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Jan 2026 DOI 10.14302/issn.2470-0436.jos-25-5905
Al-Yarabi MohammedCorresponding author
Purpose To report a rare case of Mooren’s ulcer in a healthy young male without systemic autoimmune disease, and to highlight the effectiveness of conjunctival resection as therapy for cases unresponsive to medical management. Case report A 34-year-old immunocompetent male presented with progressive peripheral corneal ulceration in the left eye. Extensive systemic and infectious evaluations, including rheumatologic, immunologic, and microbiological testing, were unremarkable. Human leukocyte antigen genotyping was DR17(03)-negative and DQ2-positive. Rheumatological evaluation yielded no definitive systemic diagnosis. Despite immunosuppressive therapy with adjuvant medications, the epithelial defect and stromal inflammation persisted. The patient underwent conjunctival resection, resulting in marked reduction in inflammation, rapid re-epithelialization, and structural stabilization of the cornea. Histopathology of excised conjunctiva showed nonspecific inflammation without granulomatous changes, vasculitis, or neoplastic features. During follow-up, patient remained in remission with visual acuity preserved at 6/6 bilaterally and no recurrence. Conclusion Mooren’s ulcer is rare but vision-threatening. Early recognition, comprehensive evaluation, and timely surgical intervention can be vision-saving. This case highlights the role of a multidisciplinary approach and supports conjunctival resection as a useful adjunct in refractory disease. Long-term follow-up is essential.
Dec 2025 DOI 10.14302/issn.2688-5328.ijp-25-5402
Yang Shih-ChiehCorresponding author
Background Prescribing appropriate analgesics with optimal dosages based on patients' pain severity is challenging, especially when multiple painkillers are involved. Tracking and analyzing the effectiveness of analgesics and their dosages over time is crucial for pain management. Existing systems lack the ability to integrate analgesic equivalent doses with temporal trends in pain scores, hindering effective decision-making. Methods We developed a Clinical Support System that calculates the daily oral morphine equivalent dose and analyzes trends in consumed equivalent doses of analgesics. The system provides a graphical user interface that displays medication prescriptions, actual medication usage, and pain scores. It offers features such as correlating analgesic drug usage with pain intensity, trend analysis of analgesic drug usage and pain intensity, and identification of effective oral morphine equivalent doses. Results The system overcomes previous barriers in drug analysis by providing real-time calculation of oral morphine equivalents and trend analysis of pain duration. It assists physicians in prescribing appropriate and safe medication dosages, enhancing medication safety for patients. Conclusions Our clinical support system offers a comprehensive solution for analyzing trends in consumed equivalent doses of analgesics. It integrates medication prescriptions, actual usage, and pain scores, providing decision-making support for pain management.
Dec 2025 DOI 10.14302/issn.2768-5209.ijen-25-5602
Lassaad MdellelCorresponding author
Chemical insecticides have been the primary method used by farmers to control pests. However, their negative environmental impacts, harmful effects on beneficial insects and human health, and prohibition in organic farming systems have driven the search for natural alternatives with insecticidal properties. These alternatives provide a safer and more sustainable way to control insect pests. Medicinal plants and their constituents play an important role in pest management. For example, ginger (Zingiber officinale) extracts contain bioactive compounds with insecticidal activities. The objective of this work was to track the population of the green peach aphid (Myzuspersicae) on pepper crops in a greenhouse, identify the active ingredients in ginger extracts, and evaluate the insecticidal effects of three concentrations of ginger-derived aqueous and essential oil extracts against M. persicae on pepper plants under laboratory and greenhouse conditions. The results demonstrate that M. persicae grows rapidly on pepper crops under greenhouse conditions, reaching high densities on leaves. The ginger extract contains two active ingredients with insecticidal effects against this pest. The significant reduction in aphid (M. persicae) populations indicates that Z. officinale aqueous extract (150 mL/L) and essential oil (2 mL/L) have strong potential for the biological control of this pest under greenhouse conditions. Thus, the use of ginger plant extract emerges as a promising alternative for reducing M. persicae infestations on pepper plants.
Nov 2025 DOI 10.14302/issn.2690-4721.ijcm-25-5786
Ornelle Elion Assiana DarrelCorresponding author
In the Republic of the Congo, tuberculosis (TB) remains a major public health concern. Although the GeneXpert MTB/RIF assay is the WHO-recommended first-line diagnostic test, smear microscopy is still used for treatment monitoring and in facilities where molecular testing is limited. Evaluating the diagnostic accuracy of smear microscopy compared to GeneXpert and MGIT culture is essential to guide diagnostic strategies and strengthen TB control in the country. A cross-sectional study was conducted among 92 presumptive pulmonary TB patients at Makelekele Hospital. Sputum samples were analyzed by smear microscopy, GeneXpert MTB/RIF, and MGIT culture. Sensitivity, specificity, positive and negative predictive value were calculated for smear microscopy and GeneXpert, using culture as the reference standard. Culture detected more Mycobacterium tuberculosis than microscopy (49% vs. 32%, P<0.001). Smear microscopy showed a sensitivity of 58% (95% CI: 43–71%) and specificity of 92% (95% CI: 80–97%). GeneXpert detected more MTB (62% vs. 49%, P<0.001) with a sensitivity of 98% (95% CI: 89–100%) and specificity of 72% (95% CI: 58–83%). GeneXpert showed superior sensitivity for TB detection, while microscopy remained specific. Expanding GeneXpert testing across the Republic of the Congo will improve TB management.
Nov 2025 DOI 10.14302/issn.3070-3379.jwc-25-5549
Chukwuma Sr ChrysanthusCorresponding author
This short communication/mini-review immensely emphasizes human health to explicate and elucidate management of the global scourge associated with the determinants and impact of vulnerabilities to extreme hydrologic events and climate change in the absence of risk reduction and their concomitant sequelae. The most effective approach for risk reduction associated with biodiversity, environmental, and health vulnerabilities due to climate change and extreme hydrological events, an ecological framework must take into cognizance exposure, vulnerability, and resilience. This framework emphasizes the significance of understanding the inextricable linkage between ecosystems and human communities are exposed and susceptible to hazards, sensitivity to these hazards, and capacity to cope, adapt and recuperate. Risk reduction incorporates structurally attenuating exposure, strengthening resilience, and sustainably enhancing overall vulnerability management. Extreme weather and climate-associated incidents impinge on human health with consequential morbidity, mortality and socioeconomic challenges and constraints. Climate change and extreme event have altered the frequency, intensity, geographic distribution, and propensity as drivers for change in the future. The indicted variables include hydrological events, such as precipitation, floods and droughts as well as heat waves, wildfires, global warming, extreme temperatures, and hurricanes. The pathways inextricably-linked with extreme events to economic dissipation, human health prognosis and outcomes remain inexplicably diverse and complex; and thus, difficult to predict due to their emergence and reemergence from local, societal and environmental factors which influence disease burden.
Mar 2025 DOI 10.14302/issn.2638-4469.japb-25-5395
Divakar ChennamsettiCorresponding author
Plant leaf diseases pose significant threats to crop yield and agricultural sustainability, making early and accurate detection crucial for effective disease management. In current years, deep neural network (DNN) techniques have shown remarkable potential in the field of image classification, including plant disease detection. The study aims to investigate the performance of two popular deep learning architectures, namely, VGG16 and InceptionResNetV2, for the detection of tomato plant leaf disease. The proposed methodology involves acquiring a diverse dataset comprising high-resolution images of healthy and diseased leaves from the target crops. Preprocessing techniques such as image augmentation and normalization are applied to enhance the generalization ability of the models and mitigate overfitting. Transfer learning is employed to initialize the deep learning architectures with weights pre-trained on large-scale image datasets to accelerate convergence and improve the models' performance in limited data scenarios. To evaluate performance of proposed networks various metrics such as validation and test accuracies, precision and recall, F1 score, and the area under the curve (AUC) are considered. From the investigations, the classification accuracy of the finest architectures is as follows: 99.8 percent for VGG16 and 99.4 percent for InceptionResNetV2 on Corn Leaves. The results suggest that the models developed during the investigation phase to identify the leaf disease were superior to any existing Deep Neural Networks (DNNs).
Jun 2024 DOI 10.14302/issn.2998-4785.ijne-24-5128
Bajaj AnubhaCorresponding author
A brief case communication discusses a rare breast carcinoma subtype, summarizing pathology features, imaging, and considerations for surgical and adjuvant management.
May 2024 DOI 10.14302/issn.2998-1506.jpa-24-5058
Shrestha SwatiCorresponding author
Wheat is a staple grain crop in the United States and around the world. Weed infestation, particularly grass weeds, poses significant challenges to wheat production, competing for resources and reducing grain yield and quality. Effective weed management practices, including early identification and targeted herbicide application are essential to avoid economic losses. Recent advancements in unmanned aerial vehicles (UAVs) and artificial intelligence (AI), offer promising solutions for early weed detection and management, improving efficiency and reducing negative environment impact. The integration of robotics and information technology has enabled the development of automated weed detection systems, reducing the reliance on manual scouting and intervention. Various sensors in conjunction with proximal and remote sensing techniques have the capability to capture detailed information about crop and weed characteristics. Additionally, multi-spectral and hyperspectral sensors have proven highly effective in weed vs crop detection, enabling early intervention and precise weed management. The data from various sensors consecutively processed with the help of machine learning and deep learning models (DL), notably Convolutional Neural Networks (CNNs) method have shown superior performance in handling large datasets, extracting intricate features, and achieving high accuracy in weed classification at various growth stages in numerous crops. However, the application of deep learning models in grass weed detection for wheat crops remains underexplored, presenting an opportunity for further research and innovation. In this review we underscore the potential of automated grass weed detection systems in enhancing weed management practices in wheat cropping systems. Future research should focus on refining existing techniques, comparing ML and DL models for accuracy and efficiency, and integrating UAV-based mapping with AI algorithms for proactive weed control strategies. By harnessing the power of AI and machine learning, automated weed detection holds the key to sustainable and efficient weed management in wheat cropping systems.
Dec 2023 DOI 10.14302/issn.2324-7339.jcrhap-23-4634
Makura AlfredCorresponding author
Introduction Human Immunodeficiency Virus (HIV) remains a persistent global public health challenge. In 2020, approximately 37.9 million individuals were living with HIV globally, including 1.7 million children <15 years old, with a global HIV prevalence of 0.8% among adults. A larger portion of people living with HIV are found in low-and middle-income countries, and Sub-Saharan Africa (SSA) is home to about 68% of people living with HIV in the world. Strikingly, with increased uptakes in PMTCT, challenges in ART programs, and high viremia among children and adolescents in SSA, the success rate of ART might be quickly compromised, with possible HIVDR emergence, particularly after years of paediatric ART exposure. Therefore, monitoring ART response in children and adolescents in terms of HIVDR patterns and other socio-economic determinants of disease progression might help achieve better treatment outcomes at individual levels. At a programmatic level, this can guide further optimization of treatment options for SSA especially Zimbabwean rural where there is paucity of information on HIVDR prevalence in children and adolescents. Methods We enrolled 89 children and adolescents experiencing virologic failure from Chidamoyo Christian Hospital in Hurungwe. We managed to amplify all the 89 using nested PCR and 32.5% (29) had resistance to at least one ART drug and analysis was done using the 29 samples. Results Among the 89 participants with virologic failure,29 were resistant to at least one of their ART drugs. 39.2% of males and 23.07% of females had HIV-1 with resistance to at least one medication. Among 29 participants with HIVDR mutations, the prevalence of at least one HIVDR mutation to protease inhibitors (PIs), Nucleotide Reverse Transcriptase Inhibitors (NRTI), and Non-Nucleotide Reverse Transcriptase Inhibitors (NNRTI) were 6.47% ,46.76% and 46.76% respectively. Of the 29 participants who had HIVDR 19 (65.5%) had resistance to a drug they were currently taking and they needed to be switched to a better effective ART regimen Conclusion Use of HIVDR testing in guiding and monitoring development of HIVDR at the start of ART or at 1st failure can be very important in treatment options and patient management.
Jul 2023 DOI 10.14302/issn.2470-5020.jnrt-23-4576
HECHAM N.Corresponding author
Background The evolution of multiple sclerosis (MS) is highly variable. Predicting this evolution at the beginning of the disease will help in the therapeutic management. The objective of this study was to describe the clinical characteristics and to identify early predictors of long-term disability among MS patients in Algeria. Methods We performed a descriptive and retrospective study of 400 MS patients followed over a 4-years period from July 2012 to July 2016 in the neurology department of Mustapha Bacha hospital in Algiers. The following parameters were systematically assessed for each patient: Age at onset, gender, relapses, initial demyelinating event, interval between first and second attack, residual deficit after first attack, onset of the progressive course, time of assignment of the successive scores of irreversible disability and type of disease modifying therapies. Univariate and multivariate Cox models were used to determine factors influencing time to Expanded Disability Status Scale (EDSS) 4 and 6. Results During the follow-up of this cohort of MS patients, a total of 144 (36%) and 83 (20%) patients reached EDSS scores 4 and 6 respectively. The median times from the onset of MS to assignment of a score 4 and 6 was 10 years and 19 years, respectively. Using the MSSS severity score, and after univariate analysis we identified several risk factors predictive of disease severity. These included male sex (P= 0.002), age of onset ≥ 40 years (P= 0.001), pyramidal (P= 0.0001), cerebellar (P= 0.002), and poly-symptomatic (P=0.0001) onset of the disease, incomplete recovery after the first attack (P= 0.0001), a high number of attacks during the first 2 years (P= 0.04) and the progressive form (P=0.001), and all these factors were correlated with a high MSSS score. However, prognostic factors in the multivariate binomial logistic regression analysis were limited to pyramidal onset, incomplete recovery after the first attack, short interval between the first and second attack, and progressive onset. Conclusion On the whole, the early predictive factors of disability in MS among Algerian patients were age of onset over 40 years, pyramidal onset, incomplete recovery after the first attack, short interval between the first and second attack and progressive form at onset. To increase the generalizability of findings, a national MS registry is strongly recommended, as well as long-term follow-up epidemiological studies.
May 2023 DOI 10.14302/issn.2642-9241.jrd-23-4566
Krishna C VeligandlaCorresponding author
Safe and effective antitussive therapy remains a significant area of unmet need for cough management. Antitussive drugs are commonly used cough suppressants and include centrally acting (opioids and non-opioids) cough suppressants and peripherally acting antitussives. Authors searched PubMed, Google Scholar and additional studies from reference lists via cross-referencing to identify studies assessing levodropropizine for the treatment of cough. Of the 748 studies identified, 13 were included. Recent clinical evidence, guideline recommendations and findings from this review suggest that levodropropizine is a peripheral antitussive which reduces cough intensity, frequency, and nocturnal awakenings in children and adults and provides better efficacy outcomes with a more favourable risk/benefit ratio compared to centrally acting antitussive agents which pose greater safety concerns and present an unacceptable risk–benefit profile. This review is aimed at Indian primary care physicians for making effective cough management decisions where the clinical evidence needs to be translated to clinical practice. Key Messages The usage of currently available centrally acting antitussive agent is greatly limited by their central depressing action and frequent side effect. The findings of this review indicate that levodropropizine is an effective antitussive agent and well tolerated in the management of cough in patients of all ages.
Apr 2023 DOI 10.14302/issn.2641-5518.jcci-23-4554
Botchorishvili IngaCorresponding author
This report details sequential rare complications arising from a vascular stent infection. Clinical course, microbiology, and imaging are outlined, with emphasis on early recognition and multidisciplinary management. Lessons for device surveillance and antimicrobial stewardship are highlighted.
Mar 2023 DOI 10.14302/issn.2766-8630.jrnm-22-4093
AJ JahangiriCorresponding author
Attenuation differences from 2 x-ray sources allow differentiation and characterization of stone types with similar radiation dose compared to single-energy CT scan. The difference is shown in colours, allowing preoperative prediction and management of stones. We determined the effect of DECT-KUB on urological management of patients with uric acid stones since it was first introduced in our centre. 50 patients with uric acid stones were selected from 2 year groups, each with 25 patients and their urological managements were reviewed retrospectively. We concluded that DECT-KUB is an accurate way of determining the chemical characteristics of renal calculi and can alter patients’ management. It has gained wide acceptance among clinicians in our centre and is now widely used to plan urological management of patients with renal calculi. Based on urological management comparison of patients who presented in the year 2011 with uric acid stones and patients in the year 2020, we concluded that patients with uric acid stones based on DECT-KUB findings can start dissolution therapy instead of surgical extraction or lithotripsy prior to biochemical analysis results become available. Although utility of DECT-KUB is widely accepted among clinicians in our centre it may not be available worldwide and this is the limiting factor in its universal use.
Oct 2022 DOI 10.14302/issn.2381-862X.jwrh-22-4228
U.O Anyanwu,Corresponding author
National Obstetrics Fistula Centre, Abakaliki
Background Gender based violence (GBV) refers to any violence targeted at an individual or group on the basis of their gender. It could occur in different forms with several clinical manifestations. The authors have described several clinical manifestations of GBV in a tertiary health centre, knowledge of which would help in case identification and early clinical management. Methods Retrospective descriptive study of all clients seen at a gbv clinic over a sixteen months period.Data was obtained from case records and clinical presentations were entered into excel. Data analysis was done usingIBM SPSS Statistics for Windows, version 25. The results were presented in frequency tables and graphs Results Of 86 clients studied, 56(65.1%) were of pediatric age (< 18years) while 30(34.9%) were adults with a mean age of 18.33+11.64(range 1-64years).72(82.6%) belonged to the low social class. Physical abuse in the forms of battering, human bite, walking and sitting disturbances, hearing loss possibly from slapping or hitting and red eye possibly from trauma on the eye, constituted 37.6% of the clinical presentations. Other presentations were; sexual abuse in the form of forced sex which constituted 34.9%, while gynaecological / obstetrics presentations in the forms of bleeding per vagina, pregnancy due to forced sex and vaginal pain made up 13.9%. Emotional/psychological abuse was observed in all clients irrespective of their different presenting complaints. Conclusion While various forms of physical abuse were common, emotional abuse was present in all clients but masked probably due to prioritization of physical injuries. Therefore we recommend that all GBV survivors be screened for psycholocal abuse and psychotherapy given.
May 2022 DOI 10.14302/issn.2643-0282.imsj-22-4160
Donald Hawkins AnthonyCorresponding author
Kincraig, Blairs, Aberdeen, Scotland, United Kingdom.
Many marine and freshwater fisheries are now in a very poor state, and many fish stocks are close to collapse. There is a need to manage fisheries more carefully, especially since fishing can affect other aspects of the environment. It is also important to reduce the adverse effects of climate changes upon the marine and freshwater environments, fishes, and other animals, and the need to manage other human activities taking place in the sea, to improve the marine environment and protect the wildlife and the fishing activities. Marine pollution, includes human waste materials, chemicals and plastics, and there is also noise and substrate vibration, from industrial and other activities that may affect both the abundance and quality of fishes and other marine animals. This paper deals with fisheries management, and environmental protection, and concludes that fishermen, fisheries scientists, fisheries managers and environmental interests must work closely together, if fishes are to be adequately protected, and fisheries are to be better managed. It describes current systems of management. It especially draws attention to the importance of moving towards an ecosystem-based approach to fisheries management. Such an approach aims to manage all those human activities that have an impact upon the marine environment and its life forms.
Feb 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4078
Gabriel Olajide ToyeCorresponding author
Department of Ear, Nose and Throat, Afe Babalola University, Ado Ekiti and Federal Teaching Hospital, Ido Ekiti
Background The COVID-19 pandemic has had significant impact on healthcare worldwide. Surgeons are at increased occupational risk of contracting COVID-19. The impact of the disease on surgical practice will continue to evolve. We assessed the impact of the disease on surgical practice and training in Nigeria. Method Survey questionnaire was designed, transcribed to Google form and electronically circulated online to surgeons practicing in Nigeria. Surgeons from various subspecialties from the six regions in Nigeria were included. Survey questions pertaining to pre-COVID-19 era surgical practices, impact on current practice and changes occurring in health facilities during this COVID-19 pandemic. Responses were collated and analyzed statistically. Results One hundred and nine (109) surgeons completed the survey, of which 2.8% were women. Majority (68.8%) of the respondents are in the consultant cadre, majority (86.2%) are working in public hospital, 88.1% running their SOPD, 81.7% have isolation wards in their centers, 66.1% have dedicated team for COVID-19 management. Only 48.6% of the frontline health workers have access to personal protective equipment (PPE), and 33.9% had formal training on the use of PPE. Only 11.0% were satisfied with level of preparation of the management. Elective cases were done only in 45% of respondents. 103(94.4 %) confirmed that the numbers of elective cases are less than pre Covid-19 period. Emergency cases were carried out by 93.6% of respondents. Only 1.8% of respondents carried out screening tests for their patients before embarking on emergency surgery. Conclusion COVID-19 has led to reduction in surgical outpatients, significant reduction in elective surgeries in Nigeria. Adequate PPE needs to be provided, there should be guidelines for safety for future. There should be adequate preparation should there be any pandemic in the near future.
Sep 2021 DOI 10.14302/issn.2690-4837.ijip-20-3944
Ababio Bannor PhilipCorresponding author
Health Facilities and Regulatory Agency, Ghana
Background Infection prevention and control system in healthcare facilities is essential in dealing with the spread of infectious diseases, especially during an outbreak period such as the COVID-19 pandemic. Objectives The study assessed the infection prevention and control (IPC) situation in selected healthcare facilities in the Greater Accra and Ashanti Regions of Ghana during the Covid-19 pandemic. Methods This was a multi-facility based cross-sectional study that used a monitoring tool of the Health Facilities Regulatory Agency (HeFRA) of Ghana to collect information on the IPC practices at the peak of the Covid-19 pandemic. Data was gathered from 501 healthcare facilities in the Greater Accra (335) and Ashanti (151) Regions. Descriptive, Chi-square, and multiple logistic regression were performed. All statistical analyses were considered significant at an alpha level of 0.05. Results 50.6% of health facilities were assessed as having good IPC systems in the overall assessment. The majority of the health facilities were evaluated as good on governance/leadership. Similarly, the majority (54.3 %)of the facilities had effective infectious waste management. The assessment levels of governance/leadership, management, quality assurance system, human resource, IPC equipment, and water management were all significantly associated with the adherence to good IPC systems. Conclusion IPC systems in most facilities were assessed as good, but some areas require critical attention to help prevent the spread of infections in healthcare facilities in Ghana. Support systems such as revised policy on IPC, governance/leadership, and infectious waste management infrastructure are needed to strengthen facilities with weak or poor IPC systems.
Jan 2021 DOI 10.14302/issn.2324-7339.jcrhap-20-3633
E.E Enwereji,Corresponding author
College of Medicine and Health Sciences, Abia State University, Uturu Abia State.
Introduction HIV prevention services to in-school adolescents need good planning and management. HIV risk reduction interventions are geared toward measuring sexual risk behaviour outcomes of adolescents that predispose them to HIV infection. The sexual behaviour of adolescents, especially in-school adolescents should be assessed in the process. Adolescents have been identified as the most vulnerable group for acquiring human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) and as such, measures should be taken to prevent them from infection. One important reason for higher HIV prevalence among adolescents, especially girls, is the frequent practice of age-discrepant partnering, where older men, who are more likely to be infected with HIV, form sexual partners with younger girls. The objective of this study is to assess the knowledge and sexual behaviour of in-school adolescents in the prevention of HIV and AIDs in rural areas of Abia State. Materials and Methods This is a descriptive cross-sectional survey that was conducted between January and March 2020. Information was collected from 66 students of a community secondary school in the state. Participants were selected by a multi-stage sampling method and data were obtained using a semi-structured pre-tested questionnaire. Results Respondents consisted of 40(60.6%) females and 26(39.4%) males with ages ranging from 13 to 19. Some of the respondents 28 (42.4%), are living with parents while 24(36.4%) live with close relatives. A good number of the respondents 39(59.1%), accepted that their friends are HIV positive. Majority of them 49(74.2%) have not been approached for sexual relationships. About 17(25.8%) of the respondents accepted that they have boyfriends and girlfriends. Out of this number, 12(18.2%) of them said they have been approached for sex and only 2(3%) of them accepted having sexual relationships with the opposite sex. Finding showed that only 1(1.5%) of the respondents claimed to have ever used condoms during sex. Of the sexually active respondents, 49(74.2%) of them are aware that HIV is a virus infection caused by having multiple sex partners while 14(21.2%) were not sure whether HIV is a virus or bacterial infection. Conclusion The study revealed a gap in the knowledge of HIV prevention as well as inappropriate sexual behaviour among the respondents. Therefore, meaningful strategies that will be culturally sensitive to modify adolescent sexual risk behaviours should be adopted.
Sep 2020 DOI 10.14302/issn.2693-1176.ijgh-20-3546
Sah BikashCorresponding author
Associate Professor, Department of Forensic Medicine and Toxicology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Corona virus disease 2019 (COVID-19) caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) has rapidly evolved as a pandemic with a challenge to the entire world for its management. Various modalities of treatment have been tried till date and when all the modalities failed then the only option that has been shown to be successful in some cases is lung transplantation. Decision for Solid-organ transplantation is not only made based upon its therapeutic requirement but also need to be supported by the law of land. In this regard, current Nepalese law is not with the provision for lung transplantation. Thus, in order to make the concerned authorities aware of it and also as a step toward the preparedness for COVID-19 pandemic, this research has been conducted with an aim to see the perception of health care professionals of tertiary care centre of eastern Nepal regarding the legal aspects of lung transplantation. Conclusion Outcome of this research has supported the therapeutic aspect of transplantation over its legal issue in the emergency conditions like COVID-19 Pandemic.
Feb 2020 DOI 10.14302/issn.2329-9487.jhc-21-3743
Elqatni M.Corresponding author
Département de Médecine Interne, Hôpital Militaire d'Instruction Med-V, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V- Rabat- Maroc.
A case report of a common iliac artery aneurysm revealing underlying Behçet’s disease. It reviews diagnostic clues, vascular complications, and multidisciplinary management.
Nov 2019 DOI 10.14302/issn.2639-3166.jar-19-3065
Marcelo Scavuzzo CarlosCorresponding author
Comision Nacional de Actividades Espaciales, CONAE. Gulich Institute, R. C45km8 Cordoba, Argentine
The importance of horticulture around the large cities, called green belt (GB), or proximity food production area is related to its contribution to the provision of food as well as its role on social, cultural and ecological aspects. Geoscience and Remote sensing (GRS) are tools that should aid in gathering and updating the information to develop science-based management plans of this areas. Recently, the improvement in terms of spatial, temporal and radiometric resolutions has changed the performance and the approach to the horticulture remote sensing. In this work, we make a brief review on the literature exploring the use of GRS techniques in horticulture, and future trends in order to exploit the available techniques for efficient crop management in the way to improve territorial planning and management. Specifically we found a lack of academic production in this area. In addition we examine the importance of this landscape areas from different points of view (food security, health, ecology, etc.). A systematic revision of published studies on remote sensing on horticulture including different platforms, sensors and methodologies are briefly presented. Finally some aspect related with future trends are discussed.
Oct 2019 DOI 10.14302/issn.2641-7669.ject-19-3040
Kader Mohiuddin AbdulCorresponding author
Secretary & Treasurer, Dr. M. Nasirullah Memorial Trust, Tejgaon, Dhaka 1215
Many lay people along with some so called “key opinion leaders” have a common slogan “There's no answer for cancer”. Again, mistake delays proper treatment and make situation worse, more often. Compliance is crucial to obtain optimal health outcomes, such as cure or improvement in QoL. Patients may delay treatment or fail to seek care because of high out-of- pocket expenditures. Despite phenomenal development, conventional therapy falls short in cancer management. There are two major hurdles in anticancer drug development: dose-limiting toxic side effects that reduce either drug effectiveness or the QoL of patients and complicated drug development processes that are costly and time consuming. Cancer patients are increasingly seeking out alternative medicine and might be reluctant to disclose its use to their oncology treatment physicians. But there is limited available information on patterns of utilization and efficacy of alternative medicine for patients with cancer. As adjuvant therapy, many traditional medicines shown efficacy against brain, head and neck, skin, breast, liver, pancreas, kidney, bladder, prostate, colon and blood cancers. The literature reviews non-pharmacological interventions used against cancer, published trials, systematic reviews and meta-analyses.
Sep 2019 DOI 10.14302/issn.2470-0436.jos-19-2998
Marie Y. Omana ElaineCorresponding author
Department of Ophthalmology, Rizal Medical Center, Pasig City, Philippines
Purpose To report a rare case of Inverting Papilloma originating from the Lacrimal Sac in Tertiary Hospital. Method Case report. Results Inverting papilloma is uncommon in lacrimal sac. More often presents in Maxillary sinus, Ethmoid sinus and lateral wall of nasal cavity. This case of 69 years old, Filipino male, who presented with a two-year history of gradually enlarging left medial canthal mass, and tearing. There were no ophthalmoplegia, visual disturbances, proptosis or pain but there was globe displacement superolaterally. Other ophthalmologic examinations were unremarkable at that time of examination. Orbital CT-scan revealed: Heterogenously enhancing mass extending to ipsilateral nasolacrimal canal and nasal cavity causing mass effect. There was note of a suspicious area of hyperostosis. Patient was referred to the Department of Otolaryngology Head and Neck Surgery for co-management. Punch biopsy was done and histopathology revealed Inverting papilloma. Combined surgical management of anterior Maxillectomy via lateral Rhinotomy approach and Dacryocystectomy was done. Intraoperatively, there was note of adhesions to bone in the area of the Lacrimal Sac corresponding to the area of hyperostosis on CT-scan. Post-operative recovery was unremarkable with unchanged visual acuity and extraocular muscle movement. Conclusions This is a case of an inverting papilloma involving the lacrimal sac and nasolacrimal duct that was managed with combined anterior maxillectomy via Lateral Rhinotomy approach and dacryocystectomy for complete resection. We recommended complete resection of the tumor to minimize recurrence. Origin in the Lacrimal Sac area was confirmed by intraoperative findings which correlated with CT- scan findings.
Sep 2019 DOI 10.14302/issn.2641-4538.jphi-19-3005
Rutayisire ErigeneCorresponding author
Mount Kenya University, School of Health Sciences, Department of Public Health, P.O. Box 5826, Kigali Campus, Rwanda
Background Globally, about 10 to 25% of the volume of bio-medical waste from hospitals and healthcare institutions presents a serious health risks to patients, healthcare personnel, and anybody who comes in contact with it. The waste management practices in Rwanda healthcare facilities are poor and need improvement. Objectives To assess the knowledge and practices regarding bio-medical waste management among healthcare personnel at Kabgayi district hospital in Southern Province of Rwanda. Materials and Methods A cross-sectional study design was conducted. A total of 200 healthcare personnel were selected randomly out of 400 target population including doctors, nurses, social workers, and cleaners. Structured questionnaire was used to collect data. Descriptive analysis using frequency and proportions were used. Chi-Square test was used to determine the association between the variables and level of significance was set at p ≤ 0.05. Results The study found that about half (49.0%) of healthcare personnel had good knowledge about waste management. We found that the majority of healthcare personel 133(66.5%) had poor practices towards bio-medical waste management. The factors associated with good practice were better knowledge on bio-medical waste management (p=0.013) and older age group (p=0.001). Conclusion/Recommendations The level of in both knowledge and practice towards bio-medical waste management among healthcare personnel was low. Continuing education and training programmes and short courses on bio-medical waste management should be carried out to improve the knowledge and practices towards bio-medical waste management among healthcare personnel.
Aug 2019 DOI 10.14302/issn.2470-5020.jnrt-19-2983
Léhleng AGBACorresponding author
Neurology Department, University Hospital Center of Kara, Kara University, PoBox 18 Kara (Togo)
Although it is a vaccine-preventable disease, tetanus is frequently found in sub-Saharan Africa. Because of its rarity, this disease poses two problems for doctors of the 21st century: to make early diagnosis in order to refer patients to appropriate care structures, and to continue to ensure correct prevention of an affection that few current doctors have met. In it generalized form, the diagnosis of tetanus is easy, but when the beginning is localized, tetanus can be change with other diseases leading to a diagnostic wandering and a delay of adequate management. We report a case of tetanus in an 18-year-old male, who was received for neck pain and stiffness of the neck with a positive Kernig sign associated to fever since 48 hours. Initially treated for meningitis, the patient will develop at day 3 of hospitalization, the signs of generalized tetanus which led to evoked the diagnosis of tetanus. This diagnosis was reinforced by the notion of a rusty nail injury to the soles of the right foot 3 weeks before hospitalization and the absence of anti-tetanus vaccination. After using tetanus serum and vaccination with antibiotics (Metronidazole and Penicillin) and Diazepam in association with stripping of the wound under the foot, the patient was improved. This case illustrates that any neurological sign with the first trismus must evoke until proof of the contrary, a tetanus especially in case of association with a wound even if the immunization schedule is up to date.
Aug 2019 DOI 10.14302/issn.2640-690X.jfm-19-2989
Blondon K.Corresponding author
Division of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland
Background Medication adherence remains a challenge for patient management. Changes in the drug regimen after a hospital stay can lead to confusion or misunderstandings. We implemented a structured patient-centered interview during which a computer-generated individualized medication plan was discussed and provided to patients at discharge. Objective To explore whether a medication plan can be a quality indicator, in terms of its content (quality) and its implementation in the resident’s workflow (feasibility). Methods An observational mixed method study with interviews of 174 patients from general internal medicine wards at 1 week and 1 month after discharge, and of 91 physicians at baseline. We report the quality of the medication plan in terms of content and state of completion. We describe feasibility for residents to complete this plan, as well as patient and resident satisfaction with the plan. Results 83% of participants received a medication plan. Physicians verified renal function (83%) to adapt doses but did not regularly assess for medication interactions (43%). Incomplete plans (61%), were due to blanks when physicians considered the information irrelevant for their patients. Error rate was <3%. Patients reported low use of their plan after discharge (64% found it useful after 1 week, whereas only 37% used it when taking their medication 1 week after discharge). Conclusion Although the plans were considered useful by both patients and physicians, their implementation could have been optimized by considering the overall process (creation to patient use). Mobile apps could help fill gaps in supporting patients for medication adherence.
Oct 2018 DOI 10.14302/issn.2639-3166.jar-18-2331
Haroun Mohamed Adam AbubakerCorresponding author
Department of Crop Science, College of Agriculture, University of Bahri, Sudan.
This study reviews the agricultural development perspective in the light of a rapid space technology development. In other words, precision agriculture as part of geoinformatics. The aim is to quantify whether the adopted technology can improve the efficiency of agricultural fields management and production to attain food security. Therefore, views of targeted groups from different States of Sudan were investigated, using stratified sampling method. Where quantitative statistics (descriptive/inductive techniques) was applied. About 800 questionnaires were distributed. The outcomes of data analysis reflected that the majority of interviewed groups 357 (82.1%) do not know the principles and application of integrated technology in the field of agricultural management. 85.3% of respondents know nothing about computer program related to precision agriculture. The majority of the respondents (84.6 %), did not get courses on precision agriculture during the under graduate study. The result also revealed that only 11.8% of the respondents use modern techniques in land preparation, 16.1 % in soil analysis, 12.5 % in the field of seed technology, and 11.4% in crop harvesting. However, 53.9% of the respondents reported that their Departments did not care about training on agricultural precision. Nevertheless, 24.3 % of the respondents got trained on precision agriculture through personal efforts, while about 19% got trained by their respective Departments. In regard to education, 16% of the respondents got trained on precision agriculture at undergraduate and only 9% after graduation. The study concludes that despite the rapid technological development, agriculture in Sudan remained lagging, and the productivity is below the expectation. It recommends that the Ministries of Agriculture in different States in Sudan should take the issue of introduction of new technology seriously to boost the agricultural development to attain food security.
Mar 2018 DOI 10.14302/issn.2578-8590.ipj-18-1952
Lagos NestorCorresponding author
Laboratorio Bioquímica de Membrana, Departamento de Fisiología y Biofísica, Facultad de Medicina. Institution: Universidad de Chile.
Objective To evaluate the effect of a single intraarticular dose of Gonyautoxins for pain control after Total Knee Arthroplasty (TKA). Subjects 30 consecutive patients with osteoarthritis with Kellgren & Lawrence level of two or more, who required TKA, were enrolled. Methods Subjects receive a single intra-articular infiltration of 40 µg dose of Gonyautoxins, immediately after TKA wound closure. The pain was measured with the Visual Analog Scale (VAS). Additionally, the range of motion at 12, 36, and 60 hours and hospital stay length were recorded. Results were compared to the 2014 TKA cohort. Results 25 patients (83.33%) achieved successful pain management. All patients achieved complete flexion ≥90° 60 hours after surgery and 24 patients achieved full extension before hospital discharge. The median VAS pain score for each evaluation period was ≥2. The 25 Gonyautoxins treated patients who achieved successful pain management had a median VAS pain score of 0 after 36 and 60 hours. Conclusions Gonyautoxins are safe and effective in pain management after TKA when used as a single intra-articular dose. This protocol shows adequate pain control in TKA, reducing discharge to 3 days and greater range of motion, improving the post-operated patient experience.
Oct 2017 DOI 10.14302/issn.3070-5657.je-17-1513
GELEN VolkanCorresponding author
Kafkas University, Turkey
Changes to proinflammatory cytokines as a result of gestational diabetes mellitus (GDM), and the pregnancy complications that these changes can cause, are of vital importance to the effective prevention and optimal management. Interleukin-6 (IL-6), interleukin-1 beta (IL-1β), and tumor necrosis factor alpha (TNF-α) are cytokines that are associated with gestational diabetes. Therefore, the aim of this review is to draw attention to the relationship between gestational diabetes and these diseases
Sep 2017 DOI 10.14302/issn.2470-5020.jnrt-17-1738
Kokou Mensah GUINHOUYACorresponding author
Clinique neurologique, CHU SylvanusOlympio, BP 57, Lomé-Togo
Myasthenia is a rare neurological condition with risk of death in case of inappropriate management. The outcome of this pathology is very bad in developing countries with inadequate technical Platform. We underlined the main difficulties of diagnostic and the management of Myasthenie and antisynthetase antibody syndrome in a 44 years-old Togolese man.
Aug 2017 DOI 10.14302/issn.2379-8572.joa-17-1672
Ozcan Kara PelinCorresponding author
Mersin University, Faculty of Medicine, Department of Nuclear Medicine, Mersin, Turkey
Accurate diagnosis of tumor thrombus and distinguishing benign thrombus from tumor thrombus avoid unnecessary anticoagulant treatment of oncological patients and it is important for patient management. In this case report, the role of FDG PET/CT in the presentation of a suspicious tumor thrombus in the left brachiocephalic vein of a patient with known laryngeal carcinoma and leiomyosarcoma diagnosis is presented.
Feb 2017 DOI 10.14302/issn.2329-9487.jhc-17-1428
A. Smart NeilCorresponding author
School of Science and Technology, University of New England.
Hypertension is a major modifiable risk factor for cardiovascular disease, responsible for approximately 31% of global mortality. The aim of this study was to examine the hypertensive responses and determine the peak rate pressure product, calculated by multiplying systolic blood pressure and heart rate, during isometric handgrip exercise. Rate pressure product is a surrogate measure of myocardial oxygen consumption. Hypertensive responses utilising rate pressure product during isometric handgrip exercise have not previously been reported. A randomized trial was conducted with 60 normotensive and 60 pre-hypertensive participants who attended once for an acute session of isometric handgrip exercise. Participants were randomized into groups exercising at 5%, 10% or 30% of their maximum voluntary contraction. Training was conducted using 4x2min isometric handgrip exercises each separated by a 3min rest period. There were no significant differences between peak systolic and diastolic blood pressure, mean arterial pressure, heart rate and rate pressure product across the four bouts of isometric handgrip exercise in all groups, all p>.05. Peak increases in rate pressure product were significantly higher than baseline at all intensities assessed; all normotensive groups p<.02, all pre-hypertensive groups p≤.001. Increases were relative to baseline blood pressure status and intensity of isometric handgrip exercise, with no significant differences between normotensive and pre-hypertensive groups. Rate pressure product responses to isometric handgrip exercise indicate that it may be a safe alternative for people unable to perform recommended levels of aerobic exercise for blood pressure management.
Nov 2016 DOI 10.14302/issn.2574-4526.jddd-16-1311
M DarouichiCorresponding author
Department of radiology
Adenosquamous carcinoma of the stomach (ASCS) is extremely rare with less than one hundred cases published in the world literature. It is defined by combined adenocarcima and squamous cells carcinoma of the stomach. ASCS is clinically aggressive and has a poor prognosis, even when discovered at an early stage. This intriguing entity is characterized by non specific symptoms or radiological signs. Integrate 18F-fluorodeoxyglucose positron emission tomography/computed tomography 18F FDG.PET/CT is useful morphologic and functional modalities for evaluating primary tumor, local extend and invasion beyond gastric wall or distant metastatic and eventually for management. Diagnosis of ASCS requires immunohistochemical confirmation. We report a 77-year-old man who was admitted to hospital because of epigastric pain, vomiting and melena since more than a month. Gastroscopy with biopsies had initially suggested gastric squamous cell carcinoma .Thoracic and abdominal computed tomography scan (CT) showed a huge mass in the gastric body, largely necrotic, infiltrating the adjacent structures without metastases. Partial gastrectomy with resection of the proximal 2/3 of the stomach, the spleen, the body and tail of pancreas and the left transverse colon was performed. Immunohistochemical analysis demonstrated ASCS with mixed adenocarcinomatous and squamous cells carcinoma with invasion of gastric lymph nodes. Unfortunately, two months after surgery, a CT of the abdomen revealed diffuse metastasis and the patient died three months later. In light of this case, we discuss the pathogenesis, staging and monitoring of this rare entity by combined 18F-FDG PET/CT with review of the literature.
Oct 2016 DOI 10.14302/issn.2470-5020.jnrt-16-1279
Damelan KombateCorresponding author
University of Lomé , Teaching Hospital CAMPUS – Lomé , Neurology Department, 03Bp 30284
Carotid-cavernous fistula (CCF) is a rare neurological condition with risk of death in case of inappropriate management. The outcome of this pathology is very bad in developing countries with inadequate technical Platform. We underlined the main difficulties of the management of CCF in a 43 years-old Togolese woman with a fatal outcome.
Mar 2016 DOI 10.14302/issn.2997-2108.jcc-15-856
Polansky HananCorresponding author
The Center for the Biology of Chronic Disease (CBCD), Rochester, USA.
This paper explores the potential of Gene‑Eden‑VIR as an adjunctive approach for cervical cancer prevention or management. The discussion reviews proposed antiviral and immunomodulatory mechanisms, existing evidence, and safety considerations. The authors call for controlled trials to clarify efficacy and appropriate clinical use.
Feb 2016 DOI 10.14302/issn.2324-7339.jcrhap-15-828
E.E Enwereji,Corresponding author
College of Medicine, Abia State University, Uturu, Nigeria
Introduction Working with people who are HIV positive is a herculean task and relevant theories to assist them medically, psychologically, economically, socially and otherwise are necessary. People who are living positively with HIV and AIDS are usually ridiculed, discriminated against, rejected and isolated. Using theories to work with them will help to cushion the negative impacts of HIV and AIDS, especially stigma which has been identified as a major barrier to health care and quality of life in illness management. The fundamental human rights of people living positively with HIV and AIDS should be protected since majority of such rights are usually trampled upon. The review aimed at discussing the potential benefits of using theories to assist people living positively with HIV and AIDS to cope with their various and varying situations in life. Materials and Method: Information for this study was collected by extensive review of recent literature on theories for assisting people living positively with HIV and AIDS. The paper reviews theories that influence long-term behaviour change among people living positively with HIV and AIDS. It assesses the need for using these theories to improve HIV and AIDS intervention in developing countries including Nigeria. In this study, eleven behaviour theories were reviewed. Result It was noted that some of the theories promoted adherence as well as helped to explain the benefits of adherence to HIV and AIDS medication. Also a good number of the theories assisted researchers in designing effective intervention strategies. Conclusion: Further research is needed to determine the effective theories that will increase adherence to long-term treatment regimens of HIV and AIDS. Such theories can be used to alleviate the potential burnout of Caregivers and people living positively with HIV and AIDS who travel long distances for diagnostic procedures and work long hours without adequate remuneration, support and supervision.
May 2015 DOI 10.14302/issn.2471-2175.jdrt-14-618
Y Chon SusanCorresponding author
Department of Dermatology, University of Texas MD Anderson Cancer Center
A case of a solitary necrotic cutaneous lesion in a neutropenic patient with acute myeloid leukemia is described. The report discusses infectious and non‑infectious differentials, work‑up under immunosuppression, and targeted management.
Feb 2014 DOI 10.14302/issn.2372-6601.jhor-13-358
Mandava SwarnaCorresponding author
Cytogenetic division, SRL Ltd., Mumbai, India.
Acute lymphoblastic leukemia (ALL) is a rapid form of leukemia characterized by clonal proliferation and accumulation of immature hematopoietic stem cells of the lymphoid lineage in the bone marrow as well as peripheral blood. Chromosomal aberrations identified in childhood ALL have an important role in disease diagnosis, prognosis and management. We present the results of hematologic, immunophenotypic, cytogenetic, FISH and Multiplex RT-PCR analysis of a 6-year-old boy diagnosed with B-cell precursor Acute Lymphoblastic Leukemia (BCP- ALL). In this study, we identified a novel chromosomal translocation t(10;15)(q22;q22) by cytogenetic and FISH analysis. To the best of our knowledge, this is the first report of this novel chromosomal translocation in this subset of ALL and has not yet been reported elsewhere. This rearrangement may include certain cancer associated tumor suppressor gene(s) or genes involved in apoptosis and transcription regulation, which on loss of normal function may lead to leukaemogenesis.