The objective of this study is to assess obstetric complications, blood loss, blood transfusion requirement, and maternal and fetal outcomes associated with the authors’ approach of Caesarean hysterectomy for placenta accreta spectrum disorders. Data were collected from case records of all females who underwent Caesarean hysterectomy between August 2013–August 2023 at Lifeline Multispeciality Hospital, Adoor, Kerala, India. There were 19 cases of Caesarean hysterectomy. The mean age was 33.63±2.90 years. Mean blood loss during surgery was 1.11±0.16 L, and the mean packed red blood cells transfused was 2.00±0.38 units. The mean gestational age of termination was 33 weeks and 5 days, and mean birth weight was 2.28±0.21 kg. There were no maternal or neonatal deaths. Placenta accreta spectrum should be managed in a multidisciplinary setup with the involvement of a senior experienced obstetrician. Early, careful bladder dissection before proceeding with hysterectomy will help in reducing haemorrhage, and in accelerating hysterectomy.
{"title":"Caesarean Hysterectomy for Placenta Accreta Spectrum in a Single Centre: A Series of 19 Cases","authors":"Presannakumari Bhanumathy, Divya Mecheril Balachandran, Nirpin Cleetus, Jesna Hassan, Skariah Pappachan, Libu G.K","doi":"10.33590/emj/10308145","DOIUrl":"https://doi.org/10.33590/emj/10308145","url":null,"abstract":"The objective of this study is to assess obstetric complications, blood loss, blood transfusion requirement, and maternal and fetal outcomes associated with the authors’ approach of Caesarean hysterectomy for placenta accreta spectrum disorders. Data were collected from case records of all females who underwent Caesarean hysterectomy between August 2013–August 2023 at Lifeline Multispeciality Hospital, Adoor, Kerala, India. There were 19 cases of Caesarean hysterectomy. The mean age was 33.63±2.90 years. Mean blood loss during surgery was 1.11±0.16 L, and the mean packed red blood cells transfused was 2.00±0.38 units. The mean gestational age of termination was 33 weeks and 5 days, and mean birth weight was 2.28±0.21 kg. There were no maternal or neonatal deaths. Placenta accreta spectrum should be managed in a multidisciplinary setup with the involvement of a senior experienced obstetrician. Early, careful bladder dissection before proceeding with hysterectomy will help in reducing haemorrhage, and in accelerating hysterectomy.","PeriodicalId":505023,"journal":{"name":"European Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140392668","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}
The 17th Annual Congress of the European Association for Haemophilia and Allied Disorders (EAHAD) took place on 6th–9th February 2024 in Frankfurt, Germany. In a comprehensive and interactive session, healthcare experts and patients gathered to discuss current approaches in clinical practice. The session was chaired by Jan Blatny, University Hospital Brno, Czechia; and Niamh O’Connell, The National Coagulation Centre, St James’s Hospital, Dublin, Ireland.
{"title":"Non-Factor Therapies: Reflections on Current Clinical Practice","authors":"Helena Bradbury","doi":"10.33590/emj/cprd5899","DOIUrl":"https://doi.org/10.33590/emj/cprd5899","url":null,"abstract":"The 17th Annual Congress of the European Association for Haemophilia and Allied Disorders (EAHAD) took place on 6th–9th February 2024 in Frankfurt, Germany. In a comprehensive and interactive session, healthcare experts and patients gathered to discuss current approaches in clinical practice. The session was chaired by Jan Blatny, University Hospital Brno, Czechia; and Niamh O’Connell, The National Coagulation Centre, St James’s Hospital, Dublin, Ireland.","PeriodicalId":505023,"journal":{"name":"European Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140241590","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}
Liver transplant is the treatment available for eligible patients with end-stage liver cirrhosis. Acute kidney injury and electrolyte abnormalities are associated with liver disease and can be exacerbated by surgery. Intraoperative renal replacement therapy has been tried in some large centres. The authors discuss the physiological changes and complications during liver transplant surgery, and review literature on the safety, feasibility, benefits, and drawbacks of intraoperative renal replacement therapy during liver transplant surgery.
{"title":"Renal Replacement Therapy During Liver Transplant Surgery","authors":"Arjun Sekar, A. Reddy, Pulkit Gandhi, Vijay Raj","doi":"10.33590/emj/11000030","DOIUrl":"https://doi.org/10.33590/emj/11000030","url":null,"abstract":"Liver transplant is the treatment available for eligible patients with end-stage liver cirrhosis. Acute kidney injury and electrolyte abnormalities are associated with liver disease and can be exacerbated by surgery. Intraoperative renal replacement therapy has been tried in some large centres. The authors discuss the physiological changes and complications during liver transplant surgery, and review literature on the safety, feasibility, benefits, and drawbacks of intraoperative renal replacement therapy during liver transplant surgery.","PeriodicalId":505023,"journal":{"name":"European Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140243040","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}
Modern targeted prophylaxis is recommended for patients with hereditary angioedema (HAE), but many remain on attenuated androgens. EMJ spoke to two HAE experts who explain how they help patients to make the switch.
建议遗传性血管性水肿（HAE）患者使用现代靶向预防疗法，但许多患者仍在使用减效雄激素。EMJ 采访了两位 HAE 专家，他们解释了如何帮助患者进行转换。
{"title":"Transitioning Patients From Second- to First-Line Prophylaxis in Hereditary Angioedema","authors":"Caroline E Cross","doi":"10.33590/emj/10307646","DOIUrl":"https://doi.org/10.33590/emj/10307646","url":null,"abstract":"Modern targeted prophylaxis is recommended for patients with hereditary angioedema (HAE), but many remain on attenuated androgens. EMJ spoke to two HAE experts who explain how they help patients to make the switch.","PeriodicalId":505023,"journal":{"name":"European Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140241379","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}
Sheharyar Zameer, Kashmala Safdar, Huma Ahmed Khan, Umer Anwar, Fatima Sohail, Rasikh Maqsood
Post-endoscopic retrograde cholangiopancreatography (ERCP) air leak (PEAL) syndrome is a rare complication that includes pneumothorax, pneumomediastinum, pneumoperitoneum, air embolism, and subcutaneous emphysema. A 71-year-old female diagnosed with mild acute biliary pancreatitis, who underwent ERCP for stone retrieval developed neck, chest, and abdominal pain, as well as swelling of the neck, along with crepitus all along the neck and face. CT scan showed pneumoperitoneum, pneumomediastinum, and subcutaneous emphysema. The patient was diagnosed as a case of PEAL syndrome, and was managed conservatively. She ultimately underwent an uneventful cholecystectomy with peroperative stone retrieval. PEAL syndrome, albeit rare, can be a potentially life-threatening complication following ERCP, which requires continuous monitoring. It may be managed conservatively, endoscopically, or surgically.
内镜逆行胰胆管造影（ERCP）术后漏气（PEAL）综合征是一种罕见的并发症，包括气胸、气胸、腹腔积气、空气栓塞和皮下气肿。一名 71 岁的女性被诊断为轻度急性胆汁性胰腺炎，在接受 ERCP 取石手术后出现颈部、胸部和腹部疼痛，颈部肿胀，颈部和面部有绉痕。CT 扫描显示腹腔积气、气胸和皮下气肿。患者被诊断为 PEAL 综合征，并接受了保守治疗。她最终顺利地接受了胆囊切除术，并在术中取出了结石。PEAL 综合征虽然罕见，但可能是ERCP术后危及生命的并发症，需要持续监测。可以采取保守治疗、内镜治疗或手术治疗。
{"title":"Post-endoscopic Retrograde Cholangiopancreatography Air Leak Syndrome: An Overview of Current Perspectives","authors":"Sheharyar Zameer, Kashmala Safdar, Huma Ahmed Khan, Umer Anwar, Fatima Sohail, Rasikh Maqsood","doi":"10.33590/emj/10305274.","DOIUrl":"https://doi.org/10.33590/emj/10305274.","url":null,"abstract":"Post-endoscopic retrograde cholangiopancreatography (ERCP) air leak (PEAL) syndrome is a rare complication that includes pneumothorax, pneumomediastinum, pneumoperitoneum, air embolism, and subcutaneous emphysema. A 71-year-old female diagnosed with mild acute biliary pancreatitis, who underwent ERCP for stone retrieval developed neck, chest, and abdominal pain, as well as swelling of the neck, along with crepitus all along the neck and face. CT scan showed pneumoperitoneum, pneumomediastinum, and subcutaneous emphysema. The patient was diagnosed as a case of PEAL syndrome, and was managed conservatively. She ultimately underwent an uneventful cholecystectomy with peroperative stone retrieval. PEAL syndrome, albeit rare, can be a potentially life-threatening complication following ERCP, which requires continuous monitoring. It may be managed conservatively, endoscopically, or surgically.","PeriodicalId":505023,"journal":{"name":"European Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140244139","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}
Ghalib Moseti, O. Orango, Benjamin Elly Odongo, P. Itsura, J. Odunga
Objective: To determine the impact of surgical treatment on quality of life (QoL) of patients with early-stage cervical cancer at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya, and Kenyatta National Hospital (KNH), Nairobi, Kenya. Methods: A cohort study conducted among 71 patients undergoing surgery for surgically amenable cervical cancer stage. Consecutive sampling of females was used to recruit participants. Participants were followed up for 3 months post-operatively. Descriptive statistics was used to describe the study participants. Bivariate analysis was used to assess the relationship between dependent and independent variables, and p value ≤0.05 was considered to be statistically significant. Results: Nearly two-thirds (63.5%) of the females had a parity of four or more, 69 (97.2%) did not have a family history of cervical cancer, and 57 (80.3%) were negative on HIV test. Most females (47.9%) had Stage IB2 cervical cancer, followed by those with Stage IB1, seen in 28 (39.4%) of the females enrolled. There were statistically significant differences in pain/discomfort (p=0.028) and anxiety/depression (p=0.028). Patients aged 20–35 years had a two-fold increased likelihood (adjusted odds ratio: 2.44; 95% confidence interval: 1.30–3.10; p=0.011) of reporting better QoL scores compared to older females. The lower the cervical cancer stage (Stage IA2), the higher the likelihood for improved QoL following surgical management of cervical cancer (adjusted odds ratio: 5.69; 95% confidence interval: 3.55–6.89; p=0.001). Conclusion: This study reports that being aged 20–35 years old and having a lower stage cervical cancer increased the likelihood of a good QoL outcome following surgical management of cervical cancer.
目的确定在肯尼亚埃尔多雷特的莫伊教学和转诊医院（MTRH）以及肯尼亚内罗毕的肯雅塔国立医院（KNH）接受手术治疗对早期宫颈癌患者生活质量（QoL）的影响：方法：对 71 名接受手术治疗的宫颈癌分期患者进行队列研究。研究采用女性连续抽样的方式招募参与者。对参与者进行了术后 3 个月的随访。研究采用描述性统计来描述参与者。采用双变量分析评估因变量和自变量之间的关系，P值≤0.05为具有统计学意义：近三分之二的女性（63.5%）的胎次为四次或四次以上，69 名女性（97.2%）无宫颈癌家族史，57 名女性（80.3%）HIV 检测呈阴性。大多数女性（47.9%）患有 IB2 期宫颈癌，其次是 IB1 期，有 28 名女性（39.4%）患有 IB1 期宫颈癌。在疼痛/不适（P=0.028）和焦虑/抑郁（P=0.028）方面，差异有统计学意义。与年龄较大的女性相比，20-35 岁的患者报告 QoL 评分较高的可能性增加了两倍（调整后的几率比：2.44；95% 置信区间：1.30-3.10；p=0.011）。宫颈癌分期越低（IA2 期），宫颈癌手术治疗后 QoL 改善的可能性越大（调整后的几率比：5.69；95% 置信区间：3.55-6.89；P=0.001）：本研究报告显示，年龄在 20-35 岁之间、宫颈癌分期较低的患者在接受宫颈癌手术治疗后获得良好 QoL 结果的可能性增加。
{"title":"Impact of Surgical Treatment on Quality of Life of Patients with Early-Stage Cervical Cancer: A Case Study of Two Referral Hospitals in Kenya","authors":"Ghalib Moseti, O. Orango, Benjamin Elly Odongo, P. Itsura, J. Odunga","doi":"10.33590/emj/10306929","DOIUrl":"https://doi.org/10.33590/emj/10306929","url":null,"abstract":"Objective: To determine the impact of surgical treatment on quality of life (QoL) of patients with early-stage cervical cancer at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya, and Kenyatta National Hospital (KNH), Nairobi, Kenya.\u0000\u0000Methods: A cohort study conducted among 71 patients undergoing surgery for surgically amenable cervical cancer stage. Consecutive sampling of females was used to recruit participants. Participants were followed up for 3 months post-operatively. Descriptive statistics was used to describe the study participants. Bivariate analysis was used to assess the relationship between dependent and independent variables, and p value ≤0.05 was considered to be statistically significant.\u0000\u0000Results: Nearly two-thirds (63.5%) of the females had a parity of four or more, 69 (97.2%) did not have a family history of cervical cancer, and 57 (80.3%) were negative on HIV test. Most females (47.9%) had Stage IB2 cervical cancer, followed by those with Stage IB1, seen in 28 (39.4%) of the females enrolled. There were statistically significant differences in pain/discomfort (p=0.028) and anxiety/depression (p=0.028). Patients aged 20–35 years had a two-fold increased likelihood (adjusted odds ratio: 2.44; 95% confidence interval: 1.30–3.10; p=0.011) of reporting better QoL scores compared to older females. The lower the cervical cancer stage (Stage IA2), the higher the likelihood for improved QoL following surgical management of cervical cancer (adjusted odds ratio: 5.69; 95% confidence interval: 3.55–6.89; p=0.001).\u0000\u0000Conclusion: This study reports that being aged 20–35 years old and having a lower stage cervical cancer increased the likelihood of a good QoL outcome following surgical management of cervical cancer.","PeriodicalId":505023,"journal":{"name":"European Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140242804","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}
Geetha Narayanan, Abhilash Menon, Sugeeth M.T., Sherry S. Abraham, Krishnan Unni, Sreejith G. Nair
{"title":"Immunoglobin D Multiple Myeloma: A Single Centre Experience","authors":"Geetha Narayanan, Abhilash Menon, Sugeeth M.T., Sherry S. Abraham, Krishnan Unni, Sreejith G. Nair","doi":"10.33590/emj/11000013","DOIUrl":"https://doi.org/10.33590/emj/11000013","url":null,"abstract":"","PeriodicalId":505023,"journal":{"name":"European Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140079646","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}
Anjlee Sawlani, Rida Masood, Jai Kumar, Kartaar Saahil
This case report highlights a rare and unique occurrence: the simultaneous presence of sickle cell thalassaemia and overlapping syndrome, which involves systemic lupus erythematosus and autoimmune hepatitis. The coexistence of sickle cell disease with overlapping syndrome is exceptionally rare, with only a few documented cases in the literature, one of which involves sickle cell β-thalassaemia. Significantly, this case enhances understanding of the intricate relationship among these conditions, and offers valuable perspectives on how to clinically manage them. The authors present the case of a young male in his early 20s, who presented with haemolytic anaemia, jaundice, joint pain, and hepatomegaly. Extensive laboratory investigations, including serological markers, haemoglobin electrophoresis, and liver function tests, confirmed the coexistence of sickle cell thalassaemia, systemic lupus erythematosus, and autoimmune hepatitis. The treatment included O2 therapy, hydration, hydroxyurea, and antibiotics. After 4–5 days, the patient showed improvement, and at discharge, hydroxyurea and folic acid were continued. Significantly, considering the complex medical history of the patient, a decision was made to include a carefully considered, low-dose steroid regimen. The choice of a maintenance dose over an induction therapy was specifically made to mitigate potential complications, particularly the risk of vaso-occlusive crises in patients with sickle cell disease. This case report contributes to the understanding of concurrent manifestation of these complex conditions, and emphasises the importance of a comprehensive approach, early diagnosis, and timely management, to optimise patient outcomes in such intricate overlapping syndromes.
{"title":"Coexistence of Sickle Cell Thalassaemia with Overlapping Syndrome: A Case Report of Systemic Lupus Erythematosus and Autoimmune Hepatitis","authors":"Anjlee Sawlani, Rida Masood, Jai Kumar, Kartaar Saahil","doi":"10.33590/emj/11000015","DOIUrl":"https://doi.org/10.33590/emj/11000015","url":null,"abstract":"This case report highlights a rare and unique occurrence: the simultaneous presence of sickle cell thalassaemia and overlapping syndrome, which involves systemic lupus erythematosus and autoimmune hepatitis. The coexistence of sickle cell disease with overlapping syndrome is exceptionally rare, with only a few documented cases in the literature, one of which involves sickle cell β-thalassaemia. Significantly, this case enhances understanding of the intricate relationship among these conditions, and offers valuable perspectives on how to clinically manage them. The authors present the case of a young male in his early 20s, who presented with haemolytic anaemia, jaundice, joint pain, and hepatomegaly. Extensive laboratory investigations, including serological markers, haemoglobin electrophoresis, and liver function tests, confirmed the coexistence of sickle cell thalassaemia, systemic lupus erythematosus, and autoimmune hepatitis. The treatment included O2 therapy, hydration, hydroxyurea, and antibiotics. After 4–5 days, the patient showed improvement, and at discharge, hydroxyurea and folic acid were continued. Significantly, considering the complex medical history of the patient, a decision was made to include a carefully considered, low-dose steroid regimen. The choice of a maintenance dose over an induction therapy was specifically made to mitigate potential complications, particularly the risk of vaso-occlusive crises in patients with sickle cell disease. This case report contributes to the understanding of concurrent manifestation of these complex conditions, and emphasises the importance of a comprehensive approach, early diagnosis, and timely management, to optimise patient outcomes in such intricate overlapping syndromes.","PeriodicalId":505023,"journal":{"name":"European Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140414844","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}
Objective: To assess the prevalence of, and the factors associated with, contraceptive use among females living with HIV at Moi Teaching and Referral Hospital, Eldoret, Kenya. Methods: A cross-sectional study with a sample including a total of 375 females living with HIV aged 15–49 years undergoing follow-up. Data were collected using a semi-structured questionnaire. Bivariate and multivariate analysis was done to check for association and predictors of contraceptive use. Results: The contraceptive prevalence rate was 64%. Factors associated with contraceptive utilisation included parity (crude odds ratio [COR]: 2.33; 95% confidence interval [CI]: 1.22–4.45; P=0.010), marital status (COR: 1.75; 95% CI: 1.04–2.97; P=0.036), and availability of information on the side effects of the contraception methods (COR: 29.93; 95% CI: 14.26–70.58; P=0.001). Multivariate analysis showed a significant association between contraceptive use and whether information on the side effects of the current contraception method was provided (adjusted OR: 34.98; 95% CI: 16.72–83.33; P=0.001).The odds of meeting the contraceptive needs of females living with HIV was 34 times higher among females who had information on side effects of the contraceptives than their counterparts who had no information. Conclusions: The contraceptive prevalence rate was 64% among females living with HIV, higher than latest national value of 61%. Females living with HIV had a high unmet need for contraceptive use at 28.4%. Key factors associated with contraceptive utilisation included awareness of side effects.
{"title":"Prevalence and Factors Associated with Contraceptive Use Among Females Living with HIV at Moi Teaching and Referral Hospital, Eldoret, Kenya","authors":"Sheila Sawe, Edwin Were, W. Mwangi, J. Odunga","doi":"10.33590/emj/10301577","DOIUrl":"https://doi.org/10.33590/emj/10301577","url":null,"abstract":"Objective: To assess the prevalence of, and the factors associated with, contraceptive use among females living with HIV at Moi Teaching and Referral Hospital, Eldoret, Kenya.\u0000\u0000Methods: A cross-sectional study with a sample including a total of 375 females living with HIV aged 15–49 years undergoing follow-up. Data were collected using a semi-structured questionnaire. Bivariate and multivariate analysis was done to check for association and predictors of contraceptive use.\u0000\u0000Results: The contraceptive prevalence rate was 64%. Factors associated with contraceptive utilisation included parity (crude odds ratio [COR]: 2.33; 95% confidence interval [CI]: 1.22–4.45; P=0.010), marital status (COR: 1.75; 95% CI: 1.04–2.97; P=0.036), and availability of information on the side effects of the contraception methods (COR: 29.93; 95% CI: 14.26–70.58; P=0.001).\u0000\u0000Multivariate analysis showed a significant association between contraceptive use and whether information on the side effects of the current contraception method was provided (adjusted OR: 34.98; 95% CI: 16.72–83.33; P=0.001).The odds of meeting the contraceptive needs of females living with HIV was 34 times higher among females who had information on side effects of the contraceptives than their counterparts who had no information.\u0000\u0000Conclusions: The contraceptive prevalence rate was 64% among females living with HIV, higher than latest national value of 61%. Females living with HIV had a high unmet need for contraceptive use at 28.4%. Key factors associated with contraceptive utilisation included awareness of side effects.","PeriodicalId":505023,"journal":{"name":"European Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140419889","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}
It is imperative to evaluate for secondary causes of membranous glomerulonephritis, from infections such as hepatitis B and C, viruses and parasites, autoimmune diseases like systemic lupus erythematosus, and other neoplasms. Tuberculosis associated with membranous glomerulonephritis is rare. The authors report a case of microbiologically proven pulmonary tuberculosis and membranous nephropathy occurring concurrently in the same patient. Antitubercular therapy alone was sufficient to cause improvement in the patient. Tuberculosis should be recognised as a potentially treatable infectious cause of secondary membranous nephropathy.
{"title":"Membranous Nephropathy and Pulmonary Tuberculosis: An Uncommon Combination: Case Report","authors":"Puneet Bhuwania, Aniket Mule, Sanggita Checker","doi":"10.33590/emj/11000011","DOIUrl":"https://doi.org/10.33590/emj/11000011","url":null,"abstract":"It is imperative to evaluate for secondary causes of membranous glomerulonephritis, from infections such as hepatitis B and C, viruses and parasites, autoimmune diseases like systemic lupus erythematosus, and other neoplasms. Tuberculosis associated with membranous glomerulonephritis is rare. The authors report a case of microbiologically proven pulmonary tuberculosis and membranous nephropathy occurring concurrently in the same patient. Antitubercular therapy alone was sufficient to cause improvement in the patient. Tuberculosis should be recognised as a potentially treatable infectious cause of secondary membranous nephropathy.","PeriodicalId":505023,"journal":{"name":"European Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140455750","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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