Pub Date : 2023-10-14DOI: 10.23958/ijirms/vol08-i10/1765
Hala Aouroud, Aouroud Meryem, Fatima Ezzahra, Khadija Krati
We present the case of a 33-year-old female patient who was admitted for evaluation of cholestatic jaundice, dark urine, pale stools, and generalized, persistent pruritus. Her symptoms had been ongoing for the past 3 months, with no history of exposure to toxic substances, hepatotoxic medications, or medicinal herbs. Additionally, she reported atypical right upper quadrant abdominal pain and inflammatory polyarthralgia. Laboratory investigations revealed normochromic normocytic aregenerative anemia (hemoglobin 8.9 g/dL), normal white blood cell count, and normal platelet count. Her C-reactive protein (CRP) was markedly elevated at 66 mg/L, and alanine transaminase (ALT) and aspartate transaminase (AST) levels were five times the upper limit of normal. Gamma-glutamyl transferase (GGT) was eight times the upper limit of normal, alkaline phosphatase (ALP) was 13 times the upper limit of normal, and total bilirubin was predominantly conjugated (136 µmol/L). Prothrombin time (PT) was within the normal range at 88%. Abdominal imaging studies, including liver, portal vein, and hepatic veins, revealed no anomalies. Serological tests for hepatitis A, B, and C were negative. Autoimmune serology showed a positive antinuclear antibody (ANA) titer of 1/520, positive anti-double-stranded DNA (anti-dsDNA) antibodies, and positive anti-Smith (anti-sm) antibodies. Further investigations for autoimmune hepatitis were negative. A diagnosis of systemic lupus erythematosus (SLE) with hepatic involvement was established.
{"title":"Systemic Lupus Erythematosus Presenting with Cholestatic Jaundice and Hepatic Involvement: An Etiology Not to Be Overlooked: A Case Report and Literature Review","authors":"Hala Aouroud, Aouroud Meryem, Fatima Ezzahra, Khadija Krati","doi":"10.23958/ijirms/vol08-i10/1765","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i10/1765","url":null,"abstract":"We present the case of a 33-year-old female patient who was admitted for evaluation of cholestatic jaundice, dark urine, pale stools, and generalized, persistent pruritus. Her symptoms had been ongoing for the past 3 months, with no history of exposure to toxic substances, hepatotoxic medications, or medicinal herbs. Additionally, she reported atypical right upper quadrant abdominal pain and inflammatory polyarthralgia. Laboratory investigations revealed normochromic normocytic aregenerative anemia (hemoglobin 8.9 g/dL), normal white blood cell count, and normal platelet count. Her C-reactive protein (CRP) was markedly elevated at 66 mg/L, and alanine transaminase (ALT) and aspartate transaminase (AST) levels were five times the upper limit of normal. Gamma-glutamyl transferase (GGT) was eight times the upper limit of normal, alkaline phosphatase (ALP) was 13 times the upper limit of normal, and total bilirubin was predominantly conjugated (136 µmol/L). Prothrombin time (PT) was within the normal range at 88%. Abdominal imaging studies, including liver, portal vein, and hepatic veins, revealed no anomalies. Serological tests for hepatitis A, B, and C were negative. Autoimmune serology showed a positive antinuclear antibody (ANA) titer of 1/520, positive anti-double-stranded DNA (anti-dsDNA) antibodies, and positive anti-Smith (anti-sm) antibodies. Further investigations for autoimmune hepatitis were negative. A diagnosis of systemic lupus erythematosus (SLE) with hepatic involvement was established.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135803821","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}
Pub Date : 2023-10-13DOI: 10.23958/ijirms/vol08-i10/1764
Flavio Fraga Vilela, Kam Cheong Wong, Guilherme Miranda Bócoli, Maria Fernanda Silva Junho, Mariana Nunes Lima Dias, Poliana Custodio Zampollo, Lucas Henrique De Carvalho Machado
Patient safety has been gaining prominence since the beginning of the 20th century, as it is a fundamental component of quality in health. This way, the application of Lean Healthcare (LH) can offer patient-focused care, achieving better results for patients, institutional management, operational management, greater customer and employee satisfaction. In this context, the present study aims to apply the LH, through the Ishikawa Diagram, to look for the possible causes of delays in surgical procedures in a regional hospital. The research used a cross-sectional, retrospective and quantitative study to survey the prevalence and nature of errors and their causes. After that, visits were made to the surgical center to explain the application of Ishikawa Diagram and its practical importance. Then, using the Ishikawa Diagram tool, the professionals were asked about the possible causes of the situation presented, participating in the elaboration of cause-effect diagrams together with the researchers through the use of a digital technology conceived in VBA (Visual Basic Application). After analysing 32 surgical procedures, four root main causes and twelve specific causes were identified for the delays in the surgical procedure. Workforce is the main cause of delays in the operating room (51%), followed by methods (22%). These causes resulted in financial losses for the hospital. However, these causes could be identified and prevented.
{"title":"Lean Healthcare in A Brazilian Hospital: Application of the Ishikawa Diagram in the Processes Management of an Operating Theater","authors":"Flavio Fraga Vilela, Kam Cheong Wong, Guilherme Miranda Bócoli, Maria Fernanda Silva Junho, Mariana Nunes Lima Dias, Poliana Custodio Zampollo, Lucas Henrique De Carvalho Machado","doi":"10.23958/ijirms/vol08-i10/1764","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i10/1764","url":null,"abstract":"Patient safety has been gaining prominence since the beginning of the 20th century, as it is a fundamental component of quality in health. This way, the application of Lean Healthcare (LH) can offer patient-focused care, achieving better results for patients, institutional management, operational management, greater customer and employee satisfaction. In this context, the present study aims to apply the LH, through the Ishikawa Diagram, to look for the possible causes of delays in surgical procedures in a regional hospital. The research used a cross-sectional, retrospective and quantitative study to survey the prevalence and nature of errors and their causes. After that, visits were made to the surgical center to explain the application of Ishikawa Diagram and its practical importance. Then, using the Ishikawa Diagram tool, the professionals were asked about the possible causes of the situation presented, participating in the elaboration of cause-effect diagrams together with the researchers through the use of a digital technology conceived in VBA (Visual Basic Application). After analysing 32 surgical procedures, four root main causes and twelve specific causes were identified for the delays in the surgical procedure. Workforce is the main cause of delays in the operating room (51%), followed by methods (22%). These causes resulted in financial losses for the hospital. However, these causes could be identified and prevented.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135854057","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}
Pub Date : 2023-10-13DOI: 10.23958/ijirms/vol08-i10/1763
Hala Aouroud, Adil Ait Errami, Nayala Hanane Essaidi, FZ. Lairani, O. Nacir, Sofia Oubaha, Zouhour Samlani, Khadija Krati
Poor therapeutic compliance in inflammatory bowel diseases (IBD) has a negative impact on treatment efficacy and patients' quality of life. Addressing this issue requires an understanding of the factors involved, which include patient-related factors, socioeconomic conditions, treatment, and healthcare system factors. The aim of this study was to identify the factors responsible for poor therapeutic compliance in patients with IBD in our context. We conducted a prospective study involving 120 patients with IBD over a 10-month period. Data was collected using two questionnaires: one general questionnaire exploring factors influencing compliance and another specific one (Morisky Score) assessing the level of compliance. Of the 120 patients included, the average age was 39.66 years, with a female predominance. Crohn's disease was the most common pathology (71.7%), and 75% of patients were adherent to treatment. Lack of means was the most common reason for treatment abandonment. Bivariate analysis revealed a significant correlation between compliance, gender, monthly income, number of hospitalizations, number of daily doses, cost, perception of treatment importance, access to the treating physician, and mode of communication. Therefore, improving therapeutic compliance requires continuous support from healthcare professionals and the healthcare system, as well as responsible patients.
{"title":"Compliance to Drug Therapy in Inflammatory Bowel Diseases: A Monocentric Experience","authors":"Hala Aouroud, Adil Ait Errami, Nayala Hanane Essaidi, FZ. Lairani, O. Nacir, Sofia Oubaha, Zouhour Samlani, Khadija Krati","doi":"10.23958/ijirms/vol08-i10/1763","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i10/1763","url":null,"abstract":"Poor therapeutic compliance in inflammatory bowel diseases (IBD) has a negative impact on treatment efficacy and patients' quality of life. Addressing this issue requires an understanding of the factors involved, which include patient-related factors, socioeconomic conditions, treatment, and healthcare system factors. The aim of this study was to identify the factors responsible for poor therapeutic compliance in patients with IBD in our context. We conducted a prospective study involving 120 patients with IBD over a 10-month period. Data was collected using two questionnaires: one general questionnaire exploring factors influencing compliance and another specific one (Morisky Score) assessing the level of compliance. Of the 120 patients included, the average age was 39.66 years, with a female predominance. Crohn's disease was the most common pathology (71.7%), and 75% of patients were adherent to treatment. Lack of means was the most common reason for treatment abandonment. Bivariate analysis revealed a significant correlation between compliance, gender, monthly income, number of hospitalizations, number of daily doses, cost, perception of treatment importance, access to the treating physician, and mode of communication. Therefore, improving therapeutic compliance requires continuous support from healthcare professionals and the healthcare system, as well as responsible patients.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135918711","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}
Pub Date : 2023-10-13DOI: 10.23958/ijirms/vol08-i10/1761
Victoria Muñoz Guillermo, Tomás Fernández Aparicio, Francisco. M Sánchez-Margallo, Federico Soria
Background: Endoureterotomy is a procedure that depends on healing by secondary intention. Healing of the ureteral muscle layer can provoke re-stricture after endoureterotomy. The aim of this comparative study was to assess the impact of ureteral muscle layer damage on ureteral healing after four endourological techniques. Methods: A total of 96 female pigs underwent initial endoscopic, nephrosonographic, and contrast fluoroscopic assessment of the urinary tract. After baseline studies, a ureteral stricture was created. Three weeks later, the ureteral stricture was diagnosed and treated. Animals were randomly assigned to four groups (Group-I, Balloon dilatation endoureterotomy; Group-II, Cold endoureterotomy with scissors; Group-III, Monopolar hot electrocautery; Group-IV, Holmium laser retrograde endoureterotomy) in which a double-pigtail ureteral stent was placed for 3 weeks. Follow-up evaluations were performed at 3–6 weeks. The final follow-up was completed at 5 months and included the aforementioned diagnostic methods and pathological study. Results: In terms of therapeutic success, complete resolution was observed in 83% of cases. No evidence of vesicoureteral reflux nor urinary tract anomalies were observed. None of the endoureteromy procedures showed statistically significant differences in ureteral muscle layer remodeling. However, less ureteral muscle layer damage was significantly associated with higher success rates in ureteral treatment and healing. The presence of a positive uroculture was associated with more extensive ureteral muscle layer damage. Conclusions: The results of this comparative study in a porcine model indicated that ureteral muscle layer damage after endoureterotomy did not differ significantly between the different analyzed endourological techniques. The extent of ureteral muscle layer damage is a predictive factor of successful ureteral healing after endoureterotomy.
{"title":"Impact of Ureteral Muscle Layer Damage on Ureteral Healing after Endoureterotomy: Experimental Animal Study","authors":"Victoria Muñoz Guillermo, Tomás Fernández Aparicio, Francisco. M Sánchez-Margallo, Federico Soria","doi":"10.23958/ijirms/vol08-i10/1761","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i10/1761","url":null,"abstract":"Background: Endoureterotomy is a procedure that depends on healing by secondary intention. Healing of the ureteral muscle layer can provoke re-stricture after endoureterotomy. The aim of this comparative study was to assess the impact of ureteral muscle layer damage on ureteral healing after four endourological techniques. Methods: A total of 96 female pigs underwent initial endoscopic, nephrosonographic, and contrast fluoroscopic assessment of the urinary tract. After baseline studies, a ureteral stricture was created. Three weeks later, the ureteral stricture was diagnosed and treated. Animals were randomly assigned to four groups (Group-I, Balloon dilatation endoureterotomy; Group-II, Cold endoureterotomy with scissors; Group-III, Monopolar hot electrocautery; Group-IV, Holmium laser retrograde endoureterotomy) in which a double-pigtail ureteral stent was placed for 3 weeks. Follow-up evaluations were performed at 3–6 weeks. The final follow-up was completed at 5 months and included the aforementioned diagnostic methods and pathological study. Results: In terms of therapeutic success, complete resolution was observed in 83% of cases. No evidence of vesicoureteral reflux nor urinary tract anomalies were observed. None of the endoureteromy procedures showed statistically significant differences in ureteral muscle layer remodeling. However, less ureteral muscle layer damage was significantly associated with higher success rates in ureteral treatment and healing. The presence of a positive uroculture was associated with more extensive ureteral muscle layer damage. Conclusions: The results of this comparative study in a porcine model indicated that ureteral muscle layer damage after endoureterotomy did not differ significantly between the different analyzed endourological techniques. The extent of ureteral muscle layer damage is a predictive factor of successful ureteral healing after endoureterotomy.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135854218","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}
Pub Date : 2023-10-12DOI: 10.23958/ijirms/vol08-i10/1758
SNEHA RAVINDRA, ANITA P JAVALGI, VIDISHA ATHANIKAR
Background: Sino-nasal lesions present similar to each other ranging from congenital, infectious, inflammatory, and traumatic to neoplastic causes, which need histopathological confirmation. Lesions like fungal sinusitis represent a fulminant, potentially fatal, disease process in immunocompromised patients. The diagnosis rests on high index of clinical suspicion with diagnostic and therapeutic implications of intraoperative consultation. Present study aimed at evaluation of sensitivity, specificity and diagnostic accuracy of intraoperative consultation in Sino-nasal lesions. Design: Present study is 10year observational cross-sectional study (October 2011 to October 2021). A total of 203 Sino-nasal lesions that were received for intraoperative consultation at histopathology laboratory were included. Frozen slides and confirmed histopathology slides of these cases were reviewed and statistical analysis done. Results: Total 203 cases were reviewed. The cases were categorised into non neoplastic, benign and malignant lesions. Fungal sinusitis (mucormycosis> aspergillosis > candidiasis) was commonest in non-neoplastic, inverted papilloma was commonest in benign lesions and adenocarcinoma was commonest in malignant lesions. Male predominance was seen in all 3 categories. Predominant age group affected was 41-60 years. The sensitivity, specificity, positive predictive value, and negative predictive value of non-neoplastic, benign and malignant lesions of frozen section were 93%, 75%, 98.80%, and 64.86%; 100%, 100%,100%, and 100%; and 100%, 98.90%, 100% and 85.70%, respectively. Conclusion: Present study emphasises that frozen studies are highly sensitive in the diagnosis of Sino-nasal lesions. Intra-operative diagnosis of fungal infections thereby facilitates immediate targeted treatment strategies for optimal outcomes.
{"title":"Intraoperative Consultation of Sino-Nasal Lesions: A Decade Experience at Tertiary Care Hospital","authors":"SNEHA RAVINDRA, ANITA P JAVALGI, VIDISHA ATHANIKAR","doi":"10.23958/ijirms/vol08-i10/1758","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i10/1758","url":null,"abstract":"Background: Sino-nasal lesions present similar to each other ranging from congenital, infectious, inflammatory, and traumatic to neoplastic causes, which need histopathological confirmation. Lesions like fungal sinusitis represent a fulminant, potentially fatal, disease process in immunocompromised patients. The diagnosis rests on high index of clinical suspicion with diagnostic and therapeutic implications of intraoperative consultation. Present study aimed at evaluation of sensitivity, specificity and diagnostic accuracy of intraoperative consultation in Sino-nasal lesions. Design: Present study is 10year observational cross-sectional study (October 2011 to October 2021). A total of 203 Sino-nasal lesions that were received for intraoperative consultation at histopathology laboratory were included. Frozen slides and confirmed histopathology slides of these cases were reviewed and statistical analysis done. Results: Total 203 cases were reviewed. The cases were categorised into non neoplastic, benign and malignant lesions. Fungal sinusitis (mucormycosis> aspergillosis > candidiasis) was commonest in non-neoplastic, inverted papilloma was commonest in benign lesions and adenocarcinoma was commonest in malignant lesions. Male predominance was seen in all 3 categories. Predominant age group affected was 41-60 years. The sensitivity, specificity, positive predictive value, and negative predictive value of non-neoplastic, benign and malignant lesions of frozen section were 93%, 75%, 98.80%, and 64.86%; 100%, 100%,100%, and 100%; and 100%, 98.90%, 100% and 85.70%, respectively. Conclusion: Present study emphasises that frozen studies are highly sensitive in the diagnosis of Sino-nasal lesions. Intra-operative diagnosis of fungal infections thereby facilitates immediate targeted treatment strategies for optimal outcomes.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135968194","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}
Pub Date : 2023-10-12DOI: 10.23958/ijirms/vol08-i10/1752
Angelina Iyinbor, Benjamin Doolittle
Objective: To design an effective and accessible intervention to foster joy in medicine and connection among resident physicians. Background: Physician thriving is a complex construct captured by Aristotle’s concept of eudaimonia: doing good and feeling good about one’s work. Prior studies among resident physicians proposed social connection and joy in medicine as important factors for resident thriving. We hypothesize that our intervention of combining the Three Good Things (3GT), a positive psychology exercise, and a weekly family-style dinner reflecting upon the 3GT would help develop these domains and cultivate eudaimonia. Methods: A pilot study of the two interventions was conducted between February 13 to February 27, 2023 among internal medicine and medicine-pediatrics residents (PGY1-PGY4) at a single institution. Participants completed the 3GT exercise daily. Several validated instruments were completed at project enrollment, mid-way through the intervention, and one month after completion: the Two-Question Maslach Burnout Inventory, the Professional Quality of Life Scale, which assesses for burnout, compassion fatigue, and compassion satisfaction, and the Harvard Flourishing Index. This protocol was approved by the Institutional Review Board of the Yale University School of Medicine. Results: Seven residents enrolled and five completed the project, of which three completed all three of the surveys (pre-, midpoint, and post-project). Burnout decreased in 1 (33%) of participants at the midpoint of the study and in 3 (100%) after one month. Compassion satisfaction improved in 2 (67%) of participants both midway through the study and at one month follow up. Flourishing increased in 1 (33%) of participants midway and 2 (67%) at one month post study completion. All participants acknowledged increased awareness of positive experiences after beginning 3GT exercises. All participants expressed desire in expanding family dinners to the entire program and found them helpful in building community. Conclusion: The 3GT and family style dinners are helpful interventions in fostering compassion satisfaction, connection, and positive reflections, and decreasing burnout. Further study with a larger sample size, in other programs, is necessary to provide generalizability. Including regular family style dinners at a program-wide level may increase thriving.
{"title":"Fostering Eudaimonia, Joy, and Connection among Resident Physicians: A Pilot Study","authors":"Angelina Iyinbor, Benjamin Doolittle","doi":"10.23958/ijirms/vol08-i10/1752","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i10/1752","url":null,"abstract":"Objective: To design an effective and accessible intervention to foster joy in medicine and connection among resident physicians. Background: Physician thriving is a complex construct captured by Aristotle’s concept of eudaimonia: doing good and feeling good about one’s work. Prior studies among resident physicians proposed social connection and joy in medicine as important factors for resident thriving. We hypothesize that our intervention of combining the Three Good Things (3GT), a positive psychology exercise, and a weekly family-style dinner reflecting upon the 3GT would help develop these domains and cultivate eudaimonia. Methods: A pilot study of the two interventions was conducted between February 13 to February 27, 2023 among internal medicine and medicine-pediatrics residents (PGY1-PGY4) at a single institution. Participants completed the 3GT exercise daily. Several validated instruments were completed at project enrollment, mid-way through the intervention, and one month after completion: the Two-Question Maslach Burnout Inventory, the Professional Quality of Life Scale, which assesses for burnout, compassion fatigue, and compassion satisfaction, and the Harvard Flourishing Index. This protocol was approved by the Institutional Review Board of the Yale University School of Medicine. Results: Seven residents enrolled and five completed the project, of which three completed all three of the surveys (pre-, midpoint, and post-project). Burnout decreased in 1 (33%) of participants at the midpoint of the study and in 3 (100%) after one month. Compassion satisfaction improved in 2 (67%) of participants both midway through the study and at one month follow up. Flourishing increased in 1 (33%) of participants midway and 2 (67%) at one month post study completion. All participants acknowledged increased awareness of positive experiences after beginning 3GT exercises. All participants expressed desire in expanding family dinners to the entire program and found them helpful in building community. Conclusion: The 3GT and family style dinners are helpful interventions in fostering compassion satisfaction, connection, and positive reflections, and decreasing burnout. Further study with a larger sample size, in other programs, is necessary to provide generalizability. Including regular family style dinners at a program-wide level may increase thriving.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"248 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135968189","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}
Pub Date : 2023-10-12DOI: 10.23958/ijirms/vol08-i10/1755
Ayia Eltayeb
Background: The literature shows inconsistency about the influencing of time of birth on pregnancy outcomes across countries, no such data exit in Sudan. Thus, the current study aimed to investigate the influence of time and day of birth on maternal and perinatal outcomes among women with low-risk pregnancy in Khartoum, Sudan. Methods: A cross-sectional study was conducted from July 2021 to August 2022 in Saad Abuelela maternity hospital, Khartoum Sudan. A structured questionnaire was used to collected sociodemographic and obstetrical data. Chi-square test was performed. Results: A total of 388 pregnant women were recruited from all low-risk women who delivered in the hospitals The mean (standard deviation) age of the women was 28.26(6.9) years and 172 (44.3%) were primiparas. According to type/frequency of complications occurred, those who were shifted to interventional delivery for fetal compromise 162(41.8%) i.e. emergency caesarean delivery 139(35.8%), and instrumental delivery 23 (5.9%); total maternal complications 51(13.1%) including who 3rd or 4th perineal tears were 12(3.1%), who complicated by postpartum hemorrhage were 36(9.3%), who experienced uterine rupture were 3(0.8%); total neonatal complications 175(45.1%) i.e. who had newborn birth injuries were 10(2.6%); who had birth Asphyxia were 62(16.0%) and who had neonatal admission to neonatal intensive care unit (NICU) were 103(26.5%). There was no association between type/frequency of complications and part of the week (working days vs. weekend days) (P value = 0.915), there was a significant statistical association with part of the day (daytime vs. evening and night-time) (P value = 0.005). Conclusion: Poor maternal and perinatal outcomes among low risk Sudanese pregnant women was found to be associated with time per day regardless of week or weekend day and not day of week. All efforts should be directed to provide appropriate healthcare services for all pregnant women regardless of time, assessing our local healthcare systems (its weakness, strengths, and opportunities) is a good start to improve maternal and perinatal health in Sudan.
{"title":"The Impacts of Time of Birth on Maternal and Perinatal Outcomes in Low-Risk Pregnancy in Khartoum, Sudan: A Cross-Sectional Hospital-Based Study","authors":"Ayia Eltayeb","doi":"10.23958/ijirms/vol08-i10/1755","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i10/1755","url":null,"abstract":"Background: The literature shows inconsistency about the influencing of time of birth on pregnancy outcomes across countries, no such data exit in Sudan. Thus, the current study aimed to investigate the influence of time and day of birth on maternal and perinatal outcomes among women with low-risk pregnancy in Khartoum, Sudan. Methods: A cross-sectional study was conducted from July 2021 to August 2022 in Saad Abuelela maternity hospital, Khartoum Sudan. A structured questionnaire was used to collected sociodemographic and obstetrical data. Chi-square test was performed. Results: A total of 388 pregnant women were recruited from all low-risk women who delivered in the hospitals The mean (standard deviation) age of the women was 28.26(6.9) years and 172 (44.3%) were primiparas. According to type/frequency of complications occurred, those who were shifted to interventional delivery for fetal compromise 162(41.8%) i.e. emergency caesarean delivery 139(35.8%), and instrumental delivery 23 (5.9%); total maternal complications 51(13.1%) including who 3rd or 4th perineal tears were 12(3.1%), who complicated by postpartum hemorrhage were 36(9.3%), who experienced uterine rupture were 3(0.8%); total neonatal complications 175(45.1%) i.e. who had newborn birth injuries were 10(2.6%); who had birth Asphyxia were 62(16.0%) and who had neonatal admission to neonatal intensive care unit (NICU) were 103(26.5%). There was no association between type/frequency of complications and part of the week (working days vs. weekend days) (P value = 0.915), there was a significant statistical association with part of the day (daytime vs. evening and night-time) (P value = 0.005). Conclusion: Poor maternal and perinatal outcomes among low risk Sudanese pregnant women was found to be associated with time per day regardless of week or weekend day and not day of week. All efforts should be directed to provide appropriate healthcare services for all pregnant women regardless of time, assessing our local healthcare systems (its weakness, strengths, and opportunities) is a good start to improve maternal and perinatal health in Sudan.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136014110","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}
Pub Date : 2023-10-06DOI: 10.23958/ijirms/vol08-i10/1762
Ibrahim halil Açar, Birol Guvenc
Introduction and Objective: Aggressive systemic mastocytosis is a lethal disease with poor prognosis in which organ damage due to mast cell activation is observed and response to medical treatment is low. The aim of this study was to evaluate the clinicopathological characteristics of ASM patients and the efficacy of cytoreductive treatments. Patients and methods: The clinicopathological features and survival analyses of 27 patients who were followed up with a diagnosis of aggressive systemic mastocytosis (ASM) and treated with cytoreductive therapy between 2017 and 2021 in our center were evaluated. Results: The mean age of the patients was 59 years and there was a slight male gender predominance (5: 4). KITD816V mutation was positive in 85% of cases. The most common symptoms at the time of diagnosis were fatigue, pruritus and dyspeptic complaints, respectively. The number of patients evaluable for response to imatinib, peginterferon alfa-2a (Peg-Ifn), cladribine and midostaurin treatments were 4, 7, 8 and 8, and the overall (partial) response rates were 25% (25%), 42% (28%), 50% (38%) and 37% (25%), respectively. Most of the responses were partial (PR) and major response (MR) was seen in very few patients. Increasing ECOG score, serum tryptase level, spleen size, and WBC count increased mortality, while decreasing hemoglobin level increased mortality. General median overall survival (OS) was 27.74 months (35.11-143.88). Two-year survival rate was 88.9% and 5-year survival rate was 63.1%. Median overall disease-free survival (DFS) was 10.86 months (9.27-12.50). Two-year DFS was 22.2%, while 5-year DFS was only 7.4%. Conclusion: The depth of response and response rates of the current therapies used in the treatment of ASM are quite low and insufficient to control the disease. Since there is an unmet therapeutic area in the treatment of ASM, there is a need for the development of new treatment modalities.
{"title":"Clinical Characteristics of Patients with Aggressive Systemic Mastocytosis and Efficacy Analysis of Systemic Therapies: A Monocentric Real-World Experience","authors":"Ibrahim halil Açar, Birol Guvenc","doi":"10.23958/ijirms/vol08-i10/1762","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i10/1762","url":null,"abstract":"Introduction and Objective: Aggressive systemic mastocytosis is a lethal disease with poor prognosis in which organ damage due to mast cell activation is observed and response to medical treatment is low. The aim of this study was to evaluate the clinicopathological characteristics of ASM patients and the efficacy of cytoreductive treatments. Patients and methods: The clinicopathological features and survival analyses of 27 patients who were followed up with a diagnosis of aggressive systemic mastocytosis (ASM) and treated with cytoreductive therapy between 2017 and 2021 in our center were evaluated. Results: The mean age of the patients was 59 years and there was a slight male gender predominance (5: 4). KITD816V mutation was positive in 85% of cases. The most common symptoms at the time of diagnosis were fatigue, pruritus and dyspeptic complaints, respectively. The number of patients evaluable for response to imatinib, peginterferon alfa-2a (Peg-Ifn), cladribine and midostaurin treatments were 4, 7, 8 and 8, and the overall (partial) response rates were 25% (25%), 42% (28%), 50% (38%) and 37% (25%), respectively. Most of the responses were partial (PR) and major response (MR) was seen in very few patients. Increasing ECOG score, serum tryptase level, spleen size, and WBC count increased mortality, while decreasing hemoglobin level increased mortality. General median overall survival (OS) was 27.74 months (35.11-143.88). Two-year survival rate was 88.9% and 5-year survival rate was 63.1%. Median overall disease-free survival (DFS) was 10.86 months (9.27-12.50). Two-year DFS was 22.2%, while 5-year DFS was only 7.4%. Conclusion: The depth of response and response rates of the current therapies used in the treatment of ASM are quite low and insufficient to control the disease. Since there is an unmet therapeutic area in the treatment of ASM, there is a need for the development of new treatment modalities.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134943604","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}
Pub Date : 2023-09-24DOI: 10.23958/ijirms/vol08-i09/1751
MICHELLE ALEJANDRA MACIAS GRAGEDA, Jorge Andres Montenegro Salcedo, Jorge Alejandro Rodríguez Ruiz, Alfonso Sánchez Terán, Oscar García Gonzalez, Edgard Lozada Hernandez
Purpose: The present article describes a patient with an atypical teratoid/rhabdoid tumor of the pineal region and a literature review about this uncommon pathology. Methods: Literature review about Atypical Teratoid Rhabdoid Tumor between March and July of 2023 using 7 databases: Web of Science, Pubmed, Cochrane Library, SCOPUS, Science Direct, Clinical key and Medscape. Clinical features: A 33-month-old patient with an Atypical Teratoid Rhabdoid Tumor (ATRT) of the pineal region presented headache, VI cranial nerve paralysis, bilateral ataxia and loss of sphincters control during 3 months. Intervention: Endoscopic ventriculostomy with biopsy that reported ATRT. Conclusions: Recent statistics show that this tumor has been underdiagnosed throughout the time and evaluation of surgical material by a neuropathologist is required for its correct diagnosis.
目的:本文报道一例不典型的松果体区畸胎瘤/横纹肌样瘤，并对这种罕见的病理进行文献回顾。方法:采用Web of Science、Pubmed、Cochrane Library、SCOPUS、Science Direct、Clinical key、Medscape等7个数据库，对2023年3 - 7月关于非典型畸胎体横纹肌样肿瘤的文献进行综述。临床特征:一例33个月大的松果体区非典型畸胎体横纹肌瘤(ATRT)患者，在3个月内出现头痛、脑神经麻痹、双侧共济失调和括约肌控制丧失。干预:内窥镜脑室造口术和活检报告ATRT。结论:最近的统计数据显示，该肿瘤一直被误诊，需要神经病理学家对手术材料进行评估才能正确诊断。
{"title":"Atypical Teratoid Rhabdoid Tumor of the Pineal Region in a 33-Month-Old Child: A Case Report","authors":"MICHELLE ALEJANDRA MACIAS GRAGEDA, Jorge Andres Montenegro Salcedo, Jorge Alejandro Rodríguez Ruiz, Alfonso Sánchez Terán, Oscar García Gonzalez, Edgard Lozada Hernandez","doi":"10.23958/ijirms/vol08-i09/1751","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i09/1751","url":null,"abstract":"Purpose: The present article describes a patient with an atypical teratoid/rhabdoid tumor of the pineal region and a literature review about this uncommon pathology. Methods: Literature review about Atypical Teratoid Rhabdoid Tumor between March and July of 2023 using 7 databases: Web of Science, Pubmed, Cochrane Library, SCOPUS, Science Direct, Clinical key and Medscape. Clinical features: A 33-month-old patient with an Atypical Teratoid Rhabdoid Tumor (ATRT) of the pineal region presented headache, VI cranial nerve paralysis, bilateral ataxia and loss of sphincters control during 3 months. Intervention: Endoscopic ventriculostomy with biopsy that reported ATRT. Conclusions: Recent statistics show that this tumor has been underdiagnosed throughout the time and evaluation of surgical material by a neuropathologist is required for its correct diagnosis.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135925547","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}
Awareness of the detrimental effects of vaping on the respiratory system has significantly increased in the last few years. In July 2019 the Wisconsin Department of Health Services and the Illinois Department of Public Health established the definitions for e-cigarette or vaping product use-associated lung injury (EVALI); it was mostly attributed to the flavoring agents containing vitamin E acetate which in the aerosol form causes surfactant dysfunction. The diagnosis and management of severe EVALI still remain a challenge as the presentation can be easily confused with many other respiratory conditions. There are no guidelines regarding the management of those patients and outcomes vary from total resolution to development of chronic lung disease. We present a patient with EVALI and acute respiratory distress syndrome (ARDS) that was successfully treated with steroids.
{"title":"Acute Respiratory Failure Due to Vaping-Induced Lung Injury: A Case Report and Management Review","authors":"Kinnera Sahithi Urlapu, Sindhaghatta Venkatram, Maryam Soliman, Diana Ronderos, Gilda Diaz-Fuentes","doi":"10.23958/ijirms/vol08-i09/1749","DOIUrl":"https://doi.org/10.23958/ijirms/vol08-i09/1749","url":null,"abstract":"Awareness of the detrimental effects of vaping on the respiratory system has significantly increased in the last few years. In July 2019 the Wisconsin Department of Health Services and the Illinois Department of Public Health established the definitions for e-cigarette or vaping product use-associated lung injury (EVALI); it was mostly attributed to the flavoring agents containing vitamin E acetate which in the aerosol form causes surfactant dysfunction. The diagnosis and management of severe EVALI still remain a challenge as the presentation can be easily confused with many other respiratory conditions. There are no guidelines regarding the management of those patients and outcomes vary from total resolution to development of chronic lung disease. We present a patient with EVALI and acute respiratory distress syndrome (ARDS) that was successfully treated with steroids.","PeriodicalId":94374,"journal":{"name":"International journal of innovative research in medical science","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135966194","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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