P. Etoundi, Agn n, J. Tochie, J. Metogo, R. Bengono, Ludovic Amengl, B. Jemea, J. Minkande
Background: Although stroke or cerebrovascular accidents (CVA) account for the second cause of death worldwide, data on CVA in the intensive care units (ICU) of Cameroon is scant. We investigated the sociodemographic, clinical, and radiological profiles, as well as outcomes of patients with CVA admitted to the ICU of the Yaounde Central Hospital. Methods: We analyzed the hospital files of all patients admitted to the ICU of Yaounde Central Hospital from 1st January 2016 to 31st December 2016. All patients with confirmed CT-scan diagnosis of CVA were retained. Patients’ files were studied for sociodemographic data, clinical variables, radiological patterns, and outcomes of ICU admission. Results: The prevalence of cerebrovascular accidents was 12.2%. The mean age was 66.2±13.5 years and 50% were males. The main reason for ICU admission was coma in 92.3%. The frequencies of comorbidities were hypertension (65.4%) and diabetes (7.7%). The main lesion for hemorrhagic CVA was at the capsulolenticular area and the main occluded vessel in ischemic CVA was the middle cerebral artery. Conclusions: The findings suggest CVA patients in the aforementioned ICU have modifiable cardiovascular factors such as hypertension and diabetes for preventive interventions. Many patients have severe hypertension on admission, reflecting uncontrolled high blood pressure before their cardiovascular event. Overall, there is an urgent need for adequate follow-up of hypertension especially in elderly patients for CVA prevention.
{"title":"The epidemiological, clinical, radiological profiles and outcome of stroke in reference sub-Saharan African intensive care unit: a cross-sectional study","authors":"P. Etoundi, Agn n, J. Tochie, J. Metogo, R. Bengono, Ludovic Amengl, B. Jemea, J. Minkande","doi":"10.5455/IM.44672","DOIUrl":"https://doi.org/10.5455/IM.44672","url":null,"abstract":"Background: Although stroke or cerebrovascular accidents (CVA) account for the second cause of death worldwide, data on CVA in the intensive care units (ICU) of Cameroon is scant. We investigated the sociodemographic, clinical, and radiological profiles, as well as outcomes of patients with CVA admitted to the ICU of the Yaounde Central Hospital. Methods: We analyzed the hospital files of all patients admitted to the ICU of Yaounde Central Hospital from 1st January 2016 to 31st December 2016. All patients with confirmed CT-scan diagnosis of CVA were retained. Patients’ files were studied for sociodemographic data, clinical variables, radiological patterns, and outcomes of ICU admission. Results: The prevalence of cerebrovascular accidents was 12.2%. The mean age was 66.2±13.5 years and 50% were males. The main reason for ICU admission was coma in 92.3%. The frequencies of comorbidities were hypertension (65.4%) and diabetes (7.7%). The main lesion for hemorrhagic CVA was at the capsulolenticular area and the main occluded vessel in ischemic CVA was the middle cerebral artery. Conclusions: The findings suggest CVA patients in the aforementioned ICU have modifiable cardiovascular factors such as hypertension and diabetes for preventive interventions. Many patients have severe hypertension on admission, reflecting uncontrolled high blood pressure before their cardiovascular event. Overall, there is an urgent need for adequate follow-up of hypertension especially in elderly patients for CVA prevention.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70793781","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}
{"title":"Keep calm and eat AAM (mango): mangiferin a miracle nutraceutical","authors":"D. R, A. V","doi":"10.5455/im.48122","DOIUrl":"https://doi.org/10.5455/im.48122","url":null,"abstract":"","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70794134","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}
H. Ibrahim, H. Mohammed, Abdelmonem Awad Hegazy, Ahmed Azony, M. Salah, M. Salem, W. Etman
Background: New prognostic and predictive biomarkers for better choice and improving the current therapies for ovarian cancer are greatly needed. This study aimed to investigate the prognostic and therapeutic importance of lysyl oxidase (LOX) and cyclooxygenase 2 (COX2) expressions in epithelial ovarian carcinoma. Methods: We performed immunohistochemical analysis on formalin-fixed paraffin sections of epithelial ovarian tumors. The association between their expressions in epithelial ovarian carcinoma (EOC) with the survival as well as response to chemotherapy was analyzed. Results: The frequency of the nuclear expression of LOX and cytoplasmic expression of COX2 was significantly higher in malignant tumors than in benign and borderline tumors. Also, there were statistically significant relationships between pathological grades and both LOX and COX2 positivity in EOC being at the higher end for poorly differentiated tumors. Both LOX and COX2 expressions were also correlated significantly with higher tumor stage. Overexpression of either LOX or COX2 in EOC was significantly associated with poor survival. Moreover, LOX and COX2 positive expressions in EOC were associated with poor response to chemotherapy. Conclusions: The increased expressions of LOX and COX2 in EOC are associated with several adverse clinicopathologic parameters, including reduced survival and chemotherapy resistance thus suggesting a role for such biomarkers in disease progression.
{"title":"Prognostic and therapeutic implications of lysyl oxidase and cyclooxygenase 2 expressions in epithelial ovarian carcinoma","authors":"H. Ibrahim, H. Mohammed, Abdelmonem Awad Hegazy, Ahmed Azony, M. Salah, M. Salem, W. Etman","doi":"10.5455/im.51649","DOIUrl":"https://doi.org/10.5455/im.51649","url":null,"abstract":"Background: New prognostic and predictive biomarkers for better choice and improving the current therapies for ovarian cancer are greatly needed. This study aimed to investigate the prognostic and therapeutic importance of lysyl oxidase (LOX) and cyclooxygenase 2 (COX2) expressions in epithelial ovarian carcinoma. Methods: We performed immunohistochemical analysis on formalin-fixed paraffin sections of epithelial ovarian tumors. The association between their expressions in epithelial ovarian carcinoma (EOC) with the survival as well as response to chemotherapy was analyzed. Results: The frequency of the nuclear expression of LOX and cytoplasmic expression of COX2 was significantly higher in malignant tumors than in benign and borderline tumors. Also, there were statistically significant relationships between pathological grades and both LOX and COX2 positivity in EOC being at the higher end for poorly differentiated tumors. Both LOX and COX2 expressions were also correlated significantly with higher tumor stage. Overexpression of either LOX or COX2 in EOC was significantly associated with poor survival. Moreover, LOX and COX2 positive expressions in EOC were associated with poor response to chemotherapy. Conclusions: The increased expressions of LOX and COX2 in EOC are associated with several adverse clinicopathologic parameters, including reduced survival and chemotherapy resistance thus suggesting a role for such biomarkers in disease progression.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70794258","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}
Anaplastic thyroid carcinoma (ATC) is an extremely destructive tumor with a median survival time not longer than eight months. ATC often presents with a swiftly expanding neck mass causing loco-regional symptoms. The trachea is outside the normal position due to pushing by the mass, likewise, the palpation of the trachea is impossible due to the increased rigid irregular tumor tissue between the skin and trachea. Vocal cord paralysis is possible or the tumor can invade the tracheal lumen. Airway management should always have the priority. Imaging evaluation should be scheduled efficiently as such information is critical for planning the tracheotomy. Tracheotomy should be executed to support ventilation in circumstances of life-threatening upper airway obstruction. Given these patients' short life expectancy, a balanced decision on the role and timing of tracheotomy must be achieved. This review provides fundamental knowledge on ATC patient tracheotomy from an objective perspective.
{"title":"Difficulties of tracheotomy in patients with anaplastic thyroid carcinoma","authors":"E. Çetinkaya, Ö. Gür, Ö. Selçuk, M. Yildiz","doi":"10.5455/im.64947","DOIUrl":"https://doi.org/10.5455/im.64947","url":null,"abstract":"Anaplastic thyroid carcinoma (ATC) is an extremely destructive tumor with a median survival time not longer than eight months. ATC often presents with a swiftly expanding neck mass causing loco-regional symptoms. The trachea is outside the normal position due to pushing by the mass, likewise, the palpation of the trachea is impossible due to the increased rigid irregular tumor tissue between the skin and trachea. Vocal cord paralysis is possible or the tumor can invade the tracheal lumen. Airway management should always have the priority. Imaging evaluation should be scheduled efficiently as such information is critical for planning the tracheotomy. Tracheotomy should be executed to support ventilation in circumstances of life-threatening upper airway obstruction. Given these patients' short life expectancy, a balanced decision on the role and timing of tracheotomy must be achieved. This review provides fundamental knowledge on ATC patient tracheotomy from an objective perspective.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70795121","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}
Introduction Arrhythmogenic cardiomyopathy is a life-threatening primary electrical disease with the potential of sudden cardiac death at the first manifestation of the disease. That is why it is very important to identify the disease as early as possible. Standard ECG may describe arrhythmogenic cardiomyopathy with different markers: T-wave inversions as a marker of right ventricular dilatation [1], Epsilon waves as a marker of pronounced right ventricular outflow tract involvement [2], QRS fragmentation in inferior leads as a marker of inferior wall involvement [3], Localized right ventricular QRS prolongation as a marker of parietal block [4], Low voltage as a marker of advanced disease, in most cases caused by phospholamban mutations [1]. In the meantime, several ECG abnormalities have been described as features of concealed arrhythmogenic cardiomyopathy at the very early stage of the disease (prehistologic phase).
{"title":"Concealed electrocardiographic features in arrhythmogenic cardiomyopathy","authors":"S. Peters","doi":"10.5455/IM.302644190","DOIUrl":"https://doi.org/10.5455/IM.302644190","url":null,"abstract":"Introduction Arrhythmogenic cardiomyopathy is a life-threatening primary electrical disease with the potential of sudden cardiac death at the first manifestation of the disease. That is why it is very important to identify the disease as early as possible. Standard ECG may describe arrhythmogenic cardiomyopathy with different markers: T-wave inversions as a marker of right ventricular dilatation [1], Epsilon waves as a marker of pronounced right ventricular outflow tract involvement [2], QRS fragmentation in inferior leads as a marker of inferior wall involvement [3], Localized right ventricular QRS prolongation as a marker of parietal block [4], Low voltage as a marker of advanced disease, in most cases caused by phospholamban mutations [1]. In the meantime, several ECG abnormalities have been described as features of concealed arrhythmogenic cardiomyopathy at the very early stage of the disease (prehistologic phase).","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70792526","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}
Acquired factor VIII deficiency is a rare disorder with a high rate of morbidity and mortality, commonly presents with bruises or bleeding in patients without previous bleeding diathesis. Presentation with thrombosis is extremely rare but if it presents with thrombosis then diagnosis and management become challenging. Balance in anticoagulation and monitoring for bleeding remains the cornerstone of treatment. We are presenting a case of 60 years old female who presented with left leg swelling and diagnosed as deep venous thrombosis and started on anticoagulation. She developed hematoma on the right arm and on further workup she was diagnosed with acquired factor VIII deficiency, treated with steroid and cyclophosphamide which resulted in a good response.
{"title":"Deep venous thrombosis in a patient with acquired factor VIII deficiency: a case report","authors":"D. Gul, Fazal Ur Raheman, S. Ali, S. A. Ali","doi":"10.5455/IM.302644370","DOIUrl":"https://doi.org/10.5455/IM.302644370","url":null,"abstract":"Acquired factor VIII deficiency is a rare disorder with a high rate of morbidity and mortality, commonly presents with bruises or bleeding in patients without previous bleeding diathesis. Presentation with thrombosis is extremely rare but if it presents with thrombosis then diagnosis and management become challenging. Balance in anticoagulation and monitoring for bleeding remains the cornerstone of treatment. We are presenting a case of 60 years old female who presented with left leg swelling and diagnosed as deep venous thrombosis and started on anticoagulation. She developed hematoma on the right arm and on further workup she was diagnosed with acquired factor VIII deficiency, treated with steroid and cyclophosphamide which resulted in a good response.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70793323","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}
{"title":"Comparing emotional intelligence between would-be and practicing medical professionals of Kathmandu","authors":"Pralhad Adhikari","doi":"10.5455/IM.36946","DOIUrl":"https://doi.org/10.5455/IM.36946","url":null,"abstract":"","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70793467","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}
Background: Data regarding iodine deficiency disorder in Upper Egypt is rare and even limited. In this study, we aim to determine the status of variable patterns of thyroid disorders and find out the relationship between some risk factors like gender, age, family history and the occurrence of thyroid disorders among Qena population referred to our nuclear medicine clinic from January 2011 to the end of December 2012. Methods: A retrospective hospital-based descriptive and analytical study was conducted on patients referred to our nuclear medicine clinic who complained of various clinical features related to the thyroid gland. The study was performed using data collected from the registration unit in the nuclear medicine clinic. Results: A total of 46 patients (9 men and 37 non-pregnant women) were included. The collected variables were sex, age, family history, menstrual status of females, thyroid-related complaints, history of thyroidectomy and I-131 therapy. 43.5% of the patients were highly affected by thyrotoxicosis, followed by hypothyroidism (26.1%), simple nodular goiter (SNG) (17.4%) and differentiated thyroid cancer (DTC) (13%). 80.4% of patients were female and 19.6% were male. The highest number of different thyroid diseases were reported in the age group of 20-49 years. Conclusions: Different risk factors including sex, age, family history are highlighted in this study, but still the low levels of iodine in the soil and drinking water in Upper Egypt and bad nutrition are the most common factors that may cause goiter.
{"title":"Patterns of thyroid disorders in Qena population: a hospital-based descriptive study","authors":"Mai Elzahry","doi":"10.5455/IM.49650","DOIUrl":"https://doi.org/10.5455/IM.49650","url":null,"abstract":"Background: Data regarding iodine deficiency disorder in Upper Egypt is rare and even limited. In this study, we aim to determine the status of variable patterns of thyroid disorders and find out the relationship between some risk factors like gender, age, family history and the occurrence of thyroid disorders among Qena population referred to our nuclear medicine clinic from January 2011 to the end of December 2012. Methods: A retrospective hospital-based descriptive and analytical study was conducted on patients referred to our nuclear medicine clinic who complained of various clinical features related to the thyroid gland. The study was performed using data collected from the registration unit in the nuclear medicine clinic. Results: A total of 46 patients (9 men and 37 non-pregnant women) were included. The collected variables were sex, age, family history, menstrual status of females, thyroid-related complaints, history of thyroidectomy and I-131 therapy. 43.5% of the patients were highly affected by thyrotoxicosis, followed by hypothyroidism (26.1%), simple nodular goiter (SNG) (17.4%) and differentiated thyroid cancer (DTC) (13%). 80.4% of patients were female and 19.6% were male. The highest number of different thyroid diseases were reported in the age group of 20-49 years. Conclusions: Different risk factors including sex, age, family history are highlighted in this study, but still the low levels of iodine in the soil and drinking water in Upper Egypt and bad nutrition are the most common factors that may cause goiter.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70794199","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}
I. Mungan, D. Kazancı, Ş. Bektaş, S. Sarı, Mine Çavuş, S. Turan
Background: Almost 1⁄4 of mechanical ventilator-supported patients undergo tracheostomy while there is a lack of standardized education and guideline-based tracheostomy care. The nursing staff should attend in appropriate educational activities to maintain their competence hence this necessitates the evaluation of their knowledge level. We aimed to analyze the knowledge level of the nursing staff related to tracheostomy care in tertiary intensive care units, in Ankara. Methods: This descriptive, cross-sectional study was designed through the questionnaire which managed during the period from January 2018 to July 2018 in Ankara, Turkey. The questionnaire was distributed to 150 nurses working in intensive care units (ICU) on a voluntary basis. The statistical analysis was done by SPSS 20.0. The correlation between categorical variables was assessed through Spearman’s rho test while the continuous variables were evaluated by the Kruskal Wallis Test and Mann-Whitney U test. Results: 138 valid questionnaires were included in the study, with a response rate of 92% and the answers about the emergent cases were not satisfactory (approximately 30% correctness). The respondents were aged 19-48 years and the percentage of the correct answer in total was %56 and only 64 nurses (46.4%) answered ≥7 questions correctly. In this study, no variable did show a significant correlation with nurses’ knowledge level. Conclusions: We have to admit that there is not any standardized education program related to tracheostomy care while the level of nurses' knowledge of tracheostomy care was below expectations and there is a need for educational programs to close the knowledge gap.
{"title":"The evaluation of nurses' knowledge related to tracheostomy care in tertiary intensive care units","authors":"I. Mungan, D. Kazancı, Ş. Bektaş, S. Sarı, Mine Çavuş, S. Turan","doi":"10.5455/im.54258","DOIUrl":"https://doi.org/10.5455/im.54258","url":null,"abstract":"Background: Almost 1⁄4 of mechanical ventilator-supported patients undergo tracheostomy while there is a lack of standardized education and guideline-based tracheostomy care. The nursing staff should attend in appropriate educational activities to maintain their competence hence this necessitates the evaluation of their knowledge level. We aimed to analyze the knowledge level of the nursing staff related to tracheostomy care in tertiary intensive care units, in Ankara. Methods: This descriptive, cross-sectional study was designed through the questionnaire which managed during the period from January 2018 to July 2018 in Ankara, Turkey. The questionnaire was distributed to 150 nurses working in intensive care units (ICU) on a voluntary basis. The statistical analysis was done by SPSS 20.0. The correlation between categorical variables was assessed through Spearman’s rho test while the continuous variables were evaluated by the Kruskal Wallis Test and Mann-Whitney U test. Results: 138 valid questionnaires were included in the study, with a response rate of 92% and the answers about the emergent cases were not satisfactory (approximately 30% correctness). The respondents were aged 19-48 years and the percentage of the correct answer in total was %56 and only 64 nurses (46.4%) answered ≥7 questions correctly. In this study, no variable did show a significant correlation with nurses’ knowledge level. Conclusions: We have to admit that there is not any standardized education program related to tracheostomy care while the level of nurses' knowledge of tracheostomy care was below expectations and there is a need for educational programs to close the knowledge gap.","PeriodicalId":93574,"journal":{"name":"International medicine (Antioch, Turkey)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70794791","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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