Pub Date : 2023-11-25DOI: 10.36349/easjms.2023.v05i10.007
Samson K. Ephraim, Cecilia Protas, Francis Tegete
Background: Orofacial clefts are the most common craniofacial anomalies in most parts of the world and its management remains a challenge to otorhinolaryngology, plastic/reconstructive, oral and maxillofacial surgeons practicing in resource limited countries. There is limited data on surgical management of these birth defects in Tanzania and Bugando Medical Centre (BMC) in particular. This study aimed to describe our own experience regarding the surgical management of orofacial clefts at BMC, a tertiary care hospital in Tanzania. Methods: This was a cross sectional study involving all children with orofacial clefts that were treated at BMC between February 2019 and June 2019. Results: A total of 98 patients with orofacial clefts were recruited. Males outnumbered males by a male to female ratio of 1.7:1. The majority of patients (64.3%) were within 12 months at presentation. The median ages at surgery in patients with cleft lip and those with cleft palate were 3 [IQR, 2 to 8] and 11(IQR, 7 to 18) months, respectively. Orofacial clefts in association with congenital anomalies were recorded in 5(5.1%) patients. More than half of patients (55.1%) had combined cleft lip and palate. Unilateral clefts, 77(78.5%) were more common and showed left side preponderance in 52(53.1%) patients. All patients underwent cleft surgery under general anesthesia. Millard rotation advancement flap repair and von-Langenbeck were the most common techniques of cleft lip and palate repair performed in 42(52.5%) and 30 (41.7%) patients, respectively. The overall complication rate was 14.3% and the most common postoperative complications were bleeding, palatal fistula, wound dehiscence and surgical site infections in 6(31.6%), 4(21.1%) and 3(15.8%) each respectively. No death was recorded in this study. Among the 98 patients operated, 79 were treated successfully giving an overall success rate of 80.6%. The success rate was significantly influenced by nutrition status (p= 0.010), co-existing con
{"title":"Surgical Management of Oro-Facial Clefts at a Tertiary Care Hospital in a Resource-Limited Setting: A Tanzanian Experience","authors":"Samson K. Ephraim, Cecilia Protas, Francis Tegete","doi":"10.36349/easjms.2023.v05i10.007","DOIUrl":"https://doi.org/10.36349/easjms.2023.v05i10.007","url":null,"abstract":"Background: Orofacial clefts are the most common craniofacial anomalies in most parts of the world and its management remains a challenge to otorhinolaryngology, plastic/reconstructive, oral and maxillofacial surgeons practicing in resource limited countries. There is limited data on surgical management of these birth defects in Tanzania and Bugando Medical Centre (BMC) in particular. This study aimed to describe our own experience regarding the surgical management of orofacial clefts at BMC, a tertiary care hospital in Tanzania. Methods: This was a cross sectional study involving all children with orofacial clefts that were treated at BMC between February 2019 and June 2019. Results: A total of 98 patients with orofacial clefts were recruited. Males outnumbered males by a male to female ratio of 1.7:1. The majority of patients (64.3%) were within 12 months at presentation. The median ages at surgery in patients with cleft lip and those with cleft palate were 3 [IQR, 2 to 8] and 11(IQR, 7 to 18) months, respectively. Orofacial clefts in association with congenital anomalies were recorded in 5(5.1%) patients. More than half of patients (55.1%) had combined cleft lip and palate. Unilateral clefts, 77(78.5%) were more common and showed left side preponderance in 52(53.1%) patients. All patients underwent cleft surgery under general anesthesia. Millard rotation advancement flap repair and von-Langenbeck were the most common techniques of cleft lip and palate repair performed in 42(52.5%) and 30 (41.7%) patients, respectively. The overall complication rate was 14.3% and the most common postoperative complications were bleeding, palatal fistula, wound dehiscence and surgical site infections in 6(31.6%), 4(21.1%) and 3(15.8%) each respectively. No death was recorded in this study. Among the 98 patients operated, 79 were treated successfully giving an overall success rate of 80.6%. The success rate was significantly influenced by nutrition status (p= 0.010), co-existing con","PeriodicalId":507417,"journal":{"name":"EAS Journal of Medicine and Surgery","volume":"72 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139237326","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}
Pub Date : 2023-11-24DOI: 10.36349/easjms.2023.v05i10.004
T. A, S. Dede, Rosemary Oluchi Stanley, Zosa Ugbana Dienye, Joy Tonye Wihioka
Cardiovascular diseases (CVDs), which are often thought to be a “man’s” challenge, are now recorded as the primary cause of death for women globally. Consequently, the present study set out to assess the cardiovascular indices in obese women resident in Rivers State, Nigeria. Utilizing the Leslie Fischer's formula; exactly 334 obese and non-obese women within their 18 and 65 years of age with no obvious health condition and resident in Upland and Riverine areas of Rivers State were recruited by the present study. The multistage sampling technique was used, and subjects were drawn across the upland and riverine locations of the State. Consenting subjects were randomly surveyed from the multi-ethnic residents of the state. Anthropometric (body mass index-BMI) data and auscultatory blood pressure measurement were done using Seca weight/height scale and mercury sphygmomanometer and stethoscope respectively. Electrocardiographic (ECG) features were recorded using the standard resting 12 – lead ECG. Numerical data obtained were subjected to statistical analyses using the statistical package for social sciences (SPSS) version 21.0. One-way analysis of variance (ANOVA) and independent t-test with a p< 0.05 considered statistically significant were determined. The BMI values were generally higher in the RVR subjects when compared to their UPL counterparts, but only that of obese class II were significant (P<0.05) of the aforementioned increases. The systolic and diastolic blood pressure (SBP and DBP) of all subjects indicated graded increases from obese class I to obese class III and these increases were seen to be significant (P<0.05) when compared to that of the non-obese and down the successive groups. The ECG features in the non-obese and obese class I subgroups indicated higher prevalence of left ventricular hypertrophy in the UPL residents than the RVR residents. The study thus found that there was a significantly raised prevalence of obesity in younger RVR .......
心血管疾病（CVDs）通常被认为是 "男人 "面临的挑战，但现在已成为全球女性死亡的主要原因。因此，本研究旨在评估尼日利亚河流州肥胖女性的心血管指数。利用莱斯利-费舍尔公式，本研究招募了居住在河流州高地和沿河地区、年龄在 18 岁至 65 岁之间、无明显健康问题的肥胖和非肥胖妇女，共计 334 人。研究采用多阶段抽样技术，受试者遍布该州的高地和沿河地区。经同意的受试者是从该州多民族居民中随机抽取的。人体测量（体重指数-BMI）数据和听诊血压测量分别使用 Seca 体重/身高秤、水银血压计和听诊器进行。心电图（ECG）特征使用标准静息 12 导联心电图进行记录。获得的数字数据使用社会科学统计软件包（SPSS）21.0 版进行统计分析。采用单因素方差分析（ANOVA）和独立 t 检验，P< 0.05 为具有统计学意义。与普通人群相比，RVR 受试者的 BMI 值普遍较高，但只有肥胖 II 级受试者的 BMI 值在上述增长中具有显著性（P<0.05）。从肥胖 I 级到肥胖 III 级，所有受试者的收缩压和舒张压（SBP 和 DBP）均呈逐级上升趋势，与非肥胖组和逐级下降组相比，上升幅度明显（P<0.05）。非肥胖和肥胖 I 级亚组的心电图特征表明，未达到肥胖 I 级的居民左心室肥厚的发生率高于达到肥胖 RVR 级的居民。因此，研究发现，房车营地年轻居民的肥胖患病率明显升高 .......
{"title":"Assessment of Cardiovascular Indices in Obese Women Resident in Rivers State, Nigeria","authors":"T. A, S. Dede, Rosemary Oluchi Stanley, Zosa Ugbana Dienye, Joy Tonye Wihioka","doi":"10.36349/easjms.2023.v05i10.004","DOIUrl":"https://doi.org/10.36349/easjms.2023.v05i10.004","url":null,"abstract":"Cardiovascular diseases (CVDs), which are often thought to be a “man’s” challenge, are now recorded as the primary cause of death for women globally. Consequently, the present study set out to assess the cardiovascular indices in obese women resident in Rivers State, Nigeria. Utilizing the Leslie Fischer's formula; exactly 334 obese and non-obese women within their 18 and 65 years of age with no obvious health condition and resident in Upland and Riverine areas of Rivers State were recruited by the present study. The multistage sampling technique was used, and subjects were drawn across the upland and riverine locations of the State. Consenting subjects were randomly surveyed from the multi-ethnic residents of the state. Anthropometric (body mass index-BMI) data and auscultatory blood pressure measurement were done using Seca weight/height scale and mercury sphygmomanometer and stethoscope respectively. Electrocardiographic (ECG) features were recorded using the standard resting 12 – lead ECG. Numerical data obtained were subjected to statistical analyses using the statistical package for social sciences (SPSS) version 21.0. One-way analysis of variance (ANOVA) and independent t-test with a p< 0.05 considered statistically significant were determined. The BMI values were generally higher in the RVR subjects when compared to their UPL counterparts, but only that of obese class II were significant (P<0.05) of the aforementioned increases. The systolic and diastolic blood pressure (SBP and DBP) of all subjects indicated graded increases from obese class I to obese class III and these increases were seen to be significant (P<0.05) when compared to that of the non-obese and down the successive groups. The ECG features in the non-obese and obese class I subgroups indicated higher prevalence of left ventricular hypertrophy in the UPL residents than the RVR residents. The study thus found that there was a significantly raised prevalence of obesity in younger RVR .......","PeriodicalId":507417,"journal":{"name":"EAS Journal of Medicine and Surgery","volume":"39 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139240976","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}
Pub Date : 2023-11-24DOI: 10.36349/easjms.2023.v05i10.005
Ghebouli K, Bendjoudi K, Larkem H, Kecir Ma, Belbekri M
Introduction: Metastatic pleural effusion complicates many cancers and impairs patients' quality of life. In a palliative situation, the decision between thoracoscopy talc pleurodesis, tube chest, iterative punctures or abstention is difficult and often operator dependent. Materials and methods: We report a study of 87 patients with metastatic pleural effusion treated by video assisted thoracoscopy talc pleurodesis. Results: Breast cancer constitutes the primary site causing metastatic pleural effusion in approximately half of cases, followed by bronchopulmonary cancers and finally digestive cancers. The complete response rate in the short and medium term is very satisfactory. We did not report any complications apart from one case of empyema. Conclusion: video assisted thoracoscopy talc pleurodesis constitutes an interesting treatment for recurrence of metastatic pleural effusion.
{"title":"Video Assisted Thoracoscopy Talc Pleurodesis in the Management of Metastatic Pleural Effusion","authors":"Ghebouli K, Bendjoudi K, Larkem H, Kecir Ma, Belbekri M","doi":"10.36349/easjms.2023.v05i10.005","DOIUrl":"https://doi.org/10.36349/easjms.2023.v05i10.005","url":null,"abstract":"Introduction: Metastatic pleural effusion complicates many cancers and impairs patients' quality of life. In a palliative situation, the decision between thoracoscopy talc pleurodesis, tube chest, iterative punctures or abstention is difficult and often operator dependent. Materials and methods: We report a study of 87 patients with metastatic pleural effusion treated by video assisted thoracoscopy talc pleurodesis. Results: Breast cancer constitutes the primary site causing metastatic pleural effusion in approximately half of cases, followed by bronchopulmonary cancers and finally digestive cancers. The complete response rate in the short and medium term is very satisfactory. We did not report any complications apart from one case of empyema. Conclusion: video assisted thoracoscopy talc pleurodesis constitutes an interesting treatment for recurrence of metastatic pleural effusion.","PeriodicalId":507417,"journal":{"name":"EAS Journal of Medicine and Surgery","volume":"670 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139240742","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}
Pub Date : 2023-11-11DOI: 10.36349/easjms.2023.v05i10.003
Protap Kumar Paul, Mohammad Shafiqur Rahman, Md.Kamrul Hasan, Nure Alam Siddique, Mohammad Alwalid Sharkar, Nureza Islam, Koushik Bhowmick, Md. Saiful Islam, Prohlad Kumar Paul
Background: Acute myocardial infarction is a condition where the blood flow to the heart muscle is blocked, leading to the death of heart tissue. It is a major cause of heart failure and fatalities worldwide. Objective: To assess risk factors in MI patients and determine clinical criteria for patients with MI. Methods: This cross-sectional observational study was done from January 2023 to June 2023 at the Mymensingh Medical College Hospital, Mymensingh, Bangladesh. A total of 100 people were observed in this study. Results: Our study showed that a maximum of 32 individuals aged 50-59 suffered from acute myocardial infarction. Most were male (74%) and Muslim (93%). 83% had hypertension, 78% had diabetes mellitus, and 77% were smokers. Different types of MI were identified, with anterolateral MI being the most common (25 patients). Conclusion: Several risk factors increase the chance of developing acute myocardial infarction, including family history, sedentary lifestyle, unhealthy diet, smoking, lack of exercise, and certain health conditions like diabetes, hypertension, dyslipidemia, SLE, vasculitis, or obesity.
{"title":"The Risk Factors in Patients of Myocardial Infarction: An Observational Study","authors":"Protap Kumar Paul, Mohammad Shafiqur Rahman, Md.Kamrul Hasan, Nure Alam Siddique, Mohammad Alwalid Sharkar, Nureza Islam, Koushik Bhowmick, Md. Saiful Islam, Prohlad Kumar Paul","doi":"10.36349/easjms.2023.v05i10.003","DOIUrl":"https://doi.org/10.36349/easjms.2023.v05i10.003","url":null,"abstract":"Background: Acute myocardial infarction is a condition where the blood flow to the heart muscle is blocked, leading to the death of heart tissue. It is a major cause of heart failure and fatalities worldwide. Objective: To assess risk factors in MI patients and determine clinical criteria for patients with MI. Methods: This cross-sectional observational study was done from January 2023 to June 2023 at the Mymensingh Medical College Hospital, Mymensingh, Bangladesh. A total of 100 people were observed in this study. Results: Our study showed that a maximum of 32 individuals aged 50-59 suffered from acute myocardial infarction. Most were male (74%) and Muslim (93%). 83% had hypertension, 78% had diabetes mellitus, and 77% were smokers. Different types of MI were identified, with anterolateral MI being the most common (25 patients). Conclusion: Several risk factors increase the chance of developing acute myocardial infarction, including family history, sedentary lifestyle, unhealthy diet, smoking, lack of exercise, and certain health conditions like diabetes, hypertension, dyslipidemia, SLE, vasculitis, or obesity.","PeriodicalId":507417,"journal":{"name":"EAS Journal of Medicine and Surgery","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139280006","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}
Pub Date : 2023-11-10DOI: 10.36349/easjms.2023.v05i10.001
M. Bah, Mamadou Dian Barry, Thierno Amadou Oury Sow, Thierno Mamaou Oury Diallo, Mamadou Madiou Barry, D. Kanté, Alimou Diallo, Demba Cissé, Youssouf Keita, I. Bah, Diallo Ab
In Africa south of the Sahara, there are very few urologists. To fill this gap, a training in urology started in Guinea in 2005. The aim of this study was to take stock of this teaching, both theoretical and practical. Two different questionnaires were established for this survey. The first one was addressed to the students in order to collect their satisfaction and wishes regarding the teaching provided, and the second one to the person in charge of the teaching concerned the objectives of the DES, the conditions of participation in this training, and the teaching methods. Nineteen students (76%) responded to our questionnaire. Their average age was 34.74 years. The teaching provided was close to the practical concerns of the students in 68.42% of cases (n=13). The difficulties encountered by the enrollees were dominated by the payment of training fees (73.68%; n=14) and access to the internet (68.42%n=13). The most cited suggestions were the improvement of the technical platform (13.32%; n=4), easy access to the internet and scientific journals (10%; n=3). The surgical simulator, surgical training in animals, and surgical tutoring during the course are the practical teaching methods to be promoted according to the training manager. In conclusion, our study has enabled us to form an opinion on the training of doctors in the context of specialisation in Guinea, and to highlight what has been achieved and what needs to be improved in order to maintain the quality of teaching.
{"title":"Teaching Urological Surgery in Guinea: Current Status and Prospects","authors":"M. Bah, Mamadou Dian Barry, Thierno Amadou Oury Sow, Thierno Mamaou Oury Diallo, Mamadou Madiou Barry, D. Kanté, Alimou Diallo, Demba Cissé, Youssouf Keita, I. Bah, Diallo Ab","doi":"10.36349/easjms.2023.v05i10.001","DOIUrl":"https://doi.org/10.36349/easjms.2023.v05i10.001","url":null,"abstract":"In Africa south of the Sahara, there are very few urologists. To fill this gap, a training in urology started in Guinea in 2005. The aim of this study was to take stock of this teaching, both theoretical and practical. Two different questionnaires were established for this survey. The first one was addressed to the students in order to collect their satisfaction and wishes regarding the teaching provided, and the second one to the person in charge of the teaching concerned the objectives of the DES, the conditions of participation in this training, and the teaching methods. Nineteen students (76%) responded to our questionnaire. Their average age was 34.74 years. The teaching provided was close to the practical concerns of the students in 68.42% of cases (n=13). The difficulties encountered by the enrollees were dominated by the payment of training fees (73.68%; n=14) and access to the internet (68.42%n=13). The most cited suggestions were the improvement of the technical platform (13.32%; n=4), easy access to the internet and scientific journals (10%; n=3). The surgical simulator, surgical training in animals, and surgical tutoring during the course are the practical teaching methods to be promoted according to the training manager. In conclusion, our study has enabled us to form an opinion on the training of doctors in the context of specialisation in Guinea, and to highlight what has been achieved and what needs to be improved in order to maintain the quality of teaching.","PeriodicalId":507417,"journal":{"name":"EAS Journal of Medicine and Surgery","volume":"174 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139280608","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}
Pub Date : 2023-11-10DOI: 10.36349/easjms.2023.v05i10.002
Sr. Juliet Macharia, A. Kihunrwa, R. Kiritta, D. Matovelo, Edgar Ndaboine, Feredina John, Francis Tegete
Background: Abdominal pregnancy is a rare form of ectopic pregnancy with a higher misdiagnosis rate. Sepsis is a life-threatening complication associated with this type of ectopic pregnancy. Various techniques for managing septic advanced abdominal pregnancy have been discussed in the literature. In this article, we report a case of managing septic abdominal pregnancy in which a macerated baby was delivered, and the necrotic placenta was left in situ. Case presentation: We report a 34-year-old African woman, para 5 living 4, who was three days post laparotomy due to abdominal pregnancy. A re-laparotomy was done due to maternal sepsis. The peritoneum had foul-smelling pus, with a necrotized placenta which was still attached to various parts of the abdomen. The placenta was left in situ and the abdomen was left open. Pus swab revealed methicillin-resistant staphylococcus aureus which was sensitive to Vancomycin. She was managed with a ten-day Vancomycin regime. Dressing with normal saline and honey twice or thrice a day for eight weeks was done. Secondary suturing was done and the patient was discharged home later in good health. Conclusion: Advanced abdominal pregnancy is a rare condition, and its management is very challenging. Once it complicates into maternal sepsis the life of the mother becomes endangered. Identifying and treating the source of infection with daily dressing using normal saline and honey is simple and cheap, it saves life.
{"title":"Managing Maternal Sepsis after Delivering an Advanced Abdominal Pregnancy in Low Resource Setting Health Facility","authors":"Sr. Juliet Macharia, A. Kihunrwa, R. Kiritta, D. Matovelo, Edgar Ndaboine, Feredina John, Francis Tegete","doi":"10.36349/easjms.2023.v05i10.002","DOIUrl":"https://doi.org/10.36349/easjms.2023.v05i10.002","url":null,"abstract":"Background: Abdominal pregnancy is a rare form of ectopic pregnancy with a higher misdiagnosis rate. Sepsis is a life-threatening complication associated with this type of ectopic pregnancy. Various techniques for managing septic advanced abdominal pregnancy have been discussed in the literature. In this article, we report a case of managing septic abdominal pregnancy in which a macerated baby was delivered, and the necrotic placenta was left in situ. Case presentation: We report a 34-year-old African woman, para 5 living 4, who was three days post laparotomy due to abdominal pregnancy. A re-laparotomy was done due to maternal sepsis. The peritoneum had foul-smelling pus, with a necrotized placenta which was still attached to various parts of the abdomen. The placenta was left in situ and the abdomen was left open. Pus swab revealed methicillin-resistant staphylococcus aureus which was sensitive to Vancomycin. She was managed with a ten-day Vancomycin regime. Dressing with normal saline and honey twice or thrice a day for eight weeks was done. Secondary suturing was done and the patient was discharged home later in good health. Conclusion: Advanced abdominal pregnancy is a rare condition, and its management is very challenging. Once it complicates into maternal sepsis the life of the mother becomes endangered. Identifying and treating the source of infection with daily dressing using normal saline and honey is simple and cheap, it saves life.","PeriodicalId":507417,"journal":{"name":"EAS Journal of Medicine and Surgery","volume":"63 6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139280891","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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