Annals of African Medicine最新文献

Background: A growing number of consumers are embracing the philosophy that natural products are better for their health and the environment. As such, they are seeking products they perceive to be safer, healthier, and without toxic chemical or synthetic ingredients. Natural products are gentle enough for daily use and provide a less abrasive alternative to more potent prescription formulations meant for short-term use. Herbal antimicrobial and antioxidant mouth rinses are considered effective adjuncts to toothbrushing and flossing for patients having gingivitis who have undergone implant treatment, providing a clinically significant benefit in the reduction of dental plaque, and also being antioxidant in nature.

Materials and methods: Three types of plant species were taken into consideration. Phyllanthus emblica fruit, Punica granatum flower, and Illicium verum fruit and seed were collected from the native trees of Chennai, Tamil Nadu.

Results and conclusion: We conclude that P. emblica fruit, P. granatum flower, and I. verum fruit and seed exhibit large amounts of flavonoids, phenolics, and tannins. This study also shows that these samples can be used in clinical practice as it has less hematotoxixity percentage. P. granatum that is a pomegranate flower shows a high positive percentage in the presence of flavonoids and phenols. These plant extracts can be used in further studies and in clinical use as mouthwash or topical gel by adding preservatives and flavoring agents.

The fifth edition of the WHO classification of tumors of the central nervous system (WHO CNS5) was published in 2021 which is the sixth version of the international standard for the diagnostics of CNS tumors. Regular updates of the consortium to inform molecular and practical approaches to CNS tumor taxonomy (cIMPACT-NOW) shaped the WHO CNS5 which continues the trend of incorporating the molecular characteristics of tumors into the histological and immunohistochemical findings. The various updates can be classified into general changes across all tumors and specific changes within the tumor groups. This mini-review highlights the general changes and the major changes in adult diffuse gliomas.

Introduction: Primary dysmenorrhea (PD) is a public disease of young female worldwide, it affects their daily performances. Severe recurrent uterine cramps are the main complaints in 90% of adolescents and 50% of reproductive-age females. This study aimed to evaluate the use of magnetic field therapy in the treatment of severe dysmenorrhea grade 3 and provide an encouraging goal to continue daily work without pain.

Methods: Two hundred and fifty female patients were recruited in this study from gynecological clinics in Basrah, southern Iraq. All had severe dysmenorrhea, patients were subjected to a questionnaire form, Visual Analog Scale, and verbal multidimensional scoring system to determine the pain intensity and grade of dysmenorrhea. Only 38 young females had severe dysmenorrhea grade 3 with ages ranging from 16 to 28 years with a mean age of 22.04 ± 1.43 years and body mass index 23.81 ± 1.94, patients subjected to electromagnetic field therapy (EMFT), two sessions per week for 20 min each for 6 weeks. Three categories were assessed, working ability, associated symptoms, and drugs used. Data were collected and statistically analyzed using SPSS version 22.

Results: The present study showed statistically significant progress (P < 0.05) in reducing pain, rare physical and mental complaints, and improved working ability with no need for drugs in majority of patients.

Conclusion: EMFT has better results than other methods in relieving pain and symptoms of dysmenorrhea with a settled lifestyle.

A tailgut cyst is a rare benign polycystic congenital lesion in presacral or retrorectal space, when there is failure of involution of tailgut. Clinical presentation may be with or without symptoms of different types related to obstruction, infection, or rarely malignancy. Symptoms may be misleading and atypical, so understanding of characteristics of tailgut cysts is important for precise and early diagnosis to be made for proper treatment and to avoid complications and malignant transformation. Magnetic resonance imaging pelvis was used as diagnostic imaging investigation, but the final confirmation was only done by histopathology. Definitive treatment is surgery, though various surgical approaches are described, surgery is tailored which will suit the individual patient's anatomy and suspected diagnosis of mass. This case review used PubMed and Web of Science databases to search for the studies. We found around 176 articles and selected 77 articles in our survey, with 8 reviews, 31 case reports, and 31 case reports and reviews.

Context: A major indication for referrals for bone scans (BS) to establish or exclude skeletal metastases. Few patients are referred with clinically indeterminate diagnosis or cancer of unknown primary (CUP), to search for bony metastases or primary tumor.

Aims: This study aimed to assess the usefulness or otherwise for BS in such instances.

Settings and design: A retrospective cross-sectional study of BS performed for CUP and indeterminate diagnosis from 2012 to 2016 in the nuclear medicine unit of a tertiary teaching hospital.

Subjects and methods: The study involved reviews of technetium-99m diphosphonate BS for patients with CUP. BSs were reported by nuclear physicians as normal, normal variants, suspicious for metastases or as malignant, and with solitary or multiple skeletal metastases.

Statistical analysis used: Data were analyzed using SPSS version 21 for descriptive analysis. Continuous data were displayed as means along with their standard deviation; categorical data were tabulated as frequencies and percentages.

Results: Of 2156 BS, 42 (0.02%) were eligible. Patients were aged 27-86 years, mainly in the sixth and seventh decades of life. Bone metastases were identified in 14 (33%) of these patients, whereas 17 BS (40%) were normal, BS appeared equivocal in 10 (23.8%).

Conclusions: Single-photon emission computed tomography/computed tomography availability would resolve the clinical dilemma in patients with equivocal and apparently normal BS.

Objective: The objective of this study was to observe the effects of various clinical factors on the activation and appearance of epileptiform abnormalities (EAs) in routine electroencephalography (rEEG) by different provocation methods.

Methods: This observational study involved a review of 136 patients presented for EEG recording due to various indications and their EEG showing EAs during various provocation methods.

Results: Generalized spike-wave discharges (GSWDs) were the most frequent activated epileptiform pattern observed in, 81 (59.1%) recordings. This pattern was seen mainly in females 49 (P = 0.00), in patients with generalized seizures 48 (P = 0.00), in prolonged EEG records 3 (P = 0.03), and in both genetic 35 (P = 0.00) and lesional epilepsies 21 (P = 0.00). Focal sharp waves with bilateral synchrony (FSWSBS) were the most activated ictal pattern (P = 0.00). Ictal EAs after hyperventilation (HV) (P = 0.03) and intermittent photic stimulation (IPS) (P = 0.01) were mainly observed in patients with uncontrolled seizures (P = 0.00), and immune-mediated epilepsy (P = 0.02). Females sex (odds ratio [OR]: 1.33, confidence interval [CI]: 0.6-2.6; P = 0.25), bilateral tonic-clonic seizures (OR: 1.17, CI: 0.5-2.4; P = 0.31) and lesional epilepsies (OR: 1.45, CI: 0.7-2.9; P = 0.20) had risk of activation of EAs by provocation methods; however this risk was not statistically significant. While sleep deprivation (SD) (OR: 6.33, CI: 2.2-18.2; P = 0.00), nonrapid eye movement sleep (NREM) (OR: 2.41, CI: 1.0-5.4; P = 0.00), and prolong EEG recording (OR: 1.91, CI: 0.9-3.9; P = 0.04) were leading to a statistically significant risk of activation and appearances of EAs due to provocation.

Conclusion: Different provocation methods can activate and augment the variety of EEG patterns of diverse clinical significance. Detection of activated ictal EAs is dependent on various patient factors, including seizure control, and the provocation method applied. Further larger prospective cohort studies with adequate sample sizes are warranted.

Background: Changing lifestyles, health care, growing age, and life expectancy have contributed to the occurrence of old age in communities. The elderly population are rising who are aged 60 or older in the present scenario. They are more prone to psychosocial problems such as stress, loneliness, low self-esteem, and anxiety. These problems impact their psychological health.

Materials and methods: This cross-sectional study was conducted at selected communities of Amritsar, Punjab. A total of 200 older adults were involved using the purposive sampling technique. Data were collected using a predesigned sociodemographic pro forma and a five-point Likert scale to assess psychosocial problems among the elderly. The data collection method employed was interviewed. In the psychosocial problems assessment tool, a total of 35 items were included, which were further categorized as follows: no psychosocial problem (0-35), mild psychosocial problem (36-70), moderate psychosocial problem (71-105), and severe psychosocial problem (106-140).

Results: The average age of the older adults was 69.31 ± 6.63 years, 65.5% were males and 34.5% were females. Regarding psychosocial problems, 69% had moderate, 16% had mild, 10.5% severe, and 4.5% had no problems. The median score was 90 (18). The median score was 17.50 (7) for stress, 38 (17.75) for loneliness, 18 (7.75) for anxiety, and 14 (7) for self-esteem. All the four domains, stress, loneliness, anxiety, and self-esteem, had a statistically significant relationship (P < 0.01). A statistically significant association was found between self-esteem, type of family, and anxiety with educational level.

Conclusion: The study concluded that older adults in communities have significant psychosocial problems such as stress, loneliness, self-esteem, and anxiety. Collaboratively, health professionals, local community leaders, and social workers can formulate and execute a health awareness campaign to avoid these issues that cause the aged much anguish.

Background: Decompressive craniectomy (DC) is a surgical procedure to treat refractory increase in intracranial pressure. DC is frequently succeeded by cranioplasty (CP), a reconstructive procedure to protect the underlying brain and maintain cerebrospinal fluid flow dynamics. However, complications such as seizures, fluid collections, infections, and hydrocephalus can arise from CP. Our aim is to investigate these complications and their possible risk factors and to discuss whether early or late CP has any effect on the outcome.

Materials and methods: A single-center retrospective cohort study was performed, including patients who underwent CP after DC between January 2014 and January 2022. Relevant information was collected such as demographics, type of brain injury, materials used in CP, timing between DC and CP, and postoperative complications. Ultimately, 63 patients were included in our study. We also compared the complication rate between patients who underwent late CP after DC (>90 days) against patients who underwent early CP (<90 days).

Results: Most patients were male (78%). The sample median age was 29 years, with pediatric patients, accounting for 36% of the samples. Overall complication rate was 57% and they were seizure/epilepsy in 50% of the patients, fluid collection (28%), infections (25%), posttraumatic hydrocephalus (17%), and bone defect/resorption (3%). Twenty-two percent of patients with complications required reoperation and underwent a second CP. The median (interquartile range) duration between the craniotomy and the CP was 56 (27-102) days, with an early (≤3 months) percentage of 68%. We found no significant difference between early (≤3 months) and late (>3 months) CP regarding complication rates.

Conclusion: Despite CP being a simple procedure, it has a considerable rate of complications. Therefore, it is important that surgeons possess adequate knowledge about such complications to navigate these challenges more effectively.

Background: Admission cardiotocography (CTG), a noninvasive procedure, is used to indicate the state of oxygenation of the fetus on admission into the labor ward.

Objective: This study assessed the association of admission CTG findings with neonatal outcome at a tertiary health facility.

Materials and methods: A prospective, observational study of 206 pregnant women who were admitted into the labor ward with singleton live pregnancies. Information on the demographic characteristics, obstetrics and medical history, admission CTG tracing, and neonatal outcome was obtained using a structured data collection form. Data were analyzed using the SPSS software version 20.0 with the level of significance set at P < 0.05.

Results: The admission CTG findings were normal in 73.3%, suspicious in 13.6%, and pathological in 13.1% of the women. The occurrence of low birth weight, special care baby unit (SCBU) admission, asphyxiated neonates, neonatal death, and prolonged hospital admission was significantly more frequent among those with pathological admission CTG results compared with normal and suspicious results (P < 0.05). The incidence of vaginal delivery was more common when the CTG findings were normal, whereas all women with pathological CTG result had a cesarean delivery.

Conclusion: Admission CTG was effective in identifying fetuses with a higher incidence of perinatal asphyxia. Neonatal outcome such as low birth weight, APGAR score, SCBU admission, and prolonged hospital admission was significantly associated with pathological CTG findings. In the absence of facilities for further investigations, prompt intervention for delivery should be ensured if admission CTG is pathological.

Background: Ultrasonographic imaging has been recently become simple portable and non-invasive adjuvant for bedside assessment of anterior neck soft tissue thickness which when measured at different levels showed to have significant role in predicting difficult laryngoscopy.

Aims and objectives: Primary objective was Ultrasonographic measurement of anterior neck soft tissue thickness at 3 levels -Distance from skin to hyoid bone (DSHB) -Distance from skin to thyrohyoid membrane (DSTM) -Distance from skin to anterior commissure of vocal cord(DSAC) and to compare and correlate the findings with Cooks modification of Cormack-Lehane score in predicting difficult laryngoscopy. Secondary objective was to compare and correlate the ultrasonographic measurements with conventional airway assessment methods.

Materials and methods: After obtaining approval from the ethical committee, 90 Patients with BMI above 25 kg /m2 was enrolled for the study. A day before the surgery a thorough Preanaesthetic evaluation and assessment of the airway is done using conventional methods. Then on the day of surgery ultrasonographic measurement of anterior neck at 3 levels was done and after inducing the patients laryngoscopy was done and Cooks modification of Cormack-Lehane score assessed.

Results: The optimal cut off values to predict difficult laryngoscopy was 1.26, 2 and 1.2 cms for DSHB, DSTM and DSAC respectively, and among the three skin to anterior commissure of vocal cord was observed to be best USG parameter with more area under the ROC curve.

Conclusion: USG measurement of anterior neck soft tissue thickness can be useful in predicting difficult laryngoscopy in overweight and obese patients also it had more diagnostic accuracy than conventional methods like MMS in predicting difficult laryngoscopy.