Adult

Ceftriaxone in pediatrics: Indication, adverse drug reaction, contraindication and drug interaction

Published on: 5th April, 2022

OCLC Number/Unique Identifier: 9470678055

Ceftriaxone is having many uses and useful “third-generation” cephalosporin that necessitates being given every day. Ceftriaxone acts as binds to one or many of the penicillin-binding proteins which inhibit the final transpeptidoglycan step of peptidoglycan synthesis in the bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.Ceftriaxone-associated biliary adverse events in children less than eighteen years cause biliary pseudolithiasis and scarcely nephrolithiasis often happen in children less than eighteen years after receiving overdoses of ceftriaxone. Ceftriaxone perhaps binds with calcium and figure insoluble chelation leading to biliary pseudolithiasis. Cholelithiasis, increased biliary thickness, and pseudolithiasis rarely happen in a period of being a child, but there are two modes of distribu¬tion described by two peaks, the first being at an early stage of development and the second is a period of life when a child develops into an adult. Hyperbilirubinemia is significantly contraindicated for neonates administrated ceftriaxone, particularly premature neonates, because of the displacement of bilirubin from albumin-binding sites and increase in blood concentrations of free bilirubin. A child than one month old and a child less than twelve-month old in special are at great risk of poor results because of bilirubin encephalopathy. Coincident administrations of ceftriaxone with aminoglycosides such as gentamycin and loop diuretics (furosemide) perhaps increase the risk of nephrotoxicity (rapid degeneration in the kidney function to the toxic outcome of double or triple medications). Coincident administrations of ceftriaxone with anticoagulant medications such as warfarin are associated with bleeding due to increased prothrombin times, which is reversible with vitamin K.
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Associations of Exercise Habits and Circulatory Dynamics with Peripheral Lower Limb Body Composition in Healthy Community-dwelling Older Individuals

Published on: 15th April, 2022

OCLC Number/Unique Identifier: 9485821986

We investigated the associations between circulatory dynamics and Body Composition (BC) of the peripheral lower limbs with Exercise Habits (EHs). We surveyed the EHs of 34 healthy older adults (6 men, 28 women) and measured their BC and skin perfusion (SP). SP did not correlate significantly with any other variable. Participants with established EHs had a lower body weight and Fat Tissue thickness (Fat-T) than those without. Multiple logistic regressions with the presence or absence of an EH as the dependent variable and BC values as the independent variables established Fat-T as a significant variable. Sex was independently associated with soleus muscle thickness, Fat-T, Bone Density (BD), and leg segmental water. Age was independently associated with Fat-T and BD, and body mass index was associated with Fat-T. EHs were not independently associated with any of the BC measurements. Physical characteristics and EHs have minimal influence on peripheral circulatory dynamics.
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A Wolff-Parkinson-White (WPW) Electrocardiographic Pattern in Asymptomatic Patient – State-of-the-Art-Review

Published on: 7th June, 2022

A comprehensive approach to asymptomatic adults with Wolff-Parkinson-White (WPW) pattern discovered incidentally on routine electrocardiography (ECG) is debatable. The objective of this review article is to update the most recent evidence on the management of young patients with asymptomatic WPW patterns. A substantial proportion of adults with WPW patterns on ECG may remain asymptomatic but the lifetime risk for fatal arrhythmias still exists. The inherent properties of the accessory pathway determine the risk of sudden cardiac death. A low-risk pathway is considered when the pre-excitation is intermittent on ambulatory monitoring or when it disappears completely or abruptly during exercise testing. On the other hand, a high-risk pathway in EP study is suggested by the presence of the shortest pre-excited RR interval (SPERRI) during atrial fibrillation of ≤ 250 ms or accessory pathway effective refractory period (APERP) ≤ 240 ms. The cardiac evaluation may thus be considered in asymptomatic patients with WPW to determine the individual risk for future symptomatic arrhythmia. A shared-decision making must be performed before offering catheter ablation whose procedural success rate is high.
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Incidence, risk factors, and outcomes of acute kidney injury among hiv positive medical admissions at the Bamenda Regional Hospital

Published on: 16th June, 2022

OCLC Number/Unique Identifier: 9538011570

Background: There is a paucity of data on the burden of acute kidney injury (AKI) in hospitalized HIV-infected patients in Sub-Saharan Africa in the “test and treat” era.Objectives: To study the incidence, risk factors, and outcomes of AKI among HIV-positive medical admissions in a secondary hospital.Materials and methods: We prospectively screened adult HIV-positive patients who gave their informed consent and were admitted to the Bamenda Regional Hospital for AKI from February to June 2020. We excluded participants with Chronic Kidney Disease (CKD) Stage 5 and those with confounders of serum creatinine. On admission and after 2-7 days, we extracted a venous blood sample from each participant to evaluate serum creatinine and diagnose AKI. The participants were then followed up on until they were discharged or died. We measured the need for dialysis, access to dialysis, and renal recovery at three months for patients with AKI. The amended KDIGO 2012 criteria were used to define and classify AKI. The University of Bamenda’s institutional review board provided ethical approval.Results: A total of 206 participants (39.8% men) were enrolled, with a mean (SD) age of 45.71(13.13) years. On enrolment, 89.8% (n = 185) of the participants were on combination antiretroviral therapy (c-ART), with 81.6% (n = 151) on tenofovir-containing regimens. The WHO HIV clinical stages 3 and 4 were present in 81.5% (n = 168) of the individuals. The most common reason for hospitalization was opportunistic infections (69.8%; n = 142). AKI was found in 30.6% (n = 63) of the patients, with 58.7% (n = 37) of them being classified as KDIGO stage 3. A total of 12 (42.9%) participants out of the 28 in need, were dialyzed. AKI was independently associated with use of traditional medicines (aOR = 2.9; 95% CI 1.4-6.3; p = 0.006), WHO HIV stages 3 and 4 (aOR = 4.1; 95% CI 1.1-15.7; p = 0.038), hypotension (aOR = 3.3; 95% CI 1.4-7.8; p = 0.008) and low haemoglobin level ≤ 8.0 g/dl (aOR = 3.5; 95% CI 1.7-7.4; p = 0.001). The AKI group used to have a significantly higher mortality rate (42.9% vs. 16.1%; p < 0.001). Renal recovery was complete in 66.7% of the 30 survivors at three months, partial in 13.3%, and no recovery in 20% of the survivors.Conclusion: Despite the growing use of combination antiretroviral medication, significant immunosuppression is still common in hospitalized HIV-positive patients, increasing the risk of AKI and worsening prognosis. In this high-risk population, early detection of AKI with renal function monitoring may improve results.
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Step VEP visual acuity in a pediatric neuro-ophthalmological cohort

Published on: 12th June, 2022

Steady-state VEPs, have been used to estimate visual acuity since the 1970s and allow responses to a range of stimulus sizes to be collected rapidly- with particular utility in infants. However, the assessment of children with cortical visual impairment is a bigger challenge that lead to the development of the Step VEP. Its initial evaluation revealed that accuracy and precision were poorer for pediatric patients than for optically degraded normal adults and that it was not necessarily successful in every child. Statistical models generated the equations: VAO = 0.56 VAStep (r2 = 0.75, F = 60.93, p = 0.000) and VAPL = 0.45 VAStep (r2 = 0.82, F = 156.85, p = 0.000), supported by a recent a systematic review of VA comparisons showing that recognition VA (optotypes) agrees more closely than discrimination VA (PL) with VEP VA. In combination, Step VEPS and subjective tests allowed complete assessment in 96% of patients, with incomplete Step VEPS much more likely to be partially successful than not, and more likely to be partially successful than incomplete subjective tests. This supports the rationale that Step VEPs maintain attention by limiting the time spent stimulating away from an individual’s threshold of spatial resolution. For the small number of patients in whom VA cannot be estimated, alternative stimuli and methods of presentation are proposed. 
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VEP visual acuity in children with cortical visual impairment

Published on: 2nd August, 2022

Given improvements in neonatal care and the increased survival rates of infants born pre-term, Cortical Visual Impairment (CVI) is now the leading cause of visual impairment (VI) in the developed world. In this study, Step VEPS, transient VEPS and Vernier Sweep VEPs all demonstrated unbiased relationships with Preferential looking (PL) cards over the whole range of Visual Acuity (VA) in children with CVI, allowing equations for clinical use to be derived. The results also suggested that a slower, vernier steady-state stimulus of 80% contrast and presented with the Step VEP algorithm could further improve VA agreement with PL and optimise developmental sensitivity. An eye tracking device has proved very useful in the clinical assessment of this cohort. It is also now known that children can have good VA and CVI, and that sweep VEPS can highlight higher processing deficits. As well as negative findings, compensatory neuroplasticity is thought to occur during maturation and it is now realistic to study this mechanism, and other age-related changes across VI with functional tests and neuroimaging (including VEPS). A cross-sectional study of adults would highlight CVI’s ultimate functional limitations.
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Role of perioperative plasma D-dimer in intracerebral hemorrhage after brain tumor surgery: A prospective study

Published on: 2nd August, 2022

Background: Intracerebral hemorrhage (ICH) is one of the most feared complications after brain tumor surgery. Despite several factors being considered to influence bleeding, an increasing number of clinical studies emphasize that hemostatic disorders, developed during surgical aggression and tumor status, could explain unexpected ICH. The objective of this prospective study was to evaluate the influence of perioperative D-dimer levels on ICH after brain tumor surgery. Methods: This prospective, observational, 18-month study, at a single third-level hospital, included all consecutive adults operated on brain tumors and postoperative stay in an intensive care unit. Three blood samples evaluated D-dimer levels (A-baseline, B-postoperative and C-24 hours after surgery). The normal range considered was 0-500ng/ml. ICH, as a primary outcome, was defined as bleeding that generates radiological signs of intracranial hypertension either by volume or by mass effect on the routine CT scan 24 hours after surgery. Other tumor features and hemostasis variables were analyzed. Chi-squared and Fisher’s exact test were used in the inferential analysis for qualitative variables and Wilcoxon and T-Test for quantitative ones. P-value < 0.05 was considered significant for a confidence interval of 95%. Results: A total of 109 patients operated on brain tumor surgery were finally included, 69 male (63,30%) and 40 female (36,70%), with a mean age of 54,60 ± 14,75 years. ICH was confirmed in 39 patients (35,78%). Their average of DDimer was A-1.526,70 ng/dl, B-1.061,88 ng/dl, and C-1.330,91 ng/dl (A p0.039, B p0,223 C p0.042, W-Wilcoxon test). The male group was also associated with ICH (p0,030 X2 test). Of those 39 patients with ICH, 30 in sample A (76,9%), 20 in sample B (51,28%) and 35 in sample C (89,74%) had a D-dimer > 500 ng/dl (p0,092, p1, p0,761 X2 test) and the relative risk of developing a postoperative hematoma in this patients was increased 0,36-fold presurgery, 0,25-fold postsurgery and 0,40-fold 24hours after surgery. D-dimer variation, had no statistical significance (p0,118, p0,195, p0,756 T-test). Platelets and prothrombin activity were associated with D-dimer levels only in sample A (p 0,02 and p 0,20, W Wilson). Conclusion: High levels of perioperative D-dimer could be considered a risk marker of ICH after brain tumor surgery. However, more studies would be worthwhile to confirm this association and develop primary prevention strategies for stroke. 
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The factors associated with mental health and the impact of COVID-19

Published on: 11th August, 2022

OCLC Number/Unique Identifier: 9591348162

The mental health impact caused by COVID-19 on adolescents was reviewed, and due to limited data, adult results were included, to support our assertion that additional mental health resources are needed for both adult and young people. Positive gains would include improved socio-emotional skills, a decrease in maladaptive behaviors contributing to the disruption in interpersonal relationships and lifetime achievements, suicide attempts and psychopathology, persistent mental health concerns found in the juvenile justice and foster care systems and substance use addiction later in adulthood (The American Psychological Association, 2019; Garber & Weersing, 2010; Office of Juvenile Justice and Delinquency Prevention, n.d.; Tomasello, 2018;). Geiger & Davis, 2019, found that 13% or 3.2 million United States (U.S.) teenagers aged 12 - 17 years old experienced at least one major depressive episode with the depression rate increasing 59% from 2007 to 2017. Therefore, we assert that developing programs to overcome barriers to mental health aid can reduce instances experienced in adolescence and adulthood.
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Prevalence and awareness of oral habits among adults in Riyadh, Saudi Arabia

Published on: 20th September, 2022

Introduction: Oral habit is common in childhood and it is proven to cause multiple adverse effects on oral and general health, while oral habits in the adult population are under looked. The prevalence of oral habits varied among different societies. The extent of these effects varies depending on a wide range of variables including the actual habit, the duration, and the intensity of the oral habit. Objectives: The primary objective is to determine the prevalence of oral habits in adults in Riyadh, Saudi Arabia, and the secondary objective is awareness of different types of oral habits and their adverse effects.Methods: Descriptive cross-sectional study using questionnaire through google form which will address the prevalence of 5 Oral habits in the adult population, Riyadh, Saudi Arabia such as nail biting, chewing on pens/pencils/Miswak, using the teeth as a tool, chewing ice, and teeth clenching/grinding and bruxism. Also, it will address the awareness of these 5 oral habits and their adverse effects on oral health and prevention modalities. Results: There were 220 participants. The majority were Saudi (52.7%), females (83.2%) with bachelor’s degrees (63.6%) and around fifty percent with age below 30 years old. The most prevalent pattern was using teeth as a tool (46.8%), followed by chewing ice (43.6%) and nail-biting (39.1%). All five habits were mainly started in childhood; however, a respectable percentage of beginning is still reported during adulthood, particularly for clenching/grinding/ bruxism and chewing ice, with a ratio of 36.4% and 25%, respectively. Most participants who reported clenching/grinding/ bruxism and nail-biting were related to stress (75.3%, 48.8%, respectively). The majority reported that oral habits could harm teeth (82.3%) and could be preventable (78.6%).Discussion: Most of the studies concentrate on oral habits in children while few studies had concentrated on oral habits in adults. Oral habit is not uncommon in adults, they have either to continue childhood bad habits or practice new oral habit. The adverse effect varies widely on oral and general health. Although the adult population is aware of these side effects few only seek medical advice.Conclusion: In Saudi Arabia, oral habit is not uncommon in adults. So the recommendation for the prevention of oral habits is to embed it in all public services, at strategic and operational levels.
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Knowledge and self-reported practice of insulin injection device disposal and associated factors among diabetes patients in Addis Ababa, Ethiopia: A cross-sectional study

Published on: 26th September, 2022

Background: Diabetes mellitus is a serious long-term condition with a major impact on the lives and well-being, of societies worldwide. Poor disposal practices of devices potentially result in personal injury and injuries to people in the household and the general community. This study aimed to assess the knowledge and self-reported practice of insulin injection device disposal and associated factors among diabetes patients in TASH, Addis Ababa, Ethiopia. Method: A cross-sectional study was conducted among 182 adults with diabetes. The study participants were selected through systematic random sampling. Data were collected from March/17/2020 - May/18/2020. Patients were interviewed using a structured questionnaire. Data were entered into Epi-data version 4. 6 and exported to SPSS version 25.0 for analysis. Bivariable and multivariable logistic regression with crude and adjusted odds ratios along with the 95% confidence interval was computed and interpreted accordingly. Good practice and adequate knowledge were defined based on median calculation; a result above the median value of good practice and adequate knowledge with a p - value < 0.05 was considered to declare a result as statistically significant.Results: About 54% of the participants had inadequate knowledge about safe insulin injection waste disposal. More than two-thirds (73%) of respondents had poor practice and 92.3% of respondents did not know how to dispose of lancets after use.Conclusion: This study revealed that the knowledge and practice of diabetic patients were inadequate and poor towards safe insulin injection waste disposal in the study area. Educating patients and awareness creation training on proper insulin injection device disposal should be considerable. 
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Dynamic knee valgus in anterior cruciate ligament non-contact injury and reinjury in professional female athletes. Determinant or not?

Published on: 15th November, 2022

Dynamic Knee Valgus (DKV) is correlated with both, Anterior Cruciate Ligament (ACL) injury and hip and ankle disorders in female athletes and has a more significant prevalence compared with male athletes because of numerous factors. The aim of this study is to determine if the connexion between DKV, landing errors, and non-contact ACL injury and re-injury in high-performance, adult, female team sport athletes can be eliminated by changing the frontal plane movement pattern and the landing errors during the rehabilitation process (RHB), a process which was focussed on dynamic knee stability with multidimensional single-leg jump landing training, on 3D knee balance improvement and multistimulus perturbation challenges and tasks,+ eccentric & concentric exercise, strength & conditioning, aerobic training that lasted from 26 - 44 weeks.Assessing and eliminating-reducing DKV during the RHB is mandatory in lowering the re-rupture rates in female professional athletes after ACL surgery and in preventing opposite knee trauma.
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Survival and predictors of mortality among HIV-infected adults receiving ART in Hawassa comprehensive specialized hospital, Sidama regional state, Ethiopia

Published on: 25th November, 2022

Background: Having claimed lives, HIV/AIDS is still a significant global public health concern. Antiretroviral therapy (ART) is now widely available, and this rapid expansion of access is dramatically improving HIV epidemic survival rates worldwide.Objectives: The aim of this study was to identify the mortality risk factors and survival status of ART patients attending Hawassa Comprehensive Specialized Hospital in 2020.Methods: In a five-year retrospective cohort research, all patients seen between January 2015 and December 2019 were analyzed. The data were analyzed with SPSS 25.0. The Kaplan-Meier Log-rank model was employed to gauge the survival time of ART patients based on explanatory variables. Both bivariate and multivariate Cox proportional hazards regression models were employed to identify the independent causes of mortality.Results: Patients on ART had a 74% overall survival probability. With a median survival of 34 months, there are 0.135 deaths for every 100 person-years. Hemoglobin level (HR = 2.38; 95% CI = 3.3-6.3), WHO clinical stage III and IV (HR = 3; 95% CI = 2.2-9.5, p = 0.04), Age >=60 (HR = 1.6; 95% CI = 1.3-2, p = 0.04) and Functional status bed ridden (HR = 3.1; 95% CI = 1.2-9.4,p = 0.04) were all independent predictors of death among RVI patients.Conclusion: In comparison to trials conducted in wealthy countries, the survival rate of ART patients in this study was low. Patients who are anemic; WHO advanced clinical stage; old age, and functional status bedridden should be closely followed and monitored.
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Pulmonary congenital cystic adenomatoid malformation: a rare congenital abnormality in adults and review of literature

Published on: 25th November, 2022

Congenital cystic adenomatoid malformation of the lung (CCAM) is characterized by an adenomatoid proliferation of bronchiole-like structures and cysts formation. The condition is most commonly found in newborns and children and may be associated with other malformations; rarely, the presentation is delayed until adulthood. We herein report two cases of CCAM in adult patients. 22 years old healthy female with pre-employment health screening chest x-Ray showed a lesion in the upper lobe of the right lung. In another case, a computed tomographic scan of the thorax (CT) confirmed a mass in the upper right lung. A 28-year-old male presented with recurrent respiratory tract infection resistant to antimicrobial therapy. CT scan of the thorax showed a mass in the left lung upper zone. Surgical resection was performed in both cases, and histopathology of the resected specimen showed both cases were consistent with the CCAM.
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Prevalence of performance-enhancing drug use among gym members in Saudi Arabia, Riyadh: A cross-sectional survey

Published on: 27th December, 2022

Context: Illicit and performance-enhancing drug (PED) use is prevalent among athletes.Aims: We examine the prevalence of PED use among amateur athletes, identify the common characteristics and associated risk factors for illicit PED use and measure the perception and awareness among gym members regarding the safety and effects of illicit drug use.Settings and design: This cross-sectional study was conducted among adult male and female gym center attendees in Riyadh, Saudi Arabia.Methods and materials: Self-administered Arabic and English questionnaires were used for data collection. Statistical analysis used: SPSS version 26 was used to perform t- and chi-square tests.Results: This study included 379 participants, of whom 59.6% were male, 52.8% were between 26 and 35 years of age, and a majority of the participants had normal (47.5%) or overweight (40.9%) body mass index. Our study revealed a high prevalence (48.5%) of PED use among gym athletes in Riyadh, Saudi Arabia. Moreover, the true prevalence might have been higher due to the possibility of underreporting by some participants because of the sensitivity of the subject. Protein powder was the most commonly used type of PED. Of all the participants, 22.3% reported anabolic androgenic steroid use. Side effects of PEDs were observed in 19% of the study participants.Conclusion: The results of this study should encourage public health researchers and health advocates to design and implement behavioral interventions to educate the public on the benefits, risks, and contraindications of dietary supplements used by athletes to enhance their body performance.Key messages•    Performance-enhancing drug (PED) use is prevalent among both professional and amateur athletes.•    Gym athletes in Riyadh, Saudi Arabia, report increasing PED use.•    Side effects and negative health impacts are associated with illicit PED use.•    Misinformation on the risks and benefits of PEDs is a major public health concern.•    More efforts should be implemented in public awareness about the risk of using PED targeting younger populations.
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Forensic analysis of raw meat adulteration using mtDNA

Published on: 29th December, 2022

Meat species identification has become essential with the increasing events of frauds like the illegal slaughter of cows, meat adulteration, and substitution. Food scam directly influences public well-being, trade, and wildlife. In Pakistan, donkey meat is used as adulterants for cow meat and is considered Haram in Islamic concepts. In this study PCR, based detection methods are used for identification purposes. The mitochondrial gene cytochrome b has been used in this study to identify the origin of meat specie. Specie-specific primers of cyt b of cow and donkey were used for identification. DNA from different binary ratios of cow and donkey meat was extracted by the phenol-chloroform method. Ratios were made from 1-10 and extracted DNA was subjected to PCR to amplify the target fragment of the cyt b gene. Primers were sensitive to identifying species origin in all meat ratios. Multiplex PCR was designed to identify both species and the results were analyzed by gel electrophoresis. Fragment size of 309bp for cow and 475bp for donkey was observed.Results of the current study conclude that PCR assays, including multiplex PCR, is efficient and has a high sensitivity for even small amount of meat. It is concluded that multiplex PCR is useful and reliable for adulterated meat detection.
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Outcome of liver transplantation for autoimmune hepatitis in South Africa

Published on: 31st December, 2022

Background: Liver Transplantation (LT) is the definitive treatment for Autoimmune Hepatitis (AIH) in patients with decompensated cirrhosis, liver failure and hepatocellular carcinoma. Outcomes of LT in AIH among black-Africans are not well-defined. We performed a single-center retrospective-review of adult LT patients. The study period was from 1st August 2004-31st August 2019. The primary aim was to document 1- & 5- year patient and graft survival. A secondary aim was to compare the survival of black-Africans to Caucasians. Data was analyzed using survival-analysis. Results: A total of 56 LT were performed for AIH. Sixty-seven percent (n = 38/56) had confirmed AIH on explant histology. Of these, the majority i.e., 79% (30/38) were female and 21% (8/38) were male. There were equal numbers of black-African 42% (n = 16/38) and Caucasian 42% (n = 16/38) patients. Rejection was four-times higher in black-Africans as compared to Caucasians. Forty-four percent (n = 17/38) had an acute rejection episode and 13% (5/38) had chronic rejection. Recurrence was found in four black-African females. Post-LT patient survival at 1- and 5- years was 86.5% and 80.7%, and graft survival was 94% and 70.8% respectively. The 5- year patient survival was insignificantly lower for black-Africans (73.9%) as compared to Caucasians (83.7%) (p - value 0.26, CI 6.3 - 12.2). Five-year graft survival was significantly lower among black-Africans (55%) as compared to Caucasians (84.8%) (p - value 0.003 CI 3.8 - 8.1)Conclusion: Black-Africans had a four-fold higher rate of rejection compared to Caucasians. Recurrent AIH was only found in patients of black ethnicity. Similar 1- & 5- year patient survival rates were observed between the two ethnicities. The 5-year graft survival among black-Africans was significantly lower than Caucasians.
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Complications of ultrasound-guided percutaneous native kidney biopsies in children: A single center experience

Published on: 5th January, 2023

Introduction: Percutaneous kidney biopsy is a necessary tool to diagnose many kidney diseases. However, major complications were reported in adults, including bleeding in the kidney or around it, creation of arteriovenous fistula, wound infection, damage to adjacent organs, or even loss of the kidney. Such complications can rapidly develop serious consequences. Exploring risk factors might help in preventing them.Objective: The current study aims to evaluate and explore the complications that happened after percutaneous kidney biopsy in children and associated risk factors.Methodology: A retrospective record-based study was conducted by reviewing the medical records of children with post-ultrasound-guided percutaneous kidney biopsy complications at King Saud Medical City, a tertiary hospital in Riyadh, Saudi Arabia during the period from May 2014 to June 2021. Data were extracted using pre-structured data collection sheet. Data collected included children’s age, gender, primary disease, laboratory findings, and kidney complications with needed management. Results: The study identified 76 children who had undergone 86 ultrasound-guided percutaneous kidney biopsies in the study period and fulfil the inclusion criteria. Children’s ages ranged from 1 years to 15 years with a mean age of 7.3 ± 4.0 years old. Most of the study children had nephrotic syndrome (61.6%; 53), followed by glomerulonephritis (25.6%; 22). Thirty-five (40.7%) children developed at least one of the complications. The most-reported complication was microscopic haematuria (32.6%; 28), followed by gross haematuria (3.5%; 3), Flank pain was reported among 3 (3.5%) children also and hematoma (1 child), only 2 children (3.9%) among those who had no complications recorded Haemoglobin drop > 2 g/dl compared to 3 of those who had complications with no statistical significance (p = .365). Prothrombin time was significantly higher among children who had renal complications than others who had not (11.7 ± 1.8 vs. 10.8 ± 1.2 seconds; p = .022).Conclusion: Suggestive by the low need to intervene in complications, ultrasound-guided percutaneous kidney biopsy is a relatively safe procedure in children. Even in the most commonly observed complication, i.e. hemorrhagic ones, blood transfusion is rarely needed.
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The prevalence and risk factors of chronic kidney disease among type 2 diabetes mellitus follow-up patients at Debre Berhan Referral Hospital, Central Ethiopia

Published on: 20th February, 2023

Background: Chronic kidney disease is a progressive loss in renal function that is more accepted as global public health importance and its magnitude is overgrowing in the least developed countries like Ethiopia. No data was found in Debre Birhan Central Ethiopia on the magnitude of chronic kidney disease among type 2 diabetes patients. Methods: Institution-based cross-sectional study was conducted among 327 at Debre Berhan Referral Hospital from March to June 2019 in Adult (≥ 18 years) type 2 diabetes follow-up patients who volunteered to give informed written consent were included in the study. Systematic random sampling was used. Data were collected by interviews using structured and pre-tested questionnaires. Descriptive statistics of the continuous and categorical variables were done. The bi-variable and multivariable logistic regression was done to show the net effect of explanatory variables on chronic renal disease. Results: A total of 327 study participants were involved in the final analysis. The Prevalence of CKD among type 2 diabetic patients was 15.9%. A significant association was found with age > 60 years [AOR 3.5 (95% CI 1.8-6.8)], alcoholic patients [AOR 2.4 (95% CI 1.2-5.1)], glycated hemoglobin levels above 7% [AOR 2.5 (95 CI 1.5-4.1)], higher level of LDL greater than 100 g/dl [AOR 2.7 (95% CI 1.9-4)] and lower level of HDL [AOR 2.9 (95% CI 1.4-6)].Conclusion: The magnitude of chronic kidney disease among type 2 diabetic follow-up patients was 15.9%. Estimated GFR should be determined for diabetic patients at regular intervals of time for earlier diagnosis of chronic kidney disease.
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Assessment of self-injurious behavior in major depressive disorder: a case report

Published on: 10th March, 2023

Introduction: Self-harm and depression are two related mental health issues that often co-occur and can have serious impacts on individuals and their well-being. Major Depressive Disorder (MDD) is a complex and multifaceted mental health condition that is prevalent among young adults. It is a significant public health concern that affects individuals, families and society as a whole, contributing to considerable social, economic, and health-related costs. Despite the high prevalence of depression in young adults, there is a lack of understanding of its etiology, risk factors, and optimal treatment strategies. Self-harm behavior is a concerning manifestation of MDD that can have serious consequences, including injury, infection, or even death.Methods: In this article, we report a case of an MDD patient with self-harm behavior and discuss the assessment method and treatment options. Our aim is to raise awareness of these pathologies among psychiatrists and the general population and to highlight the importance of early diagnosis and effective treatment in reducing the risk of self-harm behavior and suicide.Conclusion: In light of the case presented, it is evident that early detection and targeted intervention are crucial in mitigating the risk of self-injurious behavior in MDD patients. The utilization of a comprehensive assessment methodology, inclusive of a thorough review of the patient’s clinical history and utilization of standardized rating scales, proved indispensable in the tailoring of an individualized treatment regimen. The amalgamation of pharmacotherapy and psychotherapy proved to be a successful strategy in the amelioration of depressive symptoms and consequent self-harm behavior. As such, we trust that this case report will serve to sensitize clinicians to the importance of early identification and prompt management of these pathologies, in the quest for enhanced mental health outcomes.
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Coronary artery anomalies, myocardial bridging associated with fistula to pulmonary artery trunk. Case reports

Published on: 31st March, 2023

Between coronary artery anomalies, myocardial bridging means an epicardial coronary artery, mostly left anterior descending artery (LAD), running through an intramyocardial “tunnel” (usually in the middle segment), leading during systolic contraction, flow reduction, through the vessel. When this anomaly is associated with a coronary fistula, which “steals” more from the bloodstream, the symptoms are more pronounced, and the management complex is surgical in particular. Despite the presence from birth remains asymptomatic and it becomes clinically manifest later in the third to fourth decade of life, with a diverse palette of symptoms; angina, arrhythmias, and acute myocardial infarction up to sudden death. Diagnosis and particular management, medical, interventional, and surgical should avoid major cardiac complications and sudden death. We present two adult patients, with coronary artery bridging, one case associated with coronary artery fistula, LAD to pulmonary artery trunk, very symptomatic with surgical management, and the second only myocardial bridging controlled with medication and supervision.
Cite this ArticleCrossMarkPublonsHarvard Library HOLLISGrowKudosResearchGateBase SearchOAI PMHAcademic MicrosoftScilitSemantic ScholarUniversite de ParisUW LibrariesSJSU King LibrarySJSU King LibraryNUS LibraryMcGillDET KGL BIBLiOTEKJCU DiscoveryUniversidad De LimaWorldCatVU on WorldCat
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