p<0.05). Similarly, liver and kidney function tests showed a statistically significant difference against the non-treated group 1 (p<0.01). In the lipid profile test, galactomannan reduced triglyceride and cholesterol levels, while chlorogenic acid improved low-density lipoprotein and cholesterol.

Conclusion: according to this research, TFL and CAL seeds decreased fasting blood glucose levels and improved glucose tolerance, lipid profiles, liver and kidney function tests, and glucose tolerance.

Introduction: robust data on the utility of chest ultrasound scans (CUS) for triage and diagnosis of pediatric tuberculosis (TB) are lacking. Therefore, we aimed to compare CUS features to chest radiography (CXR), which is the recommended imaging modality in children with presumptive pulmonary tuberculosis (PTB).

Methods: eighty children ≤14 years of age with presumptive TB underwent CUS and CXR performed by two separate radiologists for each modality, who looked for the presence of consolidation, lymphadenopathy, and pleural effusion in both modalities. These were compared using Fisher's exact test for independence to determine whether there was a significant difference in the findings between the two modalities. Cohen's kappa coefficient was used to calculate the agreement between CXR and CUS. STATA version 15 was used for analysis.

Results: the proportions of children with abnormal findings (consolidation, lymphadenopathy, and pleural effusions) on CUS were 65% (52/80) and 81.3% (65/80) on CXR. Sixty-two-point-five percent (62.5% (33/52)) of those with abnormal findings on CUS and 51.3% (33/65) on CXR were likely to have TB. The overall agreement for these characteristics was moderate (κ-0.42). The differences in the findings of consolidation and pleural effusion were not statistically significant on either CXR or CUS, whereas that of lymphadenopathy was statistically significant (P<0.001).

Conclusion: chest ultrasound scans detected more abnormalities in children with presumptive TB. Overall, the findings were comparable to those of CXR, except for lymphadenopathy. Ultrasound is a promising triage and diagnostic tool for pediatric TB.

Among the rare and complex causes of acute intestinal occlusion: volvulus due to the ileosigmoid node. The latter is secondary to the terminal ileum which will wrap around the base of the sigmoid colon and its meso, resulting in the formation of a node. Its natural evolution is the ischemia of the ileum and sigmoid, necessitating prompt emergency surgical intervention as the primary treatment approach. In this series, we present three cases from the Department of Digestive Surgery at Arrazi Hospital, Mohammed VI University Hospital in Marrakech, while reviewing the physiopathology, the clinical presentation of this rare entity, as well as the different therapeutic options of the ileosigmoid nodes. We report three cases in the Department of Digestive Surgery at Arrazi Hospital, Mohammed VI University Hospital in Marrakech, in which the diagnosis of ileosigmoid knotting was made by means of computed tomography (CT) scan data and confirmed intraoperatively. Through these 3 reported cases and in the light of data from the literature, we will discuss the different diagnostic, therapeutic, and prognostic aspects of this very rare type of volvulus.

Introduction: tuberculosis (TB) is one of the top ten causes of death and the leading cause from a single infectious agent called Mycobacterium tuberculosis. This study aims to evaluate TB treatment outcomes among patients on first-line anti-tuberculosis treatment and identify the factors associated with successful TB treatment outcomes at Senkatana TB clinic in Lesotho from 2015-2017.

Methods: a registry-based retrospective cohort study of all TB first-line cases recorded from 2015 to 2017 was conducted at Senkatana TB clinic. Data were captured and cleaned in Epi info version 7, and exported into Stata version 14 for analysis. Bivariate logistic regression analysis was used to determine factors associated with TB treatment outcome with p-value <0.05 indicating statistical significance.

Results: a total of 1,027 TB patients were registered between 2015 and 2017. Of these, 602 (58.6%) were males and 425 (41.4%) were females, with a mean age of 39 years (SD ±12.5). A total of 843 (82.1%) patients were co-infected with HIV, of which 92.3% (n=778) were on anti-retroviral therapy (ART). The analysis of HIV co-infected with TB patients by age showed that the TB/HIV co-infection rate varies with age (p<0.001). Overall treatment success rate was at 73.4% (n= 754) and 273 (26.6%) had poor treatment outcomes, and 118 (11.5%) patients died. The odds of successful TB treatment outcome were higher in females than males (78.1% vs 70.1%, OR 1.52, 95% CI: 1.14 - 2.03, p=0.004). With regards to age, the odds of successful TB treatment outcome were higher for the 20-24 years age group (88.2% vs 65.3%, OR 3.98, 95% CI: 1.42 - 11.22, P=0.009) and 55-59 years (91.7% vs 65.3%, OR 5.84, 95% CI: 1.56 - 21.88, P=0.009), compared to ≥ 65 years age group. In addition, successful TB treatment outcomes were higher among HIV co-infected TB patients who were taking ART during TB treatment than those not taking ART (75.8% vs 23.8%, OR 11.70, 95% CI: 6.40 - 21.43, P<0.001). Patients observed by family members or friends were more likely to develop treatment success (aOR: 1.87, 95% CI: 1.13 - 3.08). Factory workers in high-risk groups had successful treatment outcomes (aOR: 1.77, 95% CI: 1.04 - 3.01).

Conclusion: tuberculosis treatment success rate was low and constant over the period of three years. Death rate, loss to follow, and not evaluated were high among our study participants and above the World Health Organization (WHO) target. In unadjusted analyses, female sex, younger age, HIV co-infected taking ART, having a treatment observer, and belonging to high-risk groups, were significantly associated with successful TB treatment outcome.

The association between spontaneous pneumothorax and a bronchial tumor is rare, and even more so with an atypical carcinoid tumor. This rare and unexpected case highlights the importance of raising clinician awareness about investigating the underlying cause of pneumothorax through endoscopic exploration. A 52-year-old female was exposed to passive smoking by her husband for 20 years. She was treated for hypothyroidism for the past two years, pulmonary tuberculosis a year ago, and cardiac disorders for the past eight months. The patient presented to the emergency room with a spontaneous left pneumothorax secondary to an atypical bronchial carcinoid tumor. The diagnosis was established through thoracic CT and bronchoscopy. Treatment involved left pneumonectomy with follow-up.