Pan African Medical Journal最新文献

Introduction: tonsillectomy is the most commonly performed surgery in children. It is a painful surgery, which is often an ordeal for both children and their parents. The study aimed to evaluate the effects of ketamine used instead of or as an adjuvant to fentanyl on early postoperative pain scores in children undergoing tonsillectomy.

Methods: we conducted a double-blind prospective randomized study including 60 children, aged between 2 and 7 years, scheduled to undergo adenotonsillectomy. Patients were randomly assigned to one of three groups: group G1 received 2 μg/kg of fentanyl, group G2 received 0.5 mg/kg of ketamine and group G3 received an association of fentanyl 1μg/kg and 0.25 mg/kg of ketamine. We recorded postoperative analgesic requirements and side effects. The pain was assessed in the post-anesthesia care unit (PACU) by the face, legs, activity, cry, and controllability (FLACC) pain scale. We evaluated the requirement for additional analgesics, postoperative nausea, and vomiting.

Results: sixty children were included. Twenty patients were randomly assigned to one of three groups. Better control of pain was noted in group G3 ( Median FLACC scale G3=0 Inter quartile range (IQR)=-1 - 1), with a significant difference at 30 min compared to both groups G1 (median FLACC scale G1=3 [IQR=-1 - 7]; p=0,008) and G2 (median FLACC scale G2=1 [IQR=-2 - 4]; p=0.036). The need for additional analgesia and side effects in the PACU were comparable for the three groups.

Conclusion: ketamine associated with fentanyl provides satisfactory early analgesia and can even replace fentanyl during tonsillectomy.

Introduction: chanting in meditation reduces stress and it is reported to have a relaxation effect during both verbal "OM" chanting (VOM) and listening to "OM" chanting (LOM). There is paucity of literature on EEG microstates information after VOM and LOM using qEEG compared to the resting condition.

Methods: therefore, to examine the effect of these actions on the brain using qEEG, it is required to compare the EEG microstates among the baseline, VOM, and LOM. In the present work, 23 adult male subjects were examined and given a paradigm designed using E-prime for both VOM and LOM chanting each of 5 min duration. A 128-channel geodesic sensor net was used to obtain the experimental data, which was later pre-processed, segmented, and analysed.

Results: the present work is the first to report the three scalp maps topographies, i.e. microstates obtained utilizing k-means cluster analysis for the response of the VOM and LOM. Also, the number of time frames, Global Explained Variance (GEV), time coverage, and mean duration parameters for the three maps were analysed statistically.

Conclusion: the study revealed three microstate topographies as markers and reported no significant effect/changes for the short-term chanting.

The thirteenth conference of the African Society of Human Genetics with the theme "harnessing genomics and translational research to improve health in Africa" was held in Dar es Salaam, Tanzania, in August 2021, using a hybrid in-person and virtual model for participation in the wake of COVID-19 pandemic. During the meeting, African research across various human genetics disciplines was presented, including talks on the genetics of infectious and non-communicable diseases, population genetics, and translational research. The meeting also featured presentations on pharmacogenomics, genetics of developmental disorders, cancer genetics and genetics of rare diseases. In-depth discussions on ethical legal and social issues in genomics research and community and patient engagement were also key sessions of this meeting. The primary focus of the conference and the discussions was how to translate the wealth of genomic research in the continent into improved health outcomes in the continent. In this report, we summarize the key scientific research relevant to Africa presented and discussed during the meeting providing an overview of the progress of human genetics in the continent. We also discuss opportunities and challenges of harnessing genomics for health improvement in Africa.

Introduction: despite evidence of the health benefits of fermented and germinated foods, consumption is waning, particularly among children in Kenya. We conducted this study to explore the knowledge, attitudes, and use of fermented and germinated complementary foods in Homa-Bay County to advocate for their use as an additional tool to address the prevalent iron and zinc deficiency among children.

Methods: an explorative mixed-study design. Six focus group discussions; followed by a cross-sectional quantitative survey with 314 caregivers. Atlas-ti software and SPSS were used for qualitative and quantitative data analysis.

Results: this community was aware of and practiced germination and fermentation of foods. However, the older caregivers knew 1.5 times more foods than younger caregivers. Caregivers' inadequate knowledge about the benefits of germinated and fermented complementary foods and a negative attitude, prevented children been offered these foods. The caregivers´ greatest concerns were diarrhea following the consumption of fermented food and the potential for stomach ulcer development due to the acidity in these foods. The caregiver's attitude, age, and level of education significantly influenced the use of fermented and germinated complementary foods. A positive attitude (AOR 4.897, 95% CI: 1.616-14.844), being 35 years or older (AOR 2.7, 95% CI: 1.670-4.428), and having no or only a primary level of education (AOR 3.344, 95% CI: 1.319-8.480) were all associated with a higher likelihood of using fermented or germinated foods.

Conclusion: to encourage caregivers to use germinated and fermented complementary foods, there must be concerted efforts to educate the community on the benefits of consuming these foods.

Introduction: lung cancer is the leading cause of cancer-related deaths worldwide, with a significant incidence in Morocco. The complex epidemiology of this disease in the country necessitates an in-depth analysis of genetic profiles to improve diagnosis and treatment. This study utilizes next-generation sequencing (NGS) to map genetic alterations in Moroccan patients with lung cancer, a field where molecular data is largely lacking. Importantly, this study presents a pioneering analysis of lung cancer in the Moroccan population using next-generation sequencing technology. While previous studies focused on a limited number of genes, our research provides a comprehensive and detailed perspective on the genetic alterations within this cohort, including the generation of an oncoprint.

Methods: this study involved 100 histologically confirmed lung cancer patients. Genetic abnormalities were detected using the NGS technique with the Oncomine Precision Assay GX protocol. Lung biopsy samples were prepared, purified, and sequenced, with the resulting data analyzed to identify significant genetic variants.

Results: the analysis revealed genetic alterations in 13 different genes, with a notable prevalence of mutations in the TP53, KRAS, and Epithelial Growth Factor Receptor (EGFR) genes. TP53 mutations were present in 27% of cases, while KRAS and EGFR showed mutations in 19% and 14% of samples, respectively. Clinically significant mutations were also identified in the ALK, MET, ERBB2, and ROS1 genes, highlighting substantial genomic diversity in this cohort.

Conclusion: the results of this study enhance the understanding of genetic alterations in Moroccan lung cancer patients and underscore the need to strengthen efforts for advanced molecular diagnosis in Morocco. The use of NGS has identified critical genetic mutations, facilitating the development of personalized treatments and improving clinical outcomes. These findings pave the way for future research aimed at refining diagnostic and therapeutic strategies, thereby contributing to better patient management.

Oligodendroglial tumors are rare tumors that constitute part of the neuroepithelial tumors of the central nervous system. A diffuse, low-grade astrocytoma (WHO grade II), oligodendrogliomas are typically encountered in adults, with children under the age of 15 accounting for about 25% of cases. Although they can arise anywhere in the central nervous system, oligodendrogliomas typically occur in the cerebral white matter. Radiotherapy is the main mode of treatment since surgical intervention is limited to the role of biopsy and management of secondary effects, due to the deep brain location of the lesion and the complexity of the involved structures. Here, we are reporting a case of an 11-year-old male, who presented with a complaint of headache and underwent contrast-enhanced computed tomography (CECT) that showed a heterogenous lesion with evidence of calcification and surrounding edema compressing the third ventricle. Oligodendroglioma was diagnosed with histopathological correlation which further confirmed the diagnosis. The patient then underwent chemotherapy and radiotherapy as adjuvant therapies. A patient's prognosis is typically bad in rare occurrences of diffuse white matter spread oligodendroglioma, which can have a significant effect on neurological health.

Introduction: in Cameroon, multi-month dispensing (MMD) of antiretrovirals (ARVs) was introduced to improve treatment adherence among people living with HIV (PLHIV). However, this strategy has limitations that may lead to viral load rebound. The purpose of this study is to assess the incidence and factors associated with viral rebound in PLHIV receiving MMD at the Dschang Regional Annex Hospital between 2018 and 2023.

Methods: we conducted a retrospective cohort study comparing the incidence of viral rebound (increase of over 100 copies/mL after suppression) and its determinants in patients on MMD versus those on monthly dispensing (MD) from January 2018 to December 2023. Data were collected from patients´ medical records using a standardized data collection sheet. Descriptive statistics were followed by bivariate and multivariate analyses to identify factors associated with viral rebound, with a significance threshold of p<0.05.

Results: a total of 519 patients (438 on MMD and 81 on MD) were included. The incidence of viral rebound was 18.8% among patients on MMD compared to 37.8% among those on MD. The male-to-female ratio was 0.53, with the majority of patients aged 30 to 45 years. MMD coverage decreased from 76% in 2018 to 51.02% in 2023. Factors significantly associated with viral rebound included dispensing type (p=0.001), treatment interruption (p=0.001), age group 30-45 years (p=0.001) and tobacco use (p=0.008).

Conclusion: the incidence of viral rebound is higher among patients on MD. Improving the management of PLHIV and promoting healthier lifestyle choices are essential to prevent long-term treatment failure.

Acute stroke occurring during cardiac catheterization is an extremely uncommon procedural complication. There is a significant research gap in the published literature regarding the occurrence of acute ischemic stroke during percutaneous coronary intervention in Asian populations, with most data originating from western countries, underscoring the need for localized studies to develop tailored detection and management strategies. We present the case of a 70-year-old Indian woman with multiple cardiovascular risk factors who experienced an acute ischemic stroke while undergoing percutaneous coronary intervention in Malaysia. We hypothesized that the clinically relevant cerebral infarction might have originated from large plaques located along the aortic arch. Catheterization-related strokes caused by embolization of fresh thrombi forming at the catheter or guidewire tips should be thrombolysed. Choosing the transradial approach reduces stroke risk but requires careful use of appropriately sized instruments and meticulous handling of guidewires to ensure patient safety.

Ocular tuberculosis in children poses significant visual risks and exhibits distinct characteristics compared to adults, necessitating careful diagnosis and management. This case illustration presents a 10-year-old girl with intermittent redness in her left eye. Despite initial treatment, her condition worsened, leading to blurred vision. She was diagnosed with ocular tuberculosis complicated by phlyctenular conjunctivitis, interstitial keratitis, diffuse anterior scleritis, anterior uveitis, and neuroretinitis. Antituberculosis therapy was initiated alongside corticosteroids and neuroprotective treatment. The patient showed significant improvement within one month and achieved full resolution after two months of treatment. Ocular tuberculosis in children, it often accompanies extrapulmonary tuberculosis and can lead to significant complications. Additionally, children tend to exhibit a heightened inflammatory response to ocular tuberculosis, necessitating more aggressive corticosteroid therapy to manage the condition effectively.