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Anterior segment and ocular adnexal lesions in patients with human immunodeficiency virus infection and acquired immunodeficiency syndrome at a tertiary hospital in Southwestern Nigeria 尼日利亚西南部一家三级医院人类免疫缺陷病毒感染和获得性免疫缺陷综合征患者的眼前节和眼附件病变
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_128_22
Y. Babalola
Background: Ocular manifestation of human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) affects various ocular structures including the anterior segment and ocular adnexae and may be a cause of ocular morbidity. The aim of the study is to determine the pattern of lesions affecting the anterior segment and ocular adnexae in patients diagnosed with HIV/AIDS whether on highly active antiretroviral therapy or not and confirmed positive for retroviral disease by western blot attending an antiretroviral therapy clinic in Southwestern Nigeria. It is a prospective, cross-sectional study on anterior segment and ocular adnexae lesions in patients with HIV/AIDS. Materials and Methods: A total of 318 consecutive patients with the confirmation of a diagnosis of HIV/AIDS attending the antiretroviral therapy clinic within the study period from 2009 to 2010 had visual acuity evaluation, a detailed ocular examination by slit-lamp biomicroscopy, and binocular indirect ophthalmoscopy. The data generated were analysed using SPSS (Statistical Package for the Social Sciences) version 16. Ethical clearance was obtained from the hospital research ethics committee. Results: Two hundred and ninety-five (92.8%) patients of the 318 recruited had anterior segment manifestations, whereas ocular adnexal lesions were present in 134 (42.1%) patients. Multiple ocular pathology of the anterior segment and ocular adnexal was present in some of the respondents recruited. There were more female respondents. One hundred and twenty-three patients (38.7%) recruited for the study were in the 40–49 years of age group with a mean age of 47.2 years (SD = 9.42 years). The most common anterior segment lesion was corneal opacity in 18 patients (5.6%), and the most common ocular adnexal lesion was pingueculum in 56 respondents (17.6%). Other HIV/AIDS-associated adnexal lesions present include hypertrichosis in 25 patients (7.9%), herpes zoster ophthalmicus (HZO) in 13 (4.1%), and squamous cell carcinoma of the conjunctiva in 4 (1.3%) patients. The most common HIV-associated anterior segment pathology was HZO-associated keratouveitis seen in four patients (1.3%) and herpes simplex keratitis in one patient (0.3%). Conjunctival microangiopathy was the most common HIV-associated ocular adnexal lesion. The relationship between viral load values and lesions involving both anterior segment and ocular adnexal disease was statistically significant as these patients tended to have higher viral loads when compared with those without lesions (P < 0.05). Conclusion: Anterior segment and ocular adnexal lesions were frequent in patients with HIV/AIDS attending a tertiary health institution in urban Nigeria. HIV/AIDS-defining ocular illnesses including HZO, conjunctival microangiopathy, and ocular surface squamous cell neoplasia are not uncommon in these patients. Potentially debilitating ocular disorders may be avoided by instituting periodic ocular examinations.
背景:人类免疫缺陷病毒和获得性免疫缺陷综合征(HIV/AIDS)的眼部表现影响包括前节和眼附件在内的多种眼部结构,可能是眼部发病率的一个原因。该研究的目的是确定在尼日利亚西南部抗逆转录病毒治疗诊所就诊的被诊断为艾滋病毒/艾滋病的患者,无论是否接受高活性抗逆转录病毒治疗并经western blot证实为抗逆转录病毒疾病阳性,其影响前段和眼附件的病变模式。这是一项对HIV/AIDS患者前段和眼附件病变的前瞻性横断面研究。材料与方法:对2009 - 2010年在抗逆转录病毒治疗诊所就诊的318例确诊为HIV/AIDS的患者进行了视力评估、裂隙灯生物显微镜详细眼部检查和双眼间接检眼镜检查。生成的数据使用SPSS(社会科学统计软件包)版本16进行分析。获得了医院研究伦理委员会的伦理许可。结果:318例患者中有295例(92.8%)有前段表现,而134例(42.1%)患者有眼附件病变。在一些被招募的应答者中,出现了前段和眼附件的多重眼部病理。女性受访者更多。研究招募的123例患者(38.7%)年龄在40-49岁之间,平均年龄为47.2岁(SD = 9.42岁)。前段病变以角膜混浊最为常见(18例,占5.6%),附件病变以钉带最为常见(56例,占17.6%)。其他与HIV/ aids相关的附件病变包括25例(7.9%)多毛症,13例(4.1%)眼带状疱疹(HZO)和4例(1.3%)结膜鳞状细胞癌。最常见的hiv相关前段病理为4例(1.3%)hzo相关角膜炎和1例(0.3%)单纯疱疹性角膜炎。结膜微血管病变是最常见的hiv相关眼附件病变。病毒载量值与同时累及前段和眼附件病变的关系有统计学意义,这些患者的病毒载量往往高于无病变的患者(P < 0.05)。结论:在尼日利亚城市三级医疗机构就诊的HIV/AIDS患者中,前段和眼附件病变较为常见。HIV/ aids定义的眼部疾病包括HZO、结膜微血管病和眼表面鳞状细胞瘤在这些患者中并不罕见。通过定期进行眼部检查,可以避免潜在的使人衰弱的眼部疾病。
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引用次数: 0
Knowledge of common cardiovascular diseases and its risk factors among members of a community in South-South Nigeria 尼日利亚南南部社区成员对常见心血管疾病及其危险因素的了解
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_124_22
P. Eromon, Tijani Ahmad Oseni, N. Fuh, C. Affusim, Osagie Lawani, Bolanle Adewuyi, Abel Ibharokhonre, Augustine Ikwu, P. Imomoh
Background: Cardiovascular diseases (CVD) are a major cause of morbidity and mortality. Reducing the burden of CVD particularly among rural dwellers will require a wholistic approach involving health education, and strengthening of primary health care to provide affordable primary care to the people. Aim: To access the knowledge of CVD and its risk factors among the people. Materials and Methods: This was a descriptive cross-sectional study of 360 adult residents of Igueben, a rural community in Edo State South-South Nigeria, selected through a multistage sampling technique. An interviewer-administered semi-structured questionnaire was used to collect data which were analysed using SPSS version 20.0. Results: Respondents were mostly female (67.78%) with a mean age of 45 ± 08 years. Over half of the respondents were farmers (58.33%), and 57.78% of respondents did not have secondary education. Over 50% had knowledge of stroke, and more than two-third of them were able to recognise common stroke symptoms such as difficulty speaking, facial weakness, and sudden limb weakness. Most respondents had knowledge of common risk factors for CVD, especially smoking, alcohol use, and hypertension. Respondents demonstrated a good knowledge of the preventive and control measures of CVD like healthy diet (60.56%), regular exercise (60.56%), alcohol and smoking cessation (60.56%), good sleep (55.56%), good health-seeking behaviour (55.55%), and avoidance of stress (54.44%). Furthermore, 78.89% of the participants recognised the need for hospital care in the event of a CVD. However, one-third of them had a poor health-seeking behaviour. Conclusion: We have found that this rural population had knowledge of stroke as a CVD as well as other common ones such as heart attack and heart failure. They also had a good health-seeking behaviour. However, while CVD awareness alone is no guarantee for positive cardiovascular outcomes, a good knowledge is clearly necessary for individuals to make informed decisions about their health by potentially adopting risk-free behaviours.
背景:心血管疾病(CVD)是导致发病率和死亡率的主要原因。减少心血管疾病的负担,特别是在农村居民中,需要采取一种全面的方法,包括健康教育和加强初级卫生保健,为人民提供负担得起的初级保健。目的:了解人群对心血管疾病及其危险因素的认识。材料和方法:这是一项描述性的横断面研究,通过多阶段抽样技术选择了尼日利亚中南部埃多州农村社区Igueben的360名成年居民。使用访谈者管理的半结构化问卷收集数据,并使用SPSS 20.0版进行分析。结果:受访者多为女性(67.78%),平均年龄45±08岁。超过一半的受访者是农民(58.33%),57.78%的受访者没有受过中等教育。超过50%的人知道中风,其中超过三分之二的人能够识别常见的中风症状,如说话困难、面部无力和突然四肢无力。大多数受访者了解心血管疾病的常见危险因素,尤其是吸烟、饮酒和高血压。受访者对心血管疾病的预防和控制措施有很好的了解,如健康饮食(60.56%)、定期锻炼(60.56%。然而,其中三分之一的人在寻求健康方面表现不佳。结论:我们发现这些农村人口知道中风是心血管疾病,也知道其他常见疾病,如心脏病发作和心力衰竭。他们也有良好的健康寻求行为。然而,尽管心血管疾病意识本身并不能保证心血管疾病的积极结果,但良好的知识对于个人通过潜在的无风险行为对自己的健康做出明智的决定显然是必要的。
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引用次数: 0
COVID-19 in Renal Transplant Patients – A Narrative Review 肾移植患者的COVID-19 -叙述性综述
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_23_23
Jayesh Valecha, Vasu Gupta, Vaidehi Mendpara, Carson Eric Snyder, Fnu Anamika, Kinna Parikh, Talha Mahmood, Shreya Garg, Rohit Jain
Abstract The World Health Organisation declared the novel coronavirus known as severe acute respiratory syndrome coronavirus 2 a pandemic in March 2020. This virus has led to the deaths of more than 6 million people worldwide. Besides causing pneumonia, COVID-19 is linked to multiple organ dysfunction, including the kidneys, especially in individuals whose immune systems are already compromised. Consequently, individuals who are currently on a waiting list for a kidney transplant or who have recently received a kidney transplant are at a significantly increased risk for developing acute kidney injury and are severely impacted by the COVID-19 infection. The pandemic has negatively affected the transplantation process and led to a decrease in the number of organ donations as well as the volume of renal transplants. This review summarises the outcomes of COVID-19 infection in renal transplant patients, its pathophysiology, the challenges faced by the transplant community, and the management of immunosuppression.
世界卫生组织于2020年3月宣布,被称为“严重急性呼吸综合征冠状病毒2”的新型冠状病毒进入大流行。这种病毒已导致全球600多万人死亡。除了引起肺炎外,COVID-19还与包括肾脏在内的多器官功能障碍有关,特别是在免疫系统已经受损的个体中。因此,目前正在等待肾移植或最近接受过肾移植的人发生急性肾损伤的风险显着增加,并受到COVID-19感染的严重影响。大流行对移植过程产生了不利影响,导致器官捐赠数量和肾脏移植量减少。本文综述了肾移植患者COVID-19感染的结局、病理生理学、移植界面临的挑战以及免疫抑制的管理。
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引用次数: 0
Review of congenital anomalies of ear, nose, and throat in a resource-challenged facility 回顾先天性耳、鼻、喉畸形在资源短缺的设施
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_127_22
J. Nwosu, E. Chime
Introduction: The complex pattern of development of the branchial arches predisposes to a myriad of congenital anomalies of the head-and-neck region. The ear, nose and throat (ENT) are by no means spared. The birth of a child with congenital anomaly elicits emotion, anxiety, the feeling of guilt, and dejection in the parents, especially the mother. They are worried and anxiously seek for the explanation which the attending doctor who is ill-equipped to venture into it. The etiological factors are many and vary. ENT anomalies are often associated with malformations of other organs and systems and should be searched for and detected. Any treatment offered should aim at restoring normal or near-normal appearance and function and allay the fears and apprehensions of the parents. Aim: The aim of the study was to review and document the incidence, variety, and presentation of ENT congenital anomalies seen and treated in the Otolaryngology Department of our institution and formulate a baseline for the future. Materials and Methods: It was a retrospective review of ENT anomalies handled in our hospital from January 2015 to December 2019. The case notes of the eligible cases were retrieved and the relevant data were extracted. The data collected were analysed with descriptive statistics and presented in tables and prose as deemed fit. Ethical Consideration: The study protocol was reviewed and approved by the hospital records department. Results: Forty-six cases were studied, 24 males and 22 females. Their ages ranged from 0.019 years (one week) to 55 years, average of 7.84 ± 10.38, 95% confidence interval of 4.75682–10.92318. There was no significant difference in the ages of the males and females P = 0.8809, t = 0.1507, dt = 44. Fourteen different malformations were detected most common of which was deafness 15 (32.61%), followed by thyroglossal cyst 7 (15.22%) with 5 different anomalies coming last with 2.17% each. Conclusion: ENT malformations are common in our locality. Adequate history and examination with appropriate investigations will help get the diagnosis and associated conditions. Multi-disciplinary approach to management will offer a better outcome. Parents and caregivers need to be properly counselled.
前言:鳃弓发育的复杂模式易导致头颈部的先天性畸形。耳鼻喉(ENT)也不能幸免。患有先天性畸形的孩子的出生会引起父母,尤其是母亲的情绪、焦虑、内疚和沮丧。他们忧心忡忡,焦急地寻找主治医生的解释,而主治医生却没有足够的能力去探究这个问题。病因多种多样。耳鼻喉异常通常与其他器官和系统的畸形有关,应予以搜索和检测。所提供的任何治疗应旨在恢复正常或接近正常的外观和功能,并减轻父母的恐惧和忧虑。目的:本研究的目的是回顾和记录我院耳鼻喉科所见和治疗的耳鼻喉先天性异常的发生率、种类和表现,并为今后制定基线。材料与方法:回顾性分析我院2015年1月至2019年12月收治的耳鼻喉科异常病例。检索符合条件的病例的病例记录并提取相关数据。收集到的数据用描述性统计进行分析,并在认为合适的表格和散文中呈现。伦理考虑:研究方案由医院档案部审查并批准。结果:共46例,男24例,女22例。年龄范围0.019岁(1周)~ 55岁,平均7.84±10.38岁,95%可信区间为4.75682 ~ 10.92318。男女年龄差异无统计学意义(P = 0.8809, t = 0.1507, dt = 44)。其中以耳聋15例(32.61%)最为常见,其次为甲状舌囊肿7例(15.22%),最后为5例(2.17%)。结论:耳鼻喉畸形在本区较为常见。充分的病史和适当的检查将有助于得到诊断和相关情况。多学科管理方法将提供更好的结果。父母和照顾者需要得到适当的咨询。
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引用次数: 0
Massive sublingual bronchogenic cyst with airway compromise 大量舌下支气管囊肿伴气道受损
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_6_23
O. Olaopa, C. Emeka, J. Idowu, R. Oluwakuyide, Adedamola Dada, G. Adebayo, O. Towolawi, Fehintolu Kolawole, O. A. Adebimpe
Bronchogenic cysts are primary cysts of the mediastinum. In rare situations, it can present in the oral cavity as a swelling of the tongue and the floor of the mouth. Usually, it is not a life-threatening clinical entity. In this report, we present a massive sublingual bronchogenic cyst with life-threatening clinical characteristics in an adult patient of a Nigerian tertiary-level medical center and the management of the case.
支气管源性囊肿是纵隔的原发性囊肿。在极少数情况下,它可以在口腔中表现为舌头和口腔底部的肿胀。通常,它不是危及生命的临床症状。在本报告中,我们提出了一个巨大的舌下支气管源性囊肿危及生命的临床特征在尼日利亚三级医疗中心的成人患者和管理的情况。
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引用次数: 0
Prevalence, Outcome, and Predictors of Placenta Migration among Pregnant Women with Placenta Praevia in Enugu Nigeria 尼日利亚埃努古地区前置胎盘孕妇胎盘迁移的患病率、结局和预测因素
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_36_23
Uchenna Anthony Umeh, Chioma Roseline Umeh, Samuel Nnamdi Obi, Theophilus Ogochukwu Nwankwo, Chudi Igwe Obuba, Euzebus Ezugwu
Abstract Background: Placenta praevia is one of the leading causes of obstetric haemorrhages and a major contributor to maternal and fetal morbidity and mortality. Although low-lying placentae are common during routine midtrimester anomaly scans, the incidence of placenta praevia at term remains low, probably due to placenta migration. It is important to follow-up pregnant women with low-lying placentae to identify the few whose placenta will remain in the lower segment and hence at risk of major obstetric haemorrhage. Aim: The objectives of this study were to determine the prevalence, predictors, and pregnancy outcome of low-lying placenta diagnosed in the midtrimester. Materials and Methods: The study was a cohort study with longitudinal follow-up of 416 pregnant women from the University of Nigeria Teaching Hospital, Enugu State University Teaching Hospital, and Mother of Christ Specialist Hospital who had an ultrasound diagnosis of low-lying placentae between 16 weeks and 20 weeks of gestation. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 22. P < 0.05 was considered statistically significant. Results: The prevalence of low-lying placenta at 20, 24, 28, 32, and 36 weeks of gestation was 51%, 41.3%, 22.3%, 12.7%, and 10.5%, respectively. 87.3% of those with low-lying placenta had normally situated placenta at term. Previous caesarean section and male gender were significant predictors of placenta praevia at delivery ( P < 0.001 and P = 0.03, respectively). Conclusion: Despite the high prevalence of low-lying placenta before 20 weeks of gestation, only a few of these placentas remain low-lying at term. Previous caesarean section and male gender were significant predictors of placenta praevia at delivery. This study recommends a routine ultrasound scan in the second or third trimester for placenta localisation.
背景:前置胎盘是产科出血的主要原因之一,也是孕产妇和胎儿发病率和死亡率的主要原因。虽然在常规的妊娠中期异常扫描中发现低处胎盘是常见的,但足月前胎盘的发生率仍然很低,可能是由于胎盘迁移。重要的是对胎盘位于低位的孕妇进行随访,以确定少数胎盘将留在低位,从而有发生重大产科出血的风险。目的:本研究的目的是确定妊娠中期诊断的低洼胎盘的患病率、预测因素和妊娠结局。材料与方法:本研究是一项队列研究,对来自尼日利亚大学教学医院、埃努古州立大学教学医院和基督之母专科医院的416名孕妇进行纵向随访,这些孕妇在妊娠16周至20周期间超声诊断为低位胎盘。使用社会科学统计软件包(SPSS)第22版进行数据分析。P & lt;0.05认为有统计学意义。结果:妊娠20周、24周、28周、32周、36周出现低位胎盘的比例分别为51%、41.3%、22.3%、12.7%、10.5%。87.3%低胎盘者足月胎盘位置正常。既往剖宫产史和男性性别是分娩时前置胎盘的显著预测因素(P <0.001和P = 0.03)。结论:尽管妊娠20周前低胎盘的发生率很高,但只有少数胎盘在足月时保持低胎盘。既往剖宫产和男性性别是分娩时前置胎盘的重要预测因素。本研究建议在妊娠中期或晚期进行常规超声扫描以定位胎盘。
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引用次数: 0
Public perceptions and experiences of COVID-19 pandemic in Ekiti: A qualitative study using thematic analysis Ekiti公众对新冠肺炎大流行的认知和体验:一项使用主题分析的定性研究
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_90_22
O. Solomon, K. Igbekoyi, C. Oluwadare, K. Oluwadiya
Background: COVID-19 pandemic has been a turbulent crisis that took the globe by surprise, killing thousands of people. Nonetheless, individuals with underlying conditions are considered to be at risk. Aim: The study examined public perceptions of the vulnerability influencing the spread of COVID-19 in Ekiti State, Nigeria. Materials and Methods: The study used a qualitative method in which 65 participated in focus group discussions to elicit information about the subject matter. Thematic analysis was used to analyse field data. Results: The study found that vulnerability to COVID-19 was based on the following themes: immunity, imported, complications, lack of knowledge, recklessness and anyone. As a result, the study concluded that individuals can be vulnerable to COVID-19 if the person has weakened or impaired immunity and that the virus was imported from other countries. Conclusion: In addition, having any of the following underlying conditions such as asthma, diabetes, heart or liver or being ignorant of the spread of the virus, and failing to follow COVID-19 containment guidelines can make people more vulnerable to the virus. Recommendations: The study, therefore, recommends that health education about the virus be implemented. This could be directed towards strengthening beliefs that conform to accepted scientific views of COVID-19 and weakening those that do not. Notably, the public should be encouraged to follow COVID-19 containment guidelines, which include wearing a face masks, washing and sanitising our hands, and social distancing.
背景:COVID-19大流行是一场动荡的危机,令全球措手不及,造成数千人死亡。然而,有潜在疾病的人被认为是有风险的。目的:该研究调查了公众对影响尼日利亚埃基蒂州COVID-19传播的脆弱性的看法。材料和方法:本研究采用定性方法,其中65人参加焦点小组讨论,以引出有关主题的信息。专题分析用于分析现场数据。结果:研究发现,对COVID-19的脆弱性基于以下主题:免疫、输入性、并发症、缺乏知识、鲁莽和任何人。因此,该研究得出的结论是,如果一个人的免疫力减弱或受损,并且病毒是从其他国家输入的,那么他可能很容易感染COVID-19。结论:此外,患有以下任何一种潜在疾病,如哮喘、糖尿病、心脏病或肝脏,或对病毒的传播一无所知,以及不遵守COVID-19遏制指南,都可能使人们更容易感染病毒。建议:因此,该研究建议实施有关该病毒的健康教育。这可以旨在加强与公认的COVID-19科学观点一致的信念,并削弱那些不一致的信念。值得注意的是,应鼓励公众遵守新冠肺炎防控指导方针,包括戴口罩、洗手和消毒、保持社交距离。
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引用次数: 0
Outcome of Flexible Ureteroscopy and Holmium Laser Lithotripsy in the Management of Renal Stones: A two-year Retrospective Study 输尿管软镜和钬激光碎石治疗肾结石的疗效:一项为期两年的回顾性研究
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_43_23
Idorenyin Cletus Akpayak, Chukwudum Dennis Ikeh
Abstract Background: Over the decades, the management of renal stones has shifted from the undesirably invasive open nephrolithotomy to the more effective and less invasive approaches with lower morbidity. These less invasive options include extracorporeal shock wave lithotripsy, percutaneous lithotripsy, and flexible ureterorenoscopy (fURS). Aim: This study seeks to evaluate the outcomes of flexible ureterorenoscopy with holmium: yttrium-aluminum-garnet (holmium:YAG) laser lithotripsy for the treatment of renal stones <2.0 cm in our patients. Patients and Methods: Records of 23 patients who underwent flexible ureteroscopy and holmium: YAG laser lithotripsy between October 2020 and September 2022 were reviewed retrospectively. The patients who had the flexible ureteroscopy and laser lithotripsy for renal stones <2.0 cm for various indications were the subjects of this study. All patients had computed tomographic urography preoperatively to locate the stone. Stone-free rate (SFR) was deduced from no stone detected on imaging and resolution of the patient’s preoperative complaints related to the renal stones at follow-up. Data on patients’ demographics, indication for the surgery, location of the stone, size of the stone, preoperative double J (DJ) placement, postoperative DJ stent placement, intraoperative and postoperative complications, and the SFR were retrieved and subjected to the statistical analysis. Results: A total of 23 patients had fURS and laser lithotripsy during the two-year study period. All the patients had solitary stone in the renal unit operated. The mean stone size for all the patients was 1.3 cm (range: 0.5–1.9 cm). Fifteen (65.2%) patients had DJ stent preoperatively. Postoperative DJ stent was placed in all our patients. Four (17.4%) patients had Grade 1 ureteric injury while none had high Grades (2, 3, and 4) ureteral injuries. Two (9.5%) patients had intraoperative bleeding, 1 (4.8%) had transient haematuria postoperatively while 2 (9.5%) patients had urinary tract infection. The SFR was 91.3% in a single surgery. Two patients (8.7%) had residual fragments in the lower calyx. Conclusion: Flexible ureteroscopy and laser holmium lithotripsy give a satisfactory SFR, with few complications. It is a safe and effective treatment modality for the treatment of stones <2.0 cm in the renal pelvicalyceal system.
背景:在过去的几十年里,肾结石的治疗已经从侵入性不良的开放式肾镜取石术转向了更有效、侵入性更小、发病率更低的方法。这些侵入性较小的选择包括体外冲击波碎石术、经皮碎石术和柔性输尿管镜(fURS)。目的:本研究旨在评估输尿管镜下钬钇铝石榴石激光碎石术治疗直径2.0 cm肾结石的疗效。患者和方法:回顾性分析2020年10月至2022年9月期间接受输尿管软镜和钬激光碎石术的23例患者的记录。本研究以输尿管软镜及激光碎石术治疗肾结石≥2.0 cm各种适应症患者为研究对象。所有患者术前均行计算机断层尿路造影定位结石。无结石率(SFR)是通过影像学检查未发现结石和随访时患者术前与肾结石相关的投诉的解决来推断的。检索患者的人口统计学、手术指征、结石位置、结石大小、术前双J (DJ)置入术、术后DJ支架置入术、术中术后并发症、SFR等数据并进行统计分析。结果:在两年的研究期间,共有23例患者接受了fURS和激光碎石术。所有患者均有肾部单纯性结石。所有患者的平均结石大小为1.3 cm(范围:0.5-1.9 cm)。术前放置DJ支架15例(65.2%)。所有患者术后均放置DJ支架。4例(17.4%)患者为1级输尿管损伤,而没有患者为2、3、4级输尿管损伤。术中出血2例(9.5%),术后一过性血尿1例(4.8%),尿路感染2例(9.5%)。单次手术的SFR为91.3%。2例(8.7%)患者下花萼有残留碎片。结论:输尿管软腔镜联合激光钬激光碎石可获得满意的SFR,并发症少。对于肾盂肾盂系统2.0 cm结石的治疗是一种安全有效的治疗方式。
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引用次数: 0
Health system responses and capacities for COVID-19 in Nigeria: A scoping review 尼日利亚卫生系统应对COVID-19的措施和能力:范围审查
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_123_22
Udochukwu Ugochukwu Ogu, N. Uguru, N. Ude, Nwadiuto C Ojielo, SO Onah, C. Okeke, BenjaminS Chudi Uzochukwu, O. Onwujekwe
Background: Nigeria is in short supply of health workforce and equipment needed to manage the infected COVID-19 individuals. The rate of occurrence of new cases of infection has the capacity to further deplete the human resources in the sector, putting a dent in the fight against the spread of the virus. This study aims to determine the capacity of Nigerian health systems to respond to COVID-19. Materials and Methods: This was a scoping review of media documents, official documents and journals, published from 1st December 2019 to 31st December 2021. Online media reports were sourced from major newspapers on FACTIVA (Vanguard, Punch, Guardian, The Nation, Business Day, and Premium Times) that reported national and state level health system responses to COVID-19. We also reviewed other online news sources that have consistently reported health systems response to COVID-19 in Nigeria. Some of these are Nigeria Health Watch, APO Africa Newsroom, Federal Ministry of Health newsletter, and national media. Results: By December 31st, 2020, Nigeria had 70 free laboratories controlled by the government. These comprised 31 federal laboratories, 30 state, 3 military, 2 Non-Governmental Organization (NGO), 2 UN and 2 private labs. In 2019, Nigeria's IHR score at point of entry 1 & 2 was 3 and 1. Routine capacities established at points of entry was improved, however, effective public health response at point of entry, remained the same. Which supports the low response capacity of the country. Nigeria's average score across the JEE 2019 had increased to 7% (from 39% in 2017 to 46% in 2019) - four new indicators and 20 indicators with improved scores from 2017. Conclusion: Nigeria's health system response and capacity to handle COVID-19 is quite poor and grossly inadequate. There is a need to increase the number of health workforce in the country and institute adequate accountability mechanisms to ensure prudent and focused management of health funds.
背景:尼日利亚缺乏管理新冠肺炎感染者所需的卫生工作人员和设备。新感染病例的发生率有可能进一步耗尽该部门的人力资源,削弱抗击病毒传播的斗争。本研究旨在确定尼日利亚卫生系统应对新冠肺炎的能力。材料和方法:这是对2019年12月1日至2021年12月31日发表的媒体文件、官方文件和期刊的范围审查。在线媒体报道来源于FACTIVA上的主要报纸(《先锋报》、《Punch》、《卫报》、《国家》、《商业日报》和《高级时报》),这些报纸报道了国家和州一级卫生系统对新冠肺炎的应对措施。我们还回顾了其他在线新闻来源,这些来源一贯报道了尼日利亚卫生系统对新冠肺炎的反应。其中包括尼日利亚健康观察、APO非洲新闻室、联邦卫生部通讯和国家媒体。结果:截至2020年12月31日,尼日利亚有70个由政府控制的免费实验室。其中包括31个联邦实验室、30个州实验室、3个军事实验室、2个非政府组织、2个联合国实验室和2个私人实验室。2019年,尼日利亚的IHR在第1和第2名的得分分别为3分和1分。入境点建立的常规能力得到了改善,但入境点的有效公共卫生应对措施保持不变。这支持了该国的低应对能力。尼日利亚在2019年JEE中的平均得分已增至7%(从2017年的39%增至2019年的46%),这是四个新指标,20个指标的得分比2017年有所提高。结论:尼日利亚的卫生系统应对新冠肺炎的能力非常差,严重不足。有必要增加该国卫生工作人员的数量,并建立适当的问责机制,以确保对卫生资金进行审慎和集中的管理。
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引用次数: 0
Comparison of the Qualities of Sevoflurane and Halothane in Paediatric Anaesthesia 七氟烷和氟烷在儿科麻醉中的质量比较
Pub Date : 2023-01-01 DOI: 10.4103/njm.njm_126_22
A. Yunus, M. Odigbo, S. Tasiu, SM Babangida, Yakubu Yunusa, Am Kabiru, MM Yusuf
Background: Inhalational anaesthetics are used for the induction and maintenance of general anaesthesia in children. More agents are evolving in an effort to discover the agent of choice in this age group, considering the safety margin, availability, affordability, and accessibility of the anaesthetics. Aim: The aim of our study was to compare the qualities of halothane and sevoflurane in paediatric patients. Materials and Methods: This was a prospective randomised study of 100 children within the age group of 5–12 years, scheduled for elective surgery in Ahmadu Bello University Teaching Hospital, Zaria, from January to October 2022, and satisfied the study inclusion criteria. The following variables (heart rate, blood pressure, arrhythmias, and complications) were recorded and analysed using IBM SPSS version 25 (Chicago) USA. P ≤ 0.05 was considered statistically significant. Results: The incidence of tolerability at induction of anaesthesia, hypoxaemia (SpO2 <90%), and airway responses (laryngospasm, coughing, and breath holding) was similar in both the groups. However, at induction of anaesthesia, the degree of muscle rigidity in the sevoflurane group was statistically significant compared with the halothane group (P = 0.028), but the difference was not statistically significant at the recovery period (P = 0.59). More so, the incidence of arrhythmias was higher in the halothane group than in the sevoflurane group. Conclusion: The overall qualities of halothane were commensurate with that of sevoflurane. However, where available and affordable, sevoflurane will be a better agent of choice in paediatric anaesthesia.
背景:吸入麻醉药用于儿童全身麻醉的诱导和维持。考虑到麻醉剂的安全边际、可用性、可负担性和可及性,越来越多的麻醉剂正在发展,以努力发现该年龄组的首选药剂。目的:我们研究的目的是比较氟烷和七氟醚在儿科患者中的质量。材料和方法:这是一项前瞻性随机研究,涉及100名5-12岁年龄组的儿童,计划于2022年1月至10月在扎里亚的艾哈迈杜·贝洛大学教学医院进行选择性手术,符合研究纳入标准。以下变量(心率、血压、心律失常和并发症)使用IBM SPSS 25版(芝加哥)USA进行记录和分析。P≤0.05被认为具有统计学意义。结果:两组在麻醉诱导、低氧血症(SpO2<90%)和气道反应(喉痉挛、咳嗽和屏气)时的耐受性发生率相似。然而,在麻醉诱导时,七氟醚组的肌肉僵硬程度与氟烷组相比具有统计学意义(P=0.028),但在恢复期差异无统计学意义(P=0.59)。更重要的是,氟烷组的心律失常发生率高于七氟醚组。结论:氟烷的总体质量与七氟醚相当。然而,在可用且价格合理的情况下,七氟烷将是儿科麻醉中更好的选择。
{"title":"Comparison of the Qualities of Sevoflurane and Halothane in Paediatric Anaesthesia","authors":"A. Yunus, M. Odigbo, S. Tasiu, SM Babangida, Yakubu Yunusa, Am Kabiru, MM Yusuf","doi":"10.4103/njm.njm_126_22","DOIUrl":"https://doi.org/10.4103/njm.njm_126_22","url":null,"abstract":"Background: Inhalational anaesthetics are used for the induction and maintenance of general anaesthesia in children. More agents are evolving in an effort to discover the agent of choice in this age group, considering the safety margin, availability, affordability, and accessibility of the anaesthetics. Aim: The aim of our study was to compare the qualities of halothane and sevoflurane in paediatric patients. Materials and Methods: This was a prospective randomised study of 100 children within the age group of 5–12 years, scheduled for elective surgery in Ahmadu Bello University Teaching Hospital, Zaria, from January to October 2022, and satisfied the study inclusion criteria. The following variables (heart rate, blood pressure, arrhythmias, and complications) were recorded and analysed using IBM SPSS version 25 (Chicago) USA. P ≤ 0.05 was considered statistically significant. Results: The incidence of tolerability at induction of anaesthesia, hypoxaemia (SpO2 <90%), and airway responses (laryngospasm, coughing, and breath holding) was similar in both the groups. However, at induction of anaesthesia, the degree of muscle rigidity in the sevoflurane group was statistically significant compared with the halothane group (P = 0.028), but the difference was not statistically significant at the recovery period (P = 0.59). More so, the incidence of arrhythmias was higher in the halothane group than in the sevoflurane group. Conclusion: The overall qualities of halothane were commensurate with that of sevoflurane. However, where available and affordable, sevoflurane will be a better agent of choice in paediatric anaesthesia.","PeriodicalId":52572,"journal":{"name":"Nigerian Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47333146","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}
引用次数: 0
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Nigerian Journal of Medicine
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