Pub Date : 2023-06-30DOI: 10.24018/clinicmed.2023.4.3.286
A. Afolabi, R. Arobieke, E. Idowu, Ayodeji Joseph Adegbulu, Olatubosun Sunday Salami, Ahmeed Abiodun Durodola
Background: Although many studies approved the use of local anesthetics in controlling Dental Procedural Pain (DPP), patient with Trigeminal Neuralgia (TN) may continue to suffer DPP in spite of being in pain remission phase for TN. This report provided information on the challenges encountered in controlling DPP with Local Anaesthesia (LA) while carrying out a fixed prosthodontic procedure in a known classical TN patient. Case Presentation: Patient had been under the care of oral medicine specialist for 9-years with history of pain remission over the last two years and had since been on routine 200mg/day carbamazepine (CBZ). Examination showed tooth 37 was clinically healthy; tooth 35 and tooth 36 were missing; and tooth 34 was mesiolingually rotated, all with negative pulp test. A diagnosis of Kennedy’s class III lower edentulous space in a classic TN patient was made. Consecutive injection of three to five doses of LA (1.8ml lidocaine with 1:100,000 epinephrine) failed to control DPP during crown preparation procedure for fixed prosthodontics. This resulted in the postponement of the procedures for three different appointment visits in this case report. Upward review of CBZ dosage from 200mg/day to 800mg/day 72 hours prior to a dental procedure under LA produced a satisfactory DPP control. Combination of CBZ with Baclofen resulted in abolition of post procedural pain which rebounded patient to the pain remission phase. Conclusion: Team management approach involving the oral medicine specialist right from the pre-procedural assessment stage is hereby advocated.
{"title":"Challenges in the Management of a Known Trigeminal Neuralgia Patient Presenting for A Fixed Dental Restoration-A Case Report","authors":"A. Afolabi, R. Arobieke, E. Idowu, Ayodeji Joseph Adegbulu, Olatubosun Sunday Salami, Ahmeed Abiodun Durodola","doi":"10.24018/clinicmed.2023.4.3.286","DOIUrl":"https://doi.org/10.24018/clinicmed.2023.4.3.286","url":null,"abstract":"\u0000Background: Although many studies approved the use of local anesthetics in controlling Dental Procedural Pain (DPP), patient with Trigeminal Neuralgia (TN) may continue to suffer DPP in spite of being in pain remission phase for TN. This report provided information on the challenges encountered in controlling DPP with Local Anaesthesia (LA) while carrying out a fixed prosthodontic procedure in a known classical TN patient. \u0000\u0000\u0000Case Presentation: Patient had been under the care of oral medicine specialist for 9-years with history of pain remission over the last two years and had since been on routine 200mg/day carbamazepine (CBZ). Examination showed tooth 37 was clinically healthy; tooth 35 and tooth 36 were missing; and tooth 34 was mesiolingually rotated, all with negative pulp test. A diagnosis of Kennedy’s class III lower edentulous space in a classic TN patient was made. Consecutive injection of three to five doses of LA (1.8ml lidocaine with 1:100,000 epinephrine) failed to control DPP during crown preparation procedure for fixed prosthodontics. This resulted in the postponement of the procedures for three different appointment visits in this case report. Upward review of CBZ dosage from 200mg/day to 800mg/day 72 hours prior to a dental procedure under LA produced a satisfactory DPP control. Combination of CBZ with Baclofen resulted in abolition of post procedural pain which rebounded patient to the pain remission phase.\u0000\u0000\u0000Conclusion: Team management approach involving the oral medicine specialist right from the pre-procedural assessment stage is hereby advocated.\u0000","PeriodicalId":52409,"journal":{"name":"European Journal of Translational and Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78155078","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 : 2023-06-30DOI: 10.24018/clinicmed.2023.4.3.285
Sibel DOĞAN KAYA, Yeşim Uygun Kızmaz
Introduction: Fosfomycin has started to be used again as a possible therapeutic alternative in cases injected with resistant bacterial pathogens. Its primary mechanism of action is inhibition of the first step of cell wall synthesis; This mechanism is effective against both Gram-positive and Gram- negative bacterial groups. However, its clinical efficacy against bacteria that develop multidrug resistance is largely unknown. Therefore, we aimed to evaluate the clinical and microbiological efficacy of intravenous Fosfomycin in a tertiary care center. Methods: The group of adult patients aged 18 years and over who applied to the hospital between January 2018 and December 2022 and were given intravenous fosfomycin therapy for at least 24 hours due to any infection were retrospectively analyzed. Results: 71 patients were included in our study. The female/male ratio of these patients was 35/36, and the mean age was 61.5±17.0 (18-84). The avarage time to treatment was 10.6 days (11.3-+11.4). 22 patients (31%) from Intensive Care Unit and 49 (69%) patients from other clinics were included in the study. 18 bacteremia (26%), 15 pneumonia (21%), 14 wound infections (19%), 13 ventilator-associated pneumonia (18%), 5 urinary tract infections (UTI) (8%), 4 abdominal infections (6%) and 2 endocarditis (3%). Detected causative microorganisms were 18 carbapenem susceptible Klebsiella pneumoniae (44%), pandrug resistan Klebsiella pneumoniae (17.5%), 5 MRSA (12.5%), 5 pandrug resistan Pseudomonas aerinosa (12%) ,4 Escherichia coli (10%), 1 Acinetobacterbaumanii (2.5%) and 1 Enterobacter spp. (2.5%). Looking at the underlying diseases, one of our patients had diabetes mellitus and another patient had chronic renal failure. Mean procalcitonin (PCT) and C reaktive protein (CRP) (cutoff value0.5 ng/mL) values were 2.53±1.2 ng/ml and 89.7±21.9 mg/dl, respectively. Median sodium (Na), potassium (K), AST, ALT, and creatinine values of the patients before and after fosfomycin IV treatment were calculated and there was no statistically significant difference. Clinics combined with fosfomycin IV were as follows: 31 meropenem (44%), 15 colistin (26%), 18 tigecycline (26%), 3 vancomycin (4%), 3 amikacin (4%) and 1 daptomycin (1%). Conclusions: According to the results of our study, it was seen that Fosfomycin is a safe and effective option in the treatment of multidrug-resistant infections. Accordingly, our results are compatible with the literature.
{"title":"Retrospective Evaluation of Intravenous Fosfomycin in Multi-drug Resistant Infections at A Tertiary Care Hospital in İstanbul","authors":"Sibel DOĞAN KAYA, Yeşim Uygun Kızmaz","doi":"10.24018/clinicmed.2023.4.3.285","DOIUrl":"https://doi.org/10.24018/clinicmed.2023.4.3.285","url":null,"abstract":"Introduction: Fosfomycin has started to be used again as a possible therapeutic alternative in cases injected with resistant bacterial pathogens. Its primary mechanism of action is inhibition of the first step of cell wall synthesis; This mechanism is effective against both Gram-positive and Gram- negative bacterial groups. However, its clinical efficacy against bacteria that develop multidrug resistance is largely unknown. Therefore, we aimed to evaluate the clinical and microbiological efficacy of intravenous Fosfomycin in a tertiary care center.\u0000Methods: The group of adult patients aged 18 years and over who applied to the hospital between January 2018 and December 2022 and were given intravenous fosfomycin therapy for at least 24 hours due to any infection were retrospectively analyzed.\u0000Results: 71 patients were included in our study. The female/male ratio of these patients was 35/36, and the mean age was 61.5±17.0 (18-84). The avarage time to treatment was 10.6 days (11.3-+11.4). 22 patients (31%) from Intensive Care Unit and 49 (69%) patients from other clinics were included in the study. 18 bacteremia (26%), 15 pneumonia (21%), 14 wound infections (19%), 13 ventilator-associated pneumonia (18%), 5 urinary tract infections (UTI) (8%), 4 abdominal infections (6%) and 2 endocarditis (3%). Detected causative microorganisms were 18 carbapenem susceptible Klebsiella pneumoniae (44%), pandrug resistan Klebsiella pneumoniae (17.5%), 5 MRSA (12.5%), 5 pandrug resistan Pseudomonas aerinosa (12%) ,4 Escherichia coli (10%), 1 Acinetobacterbaumanii (2.5%) and 1 Enterobacter spp. (2.5%). Looking at the underlying diseases, one of our patients had diabetes mellitus and another patient had chronic renal failure. Mean procalcitonin (PCT) and C reaktive protein (CRP) (cutoff value0.5 ng/mL) values were 2.53±1.2 ng/ml and 89.7±21.9 mg/dl, respectively. Median sodium (Na), potassium (K), AST, ALT, and creatinine values of the patients before and after fosfomycin IV treatment were calculated and there was no statistically significant difference.\u0000Clinics combined with fosfomycin IV were as follows: 31 meropenem (44%), 15 colistin (26%), 18 tigecycline (26%), 3 vancomycin (4%), 3 amikacin (4%) and 1 daptomycin (1%).\u0000Conclusions: According to the results of our study, it was seen that Fosfomycin is a safe and effective option in the treatment of multidrug-resistant infections. Accordingly, our results are compatible with the literature.","PeriodicalId":52409,"journal":{"name":"European Journal of Translational and Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84567233","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}
Our case report aims to present a rare interesting case on osteonecrosis associated with COVID-19 infection. We retrospectively evaluated this case after the patient underwent surgical management. In our patient, AVN was found to be developed secondary to COVID-19 infection. Infection with coronavirus confers a hypercoagulable state leading to various systemic complications. So, we suggest proper studies should be done to understand the physiopathology of COVID-19 to prevent complications and to improve supportive care during treatment.
{"title":"Osteonecrosis-An Emerging Challenge of Post COVID-19 Sequalae","authors":"Yamini Jayapalan, Anusuya Baskar, Janani Priya Mohan, Sree Mohana Preetha Maheshwaran","doi":"10.24018/clinicmed.2023.4.3.283","DOIUrl":"https://doi.org/10.24018/clinicmed.2023.4.3.283","url":null,"abstract":"Our case report aims to present a rare interesting case on osteonecrosis associated with COVID-19 infection. We retrospectively evaluated this case after the patient underwent surgical management. In our patient, AVN was found to be developed secondary to COVID-19 infection. Infection with coronavirus confers a hypercoagulable state leading to various systemic complications. So, we suggest proper studies should be done to understand the physiopathology of COVID-19 to prevent complications and to improve supportive care during treatment.","PeriodicalId":52409,"journal":{"name":"European Journal of Translational and Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135793001","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 : 2023-05-22DOI: 10.24018/clinicmed.2023.4.3.263
Anastasios N. Tzenalis, Maria P. Mastrokosta, George Kipourgos, E. Albani
Background: In order to provide optimal care, health care providers should be familiar with the principles and practice of fluid and electrolyte physiology and pathophysiology. Attention to the patient's fluid and electrolyte status is essential to nurses' knowledge. The purpose of the research is to investigate the knowledge of nurses regarding the electrolyte disorders of patients during their hospitalization in a rehabilitation center and to correlate their education with the knowledge regarding electrolyte disorders. Materials and Methods: A quantitative research was carried out using a structured questionnaire. The questionnaire was tested to ensure clarity, content validity and internal consistency (Cronbach's Alpha of 0.822). The sample consisted of 50 nurses who worked at the University General Hospital in the Rehabilitation Center. Data were coded and analyzed using the statistical program IBM-SPSS version-21. Results: Through the results it was initially observed that the largest sample considers that the recording of fluid intake and output is important. The vast majority (92%) know about electrolyte disturbances. A large part (84%) has not attended any training program. Inaccurate diagnosis of electrolyte disturbances can be a risk to the patient. Conclusions: In conclusion, it was found that the nurses studied have a satisfactory level of knowledge regarding the assessment and management of electrolyte disturbances with postgraduates nurses and university education nurses emerging as better knowledgeable of patients' electrolyte disturbances during their hospitalization in a rehabilitation center. Understanding and monitoring a patient's fluid, electrolyte, and acid-base balance is critical to providing nursing care.
{"title":"The Investigation of Nurses’ Knowledge according to Their Level of Education regarding The Pathological Electrolyte Disturbances of Patients During Their Hospitalization in A Rehabilitation Center","authors":"Anastasios N. Tzenalis, Maria P. Mastrokosta, George Kipourgos, E. Albani","doi":"10.24018/clinicmed.2023.4.3.263","DOIUrl":"https://doi.org/10.24018/clinicmed.2023.4.3.263","url":null,"abstract":"\u0000Background: In order to provide optimal care, health care providers should be familiar with the principles and practice of fluid and electrolyte physiology and pathophysiology. Attention to the patient's fluid and electrolyte status is essential to nurses' knowledge. The purpose of the research is to investigate the knowledge of nurses regarding the electrolyte disorders of patients during their hospitalization in a rehabilitation center and to correlate their education with the knowledge regarding electrolyte disorders.\u0000\u0000\u0000Materials and Methods: A quantitative research was carried out using a structured questionnaire. The questionnaire was tested to ensure clarity, content validity and internal consistency (Cronbach's Alpha of 0.822). The sample consisted of 50 nurses who worked at the University General Hospital in the Rehabilitation Center. Data were coded and analyzed using the statistical program IBM-SPSS version-21.\u0000\u0000\u0000Results: Through the results it was initially observed that the largest sample considers that the recording of fluid intake and output is important. The vast majority (92%) know about electrolyte disturbances. A large part (84%) has not attended any training program. Inaccurate diagnosis of electrolyte disturbances can be a risk to the patient.\u0000\u0000\u0000Conclusions: In conclusion, it was found that the nurses studied have a satisfactory level of knowledge regarding the assessment and management of electrolyte disturbances with postgraduates nurses and university education nurses emerging as better knowledgeable of patients' electrolyte disturbances during their hospitalization in a rehabilitation center. Understanding and monitoring a patient's fluid, electrolyte, and acid-base balance is critical to providing nursing care.\u0000","PeriodicalId":52409,"journal":{"name":"European Journal of Translational and Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73426531","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 : 2023-05-22DOI: 10.24018/clinicmed.2023.4.3.266
Y. Ishikawa, A. Marui
Background: Poor sleep shortens healthy life expectancy. However, little is known about the potential link between age-related differences in poor sleep quality and musculoskeletal impairments. This study explored the association between sleep quality and musculoskeletal impairments among community-dwelling older adults in Japan. Methods: We conducted a cross-sectional study targeting the whole community-dwelling older adults aged ≥60 years in a town, Tochigi, Japan. Poor sleep quality was defined as Pittsburgh Sleep Quality Index of >5. Presence of musculoskeletal impairments was based on the participants’ self-report of a prior diagnosis and treatment received. The association between musculoskeletal impairments and the risk of poor sleep quality was determined via multivariable logistic regression with known confounding variables, after stratification for age (60-74 and ≥75 years). Results: Of 985 participants, 341 (34.6%) reported poor sleep quality, and 137 (13.9%) had musculoskeletal impairments. Musculoskeletal impairments were significantly associated with poor sleep quality (adjusted odds ratio [aOR],=1.87; 95% confidence interval [CI], 1.16-3.00). When stratified by age, this association only remained significant among those aged 60-74 years: the ORs for poor sleep quality in participants aged 60-74 and ≥75 years were 2.07 (95% CI, 1.14-3.77) and 1.59 (95% CI, 0.70-3.64), respectively. Conclusions: Musculoskeletal impairments were associated with poor sleep quality in a Japanese population, and this relationship was more pronounced in those aged 60-74 years. The prevention and management of musculoskeletal impairments might be further emphasized to promote sleep quality among young-old adults.
{"title":"Age Variation in the Associations between Musculoskeletal Impairments and Sleep in Older Adults","authors":"Y. Ishikawa, A. Marui","doi":"10.24018/clinicmed.2023.4.3.266","DOIUrl":"https://doi.org/10.24018/clinicmed.2023.4.3.266","url":null,"abstract":"\u0000Background: Poor sleep shortens healthy life expectancy. However, little is known about the potential link between age-related differences in poor sleep quality and musculoskeletal impairments. This study explored the association between sleep quality and musculoskeletal impairments among community-dwelling older adults in Japan.\u0000\u0000\u0000Methods: We conducted a cross-sectional study targeting the whole community-dwelling older adults aged ≥60 years in a town, Tochigi, Japan. Poor sleep quality was defined as Pittsburgh Sleep Quality Index of >5. Presence of musculoskeletal impairments was based on the participants’ self-report of a prior diagnosis and treatment received. The association between musculoskeletal impairments and the risk of poor sleep quality was determined via multivariable logistic regression with known confounding variables, after stratification for age (60-74 and ≥75 years).\u0000\u0000\u0000Results: Of 985 participants, 341 (34.6%) reported poor sleep quality, and 137 (13.9%) had musculoskeletal impairments. Musculoskeletal impairments were significantly associated with poor sleep quality (adjusted odds ratio [aOR],=1.87; 95% confidence interval [CI], 1.16-3.00). When stratified by age, this association only remained significant among those aged 60-74 years: the ORs for poor sleep quality in participants aged 60-74 and ≥75 years were 2.07 (95% CI, 1.14-3.77) and 1.59 (95% CI, 0.70-3.64), respectively.\u0000\u0000\u0000Conclusions: Musculoskeletal impairments were associated with poor sleep quality in a Japanese population, and this relationship was more pronounced in those aged 60-74 years. The prevention and management of musculoskeletal impairments might be further emphasized to promote sleep quality among young-old adults.\u0000","PeriodicalId":52409,"journal":{"name":"European Journal of Translational and Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82027655","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}
{"title":"A quantitative analytical investigation on the oxycodone side effects among the recent clinical trials","authors":"Alireza Ghassemi Toussi, Farshad Ghassemi Toosi","doi":"10.31373/ejtcm/163415","DOIUrl":"https://doi.org/10.31373/ejtcm/163415","url":null,"abstract":"","PeriodicalId":52409,"journal":{"name":"European Journal of Translational and Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42543654","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 : 2023-05-11DOI: 10.24018/clinicmed.2023.4.3.278
C. Amadi, S. Lawson, K. Wala, Emmanuel M. Owamagbe, Nkeiruka J. Amadi
Background: The relationship between dyslipidemia and the severity of coronavirus disease 2019 (COVID-19) has extensively been characterized in the Western population with a dearth of data among Nigerians. Hence, the current study evaluated the lipid/lipoprotein disorders inherent in COVID-19 and its relationship with disease severity among Nigerians. Methods: This was a retrospective study conducted among 600 patients with RT-PCR-confirmed COVID-19 at the Eleme COVID-19 treatment facility in Port Harcourt, Southern Nigeria. Data were obtained from medical records using validated acquisition templates and analyzed based on lipid/lipoprotein abnormalities and disease severity status. Results: Among those studied, 54.7% had dyslipidemia while others were normolipidemic. HDL-C dyslipidemia was the most common with a preponderance of hypoalphalipoproteinemia (84.4%). Dyslipidemia afflicted mostly middle-aged, males, urban dwellers, the overweight, and those with classic COVID-19-induced respiratory symptoms. Dyslipidemic cohorts had higher pro-calcitonin, C-reactive protein, D-dimer, total white cell count, and neutrophils, but lower albumin, lymphocyte, and platelet counts compared to the normolipidemic cohorts. Dyslipidemic cohorts with concurrent severe COVID-19 had lower levels of TChol, Tg, HDL-C, and LDL-C levels compared to patients with the less-severe disease. HDL-C was the only lipid/lipoprotein parameter that was associated with severe COVID-19 on crude (OR:8.65; CI:5.96-11.44; p<0.001) and adjusted (OR:8.11; CI:5.65-10.87; p<0.001) regression models compared to other lipid/lipoprotein indices. At 96.77% sensitivity and 89.20% specificity, HDL-C had robust predictive potentials (AUC:0.97; CI:0.84-1.00; p<0.001) over COVID-19 severity. Conclusion: Dyslipidemia is frequent among those presenting with COVID-19 in association with disease severity, especially among the HDL-C dyslipidemic cohorts. Hence, these findings should be factored in during COVID-19 treatment among Nigerians with the disease.
{"title":"COVID-19-induced Dyslipidemia and Disease Severity: Perspectives from Southern Nigeria","authors":"C. Amadi, S. Lawson, K. Wala, Emmanuel M. Owamagbe, Nkeiruka J. Amadi","doi":"10.24018/clinicmed.2023.4.3.278","DOIUrl":"https://doi.org/10.24018/clinicmed.2023.4.3.278","url":null,"abstract":"\u0000Background: The relationship between dyslipidemia and the severity of coronavirus disease 2019 (COVID-19) has extensively been characterized in the Western population with a dearth of data among Nigerians. Hence, the current study evaluated the lipid/lipoprotein disorders inherent in COVID-19 and its relationship with disease severity among Nigerians. \u0000\u0000\u0000Methods: This was a retrospective study conducted among 600 patients with RT-PCR-confirmed COVID-19 at the Eleme COVID-19 treatment facility in Port Harcourt, Southern Nigeria. Data were obtained from medical records using validated acquisition templates and analyzed based on lipid/lipoprotein abnormalities and disease severity status.\u0000\u0000\u0000Results: Among those studied, 54.7% had dyslipidemia while others were normolipidemic. HDL-C dyslipidemia was the most common with a preponderance of hypoalphalipoproteinemia (84.4%). Dyslipidemia afflicted mostly middle-aged, males, urban dwellers, the overweight, and those with classic COVID-19-induced respiratory symptoms. Dyslipidemic cohorts had higher pro-calcitonin, C-reactive protein, D-dimer, total white cell count, and neutrophils, but lower albumin, lymphocyte, and platelet counts compared to the normolipidemic cohorts. Dyslipidemic cohorts with concurrent severe COVID-19 had lower levels of TChol, Tg, HDL-C, and LDL-C levels compared to patients with the less-severe disease. HDL-C was the only lipid/lipoprotein parameter that was associated with severe COVID-19 on crude (OR:8.65; CI:5.96-11.44; p<0.001) and adjusted (OR:8.11; CI:5.65-10.87; p<0.001) regression models compared to other lipid/lipoprotein indices. At 96.77% sensitivity and 89.20% specificity, HDL-C had robust predictive potentials (AUC:0.97; CI:0.84-1.00; p<0.001) over COVID-19 severity.\u0000\u0000\u0000Conclusion: Dyslipidemia is frequent among those presenting with COVID-19 in association with disease severity, especially among the HDL-C dyslipidemic cohorts. Hence, these findings should be factored in during COVID-19 treatment among Nigerians with the disease.\u0000","PeriodicalId":52409,"journal":{"name":"European Journal of Translational and Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83976328","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 : 2023-05-10DOI: 10.24018/clinicmed.2023.4.3.276
B. Utoo, C. Laima, Amina Baba Rabiu, S. Muhammad, C. F. Oyeniyi, Onuwabuchi Egwu, Musa Dawha Yahaya
Background: Maternal death reduction could be achieved through the utilization of hospital delivery services. In Nigeria, unfortunately delivery in health facilities where skill birth attendants exist is reported to be only 39%. Maternal satisfaction with hospital services will encourage utilization. Aim of the study: The study was designed to assess the satisfaction of mothers’ and their intention to utilize delivery services in subsequent pregnancies at the Federal Teaching Hospital Gombe, North-East, Nigeria. Methods: This was a descriptive, cross-sectional study conducted at the postnatal ward of the hospital amongst 250 women within 48 hours after childbirth. Data was collected with the use of a pretested, semi structured questionnaire and analysis done with SPSS statistical software version 25. Results: Overall satisfaction with delivery services was 84.4% with only 15.6% dissatisfied. Total satisfaction with the cleanliness of the facility was 92.8%, interpersonal relationship 84.8%, information provided 74.4% and technical aspects of care 82.8%. As many as 78.4% of women will utilize the facility in future for delivery services. The major reason amongst this category being satisfaction with services (76.5%). Those who do not intend to utilize facility in the future were 21.6% amongst which 27.8% gave reasons as completed family size and only 22.2% would not because of dissatisfaction. Satisfaction was only statistically related to ethnicity (P value=0.02) and none amongst obstetric variables tested. Conclusion: Majority of the women were satisfied with delivery services rendered and would utilize the facility in the future. There is need to sustain and further improve upon the quality of services.
{"title":"Mother’s Satisfaction with Delivery Services and Intended Future Utilization at Federal Teaching Hospital, Gombe, North-Eastern, Nigeria","authors":"B. Utoo, C. Laima, Amina Baba Rabiu, S. Muhammad, C. F. Oyeniyi, Onuwabuchi Egwu, Musa Dawha Yahaya","doi":"10.24018/clinicmed.2023.4.3.276","DOIUrl":"https://doi.org/10.24018/clinicmed.2023.4.3.276","url":null,"abstract":"\u0000Background: Maternal death reduction could be achieved through the utilization of hospital delivery services. In Nigeria, unfortunately delivery in health facilities where skill birth attendants exist is reported to be only 39%. Maternal satisfaction with hospital services will encourage utilization.\u0000\u0000\u0000Aim of the study: The study was designed to assess the satisfaction of mothers’ and their intention to utilize delivery services in subsequent pregnancies at the Federal Teaching Hospital Gombe, North-East, Nigeria. \u0000\u0000\u0000Methods: This was a descriptive, cross-sectional study conducted at the postnatal ward of the hospital amongst 250 women within 48 hours after childbirth. Data was collected with the use of a pretested, semi structured questionnaire and analysis done with SPSS statistical software version 25.\u0000\u0000\u0000Results: Overall satisfaction with delivery services was 84.4% with only 15.6% dissatisfied. Total satisfaction with the cleanliness of the facility was 92.8%, interpersonal relationship 84.8%, information provided 74.4% and technical aspects of care 82.8%. As many as 78.4% of women will utilize the facility in future for delivery services. The major reason amongst this category being satisfaction with services (76.5%). Those who do not intend to utilize facility in the future were 21.6% amongst which 27.8% gave reasons as completed family size and only 22.2% would not because of dissatisfaction. Satisfaction was only statistically related to ethnicity (P value=0.02) and none amongst obstetric variables tested.\u0000\u0000\u0000Conclusion: Majority of the women were satisfied with delivery services rendered and would utilize the facility in the future. There is need to sustain and further improve upon the quality of services.\u0000","PeriodicalId":52409,"journal":{"name":"European Journal of Translational and Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76184395","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 : 2023-05-10DOI: 10.24018/clinicmed.2023.4.3.261
G. G. K. P. S. Kumari, Ashutosh Kumar Singh, S. T. Mehta, M. Chavan
Mitochondria are referred to as the energy centers of cells, and mitochondrial DNA are known to alter the mitochondrial respiratory chain, which reduces cellular energy and causes ion-channel malfunction and neuronal cell death. As majority of the cells contain mitochondria, these disorders involve multiple systems. Since the energy requirements of different tissues vary, their vulnerability to mitochondrial dysfunction also varies in terms of threshold. This causes these disorders to appear clinically in a variety of ways and with significant phenotypic overlap. The genotypic and phenotypic definitions of some specific symptoms are, nevertheless, well established. Potentially deadly mitochondrial toxins are present in some epileptic medications and early diagnosis of the condition can help prevent serious morbidities. We describe a typical case of sodium valproate and lamotrigine-induced fast multiaxial worsening in a patient with myoclonic epilepsy with red ragged fibers (MERRF) as these drugs act as mitochondrial poisons and could prove life threatening for patients with mitochondrial diseases. When mitochondrial cocktail was introduced and the problematic medicines were removed, the symptoms were somewhat reversed. MERRF in progeny of non- consanguineous parents is a rare occurrence resulting in poor prognosis of the disease. Epileptic drugs lamotrigine and sodium valproate should be avoided as these drugs worsen myoclonus and cause mitochondrial toxicities. With knowledge of the information in this scenario, further harm to the patient can be prevented.
{"title":"Progressive Myoclonic Epilepsy: A Typical Case of MERRF and the Lessons Learnt","authors":"G. G. K. P. S. Kumari, Ashutosh Kumar Singh, S. T. Mehta, M. Chavan","doi":"10.24018/clinicmed.2023.4.3.261","DOIUrl":"https://doi.org/10.24018/clinicmed.2023.4.3.261","url":null,"abstract":"\u0000Mitochondria are referred to as the energy centers of cells, and mitochondrial DNA are known to alter the mitochondrial respiratory chain, which reduces cellular energy and causes ion-channel malfunction and neuronal cell death. As majority of the cells contain mitochondria, these disorders involve multiple systems. Since the energy requirements of different tissues vary, their vulnerability to mitochondrial dysfunction also varies in terms of threshold. This causes these disorders to appear clinically in a variety of ways and with significant phenotypic overlap. The genotypic and phenotypic definitions of some specific symptoms are, nevertheless, well established. Potentially deadly mitochondrial toxins are present in some epileptic medications and early diagnosis of the condition can help prevent serious morbidities. We describe a typical case of sodium valproate and lamotrigine-induced fast multiaxial worsening in a patient with myoclonic epilepsy with red ragged fibers (MERRF) as these drugs act as mitochondrial poisons and could prove life threatening for patients with mitochondrial diseases. When mitochondrial cocktail was introduced and the problematic medicines were removed, the symptoms were somewhat reversed. MERRF in progeny of non- consanguineous parents is a rare occurrence resulting in poor prognosis of the disease. Epileptic drugs lamotrigine and sodium valproate should be avoided as these drugs worsen myoclonus and cause mitochondrial toxicities. With knowledge of the information in this scenario, further harm to the patient can be prevented. \u0000","PeriodicalId":52409,"journal":{"name":"European Journal of Translational and Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79622035","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 : 2023-05-09DOI: 10.24018/clinicmed.2023.4.3.252
Haider Al-Tameemi, Sattar Al-Essawi, Ali Alyassari
Background: Imaging plays integral role in the evaluation of patients with acute traumatic brain injury (TBI), with computerized tomography (CT) being the modality of the choice and the most commonly utilized imaging tool. One of the important determinants of TBI severity is raised intracranial pressure (ICP). Optic nerve sheath diameter (ONSD) was considered as a reliable indirect surrogate for the raised ICP, however, studies assessing role of CT-derived ONSD in evaluation of patients with raised ICP or brain injury are limited. Aim of the study: To assess the correlation between ONSD measured by CT scan and the severity of TBI according to Marshall scale. Patients and methods: A cross-sectional analytic study was conducted on 60 adult patients (52 males, 8 females) presented with acute TBI and referred for brain CT examination. After initial general evaluation of brain CT images, the score of TBI was assessed according to Marshal's scale (I to VI). The transverse ONSD was manually measured on axial CT image at 3 mm distance behind eye globe. The correlation between the grade of TBI and ONSD was subjected to statistical analysis. The study was approved by the Institutional Ethical Review Committee. Results: The means of all, right-sided and left-sided ONSD were 4.695 mm, 4.606 mm and 4.785 mm respectively. There was positive, linear and statistically significant correlation (p value <0.001, r = 0.662) between the mean of ONSD measured by CT scan and Marshall score. When the ONSD measurements of the right and left sides were analyzed separately, the correlation was also significant and positive (r= 0.504 for the right side, r = 0.699 for the left side with p value <0.001 for both). ONSD showed weakly negative and statistically not significant correlation (p value= 0.571, r = - 0.075) with the duration between onset of the trauma and time of CT examination. There was no significant difference between mean ONSD measurements when correlated with the laterality of TBI, age or gender (p values 0.392 0.328 and 0.462 respectively). Conclusion: ONSD measured on brain CT scan is positively correlated with the severity of TBI as assessed by Marshall scale. Because Marshall scale has prognostic implication, ONSD may also have a prognostic value during assessment of patients with TBI.
{"title":"Correlation between Optic Nerve Sheath Diameter and Marshall Scale in Acute Traumatic Brain Injury","authors":"Haider Al-Tameemi, Sattar Al-Essawi, Ali Alyassari","doi":"10.24018/clinicmed.2023.4.3.252","DOIUrl":"https://doi.org/10.24018/clinicmed.2023.4.3.252","url":null,"abstract":"\u0000\u0000\u0000Background: Imaging plays integral role in the evaluation of patients with acute traumatic brain injury (TBI), with computerized tomography (CT) being the modality of the choice and the most commonly utilized imaging tool. One of the important determinants of TBI severity is raised intracranial pressure (ICP). Optic nerve sheath diameter (ONSD) was considered as a reliable indirect surrogate for the raised ICP, however, studies assessing role of CT-derived ONSD in evaluation of patients with raised ICP or brain injury are limited.\u0000Aim of the study: To assess the correlation between ONSD measured by CT scan and the severity of TBI according to Marshall scale.\u0000Patients and methods: A cross-sectional analytic study was conducted on 60 adult patients (52 males, 8 females) presented with acute TBI and referred for brain CT examination. After initial general evaluation of brain CT images, the score of TBI was assessed according to Marshal's scale (I to VI). The transverse ONSD was manually measured on axial CT image at 3 mm distance behind eye globe. The correlation between the grade of TBI and ONSD was subjected to statistical analysis. The study was approved by the Institutional Ethical Review Committee.\u0000Results: The means of all, right-sided and left-sided ONSD were 4.695 mm, 4.606 mm and 4.785 mm respectively. There was positive, linear and statistically significant correlation (p value <0.001, r = 0.662) between the mean of ONSD measured by CT scan and Marshall score. When the ONSD measurements of the right and left sides were analyzed separately, the correlation was also significant and positive (r= 0.504 for the right side, r = 0.699 for the left side with p value <0.001 for both). ONSD showed weakly negative and statistically not significant correlation (p value= 0.571, r = - 0.075) with the duration between onset of the trauma and time of CT examination. There was no significant difference between mean ONSD measurements when correlated with the laterality of TBI, age or gender (p values 0.392 0.328 and 0.462 respectively).\u0000Conclusion: ONSD measured on brain CT scan is positively correlated with the severity of TBI as assessed by Marshall scale. Because Marshall scale has prognostic implication, ONSD may also have a prognostic value during assessment of patients with TBI.\u0000\u0000\u0000","PeriodicalId":52409,"journal":{"name":"European Journal of Translational and Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77395411","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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