African health sciences最新文献

Background: To examine the impact of a multi-perspective nursing approach using the whole-course Enhanced Recovery After Surgery concept on laparoscopic fundoplicationoutcomes for patients with proton pump inhibitor-dependent gastroesophageal reflux disease.

Methodology: This study was a randomized controlled trial. 98 proton pump inhibitor -dependent gastroesophageal reflux disease patients who underwent aparoscopic fundoplication in our hospital from Jan 2020 to Dec 2022 were randomly divided into two groups using a random number table. Group A (n=49) received multi-perspective nursing based on the gastroesophageal reflux disease concept in addition to routine nursing intervention, while Group B (n=49) received only routine aparoscopic fundoplication perioperative nursing intervention. The groups were compared in terms of first postoperative anal exhaust time, feeding time, time out of bed, hospital stay, Visual Analogue Scale scores before and after surgery, Hamilton Anxiety Scale and Hamilton Depression Scale scores, nursing satisfaction, and complications.

Results: Group A showed significant improvements in various postoperative outcomes compared to Group B, including shorter anal exhaust time, feeding time, time out of bed, and hospital stay (P<0.05). Group A also had lower VAS pain scores, lower Hamilton Anxiety Scale and Hamilton Depression Scale scores, and higher nursing satisfaction scores than Group B (P<0.05).

Conclusion: Multi-perspective nursing with Enhanced Recovery After Surgery can improve gastroesophageal reflux disease patients' recovery, pain relief, and nursing satisfaction post- aparoscopic fundoplication.

Lesch-Nyhan syndrome was first described in 1964. It is an X-linked recessive disorder caused by the absence of the enzyme hypoxanthine-guanine phosphoribosyl ransferase (HGPRT), which is involved in the metabolism of purines (nitrogenous bases that make up nucleotide). The absence of the enzyme leads to motor and neurological dysfunction, increased uric acid production, and mental retardation. One of the main characteristics of this syndrome is compulsive self-mutilation, such as biting the lips, tongue, and fingers. Men are the most affected and the prevalence is 1/380,000 live births. Several types of treatments are managed to reduce the manifestations of Lesch-Nyhan Syndrome, such as the placement of oral appliances, dental extractions, and drug therapy, the main one being Allopurinol, which can reduce the concentration of uric acid in the body. The role of the dentist becomes essential since teeth represent the main instrument for self-mutilation. In this sense, the article aims to describe the Lesch-Nyhan syndrome, the possible treatments and report a clinical case of a 4-year-old male patient who presented the syndrome.

Background: To investigate the clinical efficacy of CO2 laser and loop electrosurgical excision procedure (LEEP) in the treatment of cervical intraepithelial neoplasia (CIN) with high-risk human papillomavirus (HPV) infection.

Methods: A total of 150 CIN patients with high-risk HPV infection admitted to our hospital from December 2020 to June 2022 were divided into CO2 laser treatment group (CO2 group) with 63 cases and LEEP treatment group (LEEP group) with 87 cases based on treatment principles and patient preferences. The postoperative recovery time, CIN treatment effect, high-risk HPV clearance rate, treatment safety, and recurrence rate were compared between the two groups.

Results: The vaginal discharge time, vaginal bleeding time, and wound healing time in the CO2 group were significantly lower than those in the LEEP group (P < 0.05). The incidence of adverse events in the CO2 group was 14.29%, which was significantly lower than that in the LEEP group (28.74%, P < 0.05).

Conclusion: CO2 laser and LEEP surgery for the treatment of CIN combined with high-risk HPV infection both have good clinical efficacy, and CO2 laser can effectively shorten the postoperative recovery time with good safety.

Introduction: Endometrial cancer is the most common malignancy of among postmenopausal women in high income countries, however, its prevalence has been reported to be raising even in low-and middle-income countries due to change in lifestyle behaviors. We aimed to determine the prevalence of endometrial cancer and its associated factors among non-pregnant women with abnormal uterine bleeding.

Methods: After obtaining ethical approval from the Research Ethical Committee of the Makerere college of Health Sciences, we retrospectively retrieved and analyzed the paraffin embedded tissue blocks of 159 patients who were non-pregnant women and they were presenting with abnormal uterine bleeding from January 2012 to December 2018. The clinical and pathological information was obtained from the patient's files. Statistical analysis was done using SPSS version 23.0. Binary logistic regression analysis was applied in determining the risk factors of endometrial cancer. A two-tailed p -value <0.05 was considered significant.

Results: The overall mean age of the patients was 36.4 ± 13.7 years and the vast majority 71.1% (113/159) of the patients were premenopausal women. The prevalence of endometrial cancer was 11.9% (19/159). Being postmenopausal (AOR = 7.7, 95% CI = 2.155 - 27.666, p = 0.003), having menarche below 12 years (AOR = 4.5, 95% CI = 0.217-0.390, p<0.001), being obese (AOR = 2.5, 95% CI = 0.305-0.822, p = 0.01), and being nulliparous (AOR = 5.4, 95% CI = 0.292-0.957, p = 0.009) were significantly associated with endometrial cancer. However, use of contraceptive pills, family history of reproductive cancers, having hypertension and/or diabetes mellitus all were not associated with endometrial cancer.

Conclusion: Our study has further proven that, there is a significant proportion of non-pregnant women with AUB who have endometrial cancer. Using the clinical parameters such as age of the patient and age at menarche, nulliparity and obesity, it may help in increasing the index of clinical suspicion in daily clinical practice to diagnosing endometrial cancer among women with AUB at early stage. This will help in improving the prognosis of the patients.

Background: Bone fractures due to occupational accidents cause labor and cost losses in the world. Vitamin D deficiency is common in the world including industrialized countries. This study aimed to investigate the relationship between fracture and vitamin D levels in patients with wrist fractures due to occupational accidents.

Methods: This study was conducted in a study group consisting of patients who were admitted to the emergency department of a university hospital due to occupational accidents and were thought to have a fracture of the hand or wrist. Blood samples were analyzed biochemically and vitamin D levels were obtained.

Results: Vitamin D3 level was 16.3 ng/mL in patients with fractures and 21 ng/mL in patients without fractures, which was statistically significant (p<0.05). Vitamin D deficiency was found in %60.2 of patients with fractures, while vitamin D deficiency was found in %50.2 of patients with fractures and there was no statistical difference (p>0.112). Vitamin D deficiency was found in %39.8 of patients with hand injury without fracture, whereas vitamin D deficiency was not detected in %33 of patients with hand injury and the comparison was statistically significant (p<0.05).

Conclusion: There is insufficient data in the literature on the relationship between bone fractures and vitamin D levels and the vitamin D levels required to prevent bone fractures. In this study, a statistically significant difference was found between the vitamin D levels of patients with fractures and those of patients without fractures. This study is beneficial for the literature in this respect, but extensive studies on the relationship between vitamin D and fractures are needed.

Background: Malaria is a serious public health challenge both in children and adolescents.

Objectives: This study was aimed to document the willingness of the adolescents to accept vaccine and its associated factors.

Methodology: This was an observational and cross-sectional study on four hundred and ninety-six secondary school adolescents in six secondary schools in Enugu from June 2023 to September 2023. Data entry and analysis were done using IBM Statistical Package for Social Sciences (SPSS) statistical software version 25.

Results: A reasonable proportion of the respondents, 68.1% were willing to receive malaria vaccine. A higher proportion of the respondents, 59.3% knew that malaria vaccination could protect against seasonal influenza. Less than one third of the respondents, 32.1% had good knowledge of malaria vaccination. The respondents who were less than 15 years were twice more likely to receive malaria vaccination when compared with those who were 15 years and above, (AOR=2.2, 95%CI: 1.1-4.7). The respondents who were males were about twice less likely to receive malaria vaccination when compared with those who were females, (AOR=0.6, 95%CI: 0.4-0.9). The respondents who had good knowledge of malaria vaccination were twice more likely to receive malaria vaccination when compared with those who had poor knowledge, (AOR=2,2, 95%CI: 1.4-3.4).

Conclusion: A reasonable proportion of secondary school adolescents were willing to receive the malaria vaccine. Willingness to receive malaria vaccine is influenced by gender, knowledge of malaria vaccine and age of the adolescent.

Background: To explore the clinical effect compare between the simultaneous-integrated boost and sequential-boost intensity modulated radiotherapy in early breast cancer patients after breast conserving surgery.

Methodology: According to the different postoperative radiotherapy methods, 66 early breast cancer patients after breast-conserving surgery were divided into two groups, 34 in the simultaneous-integrated boost group and 32 in the sequential-boost intensity group. Adverse reactions, cosmetic effects, local recurrence rate, progression-free survival and overall survival rates were compared.

Results: No statistical significance in the incidence of acute skin reaction, advanced skin reaction, myelosuppression, radiation pneumonia and other adverse reactions between two groups were observed. The fine rate of simultaneous-integrated boost group was slightly better than the sequential-boost intensity group. And the follow-up rate of the two groups was 100%. The progression-free survival rate of the simultaneous-integrated boost group and the sequential-boost intensity group were 100% and 96.88%, respectively; The overall survival rates of the two groups were all 100%; One patient in the sequential-boost intensity group had recurrence (3.13%), while none in the simultaneous-integrated boost group. No significant difference in local recurrence rate, progression-free survival and overall survival rates in the two groups were found.

Conclusion: Simultaneous-integrated boost ensures breast appearance and survival without added radiotherapy side effects vs sequential-boost intensity.

This retrospective case study assessed the influence of femtosecond laser small incision lenticule extraction (SMILE) on accommodative function. The study included 42 patients from August 2020 to July 2021 at Suining Central Hospital. They were categorized into near-vision fatigue (20 cases) and asymptomatic groups (22 cases) post-surgery. The near-vision fatigue group received visual training. Comparing pre-surgery, one week, and one month after surgery, accommodative changes were analyzed using variance and t-tests. The near-vision fatigue group had lower preoperative accommodative function (PAPM=0.16, PAF<0.001, PPRA=0.009). One-week post-surgery, they experienced further declines (PAPM=0.021, PAF=0.038, PPRA=0.001), but after one month of training, improvements were evident (PAPM<0.001, PBAF=0.005, PPRA<0.001). The asymptomatic group also had temporary declines one week after surgery, recovering by one month. Negative relative accommodation and accommodative response were minimally affected. SMILE surgery briefly reduced accommodative parameters, predominantly in the near-vision fatigue group. Appropriate training effectively alleviated postoperative near-vision discomfort. In conclusion, SMILE surgery affects accommodative function, leading to temporary declines in specific parameters. Adequate training mitigates these effects, enhancing postoperative comfort.

Background: Hepatitis B virus (HBV) infection is a significant public health problem, even with the presence of affordable and effective vaccination. Toward hepatitis B elimination by 2030, it is essential to know the prevalence of HBV in the general population and associated risk factors so as to set priorities for specific prevention and control strategies in this population.

Methods: This was an analytical cross-sectional study among 1399 general population aged 18 years and above who came for HBV screening during the world viral hepatitis day on 28th and 29th July 2019. Serological marker of HBV was done using Determine HBsAg 2 Rapid Test. Data were cleaned and analyzed using STATA version 15.1. Log-binomial regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with HBV infection.

Results: The mean age of all study participants was 43.3±16.1 years, 57.4% were aged 40 years and above, and 57.8% were females. The positive rate of hepatitis B surface antigen (HBsAg) was 2.4%. Significantly higher odds of HBV infection were among respondents aged 30-39 (OR=2.70, 95%CI 1.22, 5.97, p=0.01) compared to those aged 40 years and above and those with a history of HBV infection (OR=8.46, 95%CI 2.66, 26.86, p<0.001).

Conclusion: The prevalence of hepatitis B infection is at an intermediate epidemic level in a semi-urban population in North-eastern Tanzania. Particular attention should be among middle-aged adults, such as those aged 30-39 years compared to their older counterparts and those with a history of HBV infection.

Background: Cerebral palsy (CP) is a chronic motor function disorder which occurs in children.

Aim: To evaluate the head dimensions in children who have CP and those without in Kano.

Methodology: A cross-sectional study of 110 normal and 70 children who have CP. The age, sex, head breadths (HB), head circumferences (HC), and head lengths (HL) were obtained. The data were analyzed in Minitab 17.0 and expressed as mean ± Standard Deviation (SD). Student's -t-test and Pearson's correlations were used to determine the differences and relationships between variables. P-values <0.05 was considered significant.

Results: Children without CP had significantly larger head dimensions (p < 0.05) compared to those with CP. No sexual dimorphism (p > 0.05) was observed in head dimensions for children with or without CP. In children with CP, age showed significant correlations (p < 0.05) with head dimensions, with the strongest correlation found for head circumference (p < 0.001). Head length and head breadth were significantly correlated (p < 0.001) in both groups, with a stronger correlation in children with CP.

Conclusion: This study concludes that children with cerebral palsy (CP) have smaller head dimensions compared to non-CP children, however, no observed sexual dimorphism observed among the two groups.