Minimising Carbon Footprint in Anaesthesia Practice
Published on: 19th October, 2024
Carbon footprint refers to the total amount of greenhouse gas emitted in the atmosphere by an individual or by an organization causing global warming. There are various causes of greenhouse gas emissions and anaesthetic gases are one amongst them. Greenhouse gases warm the earth by absorbing infrared energy and slowing the rate at which the energy escapes into space. Each greenhouse gas has two important properties. One is the amount of infrared energy that a gas can absorb and the other is the lifetime of that gas in the atmosphere. Anaesthesia as a speciality contributes to carbon footprinting in three ways: direct emission, energy use, and operating room wastes and supplies. Direct emission of Waste Anaesthetic Gases (WAG) from anaesthesia workstations can either be scavenged and thrown out into the environment causing a green greenhouse gas effect or can pollute the operating room due to poor scavenging. Various techniques such as reducing direct emissions, energy use optimisation, and waste management have been tried in minimising carbon footprint in anaesthesia practice but providing safety to the patient is considered of utmost importance.
Prolonged Latency in Previable PPROM in Twin Pregnancies: A Case Series
Published on: 18th October, 2024
Previable Preterm Premature Rupture of Membranes (PPROM) before 24 weeks of gestation in dichorionic diamniotic (DCDA) twin pregnancies is a rare and challenging obstetric complication. Three cases are presented in this case series, all involving prolonged latency periods of 74, 98, and 158 days following membrane rupture. The management strategy employed was expectant, utilizing antibiotic prophylaxis and close monitoring to prevent infection. Neonatal outcomes varied, with pulmonary hypoplasia and respiratory distress observed in some cases. One twin from Case 2 died due to sepsis, while the remaining twins in all three instances survived after extended neonatal intensive care. This series highlights the potential for extended latency and favorable outcomes in select cases, though neonatal morbidity remains a significant risk, underscoring the need for individualized counseling and vigilant care.
Flood Risk Management in South-west Nigeria: Lagos as a Case Study
Published on: 18th October, 2024
Flooding is a significant natural hazard impacting societies worldwide, with increasing severity in urbanized regions. This paper presents a case study of Lagos, Nigeria, examining flood risk management efforts in the city. The purpose is to evaluate the effectiveness of current strategies and suggest improvements for reducing the impacts of flooding. Findings highlight the roles of government and private stakeholders, as well as policy challenges. Recommendations for sustainable flood management practices are provided, with implications for other high-risk areas.
A Rare Case of Cutaneuos Angioleiomyoma: A Case Report
Published on: 17th October, 2024
Cutaneous Angioleiomyoma is a very rare benign tumour of which incidence is unknown. We report a case of a 42-year-old male patient who presented with a symptomless solitary nodule over the left nostril for one and a half years duration. Complete surgical excision of the tumour was done and the sample was sent for histopathological examination. Diagnosis of this tumour was done on the evidence of histopathological examination with haematoxylin and eosin mounts. Sometimes achieving the best aesthetically accepted results may be challenging due to the site of involvement.
A Case Report on Paradoxical Emboli
Published on: 17th October, 2024
Venous Thromboembolism (VTE) is a major public health concern, affecting approximately 900,000 people annually in the United States. In rare cases, a Patent Foramen Ovale (PFO) may allow a venous thrombus to cross into the arterial circulation, causing a paradoxical embolism. This case report presents a 46-year-old male who developed left renal artery stenosis after a paradoxical embolism, likely triggered by a prolonged flight and binge alcohol consumption. The patient was found to have a moderate-sized PFO and renal infarction, confirmed by imaging studies. Despite initial anticoagulation therapy and a planned stenting procedure, intraoperative findings revealed only mild stenosis, leading to cancellation of the stent placement. The patient ultimately underwent PFO closure with an Amplatzer Talisman device. This case underscores the diagnostic challenges in managing paradoxical embolism and the need for individualized treatment, particularly concerning anticoagulation duration, the decision for PFO closure, and post-procedural antithrombotic therapy. Further research is required to establish optimal management strategies for cryptogenic embolic events.
Impact of Latex Sensitization on Asthma and Rhinitis Progression: A Study at Abidjan-Cocody University Hospital - Côte d’Ivoire (Progression of Asthma and Rhinitis related to Latex Sensitization)
Published on: 15th October, 2024
Background: The frequency of latex allergy is increasing, posing a major health problem. This increase is related to the widespread use of latex materials and cross-reactions between latex proteins and certain foods. This cross-reactivity makes latex avoidance difficult, and latex sensitization is likely to worsen atopic conditions. Objective: The authors evaluated the role of latex sensitization in the poor control of asthma and rhinitis. Methodology: An analytical cross-sectional study was conducted on 1860 patients of all ages and genders, followed up for allergic asthma and rhinitis since March 2012 in the Immuno-Allergology Unit of the Cocody University Hospital in Abidjan. Prick tests with native extracts and the European standard battery were performed to identify allergenic sensitization. The impact of latex sensitization on asthma and rhinitis control was assessed by calculating odds ratios. Results: A high frequency of latex sensitization was associated with asthma and rhinitis. The risks of poor control were related to monosensitization to latex and were even higher in the context of polysensitization. Conclusion: The impact of latex sensitization on the progression of asthma and rhinitis has been well demonstrated. It is recommended to integrate the latex sensitization status into the therapeutic management strategy of these two pathologies.
Budesonide – Oral Galenic Formulations for Crohn Disease
Published on: 11th October, 2024
The aim of this work is to verify the pharmaceutical form in the galenic field of oral Budesonide compounded used in Crohn’s disease: capsules delay release or oral suspension. In particular ways the kinds of excipients or bases-vehicle used in the galenic pharmacy practice. The therapeutic need for Crohn’s disease requires a release of the API in delayed-release DR. The Budesonide molecule shows low systemic impacts due to its hepatic metabolism vs. a topical effect useful in this pathology. In this work, the oral pharmaceutical forms are analyzed: modified-release capsules and oral suspension with specific advantages for each one. Some formulations provided by various pharmacies are reported in this work as well as new technology like the 3D-PRINTING systems for colonic targeting tablets.
The Role of Diet Therapy in Reducing the Cardiovascular Disease Risk in a Patient with a Long-Standing and Recurring History of Obesity
Published on: 11th October, 2024
Insulin resistance, often referred to as impaired insulin sensitivity. This clinical case focusses on a woman with insulin resistance and a long-standing and recurring history of obesity to demonstrate how diet therapy can be applied in addition to standard medication therapy.
Association Between Electrocardiographic Abnormalities and In-Hospital Adverse Outcome in COVID-19 Patients
Published on: 10th October, 2024
Background: SARS-CoV-2 is increasingly recognized for its cardiovascular complications. To address the knowledge gap in our region, this study investigated the relationship between electrocardiographic (ECG) features and in-hospital mortality among COVID-19 patients.Methods: A prospective cohort study was conducted involving 140 RT-PCR-confirmed COVID-19 patients at Dhaka Medical College Hospital from August 2021 to July 2022. Patients were divided into two groups based on ECG findings: normal (Group A) and abnormal (Group B). Clinical data and ECG parameters were analyzed using SPSS 24.0.Results: Patients with abnormal ECGs were older, more likely male, and presented with higher rates of dyspnea and palpitations. They were also at increased risk of severe COVID-19 and had longer hospital stays. In-hospital mortality was significantly higher in Group B (21.4% vs.4.3%). ST-T changes and atrial fibrillation were associated with increased mortality. Independent predictors of in-hospital mortality included ECG abnormalities and admission SpO₂ < 90%.Conclusion: ECG abnormalities are significantly associated with adverse outcomes in COVID-19 patients. Further large-scale studies are warranted to strengthen these findings.
Prevalence and Correlation between HbA1c Control and Duration of Diabetes with Blindness in the Eastern Part of Libya: Double Centers Study
Published on: 9th October, 2024
A prospective cross-sectional study of diabetic patients registered at the Eye department of Tobruk Medical Center in Tobruk-Libya between (01.06.2023 to 29.02.2024). At the same time data was collected in the eye department in Alwahda Derna Teaching Hospital, Data was collected using the same administered questionnaire. Grading of DR was done by slit-lamp examination and Fundoscopy by an ophthalmologist. Descriptive analysis included percentage mean, median, and p - value by using SPSS 25. There were 185 diabetic patients, ages ranging between 30 and 90 years, with a mean of 58, the majority (97.6%) were of Libyan nationality. There were 86 males and 99 females. Patients with a duration of diabetes ranging between 11 and 15 years were at almost a five-fold risk of developing DR compared to those with a duration of < 10 years. Most of advanced complicated diabetic retinopathy cases had diabetes for more than fifteen years, and no advanced disease in the cases with a duration of less than 10 years.
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