Annals of African Medicine最新文献

Background: Seizures in elderly populations present unique challenges, with potential gender-specific variations in presentation and outcomes. This study aimed to compare the characteristics of seizures between elderly male and female patients, focusing on etiology, radiological features, and electroencephalographic (EEG) findings.

Methodology: This observational cross-sectional study included 75 patients (40 males, 35 females) aged ≥60 years presenting with seizures at a tertiary care center. All patients underwent detailed clinical evaluation, neuroimaging (magnetic resonance imaging), and EEG studies. Gender-specific differences in various parameters were analyzed using appropriate statistical tests.

Results: While cerebrovascular disease was the leading cause in both groups (40.0% males, 34.3% females), neurodegenerative disorders showed significantly higher prevalence in females (31.4% vs. 20.0%, P = 0.042). Radiological findings revealed higher rates of cortical infarcts in males (35.0%) and white matter changes in females (37.1%). EEG findings were comparable between genders, with focal epileptiform discharges being the most common (55.0% males and 51.4% females). Treatment outcomes were similar, with complete seizure control achieved in 65.0% of males and 68.6% of females.

Conclusions: The study demonstrates significant gender-specific patterns in seizure etiology among elderly patients, particularly regarding neurodegenerative disorders. While radiological and EEG findings showed subtle differences, treatment outcomes were comparable between genders. These findings suggest the importance of gender-specific considerations in the evaluation and management of elderly patients with seizures.

Introduction: Kinesiophobia, which refers to the fear of physical movement and activity due to vulnerability to injury, has been associated with suboptimal outcomes following total knee arthroplasty (TKA). This study aimed to assess the impact of kinesiophobia on early functional outcomes after TKA.

Materials and methods: A cohort analysis was conducted on 60 participants aged 18 years and older. Detailed sociodemographic characteristics were recorded, and the Tampa Scale for Kinesiophobia was used to evaluate kinesiophobia. Pain intensity was measured using the Visual Analog Scale, knee flexion was assessed using a goniometer, and functional status was evaluated using the Oxford Knee Score. Data were collected and analyzed accordingly.

Results: The mean age of the patients was 56.62 ± 6.28 years, with a higher proportion of male participants in the study. The majority of patients were from the middle class (75.00%), employed (91.67%), graduates (76.67%), and married (93.33%). Positive coping style had a significantly higher mean score compared to negative coping style ( P = 0.0001*). Most patients received moderate social support (61.67%) ( P = 0.0008*). Kinesiophobia, as measured by the Tampa Scale score, demonstrated a decreasing trend with a significant difference ( P < 0.0001*). The highest kinesiophobia score was observed at 2 weeks (58.29 ± 3.51), whereas the lowest was at 6 months (21.48 ± 1.32). Significant differences were noted in pain intensity, flexion, and functional status from 2 weeks to 6 months. Age, educational status, coping style, social support, high pain intensity, and low flexion were identified as significant risk factors for kinesiophobia.

Conclusion: During the initial postoperative period, most patients exhibit low levels of kinesiophobia. Targeted interventions focusing on positive coping, social support, pain management, and improvement of knee flexion can effectively address kinesiophobia and enhance rehabilitation outcomes.

Abstract: Bardet-Biedl syndrome (BBS) is a genetic disorder affecting cilia and its functions and manifests floridly in late childhood as a multisystem disorder with the classical triad being polydactyly, atypical retinal dystrophy, and central obesity. So far, very few case reports have been reported from India and even fewer from North India. We are reporting a classic case of a 14-year-old boy presenting to the medicine outpatient department with features of lower respiratory tract infection, who, on work-up, was diagnosed as a case of BBS on clinical grounds. He underwent conservative treatment and, over the next 7 days of treatment with parenteral antibiotics and fluids, resumed in the state of normalcy. Obese children or adolescents with polydactyly must raise a suspicion in the minds of a physician and must warrant further investigations, so as to prognosticate the guardians well before complications set in.

Background: Type 2 diabetes mellitus (T2DM) impairs cardiorespiratory fitness and functional capacity. The 2-minute step test (2MST) is a simple, space-efficient method to assess aerobic capacity, especially in resource-limited settings.

Aims and objectives: To assess the relationship between glycated hemoglobin (HbA1c), disease duration, and 2MST performance in T2DM patients.

Materials and methods: A cross-sectional prospective study was conducted at Vydehi Institute of Medical Sciences with 150 T2DM patients (age 30-65 years, BMI <30 kg/m²). Participants performed the 2MST, and pre- and post-exercise vitals were recorded. HbA1c was measured using HPLC. Statistical analysis included Spearman correlation and regression analysis.

Results: T2DM patients performed significantly fewer steps compared to nondiabetic controls (P = 0.001). Significant associations were found between post-test parameters (MBDS, SBP) and HbA1c. No strong correlations were observed between HbA1c and posttest oxygen saturation.

Conclusion: The 2MST is a useful, practical tool to evaluate functional decline in T2DM patients. Its ease of use makes it suitable for diabetes screening and management in primary care and resource-limited environments.

Abstract: An 11-year-old girl presented with painful plantar hyperkeratosis and nail dystrophy, evident since infancy. Examination revealed hyperkeratotic plaques on the soles, wedge-shaped nail hypertrophy, follicular hyperkeratosis over the extremities, and oral leukokeratosis. A positive maternal history suggested autosomal dominant inheritance with variable expressivity, consistent with pachyonychia congenita. Fungal infection was excluded via KOH mount; genetic testing was unavailable due to financial constraints. Despite prior treatments with keratolytics and emollients, improvement was minimal. This case highlights the early onset, classical features, and psychosocial burden associated with pachyonychia congenita, emphasizing the importance of early diagnosis, genetic counseling, and supportive care.

Background: Fetal anomaly scans and Noninvasive Prenatal Testing (NIPT) have become increasingly important in contemporary prenatal care. These advanced techniques provide valuable insights into fetal health and development, benefiting both healthcare providers and expectant mothers. By offering detailed information about potential anomalies and genetic conditions, they help guide informed decision-making throughout the pregnancy journey.

Objective: The purpose of this study is to evaluate medical and nursing students' understanding of and attitudes concerning NIPT and fetal anomaly scans.

Materials and methods: RAK Medical and Health Sciences University's medical and nursing students participated in this survey. Students of all ages, male and female, participated in the study. A Google Form was used to gather the data, and the responses were logged.

Results: A total of 285 students voluntarily participated in this survey. There were 140 nursing students and 145 medical students. Both medical and nursing students had knowledge about fetal anomaly scans (47.37% and 5.26%). There was a notable change in answers and awareness regarding NIPT. The knowledge of medical and nursing students was at 47.02% and 43.22%. Both medical and nursing students had a good attitude about the tests and were optimistic about referring their future patients for fetal anomaly scans.

Conclusion: Both the medical and nursing students know about the anomaly scan and NIPT, and they demonstrated a positive attitude and willingness to advise parents about these in their clinical practice. There is a need for continuous reinforcement of training about these modalities to see a difference in attitude and practice.

Background: Sexual dysfunction (SD) is difficulty experienced by an individual or couple during any stage of normal sexual activity, including physical pleasure, desire, preference, arousal, or orgasm. SD has been associated with diabetes mellitus (DM) in both males and females and it affects overall quality of life and physical and emotional health and thus deserves more attention.

Objectives: The aim of this study was to ascertain the prevalence and presentation pattern of SD in persons with type 2 diabetes who are receiving care in a tertiary health institution in Nigeria.

Methods: This was a cross-sectional descriptive study that was conducted on both male and female participants with type 2 DM. The International Index Erectile Function questionnaire-5 was used to assess for male SD and the Female Sexual Function Index questionnaire was used for female SD (FSD). A P = 0.05 was taken as statistically significant.

Results: The age range of the study participants was 30-75 years with the mean age being 54.3 ± 9. The overall prevalence of SD in this study was 80.2%. The female sexual disorder was most common in the domain of arousal desire and orgasm, while male SD had the most difficulty in maintaining erection.

Conclusion: SD is a major reproductive health issue with a high prevalence among persons with diabetes. Type 2 diabetic women with FSD tend to have arousal desire and orgasm disorders nevertheless, it is beneficial to focus on the comprehensive sexual function of persons with diabetes.

Abstract: Urinary stones are a common urological condition that exhibits significant variability in prevalence, clinical presentation, and composition across different geographic regions. In India, the condition affects approximately 2 million individuals annually, with notable regional differences driven by dietary habits, environmental factors, and socioeconomic conditions. This study comprehensively reviews the clinical characteristics, urinary stone composition, and associated risk factors in India while comparing these findings with global trends. The data for this review were obtained through an extensive analysis of the available literature on urinary stone composition and clinical characteristics in India and various countries worldwide. Sources included multiple databases such as Springer, Scopus, Elsevier, Google Scholar, Wiley, Web of Science, PubMed, and Taylor and Francis. The data were synthesized to assess the prevalence, composition, and risk factors of urinary stones by region, and these were compared with international data. Mixed stones were more commonly observed in northern and coastal regions, while uric acid (UA) stones showed a higher prevalence in the southern states. Globally, calcium oxalate (CaOx) remained the dominant stone type, but certain regions exhibited a higher occurrence of struvite and UA stones, largely attributed to specific dietary patterns and infection rates. The study concludes that urinary stone composition in India varies regionally due to dietary habits, hydration, and environmental factors. While CaOx remains prevalent globally, other stone types show distinct regional differences. Targeted prevention through hydration and dietary modifications is crucial, and future research should explore genetic predispositions and the impact of climate change on stone formation.

Background: Sepsis remains a leading cause of mortality in intensive care units (ICUs) worldwide, necessitating improved diagnostic and prognostic tools. This study aimed to estimate the novel sepsis biomarkers, including presepsin, interleukin (IL)-27, hepcidin, and plasma chitotriosidase in ICU patients with sepsis, evaluating their potential for enhancing early diagnosis and monitoring.

Methods: This prospective study was conducted over 18 months at JSS Medical College and Hospital, Mysuru, India. The study included 73 ICU patients above 18 years diagnosed with bacterial sepsis based on Quick Sequential Organ Failure Assessment score and procalcitonin (PCT) levels. Blood samples were collected and analyzed using enzyme-linked immunosorbent assay with respective biomarker kits. Demographic data, clinical parameters, and laboratory values were recorded. Correlations between novel biomarkers and PCT were assessed using Pearson correlation analysis.

Results: The study population had a mean age of 55.7 years, with 60.3% male participants. Hypertension (56.16%) and type 2 diabetes mellitus (49.32%) were the most common comorbidities. Abnormal presepsin levels were observed in 53.4% of participants, showing a strong positive correlation with PCT ( r = 0.763, P < 0.001). Hepcidin levels were abnormal in 76.7% of participants, demonstrating a moderate positive correlation with PCT ( r = 0.522, P < 0.001). Only 11.0% of participants had abnormal IL-27 levels, with a weak, nonsignificant correlation with PCT ( r = 0.172, P = 0.540). All participants (100%) had abnormal chitotriosidase levels, showing a weak but significant positive correlation with PCT ( r = 0.234, P = 0.047).

Conclusion: This study supports the potential of presepsin and hepcidin as novel biomarkers for sepsis in ICU patients. These markers showed strong correlations with PCT and high rates of abnormal levels in sepsis patients. IL-27 and chitotriosidase showed less promise in our study population. Integrating these novel biomarkers, particularly presepsin and hepcidin, into clinical practice could potentially improve early diagnosis and management of sepsis in critical care settings.

Background: Intrauterine insemination (IUI) is a popular method for the treatment of infertility, however, its success rate ranges from 7 to 13% in a cycle.

Aim: The present study was carried out to assess the IUI success rate and its predictors.

Method: A prospective observational study was conducted, and 167 women (aged 21-49 years) with primary or secondary infertility were enrolled to undergo intrauterine insemination. The induction of ovulation for IUI was performed according to the standard protocols. Stimulation was done with letrozole/clomiphene/ FSH/HMG or a combination of these drugs. Human Chorionic Gonadotropin (hCG) was administered at achievement of follicular size 17-18 mm. IUI was done 36-40 hours after the hCG trigger. The luteal phase was supplemented wherever needed. A positive urine pregnancy test (UPT) done 2 weeks after IUI was considered as the primary outcome. Predictors of UPT success were evaluated using Chi-square and Independent Samples t-tests.

Results: The mean age of women was 30.58±(SD)4.43 years. The mean duration of infertility was 4±2.65 years. Majority (77.6%) had primary infertility. UPT positivity rate was 18.2% in <30 years and 21.3% in 30 to 45 years and no positive pregnancy in > 45 years. No significant association of age, BMI, level of physical activity, fertility type, ovulation induction frequency, AMH, sperm count, and HSG was seen with outcome (p>0.05). A significant association of outcome with endometrial thickness was observed( p-value 0.001).

Conclusion: The IUI success rate was 18.8%. The endometrial thickness was significant predictors of IUI.