Pub Date : 2022-06-01DOI: 10.28991/scimedj-2022-04-02-04
Richard M. Gitimu, S. Waithaka, J. Gikunju, E. Njagi
Reference interval limits for cancer biomarkers in geriatrics are rare because priority is given to the development of reference interval limits for those in the age range of 18–60 years, which are normally used for clinical trials study. The aim of this study was therefore to develop gender and age-specific reference interval limits for cancer markers CA19-9, CEA, CA 15-3, CA 125, and PSA for adults and geriatrics in Taita-Taveta County, Kenya, using the CLSI CA28-A3 guideline. This prospective cross-sectional study involved 244 healthy referents, including 124 females and 120 males of ages 50–95, between May 2015 and December 2017 at the Department of Clinical Chemistry of Moi Subcounty Hospital, Voi, Kenya. Serum CA 19-9, CEA, CA 15-3, CA 125, and PSA of the 244 referents were measured using a well-calibrated, quality controlled Clinical Chemistry AutoAnalyzer. Gender differences in the measured values of the biomarkers were assessed using the Mann-Whitney U test, while age differences were assessed using the Kruskal-Wallis H test followed by the Mann-Whitney U test with an adjusted significant ρ-value of less than 0.0167. Reference interval limits for the measured cancer biomarkers were expressed in terms of medians and ranged between 2.5 and 97.5 percentiles. The established 95% reference interval limits were: 0-58 U/mL males and 0-42.8 U/mL females for CA 19–9, 0–7 ng/mL for CEA, 0-56.9 U/mL for CA 15–3, 0–25 ng/mL for CA 125, and 0–6.8 ng/mL for PSA. Gender-related biomarker values were developed for CA 19-9 adults and geriatrics (60–70 years), CEA for geriatrics (60–70 years), and CA 15-3 for adults. Age-related biomarker values were developed for CA 19–9 males and not for females. In conclusion, gender-related 95% reference interval limits were developed for CA 19-9, CEA, CA 15-3, CA 125, and PSA, and age-related 95% reference interval limits were established for CA 19-9. CA 19-9 decreased from adulthood to the early elderly and increased in the more elderly population. These developed reference interval limits for these biomarkers, which differed from those reported in previous literature, could be adopted for use in Taita-Taveta County, Kenya, for better medical care. Doi: 10.28991/SciMedJ-2022-04-02-04 Full Text: PDF
{"title":"CLSI Guided Reference Interval Limits for Cancer Biomarkers for Adults and Geriatrics","authors":"Richard M. Gitimu, S. Waithaka, J. Gikunju, E. Njagi","doi":"10.28991/scimedj-2022-04-02-04","DOIUrl":"https://doi.org/10.28991/scimedj-2022-04-02-04","url":null,"abstract":"Reference interval limits for cancer biomarkers in geriatrics are rare because priority is given to the development of reference interval limits for those in the age range of 18–60 years, which are normally used for clinical trials study. The aim of this study was therefore to develop gender and age-specific reference interval limits for cancer markers CA19-9, CEA, CA 15-3, CA 125, and PSA for adults and geriatrics in Taita-Taveta County, Kenya, using the CLSI CA28-A3 guideline. This prospective cross-sectional study involved 244 healthy referents, including 124 females and 120 males of ages 50–95, between May 2015 and December 2017 at the Department of Clinical Chemistry of Moi Subcounty Hospital, Voi, Kenya. Serum CA 19-9, CEA, CA 15-3, CA 125, and PSA of the 244 referents were measured using a well-calibrated, quality controlled Clinical Chemistry AutoAnalyzer. Gender differences in the measured values of the biomarkers were assessed using the Mann-Whitney U test, while age differences were assessed using the Kruskal-Wallis H test followed by the Mann-Whitney U test with an adjusted significant ρ-value of less than 0.0167. Reference interval limits for the measured cancer biomarkers were expressed in terms of medians and ranged between 2.5 and 97.5 percentiles. The established 95% reference interval limits were: 0-58 U/mL males and 0-42.8 U/mL females for CA 19–9, 0–7 ng/mL for CEA, 0-56.9 U/mL for CA 15–3, 0–25 ng/mL for CA 125, and 0–6.8 ng/mL for PSA. Gender-related biomarker values were developed for CA 19-9 adults and geriatrics (60–70 years), CEA for geriatrics (60–70 years), and CA 15-3 for adults. Age-related biomarker values were developed for CA 19–9 males and not for females. In conclusion, gender-related 95% reference interval limits were developed for CA 19-9, CEA, CA 15-3, CA 125, and PSA, and age-related 95% reference interval limits were established for CA 19-9. CA 19-9 decreased from adulthood to the early elderly and increased in the more elderly population. These developed reference interval limits for these biomarkers, which differed from those reported in previous literature, could be adopted for use in Taita-Taveta County, Kenya, for better medical care. Doi: 10.28991/SciMedJ-2022-04-02-04 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46361294","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 : 2022-06-01DOI: 10.28991/scimedj-2022-04-02-02
S. K. Appiah, C. Nkansah, Kofi A Mensah, Felix Osei-Boakye, D. Serwaa, S. Bani, Gabriel Abbam, Samira Daud, Mandeiya D. A. Yakubu, Abraham B. Sagoe, C. Derigubah, Yeduah Quansah, Vincent Kawuribi
Background: The ABO blood antigens may influence the levels of vWF: Ag and put individuals at risk of coagulopathies. This study assessed the plasma vWF: Ag and its relation with ABO blood antigens among healthy adults in northern Ghana. Methods: This cross-sectional study recruited 84 blood donors, aged 18–50 years, at Tamale Teaching Hospital. Blood groups were determined using the standard tube method, and a complete blood count was measured with an automated haematology analyzer. Sandwich ELISA was used to assess plasma vWF: Ag levels. The data obtained were analyzed using SPSS version 22. Results: The frequencies of O, A, B, and AB blood groups were 34 (40.5%), 25 (29.8%), 20 (23.8%), and 5 (6.0%), respectively. vWF: Ag levels were higher among the non-O than group O individuals (p = 0.008). Plasma vWF: Ag levels were lower in group O compared to AB (p = 0.015) and A (p = 0.013) individuals. Males had higher vWF: Ag levels than females (p = 0.002). A moderately positive correlation was observed between age and vWF levels (r = 0.497, p<0.001). Blood group O participants had lower absolute neutrophil counts (p = 0.039), but higher RDW-SD (p = 0.045). Conclusion: The predominant blood group was O, followed by other groups in the order: O>A>B>AB. Plasma vWF: Ag levels were higher in non-group O compared with group O individuals. Males had higher vWF: Ag levels, and a positive correlation between age and vWF: Ag was observed. Again, blood group O participants had lower neutrophil counts, but higher RDW-SD. The relationship between ABO blood phenotypes and plasma vWF: Ag should be considered in clinical practice. The establishment of separate reference intervals of vWF: Ag for the various phenotypes of ABO is recommended. Also, the study recommends further multicenter studies to assess the link between ABO phenotypes and all the endothelial cell parameters. Doi: 10.28991/SciMedJ-2022-04-02-02 Full Text: PDF
{"title":"Plasma von Willebrand Factor Antigen Levels and Its Relation with ABO Blood Group, Age and Sex","authors":"S. K. Appiah, C. Nkansah, Kofi A Mensah, Felix Osei-Boakye, D. Serwaa, S. Bani, Gabriel Abbam, Samira Daud, Mandeiya D. A. Yakubu, Abraham B. Sagoe, C. Derigubah, Yeduah Quansah, Vincent Kawuribi","doi":"10.28991/scimedj-2022-04-02-02","DOIUrl":"https://doi.org/10.28991/scimedj-2022-04-02-02","url":null,"abstract":"Background: The ABO blood antigens may influence the levels of vWF: Ag and put individuals at risk of coagulopathies. This study assessed the plasma vWF: Ag and its relation with ABO blood antigens among healthy adults in northern Ghana. Methods: This cross-sectional study recruited 84 blood donors, aged 18–50 years, at Tamale Teaching Hospital. Blood groups were determined using the standard tube method, and a complete blood count was measured with an automated haematology analyzer. Sandwich ELISA was used to assess plasma vWF: Ag levels. The data obtained were analyzed using SPSS version 22. Results: The frequencies of O, A, B, and AB blood groups were 34 (40.5%), 25 (29.8%), 20 (23.8%), and 5 (6.0%), respectively. vWF: Ag levels were higher among the non-O than group O individuals (p = 0.008). Plasma vWF: Ag levels were lower in group O compared to AB (p = 0.015) and A (p = 0.013) individuals. Males had higher vWF: Ag levels than females (p = 0.002). A moderately positive correlation was observed between age and vWF levels (r = 0.497, p<0.001). Blood group O participants had lower absolute neutrophil counts (p = 0.039), but higher RDW-SD (p = 0.045). Conclusion: The predominant blood group was O, followed by other groups in the order: O>A>B>AB. Plasma vWF: Ag levels were higher in non-group O compared with group O individuals. Males had higher vWF: Ag levels, and a positive correlation between age and vWF: Ag was observed. Again, blood group O participants had lower neutrophil counts, but higher RDW-SD. The relationship between ABO blood phenotypes and plasma vWF: Ag should be considered in clinical practice. The establishment of separate reference intervals of vWF: Ag for the various phenotypes of ABO is recommended. Also, the study recommends further multicenter studies to assess the link between ABO phenotypes and all the endothelial cell parameters. Doi: 10.28991/SciMedJ-2022-04-02-02 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48785457","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 : 2022-06-01DOI: 10.28991/scimedj-2022-04-02-05
Phocas Havugimana, R. Ndahimana, F. Babane, E. Umutesi, P. Ntihinyurwa, Diane Mushimiyimana, F. Masaisa, E. Ntabanganyimana
Background: Admitted patients with anemia are at increased morbidity and mortality risk, as well as length of hospital stay. It affects more than 2 billion people worldwide and is causing significant morbidity and mortality. Its etiology is variable, with many predisposing factors including nutritional deficiencies, infections, malignancies, chronic inflammations, and other chronic diseases like autoimmune diseases, chronic liver disease, and chronic kidney disease. Methods: We performed a non-randomized, prospective observational study of 143 patients admitted to internal medicine between March and April 2021 and assessed their hemoglobin level in order to determine the prevalence of anemia. The demographic and clinical data were collected using a specially designed questionnaire. All patients found to have anemia were followed for outcome assessment (either discharge or death). Results: The prevalence of anemia was high (52.4%) among the 143 admitted patients in internal medicine at CHUK. Patients with HIV, cancer, and chronic kidney disease had a 5.84-, 4.11-, and 3.79-times higher risk of having anemia, respectively. In 75 patients who had anemia, 10 patients died; among them, 5 patients had severe anemia; 25 patients were 60 years old and above; 60 patients had normocytic anemia, and they had an average length of hospital stay of 20.6 days; for patients with severe anemia, the length of hospital stay was 28 days. Conclusion: This study demonstrated a high prevalence of anemia, which is associated with a high mortality rate among admitted patients in CHUK. Priority should be given to preventive medicine, optimal management of chronic disease, and geriatric medicine. Doi: 10.28991/SciMedJ-2022-04-02-05 Full Text: PDF
{"title":"A Prospective Observational Study on Prevalence of Anemia, Associated Risk Factors and Outcome","authors":"Phocas Havugimana, R. Ndahimana, F. Babane, E. Umutesi, P. Ntihinyurwa, Diane Mushimiyimana, F. Masaisa, E. Ntabanganyimana","doi":"10.28991/scimedj-2022-04-02-05","DOIUrl":"https://doi.org/10.28991/scimedj-2022-04-02-05","url":null,"abstract":"Background: Admitted patients with anemia are at increased morbidity and mortality risk, as well as length of hospital stay. It affects more than 2 billion people worldwide and is causing significant morbidity and mortality. Its etiology is variable, with many predisposing factors including nutritional deficiencies, infections, malignancies, chronic inflammations, and other chronic diseases like autoimmune diseases, chronic liver disease, and chronic kidney disease. Methods: We performed a non-randomized, prospective observational study of 143 patients admitted to internal medicine between March and April 2021 and assessed their hemoglobin level in order to determine the prevalence of anemia. The demographic and clinical data were collected using a specially designed questionnaire. All patients found to have anemia were followed for outcome assessment (either discharge or death). Results: The prevalence of anemia was high (52.4%) among the 143 admitted patients in internal medicine at CHUK. Patients with HIV, cancer, and chronic kidney disease had a 5.84-, 4.11-, and 3.79-times higher risk of having anemia, respectively. In 75 patients who had anemia, 10 patients died; among them, 5 patients had severe anemia; 25 patients were 60 years old and above; 60 patients had normocytic anemia, and they had an average length of hospital stay of 20.6 days; for patients with severe anemia, the length of hospital stay was 28 days. Conclusion: This study demonstrated a high prevalence of anemia, which is associated with a high mortality rate among admitted patients in CHUK. Priority should be given to preventive medicine, optimal management of chronic disease, and geriatric medicine. Doi: 10.28991/SciMedJ-2022-04-02-05 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41377772","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 : 2022-03-01DOI: 10.28991/scimedj-2022-0401-03
Dalia Essam Eissa, E. Rashed, M. Eissa
The recent Human Coronavirus 2019 (hCoV-19) pandemic has devastated the whole world and impacted all aspects of human life. One of the most comprehensively recorded data for this outbreak is the daily morbidities and mortalities record. The analysis of this dataset would provide insight into the pattern and progression of this disease. The present study focused on the quantitative investigation and descriptive statistical examination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as part of a series of evaluations for this epidemic in the primarily affected geopolitical regions. The year 2021 is worse than 2020 in terms of the recorded daily newly emerging cases and deaths, and there are no signs that there would be an improvement in 2022, as could be estimated from early warning signs, even if there could be an apparent decline in the outbreak waves. India is one of the major countries that have been adversely affected by this global pandemic. The present study addressed this nation as a detailed record of COVID-19 cases and deaths extracted from a chronologically arranged dataset for the newly emerged cases and deaths on a daily basis. Cumulative counts were calculated and logarithmically transformed. Two significant peaks - embracing multiple waves - were observed with tailing for morbidity and mortality, which were highly correlated. There were no signs of a recession in the outbreak census. However, relative calm periods between waves might be detected. There were rising trends in morbidities and mortalities with a clustering tendency upon examination of the run charts. The Morgan-Morgan-Finney (MMF) model was found to demonstrate the best-fitting non-linear curve for the transformed cumulative database. Derivatization of the model equation demonstrated a factor that could be used in the assessment of the outbreak effect numerically to show influence on the impacted population. Doi: 10.28991/SciMedJ-2022-0401-03 Full Text: PDF
{"title":"A Study of Morbidity and Mortality from COVID-19 in India","authors":"Dalia Essam Eissa, E. Rashed, M. Eissa","doi":"10.28991/scimedj-2022-0401-03","DOIUrl":"https://doi.org/10.28991/scimedj-2022-0401-03","url":null,"abstract":"The recent Human Coronavirus 2019 (hCoV-19) pandemic has devastated the whole world and impacted all aspects of human life. One of the most comprehensively recorded data for this outbreak is the daily morbidities and mortalities record. The analysis of this dataset would provide insight into the pattern and progression of this disease. The present study focused on the quantitative investigation and descriptive statistical examination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as part of a series of evaluations for this epidemic in the primarily affected geopolitical regions. The year 2021 is worse than 2020 in terms of the recorded daily newly emerging cases and deaths, and there are no signs that there would be an improvement in 2022, as could be estimated from early warning signs, even if there could be an apparent decline in the outbreak waves. India is one of the major countries that have been adversely affected by this global pandemic. The present study addressed this nation as a detailed record of COVID-19 cases and deaths extracted from a chronologically arranged dataset for the newly emerged cases and deaths on a daily basis. Cumulative counts were calculated and logarithmically transformed. Two significant peaks - embracing multiple waves - were observed with tailing for morbidity and mortality, which were highly correlated. There were no signs of a recession in the outbreak census. However, relative calm periods between waves might be detected. There were rising trends in morbidities and mortalities with a clustering tendency upon examination of the run charts. The Morgan-Morgan-Finney (MMF) model was found to demonstrate the best-fitting non-linear curve for the transformed cumulative database. Derivatization of the model equation demonstrated a factor that could be used in the assessment of the outbreak effect numerically to show influence on the impacted population. Doi: 10.28991/SciMedJ-2022-0401-03 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41983936","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 : 2022-03-01DOI: 10.28991/scimedj-2022-0401-4
J. Garai, P. Kertai
If a liquid contains suspended solids and flows out of a perforated pipe, the suspended particles of the right size can accumulate and eventually clog the openings. It is suggested that this physical process could be employed to effectively block the openings of the intercellular gaps in angiogenic capillaries supplying cancer tissues. Clogging the big openings supplying cancer tissues would reduce the nutrition supply, resulting in deprivation. This process predictively could slow down the tumor progression. If the proposed physical process is effective, then societies that drink water containing colloidal-size particles should have fewer occurrences of cancer. Epidemiological data is consistent with this prediction and shows an inverse correlation between the total dissolved solid concentrations in drinking water and the incidence of cancer. The effectiveness of the proposed physical process was tested in a pilot project on six rats. Four of them had suspended kaolinite minerals in the drinking water, and two of them got regular tap water. All the treated rats developed smaller tumors than the untreated control group of two. The average weight of the developed tumors was 42 percent less in the treated group. Doi: 10.28991/SciMedJ-2022-0401-4 Full Text: PDF
{"title":"Simple Physical Process Can Slow Down the Progression of Cancer","authors":"J. Garai, P. Kertai","doi":"10.28991/scimedj-2022-0401-4","DOIUrl":"https://doi.org/10.28991/scimedj-2022-0401-4","url":null,"abstract":"If a liquid contains suspended solids and flows out of a perforated pipe, the suspended particles of the right size can accumulate and eventually clog the openings. It is suggested that this physical process could be employed to effectively block the openings of the intercellular gaps in angiogenic capillaries supplying cancer tissues. Clogging the big openings supplying cancer tissues would reduce the nutrition supply, resulting in deprivation. This process predictively could slow down the tumor progression. If the proposed physical process is effective, then societies that drink water containing colloidal-size particles should have fewer occurrences of cancer. Epidemiological data is consistent with this prediction and shows an inverse correlation between the total dissolved solid concentrations in drinking water and the incidence of cancer. The effectiveness of the proposed physical process was tested in a pilot project on six rats. Four of them had suspended kaolinite minerals in the drinking water, and two of them got regular tap water. All the treated rats developed smaller tumors than the untreated control group of two. The average weight of the developed tumors was 42 percent less in the treated group. Doi: 10.28991/SciMedJ-2022-0401-4 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41418458","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 : 2022-03-01DOI: 10.28991/scimedj-2022-0401-1
Felix Osei-Boakye, Y. Wiafe, C. Nkansah, D. Serwaa, Abdul-Razak Saasi, Abdul Ganiwu, Ruth Duku-Takyi, Patrick Adu, C. Derigubah, S. K. Appiah, K. Mensah, Linda N. Antwi, R. Duneeh, O. Addai-Mensah
Introduction: The burden of hernia is disproportionately high in low-to-middle-income countries, due to the lack of fundamental resources needed to effectively diagnose and manage cases. The patterns of hernia, the haematological profile, and the predictive ability of blood cell indices were all investigated in this study. Methods: Fifty-four subjects: 27 hernia patients and 27 healthy controls were included in this single-centre, unmatched case-control study. Hernia was diagnosed using physical examination and ultrasound scan. Haematological indices of each subject were measured with an automated blood cell counter. Results: Herniae recorded were 92.59% inguinal, and 3.27% each epigastric and uterine prolapse. Hernia was prevalent in males (85.2%, p=0.008) and older subjects ≥53 years (48.1%, p=0.004). HgB (p=0.006), MCHC (p≤0.001), and RDW-CV (p=0.042) levels were significantly elevated in strangulated than non-strangulated hernia and controls respectively, while Abs GRAN (p=0.024) was decreased in non-strangulated than strangulated hernia and control groups respectively. MCHC (AUC=0.947 [0.895-0.999], p≤0.001) was the most sensitive predictor for herniation followed by age (AUC=0.750 [0.610-0.889], p=0.002); HgB (AUC=0.718 [0.580-0.857], p=0.006); and RDW-CV (AUC=0.700 [0.559-0.840], p=0.012). Also, MCHC (AUC=0.831 [0.723-0.938], p≤0.001); HgB (AUC=0.738 [0.590-0.887], p=0.005); and RBC (AUC=0.671 [0.502-0.840], p=0.045) respectively, were significant predictors of strangulation. Conclusion: Gender and age were significantly associated with hernias. Inguinal hernia and strangulation were common in the study setting, especially, among males. Also, there were significant variations in erythrocyte- and leucocyte indices across the groups, but not platelets. Erythrocyte indices were significant predictive biomarkers for hernia and strangulation. The CBC is a useful test for the early detection of herniation and strangulation. Doi: 10.28991/SciMedJ-2022-0401-1 Full Text: PDF
{"title":"Haematological Profile in Pre-Surgery Hernia Patients: A Case-Control Study in Ghana","authors":"Felix Osei-Boakye, Y. Wiafe, C. Nkansah, D. Serwaa, Abdul-Razak Saasi, Abdul Ganiwu, Ruth Duku-Takyi, Patrick Adu, C. Derigubah, S. K. Appiah, K. Mensah, Linda N. Antwi, R. Duneeh, O. Addai-Mensah","doi":"10.28991/scimedj-2022-0401-1","DOIUrl":"https://doi.org/10.28991/scimedj-2022-0401-1","url":null,"abstract":"Introduction: The burden of hernia is disproportionately high in low-to-middle-income countries, due to the lack of fundamental resources needed to effectively diagnose and manage cases. The patterns of hernia, the haematological profile, and the predictive ability of blood cell indices were all investigated in this study. Methods: Fifty-four subjects: 27 hernia patients and 27 healthy controls were included in this single-centre, unmatched case-control study. Hernia was diagnosed using physical examination and ultrasound scan. Haematological indices of each subject were measured with an automated blood cell counter. Results: Herniae recorded were 92.59% inguinal, and 3.27% each epigastric and uterine prolapse. Hernia was prevalent in males (85.2%, p=0.008) and older subjects ≥53 years (48.1%, p=0.004). HgB (p=0.006), MCHC (p≤0.001), and RDW-CV (p=0.042) levels were significantly elevated in strangulated than non-strangulated hernia and controls respectively, while Abs GRAN (p=0.024) was decreased in non-strangulated than strangulated hernia and control groups respectively. MCHC (AUC=0.947 [0.895-0.999], p≤0.001) was the most sensitive predictor for herniation followed by age (AUC=0.750 [0.610-0.889], p=0.002); HgB (AUC=0.718 [0.580-0.857], p=0.006); and RDW-CV (AUC=0.700 [0.559-0.840], p=0.012). Also, MCHC (AUC=0.831 [0.723-0.938], p≤0.001); HgB (AUC=0.738 [0.590-0.887], p=0.005); and RBC (AUC=0.671 [0.502-0.840], p=0.045) respectively, were significant predictors of strangulation. Conclusion: Gender and age were significantly associated with hernias. Inguinal hernia and strangulation were common in the study setting, especially, among males. Also, there were significant variations in erythrocyte- and leucocyte indices across the groups, but not platelets. Erythrocyte indices were significant predictive biomarkers for hernia and strangulation. The CBC is a useful test for the early detection of herniation and strangulation. Doi: 10.28991/SciMedJ-2022-0401-1 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69322342","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 : 2022-03-01DOI: 10.28991/scimedj-2022-0401-5
Emile Abimana, E. Ntabanganyimana, R. Ndahimana, Appolinaire Bizimana, E. Umutesi, R. O. Sebatunzi, F. Masaisa
Background: Venous thromboembolism (VTE) is a common and preventable disease among non-surgical hospitalized patients. Its incidence is high and alarming. Acute medical patients have VTE risk during and after hospitalization. The Padua prediction score is a risk model created to identify high VTE risk patients among non-surgical hospitalized patients. Methods: We performed a cross-sectional survey of 107 patients admitted to Internal Medicine wards who were assessed as acutely ill patients at Emergency Department, in a period of 4 weeks. The demographic and clinical data were collected using a designed questionnaire. VTE risk was defined as having a Padua Prediction score of ≥4 points. A statistical analysis was done to determine prevalence. The patients at high VTE risk received thromboprophylaxis. Results: One hundred and seven eligible patients were included. 84% were found to be at high risk for VTE. Among physiologically unstable patients, 60% of the patients were classified in red color during the time of triage; this means they were severely sick and needed resuscitation. Among the leading diagnosis, severe pneumonia was predominant (29%). Severe pneumonia and uncontrolled DM showed a significant association with high VTE risk. 11.1% of high VTE risk patients were taking anticoagulant thromboprophylaxis prior to the recruitment. Conclusion:This study demonstrated a high prevalence of VTE risk among acute ill medical patients and underuse of anticoagulants for thromboprophylaxis in potential patients at Kigali University Teaching Hospital, CHUK. The Padua prediction score should be implemented for early detection of patients at-risk of VTE in severely ill patients and to start anticoagulant thromboprophylaxis on time for reducing mortality and morbidity. Doi: 10.28991/SciMedJ-2022-0401-5 Full Text: PDF
{"title":"A Cross-sectional Study of the Assessment of Venous Thromboembolism Risk and Use of Anticoagulant Thromboprophylaxis","authors":"Emile Abimana, E. Ntabanganyimana, R. Ndahimana, Appolinaire Bizimana, E. Umutesi, R. O. Sebatunzi, F. Masaisa","doi":"10.28991/scimedj-2022-0401-5","DOIUrl":"https://doi.org/10.28991/scimedj-2022-0401-5","url":null,"abstract":"Background: Venous thromboembolism (VTE) is a common and preventable disease among non-surgical hospitalized patients. Its incidence is high and alarming. Acute medical patients have VTE risk during and after hospitalization. The Padua prediction score is a risk model created to identify high VTE risk patients among non-surgical hospitalized patients. Methods: We performed a cross-sectional survey of 107 patients admitted to Internal Medicine wards who were assessed as acutely ill patients at Emergency Department, in a period of 4 weeks. The demographic and clinical data were collected using a designed questionnaire. VTE risk was defined as having a Padua Prediction score of ≥4 points. A statistical analysis was done to determine prevalence. The patients at high VTE risk received thromboprophylaxis. Results: One hundred and seven eligible patients were included. 84% were found to be at high risk for VTE. Among physiologically unstable patients, 60% of the patients were classified in red color during the time of triage; this means they were severely sick and needed resuscitation. Among the leading diagnosis, severe pneumonia was predominant (29%). Severe pneumonia and uncontrolled DM showed a significant association with high VTE risk. 11.1% of high VTE risk patients were taking anticoagulant thromboprophylaxis prior to the recruitment. Conclusion:This study demonstrated a high prevalence of VTE risk among acute ill medical patients and underuse of anticoagulants for thromboprophylaxis in potential patients at Kigali University Teaching Hospital, CHUK. The Padua prediction score should be implemented for early detection of patients at-risk of VTE in severely ill patients and to start anticoagulant thromboprophylaxis on time for reducing mortality and morbidity. Doi: 10.28991/SciMedJ-2022-0401-5 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46021795","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 : 2022-03-01DOI: 10.28991/scimedj-2022-0401-02
N. Jain, Dnyaneshwar V Jadhav, Akash Chheda, S. Ravat, Rahil Ansari, M. Thakkar, R. Joshi, A. Sriram, Vrug Durge
Objective: Covid-19 is a highly infectious viral disease, and our understanding of the impact of this virus on the nervous system is limited. Therefore, we aimed to do a systematic analysis of the neurological manifestations. Methods: We retrospectively studied the clinical, laboratory, and radiological findings of patients with major neurological syndromes (MNS) in Covid-19 over 6 months. Results: We had 39 patients with major neurological syndromes (MNS). The most common MNS was cerebrovascular disease (CVD) (61.53%), in which ischemic stroke (83.33%), cortical sinus thrombosis (12.50%), and haemorrhagic stroke (4.16%) were seen. Among ischemic stroke patients, 50% had a large vessel occlusion, and 66.66% of patients with CVD had a significant residual disability. Cranial neuropathy (15.38%), GBS (10.26%), encephalitis (7.26%), and myelitis (5.12%) were the other MNS. Among the three encephalitis cases, two had CSF-Covid-19 PCR positivity and had severe manifestations and a poor outcome. Associated comorbidities included hypertension (30.76%), diabetes mellitus (12.82%), chronic kidney diseases (7.69%), and polycythaemia vera (2.56%). Lung involvement was seen in 64.1% of patients. Mortality was 17.94% in MNS with Covid-19. Conclusions: The most common major neurological syndrome associated with Covid-19 is CVD with increased frequency of large vessel occlusion causing significant morbidity and mortality. Simultaneous lung and other systemic involvement in MNS results in a deleterious outcome. Doi: 10.28991/SciMedJ-2022-0401-02 Full Text: PDF
{"title":"Major Neurological Syndromes with COVID-19: Lessons to Learn","authors":"N. Jain, Dnyaneshwar V Jadhav, Akash Chheda, S. Ravat, Rahil Ansari, M. Thakkar, R. Joshi, A. Sriram, Vrug Durge","doi":"10.28991/scimedj-2022-0401-02","DOIUrl":"https://doi.org/10.28991/scimedj-2022-0401-02","url":null,"abstract":"Objective: Covid-19 is a highly infectious viral disease, and our understanding of the impact of this virus on the nervous system is limited. Therefore, we aimed to do a systematic analysis of the neurological manifestations. Methods: We retrospectively studied the clinical, laboratory, and radiological findings of patients with major neurological syndromes (MNS) in Covid-19 over 6 months. Results: We had 39 patients with major neurological syndromes (MNS). The most common MNS was cerebrovascular disease (CVD) (61.53%), in which ischemic stroke (83.33%), cortical sinus thrombosis (12.50%), and haemorrhagic stroke (4.16%) were seen. Among ischemic stroke patients, 50% had a large vessel occlusion, and 66.66% of patients with CVD had a significant residual disability. Cranial neuropathy (15.38%), GBS (10.26%), encephalitis (7.26%), and myelitis (5.12%) were the other MNS. Among the three encephalitis cases, two had CSF-Covid-19 PCR positivity and had severe manifestations and a poor outcome. Associated comorbidities included hypertension (30.76%), diabetes mellitus (12.82%), chronic kidney diseases (7.69%), and polycythaemia vera (2.56%). Lung involvement was seen in 64.1% of patients. Mortality was 17.94% in MNS with Covid-19. Conclusions: The most common major neurological syndrome associated with Covid-19 is CVD with increased frequency of large vessel occlusion causing significant morbidity and mortality. Simultaneous lung and other systemic involvement in MNS results in a deleterious outcome. Doi: 10.28991/SciMedJ-2022-0401-02 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46963163","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 : 2021-12-30DOI: 10.28991/scimedj-2021-0304-10
Santhosh Kumar Ettaboina, Komalatha Nakkala, K. Laddha
The current world facing unpredictable problems with different variants of COVID-19; SARS-COV-19 is a significant lung infection caused by a coronavirus. Each type has one or more alterations to distinguish from each other. The viruses, including SARS-COV-19, continuously change the genetic code (mutations) during their genome replication. WHO labelled two variants in that we are experienced with delta (B.1.617.2) variant, now recently the omicron came (B.1.1.529) with highly mutatable strikes on it. So WHO predicted it is more dangerous than previous variants because of its mutatable capability. The mutatable strikes play an essential role in transmissibility. So there is a need to evaluate threatens raised with the new variant, so scientists are working on it. Till now, South Africa noticed major cases positive for the Omicron variant. Based on recent reports, the current paper summarized different properties of the omicron variant with others, including protein structure, diagnosis, spreadability, treatment, and potency of vaccines. Doi: 10.28991/SciMedJ-2021-0304-10 Full Text: PDF
{"title":"A Mini Review on SARS-COVID-19-2 Omicron Variant (B.1.1.529)","authors":"Santhosh Kumar Ettaboina, Komalatha Nakkala, K. Laddha","doi":"10.28991/scimedj-2021-0304-10","DOIUrl":"https://doi.org/10.28991/scimedj-2021-0304-10","url":null,"abstract":"The current world facing unpredictable problems with different variants of COVID-19; SARS-COV-19 is a significant lung infection caused by a coronavirus. Each type has one or more alterations to distinguish from each other. The viruses, including SARS-COV-19, continuously change the genetic code (mutations) during their genome replication. WHO labelled two variants in that we are experienced with delta (B.1.617.2) variant, now recently the omicron came (B.1.1.529) with highly mutatable strikes on it. So WHO predicted it is more dangerous than previous variants because of its mutatable capability. The mutatable strikes play an essential role in transmissibility. So there is a need to evaluate threatens raised with the new variant, so scientists are working on it. Till now, South Africa noticed major cases positive for the Omicron variant. Based on recent reports, the current paper summarized different properties of the omicron variant with others, including protein structure, diagnosis, spreadability, treatment, and potency of vaccines. Doi: 10.28991/SciMedJ-2021-0304-10 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45735934","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 : 2021-12-01DOI: 10.28991/SCIMEDJ-2021-0304-9
Bea Jorelli U. Fernando, M. Antonio, Ken Matthew A. De Guzman, Jan Carlo Y. Gatbonton, Sunshine T. Vendivil, R. Tiongco, S. Tesalona
Background: Pseudomonas aeruginosa (P. aeruginosa) is a gram negative bacteria that is known to cause nosocomial infections. Carbapenem is used to treat the damage caused by P. aeruginosa, however it is becoming resistant to carbapenems because of the production of β-lactamases. The objectives of the study were to systematically review the prevalence of blaNDM-1 in carbapenem-resistant Pseudomonas aeruginosa (CRPA) and to review and analyze the clinical sources as well as the antibiotic resistance profile of CRPA carrying blaNDM-1. Methods: The researchers systematically searched PubMed, ScienceDirect, and Google Scholar. Studies that met the inclusion criteria were included in the review. In assessing the methodological quality of the included studies, the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data and the JBI Critical Appraisal Checklist for Case Reports were used. Results: A total of nine studies were included in which eight were cross-sectional studies and one was a case report. The highest prevalence rate reported was 54.55% in blaNDM-1 positive CRPA isolates among the cross-sectional studies. The three most frequent sources of clinical isolates of CRPA carrying blaNDM-1 include urine, wound discharge, and tissue, among the included studies. Lastly, this review showed that among the included studies, CRPA isolates carrying blaNDM-1 were most resistant to ceftazidime and gentamicin. Conclusions: There is varying prevalence of blaNDM-1 in CRPA in different countries. Urine, wound discharge, and tissue specimens being the most frequent sources of CRPA isolates carrying blaNDM-1 poses a challenge that must be given attention by the infection control committee, thus the need for proper handling and processing of clinical specimens. Resistance to ceftazidime and gentamicin among the CRPA isolates carrying blaNDM-1highlights the growing challenge of successfully treating infections caused by this bacteria. This challenge reminds us of the importance and purpose of antibiotic stewardship that emphasizes the improvement of proper antibiotic prescription by the physicians and proper antibiotic use by the patients that can help in preventing harm and antibiotic resistance. Doi: 10.28991/SciMedJ-2021-0304-9 Full Text: PDF
{"title":"The Prevalence of blaNDM-1 in Clinical Isolates of Carbapenem-resistant Pseudomonas Aeruginosa: A Systematic Review","authors":"Bea Jorelli U. Fernando, M. Antonio, Ken Matthew A. De Guzman, Jan Carlo Y. Gatbonton, Sunshine T. Vendivil, R. Tiongco, S. Tesalona","doi":"10.28991/SCIMEDJ-2021-0304-9","DOIUrl":"https://doi.org/10.28991/SCIMEDJ-2021-0304-9","url":null,"abstract":"Background: Pseudomonas aeruginosa (P. aeruginosa) is a gram negative bacteria that is known to cause nosocomial infections. Carbapenem is used to treat the damage caused by P. aeruginosa, however it is becoming resistant to carbapenems because of the production of β-lactamases. The objectives of the study were to systematically review the prevalence of blaNDM-1 in carbapenem-resistant Pseudomonas aeruginosa (CRPA) and to review and analyze the clinical sources as well as the antibiotic resistance profile of CRPA carrying blaNDM-1. Methods: The researchers systematically searched PubMed, ScienceDirect, and Google Scholar. Studies that met the inclusion criteria were included in the review. In assessing the methodological quality of the included studies, the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data and the JBI Critical Appraisal Checklist for Case Reports were used. Results: A total of nine studies were included in which eight were cross-sectional studies and one was a case report. The highest prevalence rate reported was 54.55% in blaNDM-1 positive CRPA isolates among the cross-sectional studies. The three most frequent sources of clinical isolates of CRPA carrying blaNDM-1 include urine, wound discharge, and tissue, among the included studies. Lastly, this review showed that among the included studies, CRPA isolates carrying blaNDM-1 were most resistant to ceftazidime and gentamicin. Conclusions: There is varying prevalence of blaNDM-1 in CRPA in different countries. Urine, wound discharge, and tissue specimens being the most frequent sources of CRPA isolates carrying blaNDM-1 poses a challenge that must be given attention by the infection control committee, thus the need for proper handling and processing of clinical specimens. Resistance to ceftazidime and gentamicin among the CRPA isolates carrying blaNDM-1highlights the growing challenge of successfully treating infections caused by this bacteria. This challenge reminds us of the importance and purpose of antibiotic stewardship that emphasizes the improvement of proper antibiotic prescription by the physicians and proper antibiotic use by the patients that can help in preventing harm and antibiotic resistance. Doi: 10.28991/SciMedJ-2021-0304-9 Full Text: PDF","PeriodicalId":74776,"journal":{"name":"SciMedicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45009229","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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