Pub Date : 2024-06-07DOI: 10.24018/clinicmed.2024.5.3.337
Maureen Mwalungali, P. Petlovanyi, A. Tsarkov
Background: Perinatal depression manifests during or after pregnancy, with prenatal depression occurring during pregnancy. Traditionally, research has focused more on postpartum depression, with less attention on prenatal depression among teenagers. Objective: This study aims to examine the correlates of prenatal depression among teenage pregnant women aged 13 to 17 and to explore the relationship between these factors and depression. Methods: A cross-sectional study was conducted at a university teaching hospital and a rural health facility, involving 105 pregnant teenagers. Initial screenings to assess depression were performed using the Edinburgh Postnatal Depression Scale, complemented by psychosocial evaluations with the Perceived Stress Scale and the Rosenberg Self-Esteem Scale. Data analysis was carried out using SPSS version 20, employing both descriptive and inferential statistical methods to interpret the findings. Results: Significant factors influencing prenatal depression included attempts to abort, stress, social support, household income, education level, and marital status. Logistic regression confirmed the significance of these correlates. Conclusion: Multiple factors influence prenatal depression in teenage pregnant women. The findings highlight the need for targeted preventive care and early interventions by medical professionals to improve health outcomes for mothers and infants.
{"title":"Determinants of Prenatal Depression in Teenage Pregnant Women: A Comparative Study of Urban and Rural Settings in Lusaka Province, Zambia","authors":"Maureen Mwalungali, P. Petlovanyi, A. Tsarkov","doi":"10.24018/clinicmed.2024.5.3.337","DOIUrl":"https://doi.org/10.24018/clinicmed.2024.5.3.337","url":null,"abstract":"Background: Perinatal depression manifests during or after pregnancy, with prenatal depression occurring during pregnancy. Traditionally, research has focused more on postpartum depression, with less attention on prenatal depression among teenagers.\u0000Objective: This study aims to examine the correlates of prenatal depression among teenage pregnant women aged 13 to 17 and to explore the relationship between these factors and depression.\u0000Methods: A cross-sectional study was conducted at a university teaching hospital and a rural health facility, involving 105 pregnant teenagers. Initial screenings to assess depression were performed using the Edinburgh Postnatal Depression Scale, complemented by psychosocial evaluations with the Perceived Stress Scale and the Rosenberg Self-Esteem Scale. Data analysis was carried out using SPSS version 20, employing both descriptive and inferential statistical methods to interpret the findings.\u0000Results: Significant factors influencing prenatal depression included attempts to abort, stress, social support, household income, education level, and marital status. Logistic regression confirmed the significance of these correlates.\u0000Conclusion: Multiple factors influence prenatal depression in teenage pregnant women. The findings highlight the need for targeted preventive care and early interventions by medical professionals to improve health outcomes for mothers and infants.","PeriodicalId":510133,"journal":{"name":"European Journal of Clinical Medicine","volume":" 50","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141374405","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}
Spinal cord injury rehabilitation is a complex and continuous process aimed at improving patients' functional capacity and quality of life. The objective of this study was to assess the progress of spinal cord injury patients followed by the rehabilitation team residing outside Antananarivo. A prospective descriptive cross-sectional study was conducted over a period of seven years, from 2015 to 2022, involving all patients who had previously consulted the Rehabilitation Department at CHU-JRA. Follow-up through telephone calls and/or during follow-up consultations was carried out. Of the 50 included patients, a male predominance of 76% was observed, with a mean age of 46 years. The majority were paraplegic (84%), with an ASIA classification predominantly in category A. Only 16% benefited from rehabilitation sessions in a specialized center, while 84% practiced exercises at home. Only 10% of patients achieved a high level of functional independence. However, 62% developed pressure ulcers, and the mortality rate was 28%. The study highlights the urgent need to improve accessibility to rehabilitation services in rural areas and outside the capital, as well as the importance of mastering self-rehabilitation exercises to maintain the autonomy acquired during rehabilitation sessions at the rehabilitation center.
{"title":"Functional Evolution of Spinal Cord Injury Patients Followed by the Rehabilitation Team Residing Outside the Capital of Antananarivo","authors":"Andréa Holiarisoa Raharinantenaina, Zoniaina Valerien Herinandrianina, Synèse Joseph Bemora, Gaëtan Duval Solofomalala","doi":"10.24018/clinicmed.2024.5.3.333","DOIUrl":"https://doi.org/10.24018/clinicmed.2024.5.3.333","url":null,"abstract":"Spinal cord injury rehabilitation is a complex and continuous process aimed at improving patients' functional capacity and quality of life. The objective of this study was to assess the progress of spinal cord injury patients followed by the rehabilitation team residing outside Antananarivo. \u0000A prospective descriptive cross-sectional study was conducted over a period of seven years, from 2015 to 2022, involving all patients who had previously consulted the Rehabilitation Department at CHU-JRA. Follow-up through telephone calls and/or during follow-up consultations was carried out. \u0000Of the 50 included patients, a male predominance of 76% was observed, with a mean age of 46 years. The majority were paraplegic (84%), with an ASIA classification predominantly in category A. Only 16% benefited from rehabilitation sessions in a specialized center, while 84% practiced exercises at home. Only 10% of patients achieved a high level of functional independence. However, 62% developed pressure ulcers, and the mortality rate was 28%. \u0000The study highlights the urgent need to improve accessibility to rehabilitation services in rural areas and outside the capital, as well as the importance of mastering self-rehabilitation exercises to maintain the autonomy acquired during rehabilitation sessions at the rehabilitation center.","PeriodicalId":510133,"journal":{"name":"European Journal of Clinical Medicine","volume":"212 s698","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141375966","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 : 2024-05-17DOI: 10.24018/clinicmed.2024.5.3.334
José Miguel Ingelmo Calvo, José Ruiz Cobo, M. Allam
An innovative topical treatment for psoriasis and atopic dermatitis has recently received patent approval from the Spanish Ministry of Industry, Trade, and Tourism. This topical treatment Psorisbye, presented in the form of a lotion, includes a combination of clobetasol, papaverine hydrochloride, spironolactone, a milk-peptide complex, and propylene glycol. A 56-year-old female presented to our outpatient clinic with bilateral otic eczema. The patient had no significant past medical history and primarily complained of intense pruritus in the lesions. The patient was advised to use our recently patented lotion, Psorisbye, once daily for 7 days. Two days after beginning the treatment, the patient experienced significant relief from itching sensations. By the 8th day, during an examination at the outpatient clinic, a notable improvement in the scaled lesions was observed. While the preliminary results exhibited by Psorisbye in the context of this specific case are indeed promising, the imperative to establish its efficacy and reliability necessitates the initiation of further investigations characterized by more expansive sample sizes and prolonged follow-up periods.
{"title":"Innovative Topical Therapy for Otic Eczema","authors":"José Miguel Ingelmo Calvo, José Ruiz Cobo, M. Allam","doi":"10.24018/clinicmed.2024.5.3.334","DOIUrl":"https://doi.org/10.24018/clinicmed.2024.5.3.334","url":null,"abstract":"An innovative topical treatment for psoriasis and atopic dermatitis has recently received patent approval from the Spanish Ministry of Industry, Trade, and Tourism. This topical treatment Psorisbye, presented in the form of a lotion, includes a combination of clobetasol, papaverine hydrochloride, spironolactone, a milk-peptide complex, and propylene glycol. A 56-year-old female presented to our outpatient clinic with bilateral otic eczema. The patient had no significant past medical history and primarily complained of intense pruritus in the lesions. The patient was advised to use our recently patented lotion, Psorisbye, once daily for 7 days. Two days after beginning the treatment, the patient experienced significant relief from itching sensations. By the 8th day, during an examination at the outpatient clinic, a notable improvement in the scaled lesions was observed. While the preliminary results exhibited by Psorisbye in the context of this specific case are indeed promising, the imperative to establish its efficacy and reliability necessitates the initiation of further investigations characterized by more expansive sample sizes and prolonged follow-up periods.","PeriodicalId":510133,"journal":{"name":"European Journal of Clinical Medicine","volume":"119 33","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141126538","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 : 2024-04-08DOI: 10.24018/clinicmed.2024.5.2.331
Y. Lakhdar, Youssef El Khalifa, Aitlhadj Mohamed Amine, O. Benhoummad, Y. Rochdi, A. Raji
Background: Cervical sympatric schwannoma is a rare benign tumor originating from de Schwan cells. Its clinical presentation is misleading and it can remain asymptomatic for a long time. Mostly, it appears as slow slow-growing cervical mass and may be a differential diagnosis with other neck masses such as paragangliomas. We discuss a case of Cervical sympatric schwannoma and go over its radiological, surgical, and surgical characteristics. Case Presentation: With no prior medical history, a 61-year-old lady appeared with a right cervical mass that had been present for over two years but had lately grown in size without causing dysphagia, dysphonia, or dyspnea. Clinical examination found a firm, slightly pulsatile, non-painful latero-cervical mass measuring 2 × 3 cm. Without other abnormalities on examination of the upper aerodigestive tract or thyroid gland and no neurological deficit. Cervical Ultrasound showed an oval tissular mass with regular contours in close contact with the right common carotid artery. Computed Tomography showed a right superior jugulocarotid mass located behind the vascular axis of the neck with early central vascularization. On magnetic resonance imaging (MRI), this mass was well limited, hypointense on T1 and hyper-intense on T2 with intense contrast enhancement, corresponding to a paraganglioma or schwannoma. A full blood work came back negative. Our patient underwent a complete surgical excision of the tumour which originated in the deep branches of the cervical plexus. Following surgery, the patient had Horner’s syndrome, histopathology confirmed the diagnosis of schwannoma. Conclusions: It is still challenging to differentiate between cervical sympathetic chain schwannoma and paraganglioma clinically and radiological. In the case of the schwannoma surgical approaches must be as conservative as possible to avoid damages of the origin nerve and the patient must be aware of the possibility of Horner syndrome.
{"title":"A Report on a Case and Literature Review on Cervical Sympathetic Chain Schwannoma that Mimics a Paraganglioma","authors":"Y. Lakhdar, Youssef El Khalifa, Aitlhadj Mohamed Amine, O. Benhoummad, Y. Rochdi, A. Raji","doi":"10.24018/clinicmed.2024.5.2.331","DOIUrl":"https://doi.org/10.24018/clinicmed.2024.5.2.331","url":null,"abstract":"Background: Cervical sympatric schwannoma is a rare benign tumor originating from de Schwan cells. Its clinical presentation is misleading and it can remain asymptomatic for a long time. Mostly, it appears as slow slow-growing cervical mass and may be a differential diagnosis with other neck masses such as paragangliomas. We discuss a case of Cervical sympatric schwannoma and go over its radiological, surgical, and surgical characteristics.\u0000Case Presentation: With no prior medical history, a 61-year-old lady appeared with a right cervical mass that had been present for over two years but had lately grown in size without causing dysphagia, dysphonia, or dyspnea. Clinical examination found a firm, slightly pulsatile, non-painful latero-cervical mass measuring 2 × 3 cm. Without other abnormalities on examination of the upper aerodigestive tract or thyroid gland and no neurological deficit. Cervical Ultrasound showed an oval tissular mass with regular contours in close contact with the right common carotid artery. Computed Tomography showed a right superior jugulocarotid mass located behind the vascular axis of the neck with early central vascularization. On magnetic resonance imaging (MRI), this mass was well limited, hypointense on T1 and hyper-intense on T2 with intense contrast enhancement, corresponding to a paraganglioma or schwannoma. A full blood work came back negative. Our patient underwent a complete surgical excision of the tumour which originated in the deep branches of the cervical plexus. Following surgery, the patient had Horner’s syndrome, histopathology confirmed the diagnosis of schwannoma.\u0000Conclusions: It is still challenging to differentiate between cervical sympathetic chain schwannoma and paraganglioma clinically and radiological. In the case of the schwannoma surgical approaches must be as conservative as possible to avoid damages of the origin nerve and the patient must be aware of the possibility of Horner syndrome.","PeriodicalId":510133,"journal":{"name":"European Journal of Clinical Medicine","volume":"3 1‐2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140729488","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 : 2024-03-04DOI: 10.24018/clinicmed.2024.5.2.289
Youssef El Khalifa, O. Benhoummad, Aitlhadj Mohamed Amine, Y. Lakhdar, Y. Rochdi, A. Raji
Ramsay-Hunt syndrome corresponds to a Varicella zoster infection recurrence in the facial nerve’s sensory ganglion cells in patients with primary varicella infection. It manifests by coetaneous lesions of the sensitive Ramsay-Hunt zone, peripheral facial paralysis, and audiovestibular signs. The prognosis is usually good with well-conducted anti-viral treatment. We report the case of a 49-year-old lady who presented with several cranial nerve injuries, including impairment to cranial nerves V, VII, VIII, IX, and X, along with left facial paralysis, vesicles, discomfort in the left ear, dysphagia, and dysphonia. Her work-up in the search for an immune deficiency objected to an HIV infection. This case study aims to raise awareness among doctors to evaluate Ramsay Hunt syndrome in a patient with HIV who presents ear discomfort and insists on a diversified approach to patient care.
{"title":"Ramsay Hunt Syndrome with Numerous Cranial Nerve Damage Revealing An HIV Infection: A Case Report","authors":"Youssef El Khalifa, O. Benhoummad, Aitlhadj Mohamed Amine, Y. Lakhdar, Y. Rochdi, A. Raji","doi":"10.24018/clinicmed.2024.5.2.289","DOIUrl":"https://doi.org/10.24018/clinicmed.2024.5.2.289","url":null,"abstract":"Ramsay-Hunt syndrome corresponds to a Varicella zoster infection recurrence in the facial nerve’s sensory ganglion cells in patients with primary varicella infection. It manifests by coetaneous lesions of the sensitive Ramsay-Hunt zone, peripheral facial paralysis, and audiovestibular signs. The prognosis is usually good with well-conducted anti-viral treatment. We report the case of a 49-year-old lady who presented with several cranial nerve injuries, including impairment to cranial nerves V, VII, VIII, IX, and X, along with left facial paralysis, vesicles, discomfort in the left ear, dysphagia, and dysphonia. Her work-up in the search for an immune deficiency objected to an HIV infection. This case study aims to raise awareness among doctors to evaluate Ramsay Hunt syndrome in a patient with HIV who presents ear discomfort and insists on a diversified approach to patient care.","PeriodicalId":510133,"journal":{"name":"European Journal of Clinical Medicine","volume":"149 11‐12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140398071","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 : 2024-02-21DOI: 10.24018/clinicmed.2024.5.1.327
Mohammad Saleh Sadeghi, Leili Iranirad, Negar Vakili Razlighi, Fatemeh Lotfi, Hadi Vakili Razlighi, Mohammad Miri
Background: Evaluation of the risk factors of atherosclerosis and carotid artery stenosis have been subjected to several investigations. The present study was conducted to determine the degree of carotid artery stenosis and investigate the relationship between atherosclerosis risk factors and coronary artery involvement in coronary artery bypass graft (CABG) patients. Methods: This cross-sectional study was conducted on 450 CABG candidate patients who visited Shahid Beheshti Hospital in Qom. The patients were divided into 4 groups according to the degree of carotid artery stenosis and were examined in terms of risk factors for atherosclerosis and coronary artery involvement. Finally, the data were analyzed using SPSS statistical software. Results: In total, about 18% of the patients had carotid artery stenosis, of them 13.6% had stenosis of less than 50%, 3.2% had stenosis of 50%–70%, and 1.2% had stenosis of more than 70%. Age, history of hypertension (HTN), hyperlipidemia, and previous history of cerebrovascular accident (CVA) showed a significant relationship with carotid artery stenosis. However, gender, BMI, diabetes, history of smoking, history of angiography and lipid profile of the patients did not show a significant relationship. Also, the incidence of CVA after CABG was 1.2%. Conclusion: The present study showed that old age, HTN, hyperlipidemia, and history of CVA are directly related to the severity of carotid artery stenosis.
{"title":"Relationship between Atherosclerosis Risk Factors and Carotid Artery Stenosis in Patients Undergoing Coronary Artery Bypass Graft","authors":"Mohammad Saleh Sadeghi, Leili Iranirad, Negar Vakili Razlighi, Fatemeh Lotfi, Hadi Vakili Razlighi, Mohammad Miri","doi":"10.24018/clinicmed.2024.5.1.327","DOIUrl":"https://doi.org/10.24018/clinicmed.2024.5.1.327","url":null,"abstract":"Background: Evaluation of the risk factors of atherosclerosis and carotid artery stenosis have been subjected to several investigations. The present study was conducted to determine the degree of carotid artery stenosis and investigate the relationship between atherosclerosis risk factors and coronary artery involvement in coronary artery bypass graft (CABG) patients.\u0000Methods: This cross-sectional study was conducted on 450 CABG candidate patients who visited Shahid Beheshti Hospital in Qom. The patients were divided into 4 groups according to the degree of carotid artery stenosis and were examined in terms of risk factors for atherosclerosis and coronary artery involvement. Finally, the data were analyzed using SPSS statistical software.\u0000Results: In total, about 18% of the patients had carotid artery stenosis, of them 13.6% had stenosis of less than 50%, 3.2% had stenosis of 50%–70%, and 1.2% had stenosis of more than 70%. Age, history of hypertension (HTN), hyperlipidemia, and previous history of cerebrovascular accident (CVA) showed a significant relationship with carotid artery stenosis. However, gender, BMI, diabetes, history of smoking, history of angiography and lipid profile of the patients did not show a significant relationship. Also, the incidence of CVA after CABG was 1.2%.\u0000Conclusion: The present study showed that old age, HTN, hyperlipidemia, and history of CVA are directly related to the severity of carotid artery stenosis.","PeriodicalId":510133,"journal":{"name":"European Journal of Clinical Medicine","volume":"24 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140444832","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 : 2024-02-14DOI: 10.24018/clinicmed.2024.5.1.326
Radotina Tony Andrianaivo, Willy Francis Rakotondraibe, Bemora Joseph Synèse, W. Ratovondrainy, M. Rabarijaona, C. Andriamamonjy
Background: To report the epidemiological, therapeutic and evolutionary aspects of spinal dysraphism, with emphasis on the difficulties encountered during management in Madagascar. Methods: This is a retrospective, descriptive, multicenter study in the 7 neurosurgical centers of Madagascar over 5 years on children operated on for spinal dysraphism. Results: We collected 50 cases over 5 years. The mean age was 16.95 ± 33.94 months. Girls predominated (sex ratio = 0.85). The absence of folic acid supplementation in the mother was found in 62%. In all cases, the diagnosis was made in the postnatal period. Myelomeningocele is the most frequent form. Hydrocephalus was found in 20% of cases, orthopaedic malformation in 20%, and Chiari type II malformation in 2%. The dysraphism was localized at the lumbar level in 50% of cases. A spinal CT scan was performed in 62% of cases and transfontanellar ultrasound in 22% of cases. No magnetic resonance imaging of the brain or spinal cord was performed. A ventriculoperitoneal shunt was performed in 8% of cases. Postoperative hydrocephalus was 4%and mortality was 1% due to meningitis. The average follow-up time was 3 months with an extreme of 3 months to 3 years. Conclusion: In spite of the difficulties in the management of these children and the technical platform available in the country, they are operated correctly and the hospital mortality is low.
{"title":"The Reality of the Management of Spinal Dysraphism in a Country in a Precarious Situation: A Retrospective Study","authors":"Radotina Tony Andrianaivo, Willy Francis Rakotondraibe, Bemora Joseph Synèse, W. Ratovondrainy, M. Rabarijaona, C. Andriamamonjy","doi":"10.24018/clinicmed.2024.5.1.326","DOIUrl":"https://doi.org/10.24018/clinicmed.2024.5.1.326","url":null,"abstract":"Background: To report the epidemiological, therapeutic and evolutionary aspects of spinal dysraphism, with emphasis on the difficulties encountered during management in Madagascar.\u0000Methods: This is a retrospective, descriptive, multicenter study in the 7 neurosurgical centers of Madagascar over 5 years on children operated on for spinal dysraphism.\u0000Results: We collected 50 cases over 5 years. The mean age was 16.95 ± 33.94 months. Girls predominated (sex ratio = 0.85). The absence of folic acid supplementation in the mother was found in 62%. In all cases, the diagnosis was made in the postnatal period. Myelomeningocele is the most frequent form. Hydrocephalus was found in 20% of cases, orthopaedic malformation in 20%, and Chiari type II malformation in 2%. The dysraphism was localized at the lumbar level in 50% of cases. A spinal CT scan was performed in 62% of cases and transfontanellar ultrasound in 22% of cases. No magnetic resonance imaging of the brain or spinal cord was performed. A ventriculoperitoneal shunt was performed in 8% of cases. Postoperative hydrocephalus was 4%and mortality was 1% due to meningitis. The average follow-up time was 3 months with an extreme of 3 months to 3 years.\u0000Conclusion: In spite of the difficulties in the management of these children and the technical platform available in the country, they are operated correctly and the hospital mortality is low.","PeriodicalId":510133,"journal":{"name":"European Journal of Clinical Medicine","volume":"680 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139836985","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 : 2024-02-14DOI: 10.24018/clinicmed.2024.5.1.326
Radotina Tony Andrianaivo, Willy Francis Rakotondraibe, Bemora Joseph Synèse, W. Ratovondrainy, M. Rabarijaona, C. Andriamamonjy
Background: To report the epidemiological, therapeutic and evolutionary aspects of spinal dysraphism, with emphasis on the difficulties encountered during management in Madagascar. Methods: This is a retrospective, descriptive, multicenter study in the 7 neurosurgical centers of Madagascar over 5 years on children operated on for spinal dysraphism. Results: We collected 50 cases over 5 years. The mean age was 16.95 ± 33.94 months. Girls predominated (sex ratio = 0.85). The absence of folic acid supplementation in the mother was found in 62%. In all cases, the diagnosis was made in the postnatal period. Myelomeningocele is the most frequent form. Hydrocephalus was found in 20% of cases, orthopaedic malformation in 20%, and Chiari type II malformation in 2%. The dysraphism was localized at the lumbar level in 50% of cases. A spinal CT scan was performed in 62% of cases and transfontanellar ultrasound in 22% of cases. No magnetic resonance imaging of the brain or spinal cord was performed. A ventriculoperitoneal shunt was performed in 8% of cases. Postoperative hydrocephalus was 4%and mortality was 1% due to meningitis. The average follow-up time was 3 months with an extreme of 3 months to 3 years. Conclusion: In spite of the difficulties in the management of these children and the technical platform available in the country, they are operated correctly and the hospital mortality is low.
{"title":"The Reality of the Management of Spinal Dysraphism in a Country in a Precarious Situation: A Retrospective Study","authors":"Radotina Tony Andrianaivo, Willy Francis Rakotondraibe, Bemora Joseph Synèse, W. Ratovondrainy, M. Rabarijaona, C. Andriamamonjy","doi":"10.24018/clinicmed.2024.5.1.326","DOIUrl":"https://doi.org/10.24018/clinicmed.2024.5.1.326","url":null,"abstract":"Background: To report the epidemiological, therapeutic and evolutionary aspects of spinal dysraphism, with emphasis on the difficulties encountered during management in Madagascar.\u0000Methods: This is a retrospective, descriptive, multicenter study in the 7 neurosurgical centers of Madagascar over 5 years on children operated on for spinal dysraphism.\u0000Results: We collected 50 cases over 5 years. The mean age was 16.95 ± 33.94 months. Girls predominated (sex ratio = 0.85). The absence of folic acid supplementation in the mother was found in 62%. In all cases, the diagnosis was made in the postnatal period. Myelomeningocele is the most frequent form. Hydrocephalus was found in 20% of cases, orthopaedic malformation in 20%, and Chiari type II malformation in 2%. The dysraphism was localized at the lumbar level in 50% of cases. A spinal CT scan was performed in 62% of cases and transfontanellar ultrasound in 22% of cases. No magnetic resonance imaging of the brain or spinal cord was performed. A ventriculoperitoneal shunt was performed in 8% of cases. Postoperative hydrocephalus was 4%and mortality was 1% due to meningitis. The average follow-up time was 3 months with an extreme of 3 months to 3 years.\u0000Conclusion: In spite of the difficulties in the management of these children and the technical platform available in the country, they are operated correctly and the hospital mortality is low.","PeriodicalId":510133,"journal":{"name":"European Journal of Clinical Medicine","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139777209","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 : 2023-12-16DOI: 10.24018/clinicmed.2023.4.6.314
C. Umenzekwe, U. Nwadi, O. Ezejiofor, T. Mbaeri, Michael O Iroezindu, E. A. Obiesie, H. M. Nwankwo, Cornelius Onyeka Onuigbo, C. Okpala, O. Onu, Omokhowa Tito Asekhame
Isolated lymphoedema of the scrotum is rare. In sub-Saharan Africa, the infective cause is commonly due to lymphatic filariasis, a neglected tropical disease commonly caused by Wuchereria bancrofti. The swelling of the affected skin and soft tissues results from impaired lymphatic drainage of the affected area due to the chronic inflammatory response to the dead and dying filaria worms in the lymphatic vessels. We describe the case of a 38-year-old man who presented with isolated scrotal lymphoedema secondary to W. bancrofti infection. The patient, in addition to cyclical anti-filarial medical treatment, had successful surgical resection of redundant and fibrous scrotal tissue resulting in overall improvement in his quality of life.
{"title":"Isolated Giant Scrotal Lymphoedema From Filariasis in a Nigerian Male: A Case Report","authors":"C. Umenzekwe, U. Nwadi, O. Ezejiofor, T. Mbaeri, Michael O Iroezindu, E. A. Obiesie, H. M. Nwankwo, Cornelius Onyeka Onuigbo, C. Okpala, O. Onu, Omokhowa Tito Asekhame","doi":"10.24018/clinicmed.2023.4.6.314","DOIUrl":"https://doi.org/10.24018/clinicmed.2023.4.6.314","url":null,"abstract":"Isolated lymphoedema of the scrotum is rare. In sub-Saharan Africa, the infective cause is commonly due to lymphatic filariasis, a neglected tropical disease commonly caused by Wuchereria bancrofti. The swelling of the affected skin and soft tissues results from impaired lymphatic drainage of the affected area due to the chronic inflammatory response to the dead and dying filaria worms in the lymphatic vessels. We describe the case of a 38-year-old man who presented with isolated scrotal lymphoedema secondary to W. bancrofti infection. The patient, in addition to cyclical anti-filarial medical treatment, had successful surgical resection of redundant and fibrous scrotal tissue resulting in overall improvement in his quality of life.","PeriodicalId":510133,"journal":{"name":"European Journal of Clinical Medicine","volume":"1217 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139176959","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}
Melioidosis can present as an acute as well as chronic disease and can be fatal. Type 2 diabetes mellitus is one of the most common risk factors for acquiring this infectious disease.We present a case of a 36-year-old diabetic male patient who presented in March 2022 with acute severe melioidosis and later developed chronic melioidosis. He did not take complete treatment and presented again in January 2023 with features of Latent infection with reactivation. The blood and pus culture showed positive results for Burkholderia pseudomallei (B. pseudomallei). The use of granulocyte colony-stimulating Factor (G-CSF) in addition to antimicrobial treatment with meropenem and later ceftazidime therapy played an effective role in the recovery of the patient. In this case report we present the acute and chronic manifestations with which he reported along with management of the case, review the literature on the impaired immunity in type 2 diabetic patient in melioidosis, latent infection with (re)activation, the suggested role of G-CSF and antimicrobial therapy.
{"title":"Acute, Chronic, and Latent Infection with (Re)Activation Melioidosis","authors":"Arun Agarwal, Rajesh K. Samota, Aakanksha Agarwal, Utkarsh Shrivastava, Sunil Godara","doi":"10.24018/clinicmed.2023.4.5.316","DOIUrl":"https://doi.org/10.24018/clinicmed.2023.4.5.316","url":null,"abstract":"Melioidosis can present as an acute as well as chronic disease and can be fatal. Type 2 diabetes mellitus is one of the most common risk factors for acquiring this infectious disease.We present a case of a 36-year-old diabetic male patient who presented in March 2022 with acute severe melioidosis and later developed chronic melioidosis. He did not take complete treatment and presented again in January 2023 with features of Latent infection with reactivation. The blood and pus culture showed positive results for Burkholderia pseudomallei (B. pseudomallei). The use of granulocyte colony-stimulating Factor (G-CSF) in addition to antimicrobial treatment with meropenem and later ceftazidime therapy played an effective role in the recovery of the patient. In this case report we present the acute and chronic manifestations with which he reported along with management of the case, review the literature on the impaired immunity in type 2 diabetic patient in melioidosis, latent infection with (re)activation, the suggested role of G-CSF and antimicrobial therapy.","PeriodicalId":510133,"journal":{"name":"European Journal of Clinical Medicine","volume":"25 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139313843","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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