AIM:To evaluate the demographics,clinical characteristics,treatments,and outcomes of patients with ocular surface squamous neoplasia(OSSN)at the Philippine General Hospital.METHODS:This was a single-center,11-year ret...AIM:To evaluate the demographics,clinical characteristics,treatments,and outcomes of patients with ocular surface squamous neoplasia(OSSN)at the Philippine General Hospital.METHODS:This was a single-center,11-year retrospective,cross sectional case series on 18 cases of OSSN seen between January 2012 to June 2023.The patient’s demographics,presenting symptoms,tumor characteristics,histopathologic diagnosis,treatment,outcomes,and duration of follow-up were reviewed.RESULTS:Out of 33 identified cases of OSSN,only 18 were eligible for inclusion in the study.Mean age was 60.78y(range 31 to 80),with male predominance(66.67%).The left eye was most commonly affected(61.11%)with most presenting with fleshy mass(83.33%).Most tumors were located nasally(66.67%)and were predominantly papilliform(44.44%)in morphology with associated hyperpigmentation(38.89%).Squamous cell carcinoma(SCCA)was the most common histopathologic diagnosis(72.22%).The main primary treatment was surgical excision(94.44%)with or without adjunctive therapy,with only 1 patient undergoing first-line topical chemotherapy.Only 3 recurrences(16.67%)were noted with a median followup of 7.5mo.A statistically significant recurrence-free odds leaning towards the utilization of cryotherapy was noted.CONCLUSION:OSSN seen at the Philippine General Hospital is presented as a limbal papilliform mass,most commonly affecting elderly males.Surgical excision with adjuvant cryotherapy and/or chemotherapy is the preferred mode of treatment.展开更多
Introduction: Antibiotic resistance is a public health problem. It is due to multi-resistant bacteria (MRB). The objective of this study was to determine bacterial resistance to antibiotics in chronic renal failure at...Introduction: Antibiotic resistance is a public health problem. It is due to multi-resistant bacteria (MRB). The objective of this study was to determine bacterial resistance to antibiotics in chronic renal failure at the Edith Lucie BONGO ONDIMBA general hospital (HGELBO). Patients, material and method: This was an analytical cross-sectional study conducted from January 1 to August 31, 2019 at the HGELBO. It concerned all patients admitted to the HGELBO with positive bacteriological samples. After a study of the sensitivity to isolated species, the patients were divided into two (02) groups: those MRB positive (+) and not MRB or negative (-). Epi Info software version 3.5.1 was used for the calculation of the rates and the comparison of the variables. The adjusted odds ratio (ORa) with a 95% confidence interval was used to measure the specific effect of each risk factor such as chronic kidney disease and diabetes, in order to rule out confounding factors. Multivariate analysis by binomial logistic regression was used. Results: There were 375 bacteriological samples from 258 patients, among them 247 patients with 235 positive samples or 63%. The eleven (11) are healthy patients. The median age was 33 with extremes ranging from 16 to 90. The female sex was predominant with a sex ratio of 0.6. The majority of MRB+ cases were found in internal medicine and nephrology with 12 cases (38.7%) and hemodialysis with 4 cases (12.9%). Urinary samples were in the majority with 74.5%. <i>Escherichia coli</i> was predominant in 30.3%. After studying the sensitivity to antibiotics of the 247 species included, 113 were MRB+ and 134 BMR- <i>i.e.</i> a frequency of 45.7%. Methicilin-resistant <i>Staphylococcus aureus</i> (MRSA) was predominant (51.3%). Multivariate logistic regression analysis showed that the main risk factor was antibiotic use (0Ra: 3.2 [1.9 - 5.4];p-value < 0.01). Chronic renal failure and diabetes were not risk factors for carriage. The other risk factors identified were: hospitalization of more than 7 days (prolonged), <i>S. aureus</i> infection and male sex. Conclusion: Probabilistic antibiotic therapy leads to the selection of BMRs. Long hospital stays, male sex, and MRSA are risk factors or determinants of antibiotic resistance, but not chronic kidney disease.展开更多
Background: Preterm birth defined as childbirth occurring at less than 37 completed weeks or 259 days of gestation. The causes of preterm birth are complex and multifactorial, many risk factors that contribute in it. ...Background: Preterm birth defined as childbirth occurring at less than 37 completed weeks or 259 days of gestation. The causes of preterm birth are complex and multifactorial, many risk factors that contribute in it. Knowledge of risk factors is crucial for predicting the incidence of preterm births. This study aimed to determine the factors associated with preterm birth at the Hasan Sadikin General Hospital. Method: This study was a cross-sectional analytic using secondary data. Data derived from medical records maternity patients in the Department of Obstetrics and Gynecology Hasan Sadikin General Hospital taken in 2015. 1944 patients’ medical records who gave birth met the inclusion criteria. Data analyses used were bivariate (chi square) and multivariate (logistic regression). Result: The result showed that the variables including age (p = 0.043, OR = 1.586), antenatal care (p p p p p p Conclusion: There is a significant relationship between age, antenatal care, preterm birth history birth, anemia, hypertension, and antepartum hemorrhage with preterm birth as risk factors.展开更多
AIM： TO explore the prevalence of gallstone disease （GSD） in Taiwan and condition-associated factors related to it. METHODS： We studied a total of 2386 healthy adults （1235 males and 1151 females） voluntarily ad...AIM： TO explore the prevalence of gallstone disease （GSD） in Taiwan and condition-associated factors related to it. METHODS： We studied a total of 2386 healthy adults （1235 males and 1151 females） voluntarily admitted to Cheng Hsin General Hospital for a paid physical check-up between January 2002 and December 2002. Blood samples and ultrasound sonography results were collected. RESULTS： The overall prevalence of GSD among this study-population was 5.3%, including 1.7% （n=40） having a single stone, 2.3% （n = 55） having multiple stones, and 1.3% （n = 31） having cholecystectomy. The prevalence revealed a statistically significant increase with increasing age （P〈 0.0001）. Females exhibited a greater prevalence of multiple stones than did males （3.0% vs 1.7%, P= 0.04）. Using multiple logistic regression analysis, the following appeared to be significantly related to the prevalence of GSD： older age （40-49 years vs 〈40 years, OR= 1.63 [95% CI： 0.76-3.48], 50-59 years vs 〈40 years, OR=4.93 [95% CI： 2.43-9.99], 60-69 years vs 〈40 years, OR = 6.82 [95% CI： 3.19-14.60], ≥70 years vs 〈40 years, OR= 10.65 [95% CI： 4.78-23.73]）, higher BMI （≥27 kg/m^2 vs 〈24 kg/m^2, adjusted OR= 1.74 [95% CI： 1.04-2.88]）, and higher FPG （≥ 126 mg/dL vs 〈110 mg/dL, OR= 1.71, 95% CI： 1.01-2.96）. CONCLUSION： Older age （≥50 years）, obesity （BMI ≥ 27 kg/m^2）, and type 2 diabetes （FPG ≥126 mg/dL） are associated with the prevalence of GSD.展开更多
Objectives To investigate the prevalence and characteristics of pulmonary embolism （PE） at autopsy in a Chinese general hospital over a period of 10 years, and to evaluate the antemortem achievement of the prophylax...Objectives To investigate the prevalence and characteristics of pulmonary embolism （PE） at autopsy in a Chinese general hospital over a period of 10 years, and to evaluate the antemortem achievement of the prophylaxis, diagnosis, and treatment of PE. Methods All medical records of deaths from the West Branch of the Chinese People＇s Liberation Army （PLA） General Hospital were retrospectively re- viewed, for the period of January 1, 2006 to December 31, 2015. Cases in which autopsies had been performed were identified and further analyzed. The numbers and detailed characteristics of patients who had PEs were noted. Prophylactic measures, along with diagnosis and treatment of PE, were recorded, if performed. Results During the 10-year period, 1057 patients died in the study hospital and 278 necrop- sies were performed （autopsy rate： 26.3%）. Nine patients were found to have PE （3.2%）, and in seven of these patients （2.5%）, the PE was considered to be fatal. Embolisms were found in the trunk and bilateral main branches of the pulmonary artery tree in all seven of the fatal PE cases. Right intracardiac thrombosis was detected in five of the nine PE patients （55.6%）. All patients with PE had been hospitalized in medical departments, and only one had undergone surgery during hospitalization. Antemortem prophylaxis was performed in two of the nine PE cases （22.2%）. None of the 9 patients had received a clinical diagnosis of PE before death. Conclusions The incidence of and death rate associated with PE may vary among different races and regions. Continuous monitoring of PE by means of necropsy in certain representative medical institutions is necessary.展开更多
BACKGROUND: Modern civilization and the sharp rise in living standards have led to dramatic changes in trauma pattern in Saudi Arabia. This study aimed to describe the different patterns of injuries of patients attend...BACKGROUND: Modern civilization and the sharp rise in living standards have led to dramatic changes in trauma pattern in Saudi Arabia. This study aimed to describe the different patterns of injuries of patients attending the Emergency Department of Jazan General Hospital(JGH) in the southwest corner of Saudi Arabia.METHODS: A total number of 1 050 patients were enrolled in the study. A pre-organized data sheet was prepared for each patient attended the Emergency Department of JGH from February 2012 to January 2013. It contains data about socio-demographics, trauma data, clinical evaluation results, investigations as well as treatment strategies.RESULTS: The mean age of the patients was 25.3±16.8 years. Most(45.1%) of the patients were at age of 18–30 years. Males(64.3%) were affected by trauma more common than females. More than half(60.6%) of the patients were from urban areas. The commonest kind of injury was minor injury(60%), followed by blunt trauma(30.9%) and then penetrating trauma(9.1%). The mean time from the incident to arrival at hospital was 41.3±79.8 minutes. The majority(48.2%) of the patients were discharged after management of trivial trauma, whereas 2.3% were admitted to ICU, 7.7% transferred to inpatient wards, and 17.7% observed and subsequently discharged. The mortality rate of the patients was 2.6%.CONCLUSION: Trauma is a major health problem, especially in the young population in Saudi Arabia. Blunt trauma is more frequent than penetrating trauma, with road traffic accidents accounting for the majority.展开更多
INTRODUCTION There are many obstacles to developing,maintaining and strengthening international research collaborations,whether they are posed by geography,culture or,most recently,global economics and politics.It is ...INTRODUCTION There are many obstacles to developing,maintaining and strengthening international research collaborations,whether they are posed by geography,culture or,most recently,global economics and politics.It is critically important to overcome these obstacles,especially when it comes to fostering the types of breakthrough biomedical science that benefit from diverse perspectives,methodologies and data sets.Moreover,the research underlying these breakthroughs unfolds over the course of years,and even decades.For these reasons,and more,the Department of Psychiatry at Massachusetts General Hospital(Mass General)and the Shanghai Mental Health Center(SMHC)are taking the long view:exploring and implementing numerous collaborative research and training projects that are leading to better care and treatments for patients,both in the USA and China,who suffer from a range of psychiatric disorders.展开更多
This study aimed to estimate the survival rate of breast cancer in a group of patients followed up at the Yaoundé General Hospital in Cameroon. A retrospective review of records of patients managed for breast can...This study aimed to estimate the survival rate of breast cancer in a group of patients followed up at the Yaoundé General Hospital in Cameroon. A retrospective review of records of patients managed for breast cancer between 1995 and 2007 was carried out at the Yaoundé General Hospital. Survival analysis was carried out with survival defined as the time between the date of unequivocal diagnosis of cancer and the date of last follow-up or death. Survival curves were plotted in R.3.1.1 software. Mean age of the patients was 47.5 ± 12.36 years. Most of the patients (67.9%) presented with advanced breast cancer disease (stage III and IV). Overall patient survival rate was 30% at 5 years and 13.2% at 10 years. Median overall survival time was 2 (1.9 - 3) years. There was a correlation between survival and the stage of disease. The highest survival rates were recorded in stages I and II while the lowest rates were recorded in stage IV. There was no statistically significant difference in survival among the age groups (p = 0.15). Overall survival rates of breast cancer are 30% at 5 years and 13.2% at 10 years among Cameroonian patients and are lower compared with 90% and 82% respectively at 5 years and 10 years in some developed countries.展开更多
Objective To investigate the epidemiologic features of an outbreak of SARS that occurred in a single diabetes room of a general hospital in Beijing in late March 2003.Methods Field investigation was carried out in the...Objective To investigate the epidemiologic features of an outbreak of SARS that occurred in a single diabetes room of a general hospital in Beijing in late March 2003.Methods Field investigation was carried out in the ward,the nursing log and the hospitalization medical record of correlative patients were consulted.SARS-CoV in serum specimen from SARS patient was detected by PCR.Results The room where SARS outbreak occurred was on the 13th floor of the 16-story main ward building.There were 6 beds in the room,living with 6 female patients(aged 45-67)who were all hospitalized due to type2 diabetes.On March 24,2003,Patient 1 began to have a fever and cough,chest X-ray showed pneumonia.Five and six days later,Patient 2 and Patient 3 began to have a fever,respectively.Finally,all of these 3 patients died.Their beds were all at the same side of the room,and the other 3 patients at the opposite side were not infected.Serum SARS CoV-RNA of the Patient 3 was positive by nest-PCR.The daughter-in-law of Patient 1who accompanied Patient 1 by the bedside several days,mainly near the window,upwind of Patient 1,was not infected.Medical staff,family members and visitors of the 6 patients were not infected.Conclusions This outbreak was not transmitted by aerosol.The distance droplets travels could be up to 3.43 meters.Droplet spread has direction,and the droplets direction of propagation is closely related with the wind direction and speed.Those at the downwind position of SARS patients were susceptible to be infected.Medical staff wore face masks and good natural ventilation of this ward building may be important reasons for the prevention of infection.展开更多
Background: Tuberculosis disease affects survival among HIV co-infected patients on antiretroviral therapy. Prevalence of pulmonary tuberculosis in western Uganda is 15.3% and 7.2% in Tororo, Eastern Uganda. A study i...Background: Tuberculosis disease affects survival among HIV co-infected patients on antiretroviral therapy. Prevalence of pulmonary tuberculosis in western Uganda is 15.3% and 7.2% in Tororo, Eastern Uganda. A study in Kampala revealed Tuberculosis prevalence among immuno-incompetent group at 10%. To assess the prevalence of Pulmonary Tuberculosis (PTB) infection in HIV/AIDS patients attending ART clinic in Bududa general hospital, Bududa district, a hospital-based, cross-sectional study was carried out. Methods and materials: Two hundred thirty eight (238) HIV/AIDS positive patients attending ART clinic were recruited using consecutive simple non-probability sampling on consenting. Data collection guide was used to capture the socio-demographic information from study participants and two sputum samples (spot and early morning samples) were obtained from each participant, and processed using Hot Ziehl Neelsen for Tubercle Bacilli. Data collected was entered into MS Excel spreadsheets and Statistical Package of Social Sciences was used for descriptive data analysis and outputs in form of percentages, figures and tables presented. Results: Out of 238 study participants recruited, 14/238 were positive for Acid Fast Bacilli (AFB);giving a prevalence of pulmonary tuberculosis at 5.9% (14/238) and the most affected age group was between 26 - 35 years with the prevalence of 3.4%. More females (65.6%) participated in the study than males (34.4%). Conclusion: Tuberculosis remains a health challenge in HIV/AIDS positive people in Bududa district and there is need for early screening of all HIV patients for TB as part of their routine and intensification to follow up TB positive patients. We recommend large-scale studies on the trends in TB/HIV co-infection and associated factors should be carried out in this area. In addition, we recommend intensification of public awareness campaign about TB infection in relation to its transmission, prevention and control.展开更多
Background: Internal splintage of open tibial fractures had gained acceptance as a preferred method of early stabilization of such injuries. Patients and Methods: Fifty-five patients had been operated upon. They were ...Background: Internal splintage of open tibial fractures had gained acceptance as a preferred method of early stabilization of such injuries. Patients and Methods: Fifty-five patients had been operated upon. They were followed from July 2008 to March 2013 (56 months) with an average time of 39 months. The final results had been evaluated through a scheme including 7 parameters: pain, union, malunion, infection, range motions of nearby joints, implant and technical failure and activity and returning to the same work. Results: According to previous parameters, union was achieved in 52 cases (94.5%) at an average time of 20 weeks (16 - 52 weeks) with 5.5% incidence of nonunion. Excellent and good ranges of knee and ankle motions were achieved at final follow-up visit in 49 cases (89.09%). The incidence of complication was acceptable mainly malunion 7.3%, deep infection 12.7%, implant and technical failure 9.1% full activity and returning to the same work achieved in 89.1%. The overall net results of our series are as follows: excellent—19 cases (34.5%), good—27 cases (49.1%), fair—6 cases (10.9%) and poor—3 cases (5.5%). Conclusion: Utilizing unreamed interlocking nail for open tibial fractures is a good method of treatment particularly those of grade (II), and (IIIA).展开更多
Background: Cervical cancer is the third most common cancer worldwide, and 80% of cases occur in the developing world. A critical component of effective cervical cancer screening programs is the ability to offer women...Background: Cervical cancer is the third most common cancer worldwide, and 80% of cases occur in the developing world. A critical component of effective cervical cancer screening programs is the ability to offer women appropriate and effective treatment for cervical intra epithelial neoplasia (CIN). Objectives: This study aimed at assessing the primary experience of management of CIN by Loop Electrosurgical Excision Procedure (LEEP) in a low resource country. Methods: We carried out a descriptive cross sectional study at the Yaoundé General Hospital in Cameroon. Results: Twenty three cases of CIN were treated by LEEP. Mean age of patients was 40.5 ± 9.9 years. Six (26.1%) patients were infected by the Human Immunodeficiency Virus (HIV). LEEP was indicated in 21 (91.30%) cases for CIN2 and CIN3. The mean duration of the surgical procedure was 10 ± 3 minutes. There was one (4.3%) complication (persistent cervical bleeding). Surgical margins were negative for dysplasia or invasive carcinoma in 18 (78.26%) cases and non-applicable in 5 (21.73%) cases (thermal artefacts of margins and cervicitis without CIN). One patient with micro invasive carcinoma on post-operative histology was treated by total hysterectomy. Cervical cytology was normal at 6 months post LEEP for 15 cases out of 16 (93.8%) patients who performed the test. One woman achieved pregnancy and delivered a term baby. Conclusion: Treatment of CIN by LEEP is feasible, safe and effective in our setting.展开更多
<strong>Introduction</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</str...<strong>Introduction</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Breast cancer is often diagnosed at an advanced stage in Cameroon. The objective was to analyse consultation, diagnosis and treatment delays for breast cancer among patients followed up at the Yaoundé General Hospital (YGH) in Cameroon. </span><b><span style="font-family:Verdana;">Materials</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">Methods</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> This was a cross-sectional study carried out from the files of patients followed up for breast cancer at the YGH from January 1, 2014 to April 30, 2018. A total of 183 patients were included. We measured time elapsed between the awareness of first signs of disease and the in</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">i</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">tial consultation (consultation delays), time lapse between the initial consultation and pathological diagnosis of breast cancer (diagnosis delays), interval between pathological diagnosis and treatment onset (treatment delays), time elapsed between the initial consultation and management (health system delays) and time elapsed from awareness of first signs of disease to treatment onset (overall delays). </span><b><span style="font-family:Verdana;">Results</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> The delays (median, IIQ) were: (5.1 months;IIQ: 1.7 - 12.4), (25 days;IIQ: 10 - 67), (27 days;IIQ: 13 - 63), (2.2 months;IIQ: 1.2 - 5.8) and (9.9 months;IIQ: 4.4 - 17.6) respectiv</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">ly for consultation, diagnosis, treatment, health system and overall delays. The risks associated with a delay in initial consultation of greater than 3 months were (OR;95% CI): unschooled patients (2.01;1.66 - 2.40);monthly income below the minimum wage (2.70;1.81 - 5.96);unemployment (2.14;1.02 - 3.24) and absence of a family history of cancer (2.44;1.66 - 6.10). The main reasons for a late first consultation were: ignorance (60.2%), financial challenges (17.6%) and a preference for alternative treatment (11.1%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The consultation, diagnosis and treatment delays for breast cancer are very often long in our setting than those reported in developed countries. Both patients’ and institutional factors are demonstrated. There is a need to increase public awareness </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">on</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> the value of early diagnosis of breast cancer. Also, health system should be improved to enable early diagnosis and treatment of this affection.</span></span></span>展开更多
<strong>Aims:</strong> Wound care is the basic technique in patient care which has direct effects on treatment outcome. However, the Agriculture General Hospital (AGH), Vietnam, has never organized a conti...<strong>Aims:</strong> Wound care is the basic technique in patient care which has direct effects on treatment outcome. However, the Agriculture General Hospital (AGH), Vietnam, has never organized a continuing professional development (CPD) training program based on Vietnam’s Basic Nursing Competency Standards (VNBNCS) for their nurses. This study aimed to examine the knowledge, practice, and confidence level among nurses at the AGH after 12 months of implementing a VNBNCS-based wound care training program. <strong>Methodology: </strong>This descriptive and comparative study assessed the changes in knowledge, practice, and confidence scores of 43 nurses at five clinical departments before and 12 months after the training program (April 2018 to June 2019). Data were collected using a self-administrated knowledge questionnaire with 48 items, a 13-item confidence checklist, and a 16-item skills checklist. EpiData 3.1 and SPSS 18.0 were used to enter and analyze data, respectively. <strong>Results:</strong> The mean scores of knowledge (113.70 ± 14.75 vs. 129.7 ± 19.6), and practice (63.21 ± 19.99 vs. 132.07 ± 4.31) statistically significantly increased 12 months after training (<em>p</em> < 0.001). The mean score of confidence in performing wound care increased in all of the 13 aspects (<em>p</em> < 0.001). <strong>Conclusion:</strong> Nurses’ wound care-related knowledge, practice, and confidence have improved 12 months after training. This demonstrates the VNBNCS-based wound care training program developed by Viet Duc University Hospital is suitable for use in the AGH and has achieved its promising initial outcomes. This program should be duplicated in other health facilities.展开更多
<strong>Background:</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Postpartum haemorrhage ...<strong>Background:</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Postpartum haemorrhage is one of the leading causes of maternal morbidity and mortality worldwide. It occurs predominantly in developing countries due to poorly developed infrastructures and lack of skilled birth attendants.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Objective:</span></b></span></span><span><span><b><span style="font-family:""> </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">To identify the prevalence, causes and risk factors of primary postpartum haemorrhage following vaginal deliveries in a referral hospital (Douala General Hospital-Cameroon).</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Methods:</span></b></span></span><span><span><b><span style="font-family:""> </span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">This was a descriptive and analytical study carried in the Douala General Hospital (DGH) for which socio-demographic, clinical, obstetric and post-partum data were collected using a pre-tested questionnaire. Descriptive statistics, multivariate analysis and logistic regression allowed us to present and discuss our results, with a 95% confidence interval (CI) and </span><i><span style="font-family:Verdana;">p </span></i><span style="font-family:Verdana;">value <</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">0.05.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> The prevalence of Primary Postpartum Haemorrhage was 1.33%. Quantification of bleeding was reported in only 13.15% of cases. The main causes were: uterine atony (36.18%), placental retention (25.65%), cervical tears (12.50%), perineal tears (10.52%) and cervico-vaginal tears (08.52%). The risk factors were: age between 19</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">35 years aOR = 4.52;95% CI = 2.65</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">7.98;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.021);unemployment (aOR = 4.74;95% CI = 2.91</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">6.02;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.001);being multigravida (aOR = 9.21;95% CI = 6.43</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">12.48;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.035);history of abortion (aOR = 5.11;95% CI = 2.05</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">7.29;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.004);preterm delivery (aOR = 6.88;95% CI = 2.72</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">9.06;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.002);duration of labour</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">> 12 hours (aOR = 4.05;95% CI = 2.46</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">7.98;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.003) and macrosomia (aOR = 3.27;95% CI = 1.03</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">5</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">68;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.041).</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Conclusion:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Primary postpartum haemorrhage remains a poorly assessed obstetric complication in the maternity ward of the Douala General Hospital (DGH);Training staff on quantifying postpartum blood loss and monitoring the second and third stages of labour can help to better manage and reduce its occurrence.</span></span></span>展开更多
<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Gastritis is a very common and widely distributed condition <span>worldwide. It ...<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Gastritis is a very common and widely distributed condition <span>worldwide. It represents one of the most common pathological entities in</span> gastroenterology and digestive endoscopy. Our objective was to determine the sociodemographic, clinical, endoscopic, and histological aspects of gastritis in the digestive endoscopy unit of the General Hospital Idrissa Pouye (GHIP).<b> Materials and Method: </b>This was a retrospective study over a period of 4 years (from 1 January 2014 to 31 December 2017) at the digestive endoscopy <span>unit of GHIP. We had collated oesogastroduodenal endoscopy (EGDE) re</span>ports with gastritis appearance with gastric biopsies and reports with normal stomach appearance with gastric biopsies and their histological reports. We collected and analyzed data on age, gender, indications for endoscopy, endoscopic findings and histological results. <b>Results: </b>The reports of 593 patients were analyzed. The mean age was 45 years </span></span></span><span><span><span style="font-family:;" "="">old </span></span></span><span><span><span style="font-family:;" "="">(range 8 - 88 years</span></span></span><span><span><span style="font-family:;" "=""> old</span></span></span><span><span><span style="font-family:;" "="">) and the sex ratio was 0.63 (230 men). The indications for endoscopy were epigastralgia in (91%) of cases, dyspepsia in (22%) of cases, pyrosis in (12%) of <span>cases. The endoscopic appearance was normal in 229 patients (39%). The</span> endoscopic location of the gastritis was antral in 76%, fundic in 22% and pangastric in 2%. The gastritis was erythematous in 327 patients (90%), erosive in 126 patients (35%), congestive in 53 patients (15%), pseudonodular in 14 patients (4%) and atrophic in 10 patients (3%). Histology was normal in 8 patients (1.3%) and showed gastritis in 585 patients (98.7%). Gastritis was chronic in 575 patients (98.2%), acute in 10 patients (1.7%). Gastritis activity was moderate in (52.7%) and mild in (42.9%). Atrophy was absent in 521 patients (88.6%) and mild in 46 patients (8.2%). Intestinal metaplasia was found in 66 patients (11%). Dysplasia was present in 1.7% of cases. This dysplasia was intermediate grade (60%) in 6 patients, low grade (20%) in 2 patients and severe grade (20%). <i>H</i>. <i>pylori</i> was present in 404 patients (68%).<b> Conclusion: </b>Gastritis is </span></span></span><span><span><span style="font-family:;" "="">usually</span></span></span><span><span><span style="font-family:;" "=""> found in the digestive endoscopy unit of the GHIP. The indications for endoscopy are dominated by epigastralgia and histology is necessary for its diagnosis.</span></span></span>展开更多
Objective:To assess the prevalence of anemia and asymptomatia malaria parasitemia and the effect of prior antimalarials therapy on the parasite density in pregnant women at their first antenatal visit at the secondary...Objective:To assess the prevalence of anemia and asymptomatia malaria parasitemia and the effect of prior antimalarials therapy on the parasite density in pregnant women at their first antenatal visit at the secondary level health care facility in Nigeria.Methods:This cross sectional observational study was carried out in the antenatal clinic of General Hospital,Ikot Ekpene,Akwa Ibom State,Nigeria for 3 months period(1<sup>st</sup> June to 31<sup>st</sup> August,2009).Five hundred and fourteen women attending their first antenatal registration visits in the hospital were recruited in the study.Socio-demographic information was obtained using pre-tested questionnaires.The malaria parasite was obtained by examining thick and thin blood films prepared on 2 glass slides while the hematocrit was obtained through 2 capillary tubes read by a Hawksleys microhematocrit reader.Results:A total of 514 pregnant women participated in the study with a mean maternal age of 21.4 years and a mean gestational age at booking of 18.3 weeks.The primigravid women booked at significantly lower gestational age than multigravidae （16.2 weeks vs 21.6 weeks）.Most of the women（59.3%） were anemic,out of which 60.4%were primigravida.More than half of the women had moderate to high parasite density and only 6.8% had no malaria parasitemia.All patients with severe anemia were parasitemic.Out of the 479 （93.2%） women with parasitemia,a third had taken antimalarial drugs.A majority（60.3%） of those without prior antimalarial drugs had moderate to high density parasitemia.Conclusions: This study shows high prevalence of anemia in women with asymptomatic malarial parasitemia, particularly the primigravida.The severity of anemia is directly related to the density of malaria parasitemia.Those with effective antimalarial therapy appear to have low density parasitemia and therefore mild anemia.Routine screening for anemia and malaria parasites at booking,prompt parasite clearance and correction of anemia would reduce the associated maternal and perinatal complications.展开更多
The study assessed the relationship between exposure to stress and posttraumatic symptoms among nurses and physicians in a Jendouba general hospital. Hospital staff who were exposed to stress were assessed for posttra...The study assessed the relationship between exposure to stress and posttraumatic symptoms among nurses and physicians in a Jendouba general hospital. Hospital staff who were exposed to stress were assessed for posttraumatic stress disorder. High levels of stress symptoms were found in physicians and nurses. Logistic regression analysis showed that nurses had an increased risk for posttraumatic stress disorder factors characterized by negative behavior to patient, increased workload excessive ambiguity and role conflict and the lack of free. These findings showed that nurses suffered from more severe posttraumatic symptoms compared to physicians after exposure to prolonged stress. The gap between physicians and nurses warrants further study.展开更多
Caesarean Scar Ectopic Pregnancy (CSEP) is a rare, but potentially catastrophic complication of a previous Caesarean Section (CS) birth. This is a review of 5 cases of CSEP managed in our Early Pregnancy Unit at Watfo...Caesarean Scar Ectopic Pregnancy (CSEP) is a rare, but potentially catastrophic complication of a previous Caesarean Section (CS) birth. This is a review of 5 cases of CSEP managed in our Early Pregnancy Unit at Watford General Hospital within a 10-month period. Two patients had only one previous CS, whilst 2 had two and the last had 3 previous CS. All our patients presented within the first trimester of pregnancy (range 6 to 11 weeks’ gestation) with light vaginal bleeding;4 of them had associated mild to moderate abdominal pain. All were diagnosed using transvaginal ultrasound scan. Three of our patients were managed surgically by Suction Evacuation under Ultrasound guidance and insertion of a Foley’s catheter prophylactically for tamponade in order to reduce blood loss both intra- and post-operatively. One of our patients had a heterotopic pregnancy with a viable intrauterine pregnancy and a live CSEP. She declined any intervention so she was managed conservatively with weekly Consultant appointments and scans. There was a subsequent demise of the CSEP and she continued with a singleton pregnancy. None of our patients were managed medically. There is no absolute consensus on diagnostic criteria and there is no standard management protocol so each woman should be given all the available information and the opportunity to decide on the management of her pregnancy. The risk of a CSEP in a subsequent pregnancy should be part of the consent process for CS.展开更多
Humman immunodeficiency virus (HIV) infection is associated with opportunistic cancers notably Non-Hodgkin lymphoma (NHL). Generally the response to chemotherapy or radiation therapy is satisfactory but requires nursi...Humman immunodeficiency virus (HIV) infection is associated with opportunistic cancers notably Non-Hodgkin lymphoma (NHL). Generally the response to chemotherapy or radiation therapy is satisfactory but requires nursing measures to protect these patients from superinfection to which they are highly predisposed by the double immunosuppression. We report the case of a 54 year-old known HIV sero-positive female with lymphoma of the nasopharynx who presented lately and died of septic shock despite the favorable evolution of the tumor on treatment.展开更多
文摘AIM:To evaluate the demographics,clinical characteristics,treatments,and outcomes of patients with ocular surface squamous neoplasia(OSSN)at the Philippine General Hospital.METHODS:This was a single-center,11-year retrospective,cross sectional case series on 18 cases of OSSN seen between January 2012 to June 2023.The patient’s demographics,presenting symptoms,tumor characteristics,histopathologic diagnosis,treatment,outcomes,and duration of follow-up were reviewed.RESULTS:Out of 33 identified cases of OSSN,only 18 were eligible for inclusion in the study.Mean age was 60.78y(range 31 to 80),with male predominance(66.67%).The left eye was most commonly affected(61.11%)with most presenting with fleshy mass(83.33%).Most tumors were located nasally(66.67%)and were predominantly papilliform(44.44%)in morphology with associated hyperpigmentation(38.89%).Squamous cell carcinoma(SCCA)was the most common histopathologic diagnosis(72.22%).The main primary treatment was surgical excision(94.44%)with or without adjunctive therapy,with only 1 patient undergoing first-line topical chemotherapy.Only 3 recurrences(16.67%)were noted with a median followup of 7.5mo.A statistically significant recurrence-free odds leaning towards the utilization of cryotherapy was noted.CONCLUSION:OSSN seen at the Philippine General Hospital is presented as a limbal papilliform mass,most commonly affecting elderly males.Surgical excision with adjuvant cryotherapy and/or chemotherapy is the preferred mode of treatment.
文摘Introduction: Antibiotic resistance is a public health problem. It is due to multi-resistant bacteria (MRB). The objective of this study was to determine bacterial resistance to antibiotics in chronic renal failure at the Edith Lucie BONGO ONDIMBA general hospital (HGELBO). Patients, material and method: This was an analytical cross-sectional study conducted from January 1 to August 31, 2019 at the HGELBO. It concerned all patients admitted to the HGELBO with positive bacteriological samples. After a study of the sensitivity to isolated species, the patients were divided into two (02) groups: those MRB positive (+) and not MRB or negative (-). Epi Info software version 3.5.1 was used for the calculation of the rates and the comparison of the variables. The adjusted odds ratio (ORa) with a 95% confidence interval was used to measure the specific effect of each risk factor such as chronic kidney disease and diabetes, in order to rule out confounding factors. Multivariate analysis by binomial logistic regression was used. Results: There were 375 bacteriological samples from 258 patients, among them 247 patients with 235 positive samples or 63%. The eleven (11) are healthy patients. The median age was 33 with extremes ranging from 16 to 90. The female sex was predominant with a sex ratio of 0.6. The majority of MRB+ cases were found in internal medicine and nephrology with 12 cases (38.7%) and hemodialysis with 4 cases (12.9%). Urinary samples were in the majority with 74.5%. <i>Escherichia coli</i> was predominant in 30.3%. After studying the sensitivity to antibiotics of the 247 species included, 113 were MRB+ and 134 BMR- <i>i.e.</i> a frequency of 45.7%. Methicilin-resistant <i>Staphylococcus aureus</i> (MRSA) was predominant (51.3%). Multivariate logistic regression analysis showed that the main risk factor was antibiotic use (0Ra: 3.2 [1.9 - 5.4];p-value < 0.01). Chronic renal failure and diabetes were not risk factors for carriage. The other risk factors identified were: hospitalization of more than 7 days (prolonged), <i>S. aureus</i> infection and male sex. Conclusion: Probabilistic antibiotic therapy leads to the selection of BMRs. Long hospital stays, male sex, and MRSA are risk factors or determinants of antibiotic resistance, but not chronic kidney disease.
文摘Background: Preterm birth defined as childbirth occurring at less than 37 completed weeks or 259 days of gestation. The causes of preterm birth are complex and multifactorial, many risk factors that contribute in it. Knowledge of risk factors is crucial for predicting the incidence of preterm births. This study aimed to determine the factors associated with preterm birth at the Hasan Sadikin General Hospital. Method: This study was a cross-sectional analytic using secondary data. Data derived from medical records maternity patients in the Department of Obstetrics and Gynecology Hasan Sadikin General Hospital taken in 2015. 1944 patients’ medical records who gave birth met the inclusion criteria. Data analyses used were bivariate (chi square) and multivariate (logistic regression). Result: The result showed that the variables including age (p = 0.043, OR = 1.586), antenatal care (p p p p p p Conclusion: There is a significant relationship between age, antenatal care, preterm birth history birth, anemia, hypertension, and antepartum hemorrhage with preterm birth as risk factors.
文摘AIM： TO explore the prevalence of gallstone disease （GSD） in Taiwan and condition-associated factors related to it. METHODS： We studied a total of 2386 healthy adults （1235 males and 1151 females） voluntarily admitted to Cheng Hsin General Hospital for a paid physical check-up between January 2002 and December 2002. Blood samples and ultrasound sonography results were collected. RESULTS： The overall prevalence of GSD among this study-population was 5.3%, including 1.7% （n=40） having a single stone, 2.3% （n = 55） having multiple stones, and 1.3% （n = 31） having cholecystectomy. The prevalence revealed a statistically significant increase with increasing age （P〈 0.0001）. Females exhibited a greater prevalence of multiple stones than did males （3.0% vs 1.7%, P= 0.04）. Using multiple logistic regression analysis, the following appeared to be significantly related to the prevalence of GSD： older age （40-49 years vs 〈40 years, OR= 1.63 [95% CI： 0.76-3.48], 50-59 years vs 〈40 years, OR=4.93 [95% CI： 2.43-9.99], 60-69 years vs 〈40 years, OR = 6.82 [95% CI： 3.19-14.60], ≥70 years vs 〈40 years, OR= 10.65 [95% CI： 4.78-23.73]）, higher BMI （≥27 kg/m^2 vs 〈24 kg/m^2, adjusted OR= 1.74 [95% CI： 1.04-2.88]）, and higher FPG （≥ 126 mg/dL vs 〈110 mg/dL, OR= 1.71, 95% CI： 1.01-2.96）. CONCLUSION： Older age （≥50 years）, obesity （BMI ≥ 27 kg/m^2）, and type 2 diabetes （FPG ≥126 mg/dL） are associated with the prevalence of GSD.
文摘Objectives To investigate the prevalence and characteristics of pulmonary embolism （PE） at autopsy in a Chinese general hospital over a period of 10 years, and to evaluate the antemortem achievement of the prophylaxis, diagnosis, and treatment of PE. Methods All medical records of deaths from the West Branch of the Chinese People＇s Liberation Army （PLA） General Hospital were retrospectively re- viewed, for the period of January 1, 2006 to December 31, 2015. Cases in which autopsies had been performed were identified and further analyzed. The numbers and detailed characteristics of patients who had PEs were noted. Prophylactic measures, along with diagnosis and treatment of PE, were recorded, if performed. Results During the 10-year period, 1057 patients died in the study hospital and 278 necrop- sies were performed （autopsy rate： 26.3%）. Nine patients were found to have PE （3.2%）, and in seven of these patients （2.5%）, the PE was considered to be fatal. Embolisms were found in the trunk and bilateral main branches of the pulmonary artery tree in all seven of the fatal PE cases. Right intracardiac thrombosis was detected in five of the nine PE patients （55.6%）. All patients with PE had been hospitalized in medical departments, and only one had undergone surgery during hospitalization. Antemortem prophylaxis was performed in two of the nine PE cases （22.2%）. None of the 9 patients had received a clinical diagnosis of PE before death. Conclusions The incidence of and death rate associated with PE may vary among different races and regions. Continuous monitoring of PE by means of necropsy in certain representative medical institutions is necessary.
文摘BACKGROUND: Modern civilization and the sharp rise in living standards have led to dramatic changes in trauma pattern in Saudi Arabia. This study aimed to describe the different patterns of injuries of patients attending the Emergency Department of Jazan General Hospital(JGH) in the southwest corner of Saudi Arabia.METHODS: A total number of 1 050 patients were enrolled in the study. A pre-organized data sheet was prepared for each patient attended the Emergency Department of JGH from February 2012 to January 2013. It contains data about socio-demographics, trauma data, clinical evaluation results, investigations as well as treatment strategies.RESULTS: The mean age of the patients was 25.3±16.8 years. Most(45.1%) of the patients were at age of 18–30 years. Males(64.3%) were affected by trauma more common than females. More than half(60.6%) of the patients were from urban areas. The commonest kind of injury was minor injury(60%), followed by blunt trauma(30.9%) and then penetrating trauma(9.1%). The mean time from the incident to arrival at hospital was 41.3±79.8 minutes. The majority(48.2%) of the patients were discharged after management of trivial trauma, whereas 2.3% were admitted to ICU, 7.7% transferred to inpatient wards, and 17.7% observed and subsequently discharged. The mortality rate of the patients was 2.6%.CONCLUSION: Trauma is a major health problem, especially in the young population in Saudi Arabia. Blunt trauma is more frequent than penetrating trauma, with road traffic accidents accounting for the majority.
文摘INTRODUCTION There are many obstacles to developing,maintaining and strengthening international research collaborations,whether they are posed by geography,culture or,most recently,global economics and politics.It is critically important to overcome these obstacles,especially when it comes to fostering the types of breakthrough biomedical science that benefit from diverse perspectives,methodologies and data sets.Moreover,the research underlying these breakthroughs unfolds over the course of years,and even decades.For these reasons,and more,the Department of Psychiatry at Massachusetts General Hospital(Mass General)and the Shanghai Mental Health Center(SMHC)are taking the long view:exploring and implementing numerous collaborative research and training projects that are leading to better care and treatments for patients,both in the USA and China,who suffer from a range of psychiatric disorders.
文摘This study aimed to estimate the survival rate of breast cancer in a group of patients followed up at the Yaoundé General Hospital in Cameroon. A retrospective review of records of patients managed for breast cancer between 1995 and 2007 was carried out at the Yaoundé General Hospital. Survival analysis was carried out with survival defined as the time between the date of unequivocal diagnosis of cancer and the date of last follow-up or death. Survival curves were plotted in R.3.1.1 software. Mean age of the patients was 47.5 ± 12.36 years. Most of the patients (67.9%) presented with advanced breast cancer disease (stage III and IV). Overall patient survival rate was 30% at 5 years and 13.2% at 10 years. Median overall survival time was 2 (1.9 - 3) years. There was a correlation between survival and the stage of disease. The highest survival rates were recorded in stages I and II while the lowest rates were recorded in stage IV. There was no statistically significant difference in survival among the age groups (p = 0.15). Overall survival rates of breast cancer are 30% at 5 years and 13.2% at 10 years among Cameroonian patients and are lower compared with 90% and 82% respectively at 5 years and 10 years in some developed countries.
文摘Objective To investigate the epidemiologic features of an outbreak of SARS that occurred in a single diabetes room of a general hospital in Beijing in late March 2003.Methods Field investigation was carried out in the ward,the nursing log and the hospitalization medical record of correlative patients were consulted.SARS-CoV in serum specimen from SARS patient was detected by PCR.Results The room where SARS outbreak occurred was on the 13th floor of the 16-story main ward building.There were 6 beds in the room,living with 6 female patients(aged 45-67)who were all hospitalized due to type2 diabetes.On March 24,2003,Patient 1 began to have a fever and cough,chest X-ray showed pneumonia.Five and six days later,Patient 2 and Patient 3 began to have a fever,respectively.Finally,all of these 3 patients died.Their beds were all at the same side of the room,and the other 3 patients at the opposite side were not infected.Serum SARS CoV-RNA of the Patient 3 was positive by nest-PCR.The daughter-in-law of Patient 1who accompanied Patient 1 by the bedside several days,mainly near the window,upwind of Patient 1,was not infected.Medical staff,family members and visitors of the 6 patients were not infected.Conclusions This outbreak was not transmitted by aerosol.The distance droplets travels could be up to 3.43 meters.Droplet spread has direction,and the droplets direction of propagation is closely related with the wind direction and speed.Those at the downwind position of SARS patients were susceptible to be infected.Medical staff wore face masks and good natural ventilation of this ward building may be important reasons for the prevention of infection.
文摘Background: Tuberculosis disease affects survival among HIV co-infected patients on antiretroviral therapy. Prevalence of pulmonary tuberculosis in western Uganda is 15.3% and 7.2% in Tororo, Eastern Uganda. A study in Kampala revealed Tuberculosis prevalence among immuno-incompetent group at 10%. To assess the prevalence of Pulmonary Tuberculosis (PTB) infection in HIV/AIDS patients attending ART clinic in Bududa general hospital, Bududa district, a hospital-based, cross-sectional study was carried out. Methods and materials: Two hundred thirty eight (238) HIV/AIDS positive patients attending ART clinic were recruited using consecutive simple non-probability sampling on consenting. Data collection guide was used to capture the socio-demographic information from study participants and two sputum samples (spot and early morning samples) were obtained from each participant, and processed using Hot Ziehl Neelsen for Tubercle Bacilli. Data collected was entered into MS Excel spreadsheets and Statistical Package of Social Sciences was used for descriptive data analysis and outputs in form of percentages, figures and tables presented. Results: Out of 238 study participants recruited, 14/238 were positive for Acid Fast Bacilli (AFB);giving a prevalence of pulmonary tuberculosis at 5.9% (14/238) and the most affected age group was between 26 - 35 years with the prevalence of 3.4%. More females (65.6%) participated in the study than males (34.4%). Conclusion: Tuberculosis remains a health challenge in HIV/AIDS positive people in Bududa district and there is need for early screening of all HIV patients for TB as part of their routine and intensification to follow up TB positive patients. We recommend large-scale studies on the trends in TB/HIV co-infection and associated factors should be carried out in this area. In addition, we recommend intensification of public awareness campaign about TB infection in relation to its transmission, prevention and control.
文摘Background: Internal splintage of open tibial fractures had gained acceptance as a preferred method of early stabilization of such injuries. Patients and Methods: Fifty-five patients had been operated upon. They were followed from July 2008 to March 2013 (56 months) with an average time of 39 months. The final results had been evaluated through a scheme including 7 parameters: pain, union, malunion, infection, range motions of nearby joints, implant and technical failure and activity and returning to the same work. Results: According to previous parameters, union was achieved in 52 cases (94.5%) at an average time of 20 weeks (16 - 52 weeks) with 5.5% incidence of nonunion. Excellent and good ranges of knee and ankle motions were achieved at final follow-up visit in 49 cases (89.09%). The incidence of complication was acceptable mainly malunion 7.3%, deep infection 12.7%, implant and technical failure 9.1% full activity and returning to the same work achieved in 89.1%. The overall net results of our series are as follows: excellent—19 cases (34.5%), good—27 cases (49.1%), fair—6 cases (10.9%) and poor—3 cases (5.5%). Conclusion: Utilizing unreamed interlocking nail for open tibial fractures is a good method of treatment particularly those of grade (II), and (IIIA).
文摘Background: Cervical cancer is the third most common cancer worldwide, and 80% of cases occur in the developing world. A critical component of effective cervical cancer screening programs is the ability to offer women appropriate and effective treatment for cervical intra epithelial neoplasia (CIN). Objectives: This study aimed at assessing the primary experience of management of CIN by Loop Electrosurgical Excision Procedure (LEEP) in a low resource country. Methods: We carried out a descriptive cross sectional study at the Yaoundé General Hospital in Cameroon. Results: Twenty three cases of CIN were treated by LEEP. Mean age of patients was 40.5 ± 9.9 years. Six (26.1%) patients were infected by the Human Immunodeficiency Virus (HIV). LEEP was indicated in 21 (91.30%) cases for CIN2 and CIN3. The mean duration of the surgical procedure was 10 ± 3 minutes. There was one (4.3%) complication (persistent cervical bleeding). Surgical margins were negative for dysplasia or invasive carcinoma in 18 (78.26%) cases and non-applicable in 5 (21.73%) cases (thermal artefacts of margins and cervicitis without CIN). One patient with micro invasive carcinoma on post-operative histology was treated by total hysterectomy. Cervical cytology was normal at 6 months post LEEP for 15 cases out of 16 (93.8%) patients who performed the test. One woman achieved pregnancy and delivered a term baby. Conclusion: Treatment of CIN by LEEP is feasible, safe and effective in our setting.
文摘<strong>Introduction</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> Breast cancer is often diagnosed at an advanced stage in Cameroon. The objective was to analyse consultation, diagnosis and treatment delays for breast cancer among patients followed up at the Yaoundé General Hospital (YGH) in Cameroon. </span><b><span style="font-family:Verdana;">Materials</span></b> <b><span style="font-family:Verdana;">and</span></b> <b><span style="font-family:Verdana;">Methods</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> This was a cross-sectional study carried out from the files of patients followed up for breast cancer at the YGH from January 1, 2014 to April 30, 2018. A total of 183 patients were included. We measured time elapsed between the awareness of first signs of disease and the in</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">i</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">tial consultation (consultation delays), time lapse between the initial consultation and pathological diagnosis of breast cancer (diagnosis delays), interval between pathological diagnosis and treatment onset (treatment delays), time elapsed between the initial consultation and management (health system delays) and time elapsed from awareness of first signs of disease to treatment onset (overall delays). </span><b><span style="font-family:Verdana;">Results</span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> The delays (median, IIQ) were: (5.1 months;IIQ: 1.7 - 12.4), (25 days;IIQ: 10 - 67), (27 days;IIQ: 13 - 63), (2.2 months;IIQ: 1.2 - 5.8) and (9.9 months;IIQ: 4.4 - 17.6) respectiv</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">ly for consultation, diagnosis, treatment, health system and overall delays. The risks associated with a delay in initial consultation of greater than 3 months were (OR;95% CI): unschooled patients (2.01;1.66 - 2.40);monthly income below the minimum wage (2.70;1.81 - 5.96);unemployment (2.14;1.02 - 3.24) and absence of a family history of cancer (2.44;1.66 - 6.10). The main reasons for a late first consultation were: ignorance (60.2%), financial challenges (17.6%) and a preference for alternative treatment (11.1%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The consultation, diagnosis and treatment delays for breast cancer are very often long in our setting than those reported in developed countries. Both patients’ and institutional factors are demonstrated. There is a need to increase public awareness </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">on</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> the value of early diagnosis of breast cancer. Also, health system should be improved to enable early diagnosis and treatment of this affection.</span></span></span>
文摘<strong>Aims:</strong> Wound care is the basic technique in patient care which has direct effects on treatment outcome. However, the Agriculture General Hospital (AGH), Vietnam, has never organized a continuing professional development (CPD) training program based on Vietnam’s Basic Nursing Competency Standards (VNBNCS) for their nurses. This study aimed to examine the knowledge, practice, and confidence level among nurses at the AGH after 12 months of implementing a VNBNCS-based wound care training program. <strong>Methodology: </strong>This descriptive and comparative study assessed the changes in knowledge, practice, and confidence scores of 43 nurses at five clinical departments before and 12 months after the training program (April 2018 to June 2019). Data were collected using a self-administrated knowledge questionnaire with 48 items, a 13-item confidence checklist, and a 16-item skills checklist. EpiData 3.1 and SPSS 18.0 were used to enter and analyze data, respectively. <strong>Results:</strong> The mean scores of knowledge (113.70 ± 14.75 vs. 129.7 ± 19.6), and practice (63.21 ± 19.99 vs. 132.07 ± 4.31) statistically significantly increased 12 months after training (<em>p</em> < 0.001). The mean score of confidence in performing wound care increased in all of the 13 aspects (<em>p</em> < 0.001). <strong>Conclusion:</strong> Nurses’ wound care-related knowledge, practice, and confidence have improved 12 months after training. This demonstrates the VNBNCS-based wound care training program developed by Viet Duc University Hospital is suitable for use in the AGH and has achieved its promising initial outcomes. This program should be duplicated in other health facilities.
文摘<strong>Background:</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Postpartum haemorrhage is one of the leading causes of maternal morbidity and mortality worldwide. It occurs predominantly in developing countries due to poorly developed infrastructures and lack of skilled birth attendants.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Objective:</span></b></span></span><span><span><b><span style="font-family:""> </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">To identify the prevalence, causes and risk factors of primary postpartum haemorrhage following vaginal deliveries in a referral hospital (Douala General Hospital-Cameroon).</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Methods:</span></b></span></span><span><span><b><span style="font-family:""> </span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">This was a descriptive and analytical study carried in the Douala General Hospital (DGH) for which socio-demographic, clinical, obstetric and post-partum data were collected using a pre-tested questionnaire. Descriptive statistics, multivariate analysis and logistic regression allowed us to present and discuss our results, with a 95% confidence interval (CI) and </span><i><span style="font-family:Verdana;">p </span></i><span style="font-family:Verdana;">value <</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">0.05.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> The prevalence of Primary Postpartum Haemorrhage was 1.33%. Quantification of bleeding was reported in only 13.15% of cases. The main causes were: uterine atony (36.18%), placental retention (25.65%), cervical tears (12.50%), perineal tears (10.52%) and cervico-vaginal tears (08.52%). The risk factors were: age between 19</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">35 years aOR = 4.52;95% CI = 2.65</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">7.98;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.021);unemployment (aOR = 4.74;95% CI = 2.91</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">6.02;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.001);being multigravida (aOR = 9.21;95% CI = 6.43</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">12.48;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.035);history of abortion (aOR = 5.11;95% CI = 2.05</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">7.29;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.004);preterm delivery (aOR = 6.88;95% CI = 2.72</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">9.06;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.002);duration of labour</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">> 12 hours (aOR = 4.05;95% CI = 2.46</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">7.98;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.003) and macrosomia (aOR = 3.27;95% CI = 1.03</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">5</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">68;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.041).</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Conclusion:</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Primary postpartum haemorrhage remains a poorly assessed obstetric complication in the maternity ward of the Douala General Hospital (DGH);Training staff on quantifying postpartum blood loss and monitoring the second and third stages of labour can help to better manage and reduce its occurrence.</span></span></span>
文摘<strong>Introduction:</strong> <span><span><span style="font-family:;" "="">Gastritis is a very common and widely distributed condition <span>worldwide. It represents one of the most common pathological entities in</span> gastroenterology and digestive endoscopy. Our objective was to determine the sociodemographic, clinical, endoscopic, and histological aspects of gastritis in the digestive endoscopy unit of the General Hospital Idrissa Pouye (GHIP).<b> Materials and Method: </b>This was a retrospective study over a period of 4 years (from 1 January 2014 to 31 December 2017) at the digestive endoscopy <span>unit of GHIP. We had collated oesogastroduodenal endoscopy (EGDE) re</span>ports with gastritis appearance with gastric biopsies and reports with normal stomach appearance with gastric biopsies and their histological reports. We collected and analyzed data on age, gender, indications for endoscopy, endoscopic findings and histological results. <b>Results: </b>The reports of 593 patients were analyzed. The mean age was 45 years </span></span></span><span><span><span style="font-family:;" "="">old </span></span></span><span><span><span style="font-family:;" "="">(range 8 - 88 years</span></span></span><span><span><span style="font-family:;" "=""> old</span></span></span><span><span><span style="font-family:;" "="">) and the sex ratio was 0.63 (230 men). The indications for endoscopy were epigastralgia in (91%) of cases, dyspepsia in (22%) of cases, pyrosis in (12%) of <span>cases. The endoscopic appearance was normal in 229 patients (39%). The</span> endoscopic location of the gastritis was antral in 76%, fundic in 22% and pangastric in 2%. The gastritis was erythematous in 327 patients (90%), erosive in 126 patients (35%), congestive in 53 patients (15%), pseudonodular in 14 patients (4%) and atrophic in 10 patients (3%). Histology was normal in 8 patients (1.3%) and showed gastritis in 585 patients (98.7%). Gastritis was chronic in 575 patients (98.2%), acute in 10 patients (1.7%). Gastritis activity was moderate in (52.7%) and mild in (42.9%). Atrophy was absent in 521 patients (88.6%) and mild in 46 patients (8.2%). Intestinal metaplasia was found in 66 patients (11%). Dysplasia was present in 1.7% of cases. This dysplasia was intermediate grade (60%) in 6 patients, low grade (20%) in 2 patients and severe grade (20%). <i>H</i>. <i>pylori</i> was present in 404 patients (68%).<b> Conclusion: </b>Gastritis is </span></span></span><span><span><span style="font-family:;" "="">usually</span></span></span><span><span><span style="font-family:;" "=""> found in the digestive endoscopy unit of the GHIP. The indications for endoscopy are dominated by epigastralgia and histology is necessary for its diagnosis.</span></span></span>
文摘Objective:To assess the prevalence of anemia and asymptomatia malaria parasitemia and the effect of prior antimalarials therapy on the parasite density in pregnant women at their first antenatal visit at the secondary level health care facility in Nigeria.Methods:This cross sectional observational study was carried out in the antenatal clinic of General Hospital,Ikot Ekpene,Akwa Ibom State,Nigeria for 3 months period(1<sup>st</sup> June to 31<sup>st</sup> August,2009).Five hundred and fourteen women attending their first antenatal registration visits in the hospital were recruited in the study.Socio-demographic information was obtained using pre-tested questionnaires.The malaria parasite was obtained by examining thick and thin blood films prepared on 2 glass slides while the hematocrit was obtained through 2 capillary tubes read by a Hawksleys microhematocrit reader.Results:A total of 514 pregnant women participated in the study with a mean maternal age of 21.4 years and a mean gestational age at booking of 18.3 weeks.The primigravid women booked at significantly lower gestational age than multigravidae （16.2 weeks vs 21.6 weeks）.Most of the women（59.3%） were anemic,out of which 60.4%were primigravida.More than half of the women had moderate to high parasite density and only 6.8% had no malaria parasitemia.All patients with severe anemia were parasitemic.Out of the 479 （93.2%） women with parasitemia,a third had taken antimalarial drugs.A majority（60.3%） of those without prior antimalarial drugs had moderate to high density parasitemia.Conclusions: This study shows high prevalence of anemia in women with asymptomatic malarial parasitemia, particularly the primigravida.The severity of anemia is directly related to the density of malaria parasitemia.Those with effective antimalarial therapy appear to have low density parasitemia and therefore mild anemia.Routine screening for anemia and malaria parasites at booking,prompt parasite clearance and correction of anemia would reduce the associated maternal and perinatal complications.
文摘The study assessed the relationship between exposure to stress and posttraumatic symptoms among nurses and physicians in a Jendouba general hospital. Hospital staff who were exposed to stress were assessed for posttraumatic stress disorder. High levels of stress symptoms were found in physicians and nurses. Logistic regression analysis showed that nurses had an increased risk for posttraumatic stress disorder factors characterized by negative behavior to patient, increased workload excessive ambiguity and role conflict and the lack of free. These findings showed that nurses suffered from more severe posttraumatic symptoms compared to physicians after exposure to prolonged stress. The gap between physicians and nurses warrants further study.
文摘Caesarean Scar Ectopic Pregnancy (CSEP) is a rare, but potentially catastrophic complication of a previous Caesarean Section (CS) birth. This is a review of 5 cases of CSEP managed in our Early Pregnancy Unit at Watford General Hospital within a 10-month period. Two patients had only one previous CS, whilst 2 had two and the last had 3 previous CS. All our patients presented within the first trimester of pregnancy (range 6 to 11 weeks’ gestation) with light vaginal bleeding;4 of them had associated mild to moderate abdominal pain. All were diagnosed using transvaginal ultrasound scan. Three of our patients were managed surgically by Suction Evacuation under Ultrasound guidance and insertion of a Foley’s catheter prophylactically for tamponade in order to reduce blood loss both intra- and post-operatively. One of our patients had a heterotopic pregnancy with a viable intrauterine pregnancy and a live CSEP. She declined any intervention so she was managed conservatively with weekly Consultant appointments and scans. There was a subsequent demise of the CSEP and she continued with a singleton pregnancy. None of our patients were managed medically. There is no absolute consensus on diagnostic criteria and there is no standard management protocol so each woman should be given all the available information and the opportunity to decide on the management of her pregnancy. The risk of a CSEP in a subsequent pregnancy should be part of the consent process for CS.
文摘Humman immunodeficiency virus (HIV) infection is associated with opportunistic cancers notably Non-Hodgkin lymphoma (NHL). Generally the response to chemotherapy or radiation therapy is satisfactory but requires nursing measures to protect these patients from superinfection to which they are highly predisposed by the double immunosuppression. We report the case of a 54 year-old known HIV sero-positive female with lymphoma of the nasopharynx who presented lately and died of septic shock despite the favorable evolution of the tumor on treatment.
