Annals of African Medicine最新文献

Introduction: In recent years, patient preferences and attitudes have become crucial in shaping dental treatment choices and service utilization. Understanding these preferences is crucial for improving service delivery and patient satisfaction.

Aim: This study aims to comprehensively analyze the factors influencing these preferences, focusing on demographic, socio-economic, and behavioral variables, and the growing role of social media in healthcare decisions.

Methodology: A cross-sectional survey using an online questionnaire was conducted among Indian individuals aged 18 years and above, yielding 231 responses. The data were analyzed using descriptive statistics, Chi-square tests, and ANOVA to assess associations and significant differences among variables. Factor analysis was used to determine factors influencing the selection of dental care services.

Results: The findings suggest that younger adults (76.6% aged 18-43 years) and females (65.8%) are more engaged in digital consultations and dental care decisions. Key factors influencing dental care choices include previous experience, painless treatment, and availability. Trust in social media for dental information is low, with 72.7% expressing doubts about its accuracy. Factor analysis identified four key dimensions affecting dental care choices which were grouped as patient-centric dental service quality, external validation and assurance, experience and cost-driven decisions, and professional competence.

Conclusion: The study underscores the importance of maintaining high-quality service, effective communication, and leveraging professional referrals and online reviews to enhance patient trust and satisfaction. Despite social media's rising role, direct professional advice remains the preferred source for dental care decisions.

Background: The stressful life of medical students might induce or exacerbate irritable bowel syndrome (IBS) symptoms.

Objectives: The purpose of this study was to determine the prevalence and related factors of IBS among medical students at King Khalid University (KKU), Saudi Arabia.

Materials and methods: A descriptive cross-sectional study was conducted among medical students at the KKU. The data collection period was from January to February 2018. Stratified sampling technique was used that included medical students from the second to the sixth year, using self-administered questionnaires contain socio-demographics, medical history, Rome criteria IV, and a personality scale of manifest anxiety.

Results: The intended participants were 400 medical students (100%) with 363 (90%) respondents. The mean age was 22 ± 1.6 years; there were 52.9% males and 47.1% females. The prevalence rate of IBS according to the Rome IV criteria was 10.7%. Regarding diagnostic criteria for IBS subtypes, 23.1% represented for both IBS with predominant constipation and IBS with predominant diarrhea, IBS with mixed bowel habits, both diarrhea and constipation, are the higher percentage (43.6%), and IBS unclassified subtype represented by 10.3%. Chi-square test showed high correlation between age and smoking and body mass index (P = 0.04 and 0.05, respectively). Further, there is a significant relationship between IBS and anxiety level (P = 0.04). No gender difference was noted.

Conclusion: The prevalence of IBS among medical students at KKU was highest in the age group of 21-23 years, who were nonsmokers, and who had a relatively high grade point average. We did not find a gender difference. Compared to non-IBS students, the anxiety level of the students with IBS was dramatically higher.

Background and aims: Dexmedetomidine has been administered as an intravenous infusion for maintenance dose following a loading dose, however, there is no study conducted so far that has compared the effectiveness of dexmedetomidine administered as bolus intravenously. The study aimed to compare the hemodynamic stability between intravenous infusion and intravenous bolus injection dexmedetomidine.

Methodology: A comparative observational study was conducted among 60 participants aged 20-60 years with American Society of Anesthesiologists physical status I/II, scheduled to undergo elective ear, nose, and throat surgeries. Participants were divided into Group A (received a loading dose of 0.5 μg/kg followed by 0.3 μg/kg/h intravenous infusion of dexmedetomidine) and Group B (an intravenous bolus of dexmedetomidine 0.5 μg/kg) 15 min before the induction of anesthesia. Hemodynamic variables, anesthetic requirement, blood loss, volume of intravenous fluid, recovery time, pain scores, rescue analgesia required, and any adverse events were recorded.

Results: Heart rate, blood pressure (BP), and mean arterial pressure were found to be significantly higher among participants receiving dexmedetomidine in the bolus group (P = 0.001). Diastolic BP was higher 90 min after intubation. Mean propofol administered, total blood loss, and total intravenous fluid volume were significantly higher in the bolus group (P = 0.001). Pain scores were higher in the bolus group after 2 h and infusion group after 12 h. Participants in the infusion group took more time to recover from anesthesia.

Conclusion: Almost all outcome variables were significantly higher among the bolus group. The recovery time was nonetheless reduced. There were no adverse events reported in both groups.

Context: Patients recovering from coronavirus disease 2019 (COVID-19) infection continue to have some persistent symptoms or develop new symptoms, resulting in impairment of everyday activities beyond the initial acute period. The current study was undertaken to understand the long term health implications of covid 19 and to analyse the correlation of post covid symptoms with the severity of infection and inflammatory markers at the time of hospitalisation.

Aims: (1) To estimate the prevalence of post covid symptoms at the end of 1 month,3 months and 12 months after discharge, (2) To correlate post covid symptoms with the severity of infection and inflammatory markers at the time of hospitalisation.

Settings and design: The study design was a cross-sectional study.

Subjects and methods: A prospective observational study was done on 150 COVID-19 reverse transcription-polymerase chain reaction-positive patients aged 18 years and above recovering from acute infection discharged from Vydehi Institute of Medical Sciences and Research Centre. All the patients were followed up for 1 year, during which telephonic interviews were conducted, and a systematic enquiry was made regarding post-COVID-19 symptoms.

Statistical analysis used: Data were entered in MS Excel and analyzed in SPSS V25. Descriptive statistics are represented with percentages, mean with standard deviation, or median with interquartile range depending on the nature of the data. The Kolmogorov-Smirnov test was applied to find normality. The Chi-square test, Independent t-test, or Mann-Whitney U-test were calculated depending on normality; P < 0.05 was considered statistically significant.

Results: A total of 150 COVID-19-positive patients discharged from the hospital were included in the study. Sixty-seven percent of patients had symptoms at 1 month, 39% at 3 months, and 31% of patients persisted to have symptoms at 1 year. The most common symptoms at 1 year were fatigue (5%), breathlessness (5%), and insomnia (5%). No statistically significant correlation was found with the severity of infection, inflammatory markers, and other variables.

Conclusions: Approximately one-third of patients who recover from acute COVID-19 infection may continue to have post-COVID-19 symptoms at 1 year after infection. Fatigue is the most common post-COVID-19 symptom. Post-COVID-19 symptoms can affect COVID-19 survivors regardless of the severity of the infection.

Introduction: Metabolic syndrome (MetS) is a complex cluster of metabolic abnormalities characterized by central obesity, dyslipidemia, hypertension, and impaired glucose metabolism. Emerging evidence suggests a potential link between uric acid levels and MetS, and commercial drivers are exposed to unique occupational hazards that may predispose them to MetS and hyperuricemia.

Objectives: The objective of this study was to determine the prevalence of MetS and its relationship with serum uric acid among commercial drivers in Ado-Ekiti, Nigeria.

Materials and methods: A cross-sectional study was conducted among commercial drivers in Ado-Ekiti. Relevant information was obtained with a questionnaire, and anthropometry and blood pressure were measured. Fasting plasma glucose and lipid profiles were determined by the standard protocol. MetS was determined with the harmonized criteria. Bivariate correlation and Chi-square were used to determine the relationship between serum uric acid and MetS and its components.

Results: There were 106 participants with a median age (interquartile range) of 50 (11) years, with no difference between those with or without MetS. More than 70% of the participants drank alcohol and 75 (70.8%) participants had hyperuricemia. There was no significant correlation between serum uric acid and components of MetS. The prevalence of MetS among all the participants was 21.7% (23/106), with no difference among men with normal uric acid (25.8%) and those with elevated uric acid (20.0%), P = 0.509. Similarly, there was no statistical difference in the prevalence of the components of MetS between the two groups.

Conclusions: The prevalence of MetS among the commercial drivers was high, with no difference among men with or without hyperuricemia. Given the importance of this group of people, a system-level public health approach should be adopted to promote a healthy lifestyle to save the lives of the populace.

Abstract: Myelin oligodendrocyte glycoprotein-immunoglobulin G (MOG-IgG)-associated disease (MOGAD) is an immune mediated demyelinating disorder initially described as a subtype of neuromyelitis optica spectrum disorder with antibodies against MOG. Recently, it has been described as a separate disease entity with unique clinical and radiological features. We herein report the clinical details of eight MOG-IgG-positive patients to highlight the peculiar and varied clinical and radiological features of this condition. Encephalitis was the most common presenting feature in our study, especially in pediatric cases. Tremors and parkinsonism were noted in four cases, of which one was a child. Monophasic course was noted in seven patients. Relapsing course was noted only in a single patient who was initiated on immunosuppressants. The clinical pictures highlight the importance of screening for anti-MOG in individuals with encephalitic and multiaxial symptoms in spite of having normal imaging. Acute demyelinating encephalomyelitis such as imaging features in the pediatric age group may also be a consideration for MOG testing.

Background: Sickle cell anemia (SCA) is a hypercoagulable state characterized by a significant alteration in hemostatic parameters which may predispose an increased risk of vaso-occlusive crisis (VOC). Sickle cell disease (SCD) is the most common genetic disorder in sub-Saharan Africa. Nigeria bears a high disease burden with an estimated prevalence of 1%-3% of its population being affected by the disease. The study seeks to determine the role of von Willebrand factor (VWF), ADAMTS13, and the ratio of ADAMTS13:VWF antigen in the pathogenesis of VOC.

Objective: The objective of this study is to evaluate the level of VWF, ADAMTS13, and their ratio in SCD subjects in Calabar and to determine their role in the pathogenesis of VOC.

Methodology: This is a comparative study carried out at the University of Calabar Teaching Hospital (UCTH), Calabar. Sixty SCA patients were evaluated in VOC and steady states as well as five parented healthy controls. VWF: Ag and ADAMTS13:Ag were evaluated using Assaypro enzyme-linked immunosorbent assay kits with Lot nos. 01751728 and 04222167R, respectively. Data were analyzed by IBM SPSS Chicago software version 21. The study was approved by the UCTH Institution Ethical Review Board.

Results: The mean ages of the SCA subjects and controls were 23.5 ± 7.2 years and 26.5 ± 5.6 years, respectively (P = 0.706). There were 23 (38.3%) males in the SCA group and 21 (42.0%) females in the controls. There was no significant difference in their sex distribution (P = 0.063). The mean (standard deviation [SD]) of VWF in VOC, steady state, and controls were 2.52 ± 0.34, 1.34 ± 0.23, and 1.41 ± 0.23 IU/mL, respectively. The differences in mean were significantly higher in VOC state (P = 0.003). The mean ± SD of ADAMTS13 in VOC, steady state, and controls were 0.61 ± 0.10, 0.44 ± 0.06, and 0.62 ± 0.10 μg/L, respectively. ADAMTS13 levels did not differ significantly across the groups (P = 0.270). Similarly, there was no significant difference between ADAMTS13:VWF ratios across the groups (P = 0.318).

Conclusion: VWF level is elevated in VOC state and thus may be implicated in the pathogenesis of VOC. ADAMTS13 and the ratio of ADAMTS13:VWF are not significantly affected in VOC.

Objective: The objective of the study was to assess the prevalence of osteoporosis in patients with monoclonal gammopathy of undetermined significance (MGUS) and to determine the associated factors.

Materials and methods: We conducted a case-control study, between January 2019 and April 2019, including patients with MGUS and age- and sex-matched healthy controls (one patient/three controls). For all participants, demographic and clinical data were collected as results of bone mineral density by two-photon X-ray absorptiometry at the lumbar spine and femoral neck.

Results: In our series, we included 120 participants: 30 patients with MGUS and 90 healthy controls. In the MGUS carrier group, the mean age was 66.26 ± 8.61 years. The mean monoclonal peak was 11.57 g/L. Densitometric osteoporosis was noted in 12 (40%) patients with MGUS versus 17 (18.9%) in the control group (P = 0.021). In addition, only one patient with MGUS had a vertebral fracture. On multivariate analysis, associated factors with osteoporosis in the MGUS group were age (odds ratio [OR] = 1.14; confidence interval [CI] [1.03-1.26]; P < 0.05) and previous fracture (OR = 3.03; CI [1.22-15.06]; P < 0.05).

Conclusion: Our study suggests an increased risk of osteoporosis in patients with MGUS.

Context: Central nervous system tumors are a major cause of morbidity and mortality worldwide. The most prevalent type of primary brain tumor is glioma. The exploration of significant genetic, epigenetic, and transcriptional abnormalities has not only improved our understanding of glioma pathogenesis but has also revealed that these molecular alterations can serve as useful diagnostic markers for more precise classification and are linked to better treatment response and prognosis. Hence, incorporating molecular markers into routine tumor classification is a major priority in modern glioma diagnostics.

Aim: The aim is to assess the mutation status of isocitrate dehydrogenase (IDH)-1, alpha-thalassemia/mental retardation syndrome X-linked (ATRX), and tumor protein 53 in glioma, and look for their association with various clinicopathological features.

Methodology: A single-center prospective cohort study, where all biopsies of glioma (January 2019 to July 2020) were evaluated, and immunohistochemistry was performed to assess the expression of IDH-1, ATRX, p53, and Ki-67 index. The data were analyzed using IBM SPSS-24 software.

Results: Immunohistochemistry was performed in 123 consecutive cases of glioma. IDH-1 mutation was noted in 54 (43.9%) cases and these patients frequently presented with "seizures" (P = 0.006). The expression was maximum in World Health Organization (WHO) grade 2 tumors (65.4%) (P < 0.001), with the highest frequency in oligodendrogliomas (100% in WHO grade 2 and 3). Furthermore, these tumors showed lower proliferative indices (P = 0.001). ATRX mutation was noted in 59 (48%) and p53 overexpression was noted in 76 (61.8%) cases. These mutations were significantly associated with astrocytic phenotype (P = 0.03).

Conclusions: Molecular characterization of glioma is an important step in modern glioma diagnostics and immunohistochemistry can play an important role. IDH-1 mutation is commonly observed in adults, frontal lobe location, patients presenting with seizures, and WHO grade 2 tumors with the highest frequencies in oligodendrogliomas. ATRX and p53 can be used as surrogate markers for tumors of astrocytic lineage.