African health sciences最新文献

Background: The purpose of this study was to investigate the variations in quantitative analysis of lung adenocarcinoma based on gender using dual-energy Computed Tomography (DECT), as well as its correlation with Ki-67, a proliferative marker.

Methodology: A retrospective analysis was conducted on 79 patients diagnosed with lung adenocarcinoma, categorized into two groups based on gender. These patients underwent dual-energy CT scans, and the corresponding Ki-67 index was obtained. The study involved statistical analysis of general clinical characteristics, conventional chest imaging features, and dual-energy quantitative iodine values of the lung cancer patients in each gender group. Additionally, correlation analysis was performed to assess the relationship between the statistically significant parameters and Ki-67.

Results: A significant disparity was observed in the values of virtual non-contrast (VNC) and Ki-67 between male and female patients with lung adenocarcinoma. Notably, male patients exhibited lower iodine concentration and a smaller increase in iodine value. Several quantitative iodine parameters showed a correlation with Ki-67. Among these parameters, OVERLAY_VP exhibited the strongest correlation. Distinct quantitative iodine parameters were identified for male and female lung adenocarcinoma patients, which exhibited a correlation with Ki-67, thereby facilitating the evaluation of the proliferative activity of lung adenocarcinoma.

Conclusion: Dual-energy quantitative iodine parameters in lung adenocarcinoma patients exhibited gender-specific variations.

Background: Tuberculosis(TB) is still among the leading causes of death from a single infectious pathogen worldwide. TB treatment is long, requires multiple drug combinations, and therefore adherence monitoring. TB hair drug levels have been suggested as a technique of treatment adherence monitoring; however, the drug levels might be affected by physiological factors, alcohol use, and cigarette smoking. This can affect the pharmacokinetics and pharmacodynamics of TB drugs.

Objective: To assess the effect of physiological factors, smoking, and alcohol on isoniazid hair drug levels during TB treatment.

Methods: Patients were assessed for diabetes Mellitus, smoking, alcohol consumption, age, weight, and gender. Hair drug levels were measured by Liquid Chromatography Mass Spectrometry(LC-MS).

Results: We screened a total of 102 TB patients and enrolled 56 participants out of which 50 completed the study. We excluded 15 participants who were not sampled exactly at 1-month appointment dates and of the remaining 35; the mean hair drug level was 0.0706ng/mg, 95% CI: 0.0303-0.1109. Tests of interaction across the different subgroups yielded no statistically significant interaction coefficients(IC) except for age and gender (IC=-0.36.95%, CI: -0.55-0.17, P=0.001).

Conclusion: Physiological factors, alcohol, and smoking do not affect isoniazid hair drug levels.

Background: This is a retrospective analysis of the relationship between preoperative factors and spontaneous reperfusion (SR) in infarct-related arteries (IRAs) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI).

Methodology: 834 patients who were classified into the SR group (TIMI flow grade 2-3) and non-spontaneous reperfusion (NSR) group (TIMI flow grade 0-1) based on coronary angiography. The baseline characteristics and preoperative factors of the two groups were analyzed.

Results: Compared with the NSR group, the SR group had shorter time from symptom onset to first medical contact (P=0.002) and from symptom onset to antiplatelet loading (P=0.003), however, there was no statistically significant difference in the mode of admission and loading of antiplatelet drugs between the two groups. Multivariate logistic regression analysis indicated that diabetes history, smoking history, triglyceride level, time from symptom onset to first medical contact, time from symptom onset to antiplatelet loading, and time from antiplatelet loading to coronary angiography were all factors influencing SR were all factors influencing SR.

Conclusion: The occurrence of SR is related to early medical contact and timely use of antiplatelet drugs. Patients with diabetes history, smoking history, higher triglyceride level may benefit more.

Aim: The Araliaceae family member Hedera helix L is well-known in traditional medicine for its ability to effectively treat a wide range of illnesses. This study uses High-Pressure Liquid Chromatography (HPLC) with a Photodiode array detector (PDA) detector to examine the phytochemical composition of the ethanolic extract obtained from Hedera helix leaves and explores its potential as an anti-inflammatory agent. Specifically, flavonoids and polyphenolic compounds are the focus of this analysis.

Methods: Ethanol was used to extract compounds from ivy leaves. Real-time reverse-transcriptase polymerase chain reaction (RT-PCR) was used to investigate its anti-inflammatory properties using lipopolysaccharide-pretreated white blood cells. Phytochemical analysis of the ivy leaf extract was conducted using the reversed-phase HPLC with PDA.

Results: High-Pressure Liquid Chromatography of the ethanolic extract revealed the presence of numerous polyphenolic compounds, three of which were successfully identified as 4-Hydroxyphenyl acetic acid, rutin, and hesperidin. Furthermore, the extract demonstrated significant anti-inflammatory properties, notably inhibiting the gene expression of Interleukin-6.

Conclusions: The results of this investigation underscore the anti-inflammatory potential of Hedera helix extract. Various polyphenolic compounds and flavonoids were detected in the ethanolic extract, three of which were successfully identified. These compounds are presumed to be responsible for the observed activities. Further studies are necessary to elucidate the specific mechanisms of action.

Background: To analyze the factors associated with tip malposition and spontaneous correction rate of peripherally inserted central catheter (PICC) in newborns.

Methods: Clinical data of 1604 newborns who underwent PICC placement in our neonatal surgery department from January 2018 to January 2023 were retrospectively analyzed. They were divided into malposition group (n=104) and normal group (n=1500) according to the occurrence of tip malposition. The relevant clinical data of newborns were extracted from the hospital information system. The occurrence of PICC tip malposition and spontaneous correction were recorded. Logistic regression analysis was used to identify risk factors for PICC tip malposition in newborns.

Results: The incidence of PICC malposition was 6.48%. There were significant differences in gestational age, birth weight, lesion location, catheter direction and venous placement between the two groups (P<0.05). The independent risk factors for PICC tip malposition in newborns were lesion location, catheter direction and venous placement (P<0.05). The spontaneous correction rate within 24 hours was 27.88%, with the highest rate observed in malposition of the internal jugular vein.

Conclusion: Catheter direction, lesion location and venous placement are independent risk factors for PICC tip malposition in newborns, and some newborns may spontaneously correct within 24 hours.

Background: Carbapenems are the most commonly used antibiotics for severe infections induced by metallo-beta-lactamases producing Enterobacteriaceae and Pseudomonas aeruginosa. Resistance to almost all β-lactam antibiotics, including carbapenems, is conferred by metallo-β-lactamases (MBLs).

Objectives: Detection and inhibition of MBLs production as a promising approach to overcome resistance to carbapenems.

Methods: 160 clinical isolates of Acinetobacter baumannii, Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae were tested for antimicrobial susceptibility by The disk-diffusion method. The ability of the isolates to produce MBL enzyme was detected phenotypically and genotypically by PCR. The potential ability of pantoprazole and omeprazole to inhibit metallo-β-lactamases (MBLs) was confirmed by real-time PCR.

Results: Omeprazole and pantoprazole reduced the hydrolytic activities of MBLs. Both drugs had synergistic effects with meropenem. Meropenem minimum inhibitory concentration decreased in the presence of pantoprazole (2-16) folds, and omeprazole (2-32) folds. The metallo-β-lactamases genes bla_NDM , bla_IMP and bla_VIM were downregulated by both drugs. In silico study showed that both drugs had reasonable binding energy and revealed that omeprazole had higher binding energy and chelating activity of zinc ions of the enzymes.

Conclusion: The combination between meropenem and omeprazole or pantoprazole could be useful for treating infections caused by MBLs producing bacteria.

Background: During 2018-2020, almost half of all neonatal deaths reviewed in Uganda were due to birth asphyxia. In 2015, Uganda adopted the Every Newborn Action Plan interventions to renew the focus on surveillance for birth asphyxia and other childhood-related illnesses. In 2016, the Ministry of Health implemented an evidence-based educational program for birth attendants about neonatal resuscitation techniques to improve the management of birth asphyxia. We described the trends and distribution of birth asphyxia in Uganda during 2017-2020 following these renewed efforts.

Methods: We analysed birth asphyxia surveillance data from the District Health Information System 2 from January 2017-December 2020. We calculated the incidence of birth asphyxia per 1,000 deliveries at district, regional, and national levels. We used line graphs to demonstrate the trend of birth asphyxia incidence with the corresponding reporting rates at national and regional levels. We used logistic regression to evaluate the significance of the trends. Using choropleth maps, we described the distribution of birth asphyxia incidence at district level.

Results: The average national annual incidence of birth asphyxia in 2020 was 31 per 1,000, with an increase of 4.5% from 2017 to 2020 (OR=1.05; 95%CI=1.04-1.05, p=0.001), with national quarterly reporting rates of 70-80% over the same period. Incidence in the Northern and Eastern Regions increased by 6% (OR=1.06; 95%CI=1.05-1.07, p=0.001) and 5% (OR=1.05; 95%CI=1.03-1.05, p=0.001), respectively, over the study period. Bundibugyo, Iganga, and Mubende Districts had rates of >60/1,000 during each of the four years of the study period. The least affected district was Kazo District, with an overall incidence of 3/1,000 over the study period.

Conclusion: The incidence of birth asphyxia increased nationally from 2017-2020. We recommend efforts towards reducing the burden of birth asphyxia in Uganda, with emphasis on the most affected districts.

The Philadelphia chromosome is usually express on about 30% acute B lymphoblastic leukemia. Most of Ph-positive acute lymphoblastic leukemia patients have ela2 BCR-ABL transcripts, other atypical fusion genes such as ela3 have been rare reported. We reported a case of Ph-positive B-acute lymphoblastic leukemia with a scare ela3 fusion transcript. She presented with a complex karyotype and showed good early response to imatinib and dasatinib but relapsed six months after diagnosis, and E255v, T315I mutations were successively detected in the ABL kinase region, then he switched to ponatinib and underwent allogeneic hematopoietic stem cell transplantation. But the Minimal Residual Disease increased after 16 months, the patient was treated with CD19 chimeric antigen receptor T cell immunotherapy, and changed to olverembatinib targeted therapy. This subgroup of acute lymphoblastic leukemia might have poorer prognosis than patients with common transcripts. we recommend the third-generation tyrosine-kinase inhibitor as a first choice for their initial therapy and allogeneic hematopoietic stem cell transplantation or immunotherapy and new clinical trials should be considered as early as possible.

The estimated number of Africans suffering from some form of dementia in 2015 was 2.13 million and this is projected to rise to 7.62 million by 2050. Many sufferers engage in irrational behaviour which, across many African countries, is interpreted as resulting from witchcraft. As a result, the families of dementia sufferers are ostracised and dementia sufferers themselves are subject to violence. This article reports an action research project carried out in four rural communities near Goma in the eastern Democratic Republic of Congo in 2022 and 2023. In the exploration phase, data was collected from the families of dementia sufferers and from other community members concerning their experiences, attitudes and behaviour towards dementia sufferers and their families. This provided the basis for an intervention in the form of a community education programme which presented objective information about the disease. An evaluation of the outcomes of the intervention in two of the communities was carried out nine months later and found that there had been a dramatic positive change in attitudes and behaviour towards dementia sufferers, both by their families and by community members in general.

Background: "Ebinyo" is a form of infant oral mutilation (IOM) practiced by some traditional healers in parts of sub-Saharan Africa, and often results in severe health complications. We present a novel case of ebinyo in a child from northern Uganda which resulted in sepsis and disseminated intravascular coagulation (DIC) with peripheral extremity gangrene.

Case presentation: A 3-year-old male presented with two weeks of epistaxis, oralbleeding, and cough to a large referral hospital in northern Uganda. At home, the child had undergone ebinyo, performed by a traditional healer, and was receiving treatment for malaria. On arrival, the child presented with fever, jaundice, and malaise. Labs revealed pancytopenia and an elevated D-dimer, diagnosed as DIC. On day four, physical exam revealed demarcated darkening of the fourth digit on the right foot and third and fourth digits on the left foot, diagnosed as dry gangrene. A doppler ultrasound revealed lower extremity arterial insufficiency. On day seven, the patient started improving with vancomycin. On day eleven, the patient was discharged.

Conclusion: This case describes an uncommon sequela of sepsis and DIC with peripheral extremity gangrene after undergoing ebinyo. Prompt identification of ebinyo is critical for diagnosis and management of its complications.