Pub Date : 2023-10-04DOI: 10.21744/ijhms.v6n4.2200
Ida Aju Kusuma Wardani, Lely Setyawati Kurniawan
Suicide is a major public health problem worldwide. Attempted suicide (AT) is a deliberate act of self-harm that has the intent to die, but does not result in death. Young adults are less likely to receive mental health care than younger and older individuals. This study aims to determine the description of anxiety and depression and provide an analysis of patients who attempted suicide who entered the Emergency Unit at Prof. Dr. IGNG Ngoerah Hospital Denpasar. The research was conducted at Prof. dr. IGNG Ngoerah Hospital Denpasar. The research method was descriptive analytic, cross-sectional using demographic questionnaires, Mini International Neuropsychiatry Interview (MINI), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Data were processed using SPSS software. The study found that the mean age of 30 years and female gender were the most common. There is a close relationship between anxiety and depression with suicide risk.
{"title":"Analysis of anxiety and depression in young adult patients with suicide attempts in the emergency department RSUP Prof. Dr. IGNG Ngoerah Denpasar","authors":"Ida Aju Kusuma Wardani, Lely Setyawati Kurniawan","doi":"10.21744/ijhms.v6n4.2200","DOIUrl":"https://doi.org/10.21744/ijhms.v6n4.2200","url":null,"abstract":"Suicide is a major public health problem worldwide. Attempted suicide (AT) is a deliberate act of self-harm that has the intent to die, but does not result in death. Young adults are less likely to receive mental health care than younger and older individuals. This study aims to determine the description of anxiety and depression and provide an analysis of patients who attempted suicide who entered the Emergency Unit at Prof. Dr. IGNG Ngoerah Hospital Denpasar. The research was conducted at Prof. dr. IGNG Ngoerah Hospital Denpasar. The research method was descriptive analytic, cross-sectional using demographic questionnaires, Mini International Neuropsychiatry Interview (MINI), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Data were processed using SPSS software. The study found that the mean age of 30 years and female gender were the most common. There is a close relationship between anxiety and depression with suicide risk.","PeriodicalId":51699,"journal":{"name":"International Journal of Medical Research & Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135644671","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 : 2023-09-30DOI: 10.58806/ijhmr.2023.v2i9n12
Frank (D.C.) H
This Point of View provides an overview of the integrated treatment framework for influenza and COVID-19 in the post-pandemic era. We discuss the available medications for influenza treatment and compare their efficacy. Additionally, we address the issue of antiviral resistance and the safety considerations associated with these medications. The research methods and findings supporting this treatment approach are discussed, highlighting its potential limitations and challenges. This work aims to contribute to the development of effective treatment strategies for influenza and COVID-19, considering the evolving landscape of infectious diseases in the aftermath of the pandemic.
{"title":"An Integrated Treatment Framework For Influenza In Covid-Aftermath","authors":"Frank (D.C.) H","doi":"10.58806/ijhmr.2023.v2i9n12","DOIUrl":"https://doi.org/10.58806/ijhmr.2023.v2i9n12","url":null,"abstract":"This Point of View provides an overview of the integrated treatment framework for influenza and COVID-19 in the post-pandemic era. We discuss the available medications for influenza treatment and compare their efficacy. Additionally, we address the issue of antiviral resistance and the safety considerations associated with these medications. The research methods and findings supporting this treatment approach are discussed, highlighting its potential limitations and challenges. This work aims to contribute to the development of effective treatment strategies for influenza and COVID-19, considering the evolving landscape of infectious diseases in the aftermath of the pandemic.","PeriodicalId":51699,"journal":{"name":"International Journal of Medical Research & Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136344687","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 : 2023-09-30DOI: 10.58806/ijhmr.2023.v2i9n11
Dr. Elife Ozkan, Gizem Uzumoglu, RPh, Zehra Eraltug, RPh
Total parenteral nutrition (TPN) is the treatment modality of providing intravenous nutrition for patients who cannot get oral feeding. Physicians use standard scales, such as NRS-2002 and NUTRIC, for TPN orders. The usage of NRS-2002 in public hospitals has been mandatory in Turkey since 2015. The quality management department of Izmir Tire Public Hospital recognized that TPN consumption increased dramatically since 2015. The orders, which increased in direct proportion to the number of patients, showed that it should be investigated by evaluating their necessity according to nutritional practice standards. The objective of this study is to research the effect of e-orders incorporated with a clinical decision support system on TPN consumption. We digitalized the NRS-2002 form and added a clinical decision support system to calculate the score and calorie requirements. We found that the total number of NRS-2002 forms completed by physicians increased by 95%, the number of TPN orders decreased by 41%, and the cost decreased by 38% in 2018. This study showed that e-ordering of TPN combined with a clinical decision support system is beneficial for decreasing costs.
{"title":"Presenting The Role Of CPOE Incorporating With CDSS In Decreasing The Costs Of TPN In ICU","authors":"Dr. Elife Ozkan, Gizem Uzumoglu, RPh, Zehra Eraltug, RPh","doi":"10.58806/ijhmr.2023.v2i9n11","DOIUrl":"https://doi.org/10.58806/ijhmr.2023.v2i9n11","url":null,"abstract":"Total parenteral nutrition (TPN) is the treatment modality of providing intravenous nutrition for patients who cannot get oral feeding. Physicians use standard scales, such as NRS-2002 and NUTRIC, for TPN orders. The usage of NRS-2002 in public hospitals has been mandatory in Turkey since 2015. The quality management department of Izmir Tire Public Hospital recognized that TPN consumption increased dramatically since 2015. The orders, which increased in direct proportion to the number of patients, showed that it should be investigated by evaluating their necessity according to nutritional practice standards. The objective of this study is to research the effect of e-orders incorporated with a clinical decision support system on TPN consumption. We digitalized the NRS-2002 form and added a clinical decision support system to calculate the score and calorie requirements. We found that the total number of NRS-2002 forms completed by physicians increased by 95%, the number of TPN orders decreased by 41%, and the cost decreased by 38% in 2018. This study showed that e-ordering of TPN combined with a clinical decision support system is beneficial for decreasing costs.","PeriodicalId":51699,"journal":{"name":"International Journal of Medical Research & Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136344809","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}
Many unwanted pregnancies and its associated complications have resulted from refusal of some women of reproductive age to the use of contraceptives in general particularly the hormonal contraceptive in our environment. The fear of side effects, religious belief, ignorance and other myths surrounding the use of contraceptives had contributed to this. The main objective of the study was to find out if the reported side effects of hormonal contraceptives by women of reproductive age in Enugu, South Eastern Nigeria, are truth or myth. It was a combination of prospective and retrospective study with interviewer administered questionnaire to assess socio-demographic data, reasons why some women were not using hormonal contraceptives, side effects and benefits of hormonal contraceptives. From the 410 respondents, the study showed that 232 respondents (56.6%, X2=7.686) of respondents used hormonal contraceptive which was significant (p<0.05). 178respondents (43.4%) respondents did not use hormonal contraception. 76.0% of the hormonal contraceptives users had side effects while 24.0% did not. Irregular menses (44.4%) was the commonest side effect.130 respondents (73.0%) gave reasons such as religious belief, ignorance, fear of side effects etc as preventing factors to the use of contraceptives. The study showed that 69.8% of users were not discouraged by side effects and 81.1% agreed to recommend it to their friends and family relatives because of its numerous benefits. While it was true from the study that hormonal contraceptives was associated with some side effects of which some disappeared without intervention within 3-5 months of use (35.1%), and others were taken care of through medical interventions, some myths(religious belief, ignorance, husband approval, etc) were also limitations against hormonal contraceptives use.
{"title":"The Reported Side Effects Of Hormonal Contraception By Women Of Reproductive Age In Selected Hospitals In Enugu: Truth Or Myth","authors":"Anonde Chinedu Matthew, Obinna Onwujekwe, Itodo Samuel Olusegun, Itodo Miracle Chekwube","doi":"10.58806/ijhmr.2023.v2i9n13","DOIUrl":"https://doi.org/10.58806/ijhmr.2023.v2i9n13","url":null,"abstract":"Many unwanted pregnancies and its associated complications have resulted from refusal of some women of reproductive age to the use of contraceptives in general particularly the hormonal contraceptive in our environment. The fear of side effects, religious belief, ignorance and other myths surrounding the use of contraceptives had contributed to this. The main objective of the study was to find out if the reported side effects of hormonal contraceptives by women of reproductive age in Enugu, South Eastern Nigeria, are truth or myth. It was a combination of prospective and retrospective study with interviewer administered questionnaire to assess socio-demographic data, reasons why some women were not using hormonal contraceptives, side effects and benefits of hormonal contraceptives. From the 410 respondents, the study showed that 232 respondents (56.6%, X2=7.686) of respondents used hormonal contraceptive which was significant (p<0.05). 178respondents (43.4%) respondents did not use hormonal contraception. 76.0% of the hormonal contraceptives users had side effects while 24.0% did not. Irregular menses (44.4%) was the commonest side effect.130 respondents (73.0%) gave reasons such as religious belief, ignorance, fear of side effects etc as preventing factors to the use of contraceptives. The study showed that 69.8% of users were not discouraged by side effects and 81.1% agreed to recommend it to their friends and family relatives because of its numerous benefits. While it was true from the study that hormonal contraceptives was associated with some side effects of which some disappeared without intervention within 3-5 months of use (35.1%), and others were taken care of through medical interventions, some myths(religious belief, ignorance, husband approval, etc) were also limitations against hormonal contraceptives use.","PeriodicalId":51699,"journal":{"name":"International Journal of Medical Research & Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136343897","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 : 2023-09-29DOI: 10.21744/ijhms.v6n3.2199
I Gede Eka Wiratnaya, Risang Haryo Raditya
Introduction: Giant Cell Tumors are benign, aggressive tumors typically found in the epiphysis of long bones. It has a potential for aggressive behaviour and the capacity to metastasize. the most common symptom of a giant cell tumor is a pain in the area of the tumor. The patient may also have pain with the movement of the nearby joint. Case: We reported an 18-year-old boy with an extensive giant-cell tumor of proximal humerus. Radiograph show a primary malignant bone tumour proximal humerus dextra with soft tissue swelling. There was a lytic lesion, with wide zone transition on proximal humerus dextra, and a trabeculated bone outside the normal lesion was treated by segmental resection and shoulder reconstruction. A prosthesis was used to reconstruct the shoulder joint, the rotator cuff was reattached to the bone after making a semicircular trough. Discussion: There are several therapy options for the patient, the non-operative and operative therapy. The non-operative way such as radiation therapy, medication therapy, and tumor embolization. The operative way such as extensive, complete resection, and amputation. Conclusion: Wide excision is suitable for this patient, we can save normal tissue and do some shoulder reconstruction.
{"title":"Bone tumor wide excision due to giant cell tumor of proximal humerus","authors":"I Gede Eka Wiratnaya, Risang Haryo Raditya","doi":"10.21744/ijhms.v6n3.2199","DOIUrl":"https://doi.org/10.21744/ijhms.v6n3.2199","url":null,"abstract":"Introduction: Giant Cell Tumors are benign, aggressive tumors typically found in the epiphysis of long bones. It has a potential for aggressive behaviour and the capacity to metastasize. the most common symptom of a giant cell tumor is a pain in the area of the tumor. The patient may also have pain with the movement of the nearby joint. Case: We reported an 18-year-old boy with an extensive giant-cell tumor of proximal humerus. Radiograph show a primary malignant bone tumour proximal humerus dextra with soft tissue swelling. There was a lytic lesion, with wide zone transition on proximal humerus dextra, and a trabeculated bone outside the normal lesion was treated by segmental resection and shoulder reconstruction. A prosthesis was used to reconstruct the shoulder joint, the rotator cuff was reattached to the bone after making a semicircular trough. Discussion: There are several therapy options for the patient, the non-operative and operative therapy. The non-operative way such as radiation therapy, medication therapy, and tumor embolization. The operative way such as extensive, complete resection, and amputation. Conclusion: Wide excision is suitable for this patient, we can save normal tissue and do some shoulder reconstruction.","PeriodicalId":51699,"journal":{"name":"International Journal of Medical Research & Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135248107","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 : 2023-09-28DOI: 10.58806/ijhmr.2023.v2i9n10
Udobi S.I, Onuh A.C, Udobi J.I, Ezeama C.O.
Objective: To document the various structural uterine abnormalities detected on transabdominal ultrasonography (TAUS) and hysterosalpingography (HSG) of premenopausal women with infertility and abnormal uterine bleeding (AUB) and determine whether the structural abnormalities correlate well with the clinical forms of AUB among the patients. Methodology: This is a prospective and analytical study of 98 infertile women with history of AUB, referred for HSG. Clinical history including the forms of AUB were obtained from the subjects. Subjects were evaluated with TAUS and HSG after obtaining both ethical clearance and informed consent. Statistical analysis was with the Statistical Package for Social Sciences (SPSS) version 21. Simple frequency, measures of central tendency and dispersion, crosstabulation as well as Pearson’s correlation tests were carried out. For correlation, p ≤ 0.05 was considered significant. Result: Fibroids, followed by intrauterine adhesions (IUA) were the commonest structural uterine abnormalities. Fibroids were detected with both TAUS and HSG, while IUA were detected with HSG only. Shortened menstrual flow was the commonest form of AUB and occurred in 52 (53.1%) of the subjects, followed by light menstrual flow 41(41.8%). The menses were irregular in 33(33.7%), light and shortened in 32(32.7%), heavy in 21(21.4%), prolonged in 16(16.3%), and, heavy and prolonged in 9(9.2%). Fibroids occurred most frequently among those with heavy and prolonged menstrual bleeding while IUA occurred most frequently among those with scanty and reduced menstrual bleeding. On TAUS, HSG, or combined TAUS and HSG, there were significant correlations between fibroids and prolonged heavy menses, fibroids and heavy menses, and, fibroid and prolonged menses. On HSG, significant correlation existed between IUA and scanty short menses. Conclusion: Uterine fibroids and intrauterine adhesions were the commonest structural uterine abnormalities detected. There was significant correlation between fibroids and history of heavy menstrual flow as well as between fibroids and prolonged menses, and IUA and scanty short menses.
{"title":"Correlation Of Structural Uterine Abnormalities With Abnormal Uterine Bleeding Among Premenopausal Women With Infertility","authors":"Udobi S.I, Onuh A.C, Udobi J.I, Ezeama C.O.","doi":"10.58806/ijhmr.2023.v2i9n10","DOIUrl":"https://doi.org/10.58806/ijhmr.2023.v2i9n10","url":null,"abstract":"Objective: To document the various structural uterine abnormalities detected on transabdominal ultrasonography (TAUS) and hysterosalpingography (HSG) of premenopausal women with infertility and abnormal uterine bleeding (AUB) and determine whether the structural abnormalities correlate well with the clinical forms of AUB among the patients. Methodology: This is a prospective and analytical study of 98 infertile women with history of AUB, referred for HSG. Clinical history including the forms of AUB were obtained from the subjects. Subjects were evaluated with TAUS and HSG after obtaining both ethical clearance and informed consent. Statistical analysis was with the Statistical Package for Social Sciences (SPSS) version 21. Simple frequency, measures of central tendency and dispersion, crosstabulation as well as Pearson’s correlation tests were carried out. For correlation, p ≤ 0.05 was considered significant. Result: Fibroids, followed by intrauterine adhesions (IUA) were the commonest structural uterine abnormalities. Fibroids were detected with both TAUS and HSG, while IUA were detected with HSG only. Shortened menstrual flow was the commonest form of AUB and occurred in 52 (53.1%) of the subjects, followed by light menstrual flow 41(41.8%). The menses were irregular in 33(33.7%), light and shortened in 32(32.7%), heavy in 21(21.4%), prolonged in 16(16.3%), and, heavy and prolonged in 9(9.2%). Fibroids occurred most frequently among those with heavy and prolonged menstrual bleeding while IUA occurred most frequently among those with scanty and reduced menstrual bleeding. On TAUS, HSG, or combined TAUS and HSG, there were significant correlations between fibroids and prolonged heavy menses, fibroids and heavy menses, and, fibroid and prolonged menses. On HSG, significant correlation existed between IUA and scanty short menses. Conclusion: Uterine fibroids and intrauterine adhesions were the commonest structural uterine abnormalities detected. There was significant correlation between fibroids and history of heavy menstrual flow as well as between fibroids and prolonged menses, and IUA and scanty short menses.","PeriodicalId":51699,"journal":{"name":"International Journal of Medical Research & Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135344271","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 : 2023-09-27DOI: 10.58806/ijhmr.2023.v2i9n09
Gichuki Joseph Maina, Loise Ndunge, Anthony Gikonyo, Charles Masese, Timothy Wachira, Duncan Luvayo, Premanand Ponoth
Background: Malignant Small round Cell Tumor (MSRCT) is very rare group of tumors. Malignant cells have similar histologic appearance making it difficult to distinguish one from another, and poses a diagnostic challenge with needs for a multimodal approach. Immunohistochemistry and immunophenotyping by flow cytometry, reverse transcriptase polymer chain reaction (RT-PCR) and fluorescence in situ hybridization are needed to confirm. The appropriate and best treatment in early stages of MSRCT is early surgical excision with chemoradiotherapy based on patient specification. Inspite of all these, tumors have poor prognosis and chance of recurrence are high. Method: Case study of a 27-year-old male who presented with a non-productive cough for 4 weeks, with feverish feeling with weight loss and shortness of breath and a new onset precordial chest pain non radiating and worse on exertion. On examination his vitals were: BP 121/91 mm of hg, pulse rate 114bpm, temperature 36.3 degrees Celsius, respiratory rate 24/per min, SPO2 96%.On examination, Elevated Jugular Venous Pressure, hyperactive precordium, displaced apex beat to 6th intercostal space anterior axillary line, muffled heart sounds and bilateral lower limb edema. Respiratory exam was unremarkable. Sputum gene expert was negative for mycobacterium tuberculosis and covid 19 rapid test was negative. Chest X Ray showed cardiomegaly and a transthoracic echocardiography revealed moderate-large pericardial effusion, with mild collapse of right atrium in diastole. Pericardiocentesis done showed hemorrhagic effusion with lymphocytes cell component, patient was initiated on treatment for TB pericarditis empirically. Three months later a chest CT scan done revealed extensive mediastinal/pericardial mass with lung nodules. An ultrasound guided mediastinal/Pericardial biopsy was done, revealed a poorly differentiated small round cell carcinoma. Results: Patient expired 14 weeks from the initial onset of symptoms while awaiting immunohistochemistry studies for specific diagnosis of the tumor and oncology review. Discussion: This demonstrates the complexity of establishing differential diagnosis of MSRCT in a resource limited setting with subsequent delay in treatment initiation, heralds poor prognosis. This also confirms difficulties in establishing differential diagnosis in poorly differentiated tumor.
背景:恶性小圆细胞瘤(MSRCT)是一类非常罕见的肿瘤。恶性细胞具有相似的组织学外观，使其难以区分，并提出了诊断挑战，需要多模式方法。需要流式细胞术、逆转录酶聚合酶链反应(RT-PCR)和荧光原位杂交的免疫组织化学和免疫表型进行证实。早期MSRCT的适当和最佳治疗是根据患者的具体情况进行早期手术切除和放化疗。尽管如此，肿瘤预后差，复发率高。方法:病例研究一名27岁男性患者，他表现为非咳嗽4周，伴有发热感，体重减轻和呼吸短促，新发无放射性心前胸痛，用力时加重。检查结果:血压121/91 mm hg，脉率114bpm，体温36.3℃，呼吸频率24/ min, SPO2 96%。经检查，颈静脉压升高，心前膜亢进，先端搏动移位至第6肋间隙腋前线，心音低沉，双侧下肢水肿。呼吸检查无明显异常。痰基因专家检测结核分枝杆菌阴性，新冠肺炎快速检测阴性。胸部X线显示心脏肿大，经胸超声心动图显示中度心包积液，舒张期右心房轻度塌陷。经心包穿刺发现有淋巴细胞成分的出血性积液，患者开始经验性治疗结核性心包炎。三个月后，胸部CT扫描显示广泛的纵隔/心包肿块伴肺结节。超声引导下的纵隔/心包活检显示为低分化小圆细胞癌。结果:患者在等待肿瘤特异性诊断和肿瘤学检查的免疫组化研究期间，从最初症状出现到死亡14周。讨论:这表明在资源有限的情况下建立MSRCT鉴别诊断的复杂性，随后的治疗开始延迟，预示着预后不良。这也证实了在低分化肿瘤中建立鉴别诊断的困难。
{"title":"Malignant Small Round Cell Tumor: A Rare Aggressive Malignancy-Case Report","authors":"Gichuki Joseph Maina, Loise Ndunge, Anthony Gikonyo, Charles Masese, Timothy Wachira, Duncan Luvayo, Premanand Ponoth","doi":"10.58806/ijhmr.2023.v2i9n09","DOIUrl":"https://doi.org/10.58806/ijhmr.2023.v2i9n09","url":null,"abstract":"Background: Malignant Small round Cell Tumor (MSRCT) is very rare group of tumors. Malignant cells have similar histologic appearance making it difficult to distinguish one from another, and poses a diagnostic challenge with needs for a multimodal approach. Immunohistochemistry and immunophenotyping by flow cytometry, reverse transcriptase polymer chain reaction (RT-PCR) and fluorescence in situ hybridization are needed to confirm. The appropriate and best treatment in early stages of MSRCT is early surgical excision with chemoradiotherapy based on patient specification. Inspite of all these, tumors have poor prognosis and chance of recurrence are high. Method: Case study of a 27-year-old male who presented with a non-productive cough for 4 weeks, with feverish feeling with weight loss and shortness of breath and a new onset precordial chest pain non radiating and worse on exertion. On examination his vitals were: BP 121/91 mm of hg, pulse rate 114bpm, temperature 36.3 degrees Celsius, respiratory rate 24/per min, SPO2 96%.On examination, Elevated Jugular Venous Pressure, hyperactive precordium, displaced apex beat to 6th intercostal space anterior axillary line, muffled heart sounds and bilateral lower limb edema. Respiratory exam was unremarkable. Sputum gene expert was negative for mycobacterium tuberculosis and covid 19 rapid test was negative. Chest X Ray showed cardiomegaly and a transthoracic echocardiography revealed moderate-large pericardial effusion, with mild collapse of right atrium in diastole. Pericardiocentesis done showed hemorrhagic effusion with lymphocytes cell component, patient was initiated on treatment for TB pericarditis empirically. Three months later a chest CT scan done revealed extensive mediastinal/pericardial mass with lung nodules. An ultrasound guided mediastinal/Pericardial biopsy was done, revealed a poorly differentiated small round cell carcinoma. Results: Patient expired 14 weeks from the initial onset of symptoms while awaiting immunohistochemistry studies for specific diagnosis of the tumor and oncology review. Discussion: This demonstrates the complexity of establishing differential diagnosis of MSRCT in a resource limited setting with subsequent delay in treatment initiation, heralds poor prognosis. This also confirms difficulties in establishing differential diagnosis in poorly differentiated tumor.","PeriodicalId":51699,"journal":{"name":"International Journal of Medical Research & Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135536779","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 : 2023-09-27DOI: 10.58806/ijhmr.2023.v2i9n08
Rimande U.Joel MBBS, MSc, FWACS, FMCR, Rosethe Rimande-Joel RN, Dip. PON, BEd, PhD, Eyo O. Ekpenyong MBBS, FWACS, Mni,, Charles Anjorin MBBS, FMCP, FWACP,, Peter Teru Yaru, MBBS FMC Paed, Millicent O. Obajimi MBBS, DMRD, FWACS, FMCR
Background: Infective endocarditis is a lethal infection affecting the endocardium of the heart and the valves.The causes are varied with staphylococcus aureus and streptococcus as the major causative agents.The triad of fever exceeding 38oc,vegetation in the heart and blood culture of the causative agents are the hallmarks of the diagnosis .The disease is known to be affect all ages with the very young age group, those with congenital heart disease and those on cardiac prosthesis as the most vulnerable. Septic emboli from the septic vegetation can spread to the brain, kidney, spleen, and lungs resulting in massive metastatic infections.It therefore has multisystemic manifestations and complications. Though neurological complications are common, brain abcess is known to be rare constituting only 1.0% of neurological complications. Objective: The study aimed at reporting occurrence of both cerebral and cerebellar micro- and macro-abscesses in a 3 year boy with infective endocarditis; a rare occurrence in the literature. Methods: This case report was carried out at University College Hospital Ibadan. Results: The boy presented with fever of 38oc for five weeks, convulsions and altered state of consciousness for ten days..In course of treatment patient however developed irritability and aggressive behaviour, which attracted the use of largactil to which he reacted with extrapyramidal signs and convulsions. Within the week he developed yellowness of the eyes and increase in abdominal girth. Patient had cranial computed tomography (CT) after plain skull X-rays and was referred to University College Hospital Ibadan as a result of the radiologically diagnosed brain abscess seen on CT images. child had grunting respiration with dyspnea, and the respiratory rate was 50/mm. However, the chest was clinically clear. In the cardiovascular system (CVS); the pulse was 140/mm, with moderate volume. The blood pressure (BP) was l60/110 mmHg. The first and second heart sounds were heard with a gallop rhythm. Cranial CT scan showed multiple ring enhancing hypodense lesions with surrounding hypodensity measuring 1cm in diameter and above with only a few measuring less than 1.0cm in both cerebral hemispheres and cerebelli in keeping with multiple cerebral and cerebellar abscesses. An echocardiography showed a brightly echogenic spot attached to the papillary muscle in the left ventricle suggesting vegetation consistent with an infective endocarditis. Retroviral test was negative for both type I and II.Blood culture — was negative, however urine culture yielded klebsiella sp. Serum urea, creatinine, Ca2+ and P04 were all elevated.The abdominal ultrasound scan confirmed the hepatosplenomegaly with decreased echogenicity but both kidneys appeared normal.There was no demonstrable ascitis. The boy was placed on antimicrobials; and had craniotomy for the drainage of the macroabscesses. He improved significantly. His renal and cardiac condition equally improved; he was subse
{"title":"Multiple Brain Abscesses In A Child With Infective Endocarditis","authors":"Rimande U.Joel MBBS, MSc, FWACS, FMCR, Rosethe Rimande-Joel RN, Dip. PON, BEd, PhD, Eyo O. Ekpenyong MBBS, FWACS, Mni,, Charles Anjorin MBBS, FMCP, FWACP,, Peter Teru Yaru, MBBS FMC Paed, Millicent O. Obajimi MBBS, DMRD, FWACS, FMCR","doi":"10.58806/ijhmr.2023.v2i9n08","DOIUrl":"https://doi.org/10.58806/ijhmr.2023.v2i9n08","url":null,"abstract":"Background: Infective endocarditis is a lethal infection affecting the endocardium of the heart and the valves.The causes are varied with staphylococcus aureus and streptococcus as the major causative agents.The triad of fever exceeding 38oc,vegetation in the heart and blood culture of the causative agents are the hallmarks of the diagnosis .The disease is known to be affect all ages with the very young age group, those with congenital heart disease and those on cardiac prosthesis as the most vulnerable. Septic emboli from the septic vegetation can spread to the brain, kidney, spleen, and lungs resulting in massive metastatic infections.It therefore has multisystemic manifestations and complications. Though neurological complications are common, brain abcess is known to be rare constituting only 1.0% of neurological complications. Objective: The study aimed at reporting occurrence of both cerebral and cerebellar micro- and macro-abscesses in a 3 year boy with infective endocarditis; a rare occurrence in the literature. Methods: This case report was carried out at University College Hospital Ibadan. Results: The boy presented with fever of 38oc for five weeks, convulsions and altered state of consciousness for ten days..In course of treatment patient however developed irritability and aggressive behaviour, which attracted the use of largactil to which he reacted with extrapyramidal signs and convulsions. Within the week he developed yellowness of the eyes and increase in abdominal girth. Patient had cranial computed tomography (CT) after plain skull X-rays and was referred to University College Hospital Ibadan as a result of the radiologically diagnosed brain abscess seen on CT images. child had grunting respiration with dyspnea, and the respiratory rate was 50/mm. However, the chest was clinically clear. In the cardiovascular system (CVS); the pulse was 140/mm, with moderate volume. The blood pressure (BP) was l60/110 mmHg. The first and second heart sounds were heard with a gallop rhythm. Cranial CT scan showed multiple ring enhancing hypodense lesions with surrounding hypodensity measuring 1cm in diameter and above with only a few measuring less than 1.0cm in both cerebral hemispheres and cerebelli in keeping with multiple cerebral and cerebellar abscesses. An echocardiography showed a brightly echogenic spot attached to the papillary muscle in the left ventricle suggesting vegetation consistent with an infective endocarditis. Retroviral test was negative for both type I and II.Blood culture — was negative, however urine culture yielded klebsiella sp. Serum urea, creatinine, Ca2+ and P04 were all elevated.The abdominal ultrasound scan confirmed the hepatosplenomegaly with decreased echogenicity but both kidneys appeared normal.There was no demonstrable ascitis. The boy was placed on antimicrobials; and had craniotomy for the drainage of the macroabscesses. He improved significantly. His renal and cardiac condition equally improved; he was subse","PeriodicalId":51699,"journal":{"name":"International Journal of Medical Research & Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135537732","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 : 2023-09-27DOI: 10.58806/ijhmr.2023.v2i9n07
Thi-Quynh Nguyen, Thi-Bich-Thuy Luong, Thi-Thuy Ngo, Thi-Yen Mai
Background: Hand-Foot-and-Mouth Disease (HFMD) is most frequently caused by Enterovirus71 (EV-A71) or Coxsackie virus A16 (CV-A16), infants and young children are at greatest risk. Describing the spatial patterns of HFMD can help develop and better target interventions. The objective of this study is to identify spatial patterns of HFMD in the first 8-months of 2023 in Ho Chi Minh city, Vietnam. Methods: The global Moran’s I statistic, Moran’s I scatterplot and local Moran’s I statistic and Boxplot will be applied to study spatial patterns of HFMD. Spatial patterns including spatial clusters (high-high and low-low) and spatial outliers (low-high and high-low) will be identified for HFMD cases and HFMD infection rates. Results: three high-high spatial clusters were mainly distributed in districts in the western region of the city such as Binh Tan, Binh Chanh, and Tan Phu. These high-high spatial clusters belonged to districts having the highest rates of HFMD infections in the city with their corresponding rates of 289, 283 and 281 cases/100,000 inhabitants, respectively. On the other hand, two low-low spatial clusters were detected in Districts 1 and 5 in the city center with their HFMD infection rates of 190 and 209 cases/100,000 inhabitants, respectively. Conclusions : findings in this study support the usefulness of boxplots, local and global Moran’s I statistics, and Moran’s I scatterplots in the identification of spatial clusters and spatial outliers of HFMD.
{"title":"Spatial Patterns Of Hand-Foot And Mouth Disease In Ho Chi Minh City, Vietnam","authors":"Thi-Quynh Nguyen, Thi-Bich-Thuy Luong, Thi-Thuy Ngo, Thi-Yen Mai","doi":"10.58806/ijhmr.2023.v2i9n07","DOIUrl":"https://doi.org/10.58806/ijhmr.2023.v2i9n07","url":null,"abstract":"Background: Hand-Foot-and-Mouth Disease (HFMD) is most frequently caused by Enterovirus71 (EV-A71) or Coxsackie virus A16 (CV-A16), infants and young children are at greatest risk. Describing the spatial patterns of HFMD can help develop and better target interventions. The objective of this study is to identify spatial patterns of HFMD in the first 8-months of 2023 in Ho Chi Minh city, Vietnam. Methods: The global Moran’s I statistic, Moran’s I scatterplot and local Moran’s I statistic and Boxplot will be applied to study spatial patterns of HFMD. Spatial patterns including spatial clusters (high-high and low-low) and spatial outliers (low-high and high-low) will be identified for HFMD cases and HFMD infection rates. Results: three high-high spatial clusters were mainly distributed in districts in the western region of the city such as Binh Tan, Binh Chanh, and Tan Phu. These high-high spatial clusters belonged to districts having the highest rates of HFMD infections in the city with their corresponding rates of 289, 283 and 281 cases/100,000 inhabitants, respectively. On the other hand, two low-low spatial clusters were detected in Districts 1 and 5 in the city center with their HFMD infection rates of 190 and 209 cases/100,000 inhabitants, respectively. Conclusions : findings in this study support the usefulness of boxplots, local and global Moran’s I statistics, and Moran’s I scatterplots in the identification of spatial clusters and spatial outliers of HFMD.","PeriodicalId":51699,"journal":{"name":"International Journal of Medical Research & Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135537402","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 : 2023-09-23DOI: 10.58806/ijhmr.2023.v2i9n06
Huong-Giang Nguyen, Thi-Tuyet-Mai Nguyen
Background: Dengue hemorrhagic fever is a notable vector-borne viral disease, currently becoming the most dreaded worldwide health problem in terms of the number of people affected. The objective of this study is to investigate spatial clustering of dengue hemorrhagic fever incidence in the first 9-months of 2023 in Ho Chi Minh city, Vietnam. Methods: the global Moran’s I statistic, Moran’s I scatterplot and local statistic were employed to spatial clusters (high-high and low-low) and spatial outliers (low-high and high-low) in the study area of Ho Chi Minh city. The first and third order of contiguity were used to constructe spatial weight matrix. Results: it was found from a case study of the first 9-months of 2023 in Ho Chi Minh city, a total of four high-high clusters, two low-low spatial clusters were detected in urban area and rural areas in the north and south of the Ho Chi Minh city, respectively when using the first order contiguity (statistically significance at the 0.05 level). For the case of using the third order of contiguity, a total of six high-low, two low-high spatial clusters and one low-low spatial cluster were successfully identified. Conclusions: the study results has proven the effective use of the global Moran’s I statistic, Moran’s I scatterplot and local Moran’s I statistic in the identification of spatial clustering of dengue hemorrhagic fever incidence.
{"title":"Spatial Clustering Analysis Of Dengue Hemorrhagic Fever In The First 9-Monthsof 2023 In Ho Chi Minh City, Vietnam","authors":"Huong-Giang Nguyen, Thi-Tuyet-Mai Nguyen","doi":"10.58806/ijhmr.2023.v2i9n06","DOIUrl":"https://doi.org/10.58806/ijhmr.2023.v2i9n06","url":null,"abstract":"Background: Dengue hemorrhagic fever is a notable vector-borne viral disease, currently becoming the most dreaded worldwide health problem in terms of the number of people affected. The objective of this study is to investigate spatial clustering of dengue hemorrhagic fever incidence in the first 9-months of 2023 in Ho Chi Minh city, Vietnam. Methods: the global Moran’s I statistic, Moran’s I scatterplot and local statistic were employed to spatial clusters (high-high and low-low) and spatial outliers (low-high and high-low) in the study area of Ho Chi Minh city. The first and third order of contiguity were used to constructe spatial weight matrix. Results: it was found from a case study of the first 9-months of 2023 in Ho Chi Minh city, a total of four high-high clusters, two low-low spatial clusters were detected in urban area and rural areas in the north and south of the Ho Chi Minh city, respectively when using the first order contiguity (statistically significance at the 0.05 level). For the case of using the third order of contiguity, a total of six high-low, two low-high spatial clusters and one low-low spatial cluster were successfully identified. Conclusions: the study results has proven the effective use of the global Moran’s I statistic, Moran’s I scatterplot and local Moran’s I statistic in the identification of spatial clustering of dengue hemorrhagic fever incidence.","PeriodicalId":51699,"journal":{"name":"International Journal of Medical Research & Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135957985","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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