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Introduction Fights, domestic violence and street crimes are the major causes of stab wounds in the Kingdom of Saudi Arabia (KSA). The objective of the study was to describe the nature and severity of stab wounds at a tertiary care hospital in KSA. Methods A cross-sectional study, which included 106 patients, was conducted at the King Khalid Hospital and Prince Sultan Centre for Health Care in Al Kharj. The patients that fulfilled the inclusion criteria were recruited for the study after having confirmed their consent. The authors procured and analysed the patients' clinical notes to obtain information that was pertinent to the study. The authors recorded all data within a Microsoft Excel document. SPSS 22.0 was utilized for statistical analysis. Results Of 106 patients, the majority were adolescents and young adults under the age of 40 (n = 77). Eighty-seven point seven percent of patients were male and 84.0% were Saudis. Demographic details were tabulated. The top three causes were fights (20.8%) followed by domestic violence (18.9%) and street crime (17.0%). Degree of shock, stabbing zones, injury to vessels, nerves and bones, injury severity score (ISS) and Glasgow Coma Scale (GCS) were tabulated. Conclusion The nature and severity of stab wounds should be carefully evaluated and properly managed, as these may lead to serious complications. © Abdulmohsen Khlaif Alenazi et al.Introduction Constipation is rare in sub-Saharan Africa, due to the high intake of dietary fiber. The purpose of this work was to describe the different clinical features of functional constipation in the general population in Cotonou and to determine the impact of diet on its occurrence. Methods This study was conducted from July to August 2017. Subjects were considered affected by functional constipation when criteria for Rome IV or Bristol stool scale were completed. Results In total, 1058 participants were enrolled (574 men, sex-ratio 1.2; average age 29 years). The prevalence of functional constipation was 24.2% (Rome IV) and 20.4% (Bristol stool scale). Clinical manifestations were dominated by the emission of hard or fragmented stools (90.6%), pushing efforts during defecation (78.9%), and feeling of incomplete evacuation (76.2%). Dietary habits among people affected by constipation were at breakfast, maize meal + donut/peanuts (39.1%), lunch, corn dough (38.7%), at dinner, corn dough (57.4%), and as a snack banana (35.5%). There was no statistically significant relationship between constipation and morning meal (p=0.09), lunch meal (p=0.901), snack (p=0.09) or dinner (p=0.75) respectively. Conclusion The emission of hard or fragmented stools was the most common clinical manifestation among people affected by constipation living in Cotonou. Dietary habits do not influence the occurrence of functional constipation in our case series. © Jean Séhonou et al.Introduction Colorectal cancer is a true scourge and a major public health problem. The main purpose of this study was to identify the impact of socio-economic factors and education level on the onset of colorectal cancer and of diagnosis stage in the Moroccan population. Methods We conducted a case-control study of patients treated for cancer at the Mohammed VI center from January 2015 to January 2017. We interviewed, on a prospective basis and using a structured and pre-tested questionnaire, 225 patients and 225 eligible and consenting subjects. Results The average age of patients was 55.49± 14.06 years. In 53% of cases diagnosis was made at early-stage colorectal cancer while in 47% at advanced stage. In addition, a detailed analysis of the studied population according to the socio-economic status (SES), showed a proportion of 25.33% (patients) versus 17.33% (control) in the low SES group, while, equivalent rates (45.33% patients versus 45.33% control) in the middle SES group. In the high SES group, the rate of patients was only 16.89% patients versus 37.34% control (p = 0.0001). Education and SES were strongly correlated with diagnosis stage, with a significant difference. Then 36.44% of illiterate patients were diagnosed in advanced stage versus 5.33% of patients who had completed their secondary education level or university course (p = 0.02). Similarly 20.45% of patients with low SES were diagnosed in late stage versus 5.33% of patients with higher SES (p = 0.03). Conclusion Our results highlight that the risk of developing colorectal cancer is strongly dependent on the education and the socio-economic status of patients. A more thorough investigation is needed to clarify the causes of this inequality. © Fatima Ezzahra Imad et al.Osmotic demyelination syndrome is characterized by the loss of myelin in the center of the basis pontis and other areas of the central nervous system. We report a case of osmotic demyelination syndrome in a 55-year-old female, with a past medical history of arterial hypertension and multi-level cervical spondylosis, hospitalized for acute altered mental status complicating an array of acute gastroenteritis, the patient was afebrile. The course was marked by neurologic aggravation with confusion, aphasia, tetraplegia and osteo-tendinous areflexia. Staurosporine Initial cerebral magnetic resonance imaging did not show any specific abnormalities. The diagnosis of Central pontine myelinolysis and extrapontine myelinolysis was confirmed by a cerebral magnetic resonance imaging done after 20 days of the first. The rapid correction of hyponatremia was the main cause of this syndrome, without neglecting the very likely role of the associated hypokalemia. The evolution of centropontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) is variable. The treatment is primarily preventive based on the careful correction of severe hyponatraemia and contributing factors. © Zakaria Ghoummid et al.Introduction Malaria has proven to be the most fatal parasitic disease known to man. Among the pillars to malaria control are early and accurate diagnosis. In 2010, the World Health Organization launched its test, treat and track initiative which seeks to ensure that all suspected cases of malaria are tested. However, after several years of implementation, the use of malaria tests in diagnosing malaria has not been optimum. This study was conducted to assess the level of knowledge of prescribers on malaria Rapid Diagnostic Test and microscopy and to determine factors influencing prescribers' decision to request and use malaria tests in practice. Methods A cross sectional study was carried out among 100 prescribers of various categories working in 4 hospitals in Ghana in March 2019. A pre-tested self-administered questionnaire was used to collect information on knowledge, malaria diagnostic practices and challenges faced by prescribers regarding parasitological testing for malaria in their health facilities. Results Overall, 73% of respondents had good knowledge on malaria diagnostics. Routine use of malaria tests in diagnosing malaria was reported as 84%. Only 9% reported complete reliance on test results. Most participants (90%) reported awareness of the test-based case management of malaria. Conclusion This study demonstrated that even though there was a high level of awareness of the test-before treatment policy among prescribers, significant numbers did not routinely request a malaria test for all suspected cases of malaria. Factors cited as barriers by prescribers were both health worker and health-system related that are all potentially modifiable. © James Kojo Prah et al.Burkitt's lymphoma (BL) is a frequent childhood B cell non-Hodgkin's lymphoma (NHL) in equatorial Africa associated with infections. Chronic Epstein Barr virus (EBV) infections can lead to host immune stimulation that may trigger genetic translocation(s), neoplastic transformation and proliferation of B cells. We determined EBV immunoglobulin G (IgG) in sera from participants and EBER-1 in tumour sections in confirmed BL cases at Moi Teaching and Referral Hospital (MTRH). A cross sectional study of children with clinical and histology diagnosis of NHL from whom BL status were confirmed by immunohistochemistry (IHC) was carried out. Epstein Barr virus IgG in sera was determine using Enzyme-linked immunosorbant assay, IHC for EBER-1 and MYC protein in tumour sections. Demographic and clinical information were obtained from questionnaires and hospital files respectively. Ninety three percent of sera were EBV IgG positive of which 31.7% were confirmed as BL. All jaw BL tumours and 86.7% of BL tumours carried EBER-1 antigen. Odds ratio of EBER-1 positive was 1.39, 95% CI 0.16-12.19 in BL tumours regardless of age or gender. EBV infection among the study participants may be associated with BL, however, EBER-1 and MYC negative in BL tumours suggest alternative BL pathogenesis or variant. © Isaac Ndede et al.We propose to study the epidemiological aspects of North African psoriasis and determine the cardiovascular comorbidities and addictive behaviors associated with psoriasis. This is a North African case-control study which was conducted over a five year period (October 2008 through August 2013), involving 671 psoriatic patients and 1,242 controls identified in various Algerian, Tunisian and Moroccan university hospitals. For each patient, epidemiological characteristic, addictive behaviors, and cardiovascular pathologies associated with psoriasis were noted. Six hundred and seventy one psoriasis patients and 1,242 controls were included in this study. The average age was 47.24 years and the M/F sex-ratio was 1.11 (354 men and 317 women). Statistical analysis showed that psoriasis patients were more likely to develop addictive behaviors than controls (smoking p less then 10-5 and alcohol consumption p less then 10-5), together with dyslipidemia (30.1% of patients p less then 10-5), obesity (23.8% of patients p less then 10-4), hypertension (22.3% of patients p less then 10-5), diabetes (21.7% of occurrences p less then 10-5) and metabolic syndrome (37.4% of patients p less then 10-5). The relative risk for developing psoriasis was 1.9 in hypertensive patients, 1.7 in diabetic patients, 3.9 in dyslipidemic patients, 1.8 in obese patients, 2.6 in those with metabolic syndrome, 2.1 in smokers and 2.8 in alcoholics. Our work confirms the high incidence of addictive behaviors and of cardiovascular and metabolic comorbidities during the North-African psoriasis, hence the need for a multidisciplinary comprehensive care based on a guideline suited to the characteristics of North-African psoriatic patients. © Amina Aounallah et al.Posttraumatic carotid-cavernous fistula (CCF) is a very rare complication that can occur in patients with craniomaxillofacial trauma. It is defined by abnormal communication between arteries and veins located in the cavernous sinus. CCFs can be divided into two groups direct, which are usually post traumatic and classically with a high flow and acute onset of symptoms. On the other hand, indirect CCFs are in the most of cases idiopathic and typically insidious of onset. The aim of the present case report is to describe an atypical presentation of direct CCF characterized by the insidious onset of symptoms with the goal to think about this rare complication and so not to delay the treatment which is an emergency in this case. © Yousra Ajhoun et al.

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