Pub Date : 2023-06-01DOI: 10.28991/scimedj-2023-05-02-02
Dzunisani B. Mhlari, M. Mokgatle, N. M. Mogale, R. J. Seretlo
Background: The Universal Test and Treat (UTT) strategy ensures that people test and initiate early treatment in health facilities. Communities have benefited from this strategy to help manage HIV and prevent the spread of the disease, but the way people perceive the strategy and their experiences of testing and initiating antiretroviral therapy (ART) on the same day have an impact on their remaining on treatment and on their adherence. The aim of the study: The aim of this study was to describe the perceptions and explore the experiences of newly enrolled patients regarding the UTT strategy employed in health facilities in Kgetleng sub-district. Method: This is a qualitative study that used in-depth interviews to describe the perceptions and explore the experiences of newly enrolled patients regarding the UTT strategy employed in health facilities in Kgetleng sub-district. The twenty-seven participants were purposefully selected from three health facilities in the sub-district. The data were collected and transcribed verbatim. The transcripts were analyzed using thematic content analysis. Results: The participants reported that they were not knowledgeable about or aware of the strategy until they tested positive in their clinics. HIV testing services (HTS) are still underused, as the participants presented to the facilities only when they were seriously ill, had various symptoms, or were pregnant. They described accepting their status and treatment because they were already sick, and there was nothing that they could do but take treatment. Despite the different emotions they experienced, the participants were able to accept their treatment and their status. Surprisingly, those who were still in denial also accepted treatment. Some were able to disclose and received support from their family, partners, and friends, but others had not disclosed. The data also showed their fear of stigmatization if they were seen coming to the clinic frequently. Conclusion: Being diagnosed with the human immunodeficiency virus (HIV) is still a source of embarrassment. There is still a need to educate communities about the virus, encourage them to use HTS, and empower them with information to minimize stigma and promote social support. Doi: 10.28991/SciMedJ-2023-05-02-02 Full Text: PDF
{"title":"Community Preparedness, Acceptability, and Uptake of UTT Services in PHC Facilities","authors":"Dzunisani B. Mhlari, M. Mokgatle, N. M. Mogale, R. J. Seretlo","doi":"10.28991/scimedj-2023-05-02-02","DOIUrl":"https://doi.org/10.28991/scimedj-2023-05-02-02","url":null,"abstract":"Background: The Universal Test and Treat (UTT) strategy ensures that people test and initiate early treatment in health facilities. Communities have benefited from this strategy to help manage HIV and prevent the spread of the disease, but the way people perceive the strategy and their experiences of testing and initiating antiretroviral therapy (ART) on the same day have an impact on their remaining on treatment and on their adherence. The aim of the study: The aim of this study was to describe the perceptions and explore the experiences of newly enrolled patients regarding the UTT strategy employed in health facilities in Kgetleng sub-district. Method: This is a qualitative study that used in-depth interviews to describe the perceptions and explore the experiences of newly enrolled patients regarding the UTT strategy employed in health facilities in Kgetleng sub-district. The twenty-seven participants were purposefully selected from three health facilities in the sub-district. The data were collected and transcribed verbatim. The transcripts were analyzed using thematic content analysis. Results: The participants reported that they were not knowledgeable about or aware of the strategy until they tested positive in their clinics. HIV testing services (HTS) are still underused, as the participants presented to the facilities only when they were seriously ill, had various symptoms, or were pregnant. They described accepting their status and treatment because they were already sick, and there was nothing that they could do but take treatment. Despite the different emotions they experienced, the participants were able to accept their treatment and their status. Surprisingly, those who were still in denial also accepted treatment. Some were able to disclose and received support from their family, partners, and friends, but others had not disclosed. The data also showed their fear of stigmatization if they were seen coming to the clinic frequently. Conclusion: Being diagnosed with the human immunodeficiency virus (HIV) is still a source of embarrassment. There is still a need to educate communities about the virus, encourage them to use HTS, and empower them with information to minimize stigma and promote social support. Doi: 10.28991/SciMedJ-2023-05-02-02 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139371850","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 : 2023-06-01DOI: 10.28991/scimedj-2023-05-02-04
SciMedicine Journal, F. C. Makhandule, M. Bhuiyan
Phyllodes Tumors are rare fibroepithelial neoplasms of the breast, accounting for less than 1% of all breast neoplasms. Preoperative diagnosis of Phyllodes Tumors is not easy, and a definitive diagnosis depends on a complete excision of the tumor. We present a case of a Giant Fungating Borderline Phyllodes Tumor of the breast. The main objective is to share our experience with the Phyllodes tumor of the breast from Mankweng Academic Hospital, Limpopo, South Africa. Case Report: A 50-year-old postmenopausal patient presented to our Breast Oncology clinic with a history of a slow-growing left breast mass for a duration of more than 1 year. It started as a small mass and progressively increased in size. She previously had two core needle biopsies, of which both histological analyses were inconclusive. In the last four months, there were multiple ruptured round masses associated with pain, bleeding, and an offensive discharge. The patient does not have any family history of breast cancer. On examination, the left breast has a fungating mass of 15×15 cm, with areas of necrosis and hemorrhage. There were no associated axillary lymph nodes and no abnormal findings in the right breast. Chest X-ray: normal. A mammogram was not done owing to the fear and risk of bleeding. A mastectomy was performed, and it was a highly vascularized mass. The excised specimen weighed 2.7 kg and was sent for histological assessment, which showed features of fibroepithelial proliferation consistent with Borderline Phyllodes Tumor with areas of stromal atypia, focal increase in cellularity, mitosis 5 per 10 High Power Field (HPF), and clear surgical margins of 0.9 millimeters (mm). The patient was reviewed six weeks after the operation. Conclusion: Owing to the rare nature and misdiagnosis of Phyllodes tumors, it is important to obtain a tissue biopsy for histological assessment of all suspicious breast lesions, regardless of age. Doi: 10.28991/SciMedJ-2023-05-02-04 Full Text: PDF
{"title":"Giant Fungating Borderline Phyllodes Tumor of the Breast","authors":"SciMedicine Journal, F. C. Makhandule, M. Bhuiyan","doi":"10.28991/scimedj-2023-05-02-04","DOIUrl":"https://doi.org/10.28991/scimedj-2023-05-02-04","url":null,"abstract":"Phyllodes Tumors are rare fibroepithelial neoplasms of the breast, accounting for less than 1% of all breast neoplasms. Preoperative diagnosis of Phyllodes Tumors is not easy, and a definitive diagnosis depends on a complete excision of the tumor. We present a case of a Giant Fungating Borderline Phyllodes Tumor of the breast. The main objective is to share our experience with the Phyllodes tumor of the breast from Mankweng Academic Hospital, Limpopo, South Africa. Case Report: A 50-year-old postmenopausal patient presented to our Breast Oncology clinic with a history of a slow-growing left breast mass for a duration of more than 1 year. It started as a small mass and progressively increased in size. She previously had two core needle biopsies, of which both histological analyses were inconclusive. In the last four months, there were multiple ruptured round masses associated with pain, bleeding, and an offensive discharge. The patient does not have any family history of breast cancer. On examination, the left breast has a fungating mass of 15×15 cm, with areas of necrosis and hemorrhage. There were no associated axillary lymph nodes and no abnormal findings in the right breast. Chest X-ray: normal. A mammogram was not done owing to the fear and risk of bleeding. A mastectomy was performed, and it was a highly vascularized mass. The excised specimen weighed 2.7 kg and was sent for histological assessment, which showed features of fibroepithelial proliferation consistent with Borderline Phyllodes Tumor with areas of stromal atypia, focal increase in cellularity, mitosis 5 per 10 High Power Field (HPF), and clear surgical margins of 0.9 millimeters (mm). The patient was reviewed six weeks after the operation. Conclusion: Owing to the rare nature and misdiagnosis of Phyllodes tumors, it is important to obtain a tissue biopsy for histological assessment of all suspicious breast lesions, regardless of age. Doi: 10.28991/SciMedJ-2023-05-02-04 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139371525","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 : 2023-06-01DOI: 10.28991/scimedj-2023-05-02-05
Simone Lao, Shayna Keying Seow, Rong Ting Ong, Vaidehi S. Dave, M. Ling
Recent studies have suggested that diet may affect the gut microbiome, subsequently influencing mental health. While several systematic reviews have been done on the effects of diet on mental health via the gut microbiome, there are focused on either specific diets or mental disorders. This systematic review examines the effect of diet and broad-based mental health via the gut microbiome. 21 out of 99 studies published prior to 2023 and listed in PubMed are included. Our analysis suggests that a vegan diet, a Mediterranean-style diet, fiber, probiotics, dietary vitamin D, unpasteurized milk, foods with a low omega-3 to omega-6 ratio, and Xiao Yan Sanmay have positive effects on gut microbiome, leading to a positive influence on mental health, while a meat-rich diet, a high-fat diet, high fructose intake, and zinc deficiency may have negative effects on gut microbiome, leading to a negative influence on mental health. Collectively, the effects of diet on mental health via gut microbiome may be explained by the composition of gut microbiome and the metabolites produced by gut microbiome on gut permeability. Doi: 10.28991/SciMedJ-2023-05-02-05 Full Text: PDF
{"title":"Systematic Review on the Effects of Food on Mental Health via Gut Microbiome","authors":"Simone Lao, Shayna Keying Seow, Rong Ting Ong, Vaidehi S. Dave, M. Ling","doi":"10.28991/scimedj-2023-05-02-05","DOIUrl":"https://doi.org/10.28991/scimedj-2023-05-02-05","url":null,"abstract":"Recent studies have suggested that diet may affect the gut microbiome, subsequently influencing mental health. While several systematic reviews have been done on the effects of diet on mental health via the gut microbiome, there are focused on either specific diets or mental disorders. This systematic review examines the effect of diet and broad-based mental health via the gut microbiome. 21 out of 99 studies published prior to 2023 and listed in PubMed are included. Our analysis suggests that a vegan diet, a Mediterranean-style diet, fiber, probiotics, dietary vitamin D, unpasteurized milk, foods with a low omega-3 to omega-6 ratio, and Xiao Yan Sanmay have positive effects on gut microbiome, leading to a positive influence on mental health, while a meat-rich diet, a high-fat diet, high fructose intake, and zinc deficiency may have negative effects on gut microbiome, leading to a negative influence on mental health. Collectively, the effects of diet on mental health via gut microbiome may be explained by the composition of gut microbiome and the metabolites produced by gut microbiome on gut permeability. Doi: 10.28991/SciMedJ-2023-05-02-05 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139371456","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 : 2023-06-01DOI: 10.28991/scimedj-2023-05-02-03
Felix Osei-Boakye, Nicholas Agyepong, C. Nkansah, Abdul-Razak Saasi, D. Serwaa, Mark Danquah, Kwesi Kattah, Mohammed Khadija, Fati Salifu, Andrea Owusu Antwi
Background: Different seasons present varied environmental factors that influence the occurrence of transfusion-driven diseases. Therefore, this study determined the patterns of blood transfusion among hospitalized patients and the effect of season on ABO/Rh phenotypes. Methods: A single-center retrospective cross-sectional study was conducted on 5089 hospitalized patients that were transfused with blood at Sunyani Municipal Hospital. Archived blood transfusion records were retrieved and analyzed using GraphPad Prism, and SPSS. The association, effect size, and yearly trends of transfusion patterns were determined. Results: The majority of the participants were females (63.0% [3208]), 36-49 years old (20.4% [1039]), O phenotype (48.1% [2447]), Rh-positive (93.1% [4737]), and transfused in the rainy season (61.0% [3103]). Patients’ ABO was weakly associated with age (r = 0.07, p≤0.001) and season (r = 0.05, p = 0.008). Eighty percent (4053/5089) of the transfusions were ABO group-specific, and 28.3% (1146/4053) of this occurred at the emergency ward. The source of transfusion request was weakly associated with season (r = 0.1, p≤0.001) and type of transfusion (r = 0.1, p = 0.002). The rainy season (slope: 142.9, p≤0.001) and ABO-specific transfusions (slope: 219.5, p≤0.001) showed consistent increasing trends over the years. Conclusion: Blood transfusion was frequent among females, adults, Rh-positive and O phenotypes, and in the rainy season. Age and season were significantly associated with ABO, but not Rh. A transfusion request was associated with the season and type of transfusion, with the majority of transfusions occurring in the rainy season and emergency ward. There was an increasing yearly trend in blood transfusions. Doi: 10.28991/SciMedJ-2023-05-02-03 Full Text: PDF
{"title":"Effect of Season on Blood Transfusion Patterns: A Retrospective Study","authors":"Felix Osei-Boakye, Nicholas Agyepong, C. Nkansah, Abdul-Razak Saasi, D. Serwaa, Mark Danquah, Kwesi Kattah, Mohammed Khadija, Fati Salifu, Andrea Owusu Antwi","doi":"10.28991/scimedj-2023-05-02-03","DOIUrl":"https://doi.org/10.28991/scimedj-2023-05-02-03","url":null,"abstract":"Background: Different seasons present varied environmental factors that influence the occurrence of transfusion-driven diseases. Therefore, this study determined the patterns of blood transfusion among hospitalized patients and the effect of season on ABO/Rh phenotypes. Methods: A single-center retrospective cross-sectional study was conducted on 5089 hospitalized patients that were transfused with blood at Sunyani Municipal Hospital. Archived blood transfusion records were retrieved and analyzed using GraphPad Prism, and SPSS. The association, effect size, and yearly trends of transfusion patterns were determined. Results: The majority of the participants were females (63.0% [3208]), 36-49 years old (20.4% [1039]), O phenotype (48.1% [2447]), Rh-positive (93.1% [4737]), and transfused in the rainy season (61.0% [3103]). Patients’ ABO was weakly associated with age (r = 0.07, p≤0.001) and season (r = 0.05, p = 0.008). Eighty percent (4053/5089) of the transfusions were ABO group-specific, and 28.3% (1146/4053) of this occurred at the emergency ward. The source of transfusion request was weakly associated with season (r = 0.1, p≤0.001) and type of transfusion (r = 0.1, p = 0.002). The rainy season (slope: 142.9, p≤0.001) and ABO-specific transfusions (slope: 219.5, p≤0.001) showed consistent increasing trends over the years. Conclusion: Blood transfusion was frequent among females, adults, Rh-positive and O phenotypes, and in the rainy season. Age and season were significantly associated with ABO, but not Rh. A transfusion request was associated with the season and type of transfusion, with the majority of transfusions occurring in the rainy season and emergency ward. There was an increasing yearly trend in blood transfusions. Doi: 10.28991/SciMedJ-2023-05-02-03 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139371869","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 : 2023-06-01DOI: 10.28991/scimedj-2023-05-02-01
SciMedicine Journal, O. E. Oyewunmi, O. B. Aladeniyi, O. Bodunwa
In a pressing global health concern with substantial morbidity and mortality rates, accurate survival prediction is paramount for informed decision-making and enhanced patient well-being. This study presented a comparative investigation aimed at predicting the survival events of heart failure (HF) patients through the utilization of both machine learning and statistical algorithms. A comprehensive dataset drawn from Allied Hospital and the Faisalabad Institute of Cardiology, Faisalabad, Pakistan, was used. The Synthetic Minority Over-Sampling Technique (SMOTE) was employed on the data to rectify the imbalance, and a notable improvement was observed. To ascertain significant variables, statistical methods (Mann-Whitney and Chi-Square) were compared with machine learning-based feature selection to identify pivotal features for survival prediction, namely ejection fraction and serum creatinine. Remarkably, on final training with these features, the Random Forest Classifier emerges as the top-performing model, boasting an accuracy exceeding 90%. These findings hold the potential to substantially enhance patient prognosis, management, and outcomes, consequently alleviating the strain on healthcare systems. Doi: 10.28991/SciMedJ-2023-05-02-01 Full Text: PDF
{"title":"Comparative Study on Prediction of Survival Event of Heart Failure Patients Using Machine Learning and Statistical Algorithms","authors":"SciMedicine Journal, O. E. Oyewunmi, O. B. Aladeniyi, O. Bodunwa","doi":"10.28991/scimedj-2023-05-02-01","DOIUrl":"https://doi.org/10.28991/scimedj-2023-05-02-01","url":null,"abstract":"In a pressing global health concern with substantial morbidity and mortality rates, accurate survival prediction is paramount for informed decision-making and enhanced patient well-being. This study presented a comparative investigation aimed at predicting the survival events of heart failure (HF) patients through the utilization of both machine learning and statistical algorithms. A comprehensive dataset drawn from Allied Hospital and the Faisalabad Institute of Cardiology, Faisalabad, Pakistan, was used. The Synthetic Minority Over-Sampling Technique (SMOTE) was employed on the data to rectify the imbalance, and a notable improvement was observed. To ascertain significant variables, statistical methods (Mann-Whitney and Chi-Square) were compared with machine learning-based feature selection to identify pivotal features for survival prediction, namely ejection fraction and serum creatinine. Remarkably, on final training with these features, the Random Forest Classifier emerges as the top-performing model, boasting an accuracy exceeding 90%. These findings hold the potential to substantially enhance patient prognosis, management, and outcomes, consequently alleviating the strain on healthcare systems. Doi: 10.28991/SciMedJ-2023-05-02-01 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139371391","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 : 2023-03-01DOI: 10.28991/scimedj-2023-05-01-01
SciMedicine Journal, N. Mahmoodian, Harshita Thadesar, M. Sadeghi, Marilena Georgiades, M. Pech, C. Hoeschen
Microwave ablation (MWA) therapy as a thermal ablation procedure is an excellent alternative to open surgery for tumor treatment. The technique is considered advantageous for patients who are not candidates for open surgery due to factors such as age, anatomic limitations, resection, etc. Computed tomography (CT) is a commonly used interventional imaging modality during MWA therapy for localizing the tumor and finalizing the tumor treatment process. However, the CT scan of the body usually includes neighboring organs that are not relevant to lung tumor MWA therapy. Therefore, the segmentation of the lung and lung tumor in CT images provides valuable information about the tumor margin. This information can assist physicians in precisely and completely destroying the tumor during the MWA procedure. To solve the aforementioned problem, deep learning (DL), in particular, achieves a higher level of accuracy in segmentation than machine learning techniques due to its composition of multiple learning layers. The immediate goal is to distinguish among the different tissue structures of the tumor, healthy tissue, and the ablated area in lung CT images using the DL method to segment the organ and cancer area. Researchers have proposed various segmentation models. However, different segmentation tasks require different perception fields. In this study, we propose a new DL model that includes a residual block based on the U-Net model to accurately segment the lung organ and lung tumor tissue. The dataset consists of lung CT images acquired during MWA therapy using a CT scanner at the University Hospital Magdeburg. Manual tumor segmentation has been performed and confirmed by physicians. The results of our proposed method can be compared with those of the U-net model with a SSIM of 90%. Furthermore, accurately determining the margin area of the tumor tissue can decrease insufficient tumor ablation, which often leads to tumor recurrence. We anticipate that our proposed model can be generalized to perform tumor segmentation on CT images of different organs during MWA treatment. Finally, we hope that this method can achieve sufficient accuracy to decrease tumor recurrence and enable dose reduction for patients in interventional CT imaging. Doi: 10.28991/SciMedJ-2023-05-01-01 Full Text: PDF
{"title":"Lung and Lung Tumor Segmentation of CT Images During MWA Therapy Using AI Algorithm","authors":"SciMedicine Journal, N. Mahmoodian, Harshita Thadesar, M. Sadeghi, Marilena Georgiades, M. Pech, C. Hoeschen","doi":"10.28991/scimedj-2023-05-01-01","DOIUrl":"https://doi.org/10.28991/scimedj-2023-05-01-01","url":null,"abstract":"Microwave ablation (MWA) therapy as a thermal ablation procedure is an excellent alternative to open surgery for tumor treatment. The technique is considered advantageous for patients who are not candidates for open surgery due to factors such as age, anatomic limitations, resection, etc. Computed tomography (CT) is a commonly used interventional imaging modality during MWA therapy for localizing the tumor and finalizing the tumor treatment process. However, the CT scan of the body usually includes neighboring organs that are not relevant to lung tumor MWA therapy. Therefore, the segmentation of the lung and lung tumor in CT images provides valuable information about the tumor margin. This information can assist physicians in precisely and completely destroying the tumor during the MWA procedure. To solve the aforementioned problem, deep learning (DL), in particular, achieves a higher level of accuracy in segmentation than machine learning techniques due to its composition of multiple learning layers. The immediate goal is to distinguish among the different tissue structures of the tumor, healthy tissue, and the ablated area in lung CT images using the DL method to segment the organ and cancer area. Researchers have proposed various segmentation models. However, different segmentation tasks require different perception fields. In this study, we propose a new DL model that includes a residual block based on the U-Net model to accurately segment the lung organ and lung tumor tissue. The dataset consists of lung CT images acquired during MWA therapy using a CT scanner at the University Hospital Magdeburg. Manual tumor segmentation has been performed and confirmed by physicians. The results of our proposed method can be compared with those of the U-net model with a SSIM of 90%. Furthermore, accurately determining the margin area of the tumor tissue can decrease insufficient tumor ablation, which often leads to tumor recurrence. We anticipate that our proposed model can be generalized to perform tumor segmentation on CT images of different organs during MWA treatment. Finally, we hope that this method can achieve sufficient accuracy to decrease tumor recurrence and enable dose reduction for patients in interventional CT imaging. Doi: 10.28991/SciMedJ-2023-05-01-01 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44345047","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 : 2023-03-01DOI: 10.28991/scimedj-2023-05-01-04
S. M. Muneeb Ali, M. I. Memon, Salman Shafi Koul, T. Pasha, Fazal Rabbi, Syed Amir Gilani, A. Butt, Rana Imran Sikander, Muhammad Khan, Tawseef Ahmad
Background: Ivabradine is a selective inhibitor of (If) channels in the sinoatrial node and a pure bradycardic agent with no deleterious effect on other aspects of cardiac function nor on blood pressure. This study was conducted to evaluate the effect of Ivabradine on controlling tachycardia in sepsis patients as compared to placebo. Methods: A total of 100 patients admitted to the Medical Intensive Care Unit (MICU) were recruited in this randomized controlled trial. A total of 50 patients were randomly allocated to either Group A (the Ivabradine group) or Group B (the control group). Heart rate (HR) was recorded for all patients at baseline, 12, 24, 48, 72, 96, and 120 hours. Mean arterial pressure (MAP), ejection fraction (EF), and change in Norepinephrine (NE) dosage were recorded at baseline and post-intervention (120 hours). A mortality rate was recorded for both groups. Results: The patients had a mean age of 32.49 + 16.22 years. There were 56 males and 44 females in the study. Epilepsy (n = 12, 12%) and tetanus (n = 11, 11%) were the most common primary diagnosis. Ventilator Associated Pneumonia (n = 60) was found to be the most common infection. Patients in Group A (23.2 + 11.02 beats per minute) had a significantly greater heart rate reduction at 120 hours in mean heart rate as compared to Group B patients (8.92 + 30.46 beats per minute, p = 0.002). The increase in mean MAP for Group A (1.68 + 2.44 mm Hg) was also significantly greater than that for Group B (0.54 + 2.46 mm Hg, p = 0.022). There was no difference in the mean change in NE dosage between Groups A (0.63 + 0.25 units/minute) and B (-0.34 + 0.36 units/minute, p = 0.106). A significantly greater increase in EF was found for Group A (1.16 + 1.5%), in comparison to Group B (0.30 + 1.69 %, p = 0.009). There were 22 (44%) deaths reported in Group A as compared to 24 (48%, p = 0.688) in Group B. Conclusion:Ivabradine has a significantly greater effect on controlling heart rate as compared to placebo in sepsis patients. The use of Ivabradine should be included in clinical guidelines for managing sepsis patients in ICU settings. Doi: 10.28991/SciMedJ-2023-05-01-04 Full Text: PDF
{"title":"Effect of Ivabradine in Controlling Heart Rate in Patients with Sepsis and Septic Shock: Randomized Control Trails","authors":"S. M. Muneeb Ali, M. I. Memon, Salman Shafi Koul, T. Pasha, Fazal Rabbi, Syed Amir Gilani, A. Butt, Rana Imran Sikander, Muhammad Khan, Tawseef Ahmad","doi":"10.28991/scimedj-2023-05-01-04","DOIUrl":"https://doi.org/10.28991/scimedj-2023-05-01-04","url":null,"abstract":"Background: Ivabradine is a selective inhibitor of (If) channels in the sinoatrial node and a pure bradycardic agent with no deleterious effect on other aspects of cardiac function nor on blood pressure. This study was conducted to evaluate the effect of Ivabradine on controlling tachycardia in sepsis patients as compared to placebo. Methods: A total of 100 patients admitted to the Medical Intensive Care Unit (MICU) were recruited in this randomized controlled trial. A total of 50 patients were randomly allocated to either Group A (the Ivabradine group) or Group B (the control group). Heart rate (HR) was recorded for all patients at baseline, 12, 24, 48, 72, 96, and 120 hours. Mean arterial pressure (MAP), ejection fraction (EF), and change in Norepinephrine (NE) dosage were recorded at baseline and post-intervention (120 hours). A mortality rate was recorded for both groups. Results: The patients had a mean age of 32.49 + 16.22 years. There were 56 males and 44 females in the study. Epilepsy (n = 12, 12%) and tetanus (n = 11, 11%) were the most common primary diagnosis. Ventilator Associated Pneumonia (n = 60) was found to be the most common infection. Patients in Group A (23.2 + 11.02 beats per minute) had a significantly greater heart rate reduction at 120 hours in mean heart rate as compared to Group B patients (8.92 + 30.46 beats per minute, p = 0.002). The increase in mean MAP for Group A (1.68 + 2.44 mm Hg) was also significantly greater than that for Group B (0.54 + 2.46 mm Hg, p = 0.022). There was no difference in the mean change in NE dosage between Groups A (0.63 + 0.25 units/minute) and B (-0.34 + 0.36 units/minute, p = 0.106). A significantly greater increase in EF was found for Group A (1.16 + 1.5%), in comparison to Group B (0.30 + 1.69 %, p = 0.009). There were 22 (44%) deaths reported in Group A as compared to 24 (48%, p = 0.688) in Group B. Conclusion:Ivabradine has a significantly greater effect on controlling heart rate as compared to placebo in sepsis patients. The use of Ivabradine should be included in clinical guidelines for managing sepsis patients in ICU settings. Doi: 10.28991/SciMedJ-2023-05-01-04 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44687170","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 : 2023-03-01DOI: 10.28991/scimedj-2023-05-01-03
C. O. Attamah, Ugochukwu C. Ezeibe, D. J. Okoronkwo
The study ascertained the production practices of small-scale broiler farmers in Aguata Local Government Area of Anambra State, Nigeria. A multistage sampling procedure was adopted for the random selection of 80 farmers using a structured interview schedule. The data were analysed using descriptive statistics. The result reveals that 87.5% of the farmers adopted a deep litter housing system, and 98.75% ensured their poultry houses were sited in well-drained soil and properly ventilated pens. About 93% and 98% of the farmers had brooding and finishing houses separately on their farms and ensured adequate lighting and heat in their brooding houses, respectively. The result shows that 100% and 93.75% of the respondents administered antibiotics and multivitamins at the early stage of day-old chicks and adhered to the Gumboro and Lasota vaccine schedules, respectively, while only 1.25% of the farmers provided a footbath at the entry of their poultry house. All the farmers used broiler starters and finishers in feeding their birds, and the mean weekly duration of broiler starter and finisher feeding was 4.09 and 4.28 weeks, respectively, while 98.75% ensured to always provide water for their birds. The study concluded that the use of recommended production practices was high to some extent among farmers. Hence, the level of information on broiler production practices should be increased by the government extension service unit to enable farmers to keep abreast of current and necessary information on broiler production. Doi: 10.28991/SciMedJ-2023-05-01-03 Full Text: PDF
{"title":"Exploring Small-Scale Broiler Farming Practices and Vaccine Adherence: A Study in Aguata, Nigeria","authors":"C. O. Attamah, Ugochukwu C. Ezeibe, D. J. Okoronkwo","doi":"10.28991/scimedj-2023-05-01-03","DOIUrl":"https://doi.org/10.28991/scimedj-2023-05-01-03","url":null,"abstract":"The study ascertained the production practices of small-scale broiler farmers in Aguata Local Government Area of Anambra State, Nigeria. A multistage sampling procedure was adopted for the random selection of 80 farmers using a structured interview schedule. The data were analysed using descriptive statistics. The result reveals that 87.5% of the farmers adopted a deep litter housing system, and 98.75% ensured their poultry houses were sited in well-drained soil and properly ventilated pens. About 93% and 98% of the farmers had brooding and finishing houses separately on their farms and ensured adequate lighting and heat in their brooding houses, respectively. The result shows that 100% and 93.75% of the respondents administered antibiotics and multivitamins at the early stage of day-old chicks and adhered to the Gumboro and Lasota vaccine schedules, respectively, while only 1.25% of the farmers provided a footbath at the entry of their poultry house. All the farmers used broiler starters and finishers in feeding their birds, and the mean weekly duration of broiler starter and finisher feeding was 4.09 and 4.28 weeks, respectively, while 98.75% ensured to always provide water for their birds. The study concluded that the use of recommended production practices was high to some extent among farmers. Hence, the level of information on broiler production practices should be increased by the government extension service unit to enable farmers to keep abreast of current and necessary information on broiler production. Doi: 10.28991/SciMedJ-2023-05-01-03 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45482574","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 : 2023-03-01DOI: 10.28991/scimedj-2023-05-01-05
F. C. Makhandule, M. M. Z. U. Bhuiyan, K. N. Mongwe
Background: Intestinal Non-Hodgkin lymphoma is an uncommon cause of acute abdominal pain. The main objective of the present case report is to share our experience with Diffuse Large B Cell Non-Hodgkin Lymphoma with spontaneous bowel perforation in a setting of HIV. Method: Description of a Case Report Diffuse Large B-Cell Non-Hodgkin Lymphoma with a spontaneous bowel perforation: A 39-year-old female patient presented with a one-day history of acute abdomen. She is known retroviral disease reactive with CD4 count 534, Viral Load 131 on Antiretroviral Treatment-Fixed Dose Regimen duration of more than 5 years and was being treated for Peptic Ulcer Disease. Chest X-ray: showed pneumoperitoneum consistent with a perforation. A Laparotomy was performed and found a perforated Jejunum leaking small bowel contents. Resection and primary anastomosis were performed, and washout was done. Post-Operative condition was uneventful, and she was discharged four days after the operation. The resected portion was sent for histology, which showed perforation of the Jejunum secondary to a Diffuse Large B Cell Non-Hodgkin Lymphoma. Conclusion: The diagnosis of Intestinal Lymphoma poses a diagnostic challenge for both developed and developing countries; however, coupling the risk factors with signs and symptoms can assist one in making a diagnosis. It is therefore important to always have a high index of suspicion, particularly for HIV patients with lymphadenopathy. Doi: 10.28991/SciMedJ-2023-05-01-05 Full Text: PDF
{"title":"Case Report on Diffuse Large B-Cell Non-Hodgkin Lymphoma with a Spontaneous Bowel Perforation","authors":"F. C. Makhandule, M. M. Z. U. Bhuiyan, K. N. Mongwe","doi":"10.28991/scimedj-2023-05-01-05","DOIUrl":"https://doi.org/10.28991/scimedj-2023-05-01-05","url":null,"abstract":"Background: Intestinal Non-Hodgkin lymphoma is an uncommon cause of acute abdominal pain. The main objective of the present case report is to share our experience with Diffuse Large B Cell Non-Hodgkin Lymphoma with spontaneous bowel perforation in a setting of HIV. Method: Description of a Case Report Diffuse Large B-Cell Non-Hodgkin Lymphoma with a spontaneous bowel perforation: A 39-year-old female patient presented with a one-day history of acute abdomen. She is known retroviral disease reactive with CD4 count 534, Viral Load 131 on Antiretroviral Treatment-Fixed Dose Regimen duration of more than 5 years and was being treated for Peptic Ulcer Disease. Chest X-ray: showed pneumoperitoneum consistent with a perforation. A Laparotomy was performed and found a perforated Jejunum leaking small bowel contents. Resection and primary anastomosis were performed, and washout was done. Post-Operative condition was uneventful, and she was discharged four days after the operation. The resected portion was sent for histology, which showed perforation of the Jejunum secondary to a Diffuse Large B Cell Non-Hodgkin Lymphoma. Conclusion: The diagnosis of Intestinal Lymphoma poses a diagnostic challenge for both developed and developing countries; however, coupling the risk factors with signs and symptoms can assist one in making a diagnosis. It is therefore important to always have a high index of suspicion, particularly for HIV patients with lymphadenopathy. Doi: 10.28991/SciMedJ-2023-05-01-05 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135532519","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 : 2023-03-01DOI: 10.28991/scimedj-2023-05-01-02
K. Mensah, V. O. Ofori, C. Nkansah, S. K. Appiah, D. Sackey, Vincent Kawuribi, S. Bani, H. A. Osumanu, Selina Mintaah, Helen Owusu-Asante, Gabriel Abbam, Nicholas Klevor, Felix O-Boakye, Samira Daud, C. Derigubah
Blood cell abnormalities may occur among COVID-19 patients and could be detrimental during the disease’s progression. This study assessed complete blood count (CBC) parameters and determined abnormal changes in the peripheral blood of COVID-19 patients receiving care at Komfo Anokye Teaching Hospital (KATH), Ghana. This hospital-based descriptive cross-sectional study conducted at KATH, Kumasi, Ghana, recruited seventy-three (73) RT-PCR-confirmed COVID-19 participants. Venous blood was taken from participants into EDTA tubes and used for CBC analyses and the preparation of a thin blood film for blood cell morphological examination. Data obtained were analyzed with SPSS version 22.0, and p< 0.05 was considered statistically significant. Females were predominant (45/61.6) and had a higher COVID-19 cycle threshold (CT) value than males (p=0.027). The overall prevalence of anaemia among the study participants was 56.2% (65.5% in males and 50% in females). Geriatrics (>70 years old) had relatively lower Hb compared to other age groups in the study. Erythrocytopaenia (18/73), leucocytosis (28/73), lymphopaenia (9/73), and thrombocytopaenia (21/73) were common among the COVID-19 participants. Red cell morphological abnormalities were seen in the study participants: echinocytes (11/73), elliptocytes (6/73), stomatocytes (1/73), acanthocytes (4/73), pencil-shaped cells (5/73), schistocytes (15/73), ovalocytes (2/73) and target cells (1/73). Moreover, the acanthocytes were significantly higher in males compared to females (4 vs. 0, p=0.019). Again, reactive lymphocytes (8/73), neutrophil toxic granulation (18/73), neutrophil cytoplasmic vacuolation (42/73), smear cells (8/73), and one each of atypical lymphocyte and Dohle body were present among the COVID-19 participants. The COVID-19 CT value was lower among male participants. The overall prevalence of anaemia among COVID-19 participants was high, with males and the aged (>70 years) predominantly affected. COVID-19 patients have abnormal blood cell counts and significant morphological abnormalities in peripheral blood. Early detection of haematological abnormalities would be beneficial in the management of COVID-19 patients. Further study to assess the haematopoietic activities of COVID-19 patients is recommended. Doi: 10.28991/SciMedJ-2023-05-01-02 Full Text: PDF
{"title":"Blood Cell Indices and Morphological Abnormalities Detected Among COVID-19 Patients Receiving Care","authors":"K. Mensah, V. O. Ofori, C. Nkansah, S. K. Appiah, D. Sackey, Vincent Kawuribi, S. Bani, H. A. Osumanu, Selina Mintaah, Helen Owusu-Asante, Gabriel Abbam, Nicholas Klevor, Felix O-Boakye, Samira Daud, C. Derigubah","doi":"10.28991/scimedj-2023-05-01-02","DOIUrl":"https://doi.org/10.28991/scimedj-2023-05-01-02","url":null,"abstract":"Blood cell abnormalities may occur among COVID-19 patients and could be detrimental during the disease’s progression. This study assessed complete blood count (CBC) parameters and determined abnormal changes in the peripheral blood of COVID-19 patients receiving care at Komfo Anokye Teaching Hospital (KATH), Ghana. This hospital-based descriptive cross-sectional study conducted at KATH, Kumasi, Ghana, recruited seventy-three (73) RT-PCR-confirmed COVID-19 participants. Venous blood was taken from participants into EDTA tubes and used for CBC analyses and the preparation of a thin blood film for blood cell morphological examination. Data obtained were analyzed with SPSS version 22.0, and p< 0.05 was considered statistically significant. Females were predominant (45/61.6) and had a higher COVID-19 cycle threshold (CT) value than males (p=0.027). The overall prevalence of anaemia among the study participants was 56.2% (65.5% in males and 50% in females). Geriatrics (>70 years old) had relatively lower Hb compared to other age groups in the study. Erythrocytopaenia (18/73), leucocytosis (28/73), lymphopaenia (9/73), and thrombocytopaenia (21/73) were common among the COVID-19 participants. Red cell morphological abnormalities were seen in the study participants: echinocytes (11/73), elliptocytes (6/73), stomatocytes (1/73), acanthocytes (4/73), pencil-shaped cells (5/73), schistocytes (15/73), ovalocytes (2/73) and target cells (1/73). Moreover, the acanthocytes were significantly higher in males compared to females (4 vs. 0, p=0.019). Again, reactive lymphocytes (8/73), neutrophil toxic granulation (18/73), neutrophil cytoplasmic vacuolation (42/73), smear cells (8/73), and one each of atypical lymphocyte and Dohle body were present among the COVID-19 participants. The COVID-19 CT value was lower among male participants. The overall prevalence of anaemia among COVID-19 participants was high, with males and the aged (>70 years) predominantly affected. COVID-19 patients have abnormal blood cell counts and significant morphological abnormalities in peripheral blood. Early detection of haematological abnormalities would be beneficial in the management of COVID-19 patients. Further study to assess the haematopoietic activities of COVID-19 patients is recommended. Doi: 10.28991/SciMedJ-2023-05-01-02 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43865326","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}