Student's Journal of Health Research Africa
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INVESTIGATING INFECTION'S ROLE AS A CONTRIBUTING FACTOR IN THE GENETIC AND EPIGENETIC MECHANISMS OF ENDOMETRIOSIS: A NARRATIVE REVIEW.
Get PDFEndometriosis is a chronic gynecological condition, characterized by the presence of endometrial-like tissue outside the uterus. It is associated with symptoms such as pelvic pain, dysmenorrhea, and infertility, significantly impacting women's quality of life. Despite its prevalence, the pathophysiology of endometriosis is not fully understood, with genetic, epigenetic, environmental, immunological, and hormonal factors all playing roles in its development. This review aims to systematically examine the evidence linking infections to the genetic and epigenetic mechanisms of endometriosis, highlighting how these interactions may contribute to the disease's development and progression. Recent research has identified a connection between genetic predispositions to endometriosis and an enhanced immune response to infections. Specific genetic markers associated with an increased risk of endometriosis have also been linked to heightened immune reactions to infectious agents, suggesting a complex interplay between endometriosis and infections. Variations in genes regulating the immune system and inflammatory processes, such as the Toll-like receptor 4 (TLR4), have been implicated in both endometriosis and the body's response to infections. Furthermore, infections can induce epigenetic changes that may influence the development and severity of endometriosis by altering gene expression related to inflammation, immune surveillance, and tissue repair. Understanding the relationship between infections, genetic predispositions, and epigenetic modifications in endometriosis opens new avenues for research into targeted therapies. Addressing the underlying genetic and immunological factors contributing to endometriosis could lead to more effective treatment strategies, potentially improving the quality of life for those affected by the condition. Clinicians should consider the potential role of infections in the exacerbation of endometriosis symptoms and the importance of comprehensive patient evaluations to identify and treat any concurrent infections. Future therapeutic strategies should also explore anti-inflammatory therapies and preventive measures against pathogens known to influence endometriosis progression
EXAMINING PLACENTA ACCRETA, PERCRETA, AND INCRETA IN PERIPARTUM HYSTERECTOMIES: A RETROSPECTIVE CROSS-SECTIONAL STUDY.
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Abnormal placentation, encompassing placenta accreta, increta, and percreta, poses significant risks to maternal health, necessitating prompt diagnosis and management. With increasing cesarean delivery rates contributing to rising incidences of these conditions, understanding their clinical characteristics, management approaches, and outcomes in peripartum hysterectomies is crucial. The study seeks to investigate the incidence, clinical characteristics, association, and outcomes of placenta accreta, percreta, and increta in peripartum hysterectomies.
Methods
A retrospective cross-sectional study was conducted in which 40 participants meeting inclusion criteria, such as antenatal diagnoses of abnormal placentation or relevant obstetric histories, were included. Clinical data were collected from histology requisition forms, with statistical analysis achieved using SPSS version 21.0.
Results
The study revealed a notable incidence of abnormal placentation, with placenta accreta being the most common (62.5%). Clinical presentations varied, with antepartum hemorrhage predominating (70%). Peripartum hysterectomy emerged as the primary management strategy, yielding favorable maternal outcomes overall. Statistical analysis identified associations between previous cesarean sections and abnormal placentation incidence, highlighting the importance of risk mitigation strategies (p < 0.05).
Conclusion
Abnormal placentation remains a significant concern in peripartum care, necessitating a multidisciplinary approach for optimal management. Early diagnosis, prompt intervention, and ongoing research are essential to improve maternal outcomes and minimize complications associated with these conditions.
Recommendations
Healthcare providers should prioritize early and accurate diagnosis, adopt a multidisciplinary approach to management, and focus on mitigating risk factors such as previous cesarean sections. Continued research and education are essential for refining treatment strategies and improving outcomes for women affected by abnormal placentation
SELF-MANAGEMENT GOAL SETTING AMONG WOMEN DIAGNOSED WITH GESTATIONAL DIABETES MELLITUS; A CROSS-SECTIONAL STUDY IN A LOW-INCOME SETTING IN CENTRAL UGANDA.
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Copying with a diagnosis of Gestational Diabetes Mellitus (GDM) is very stressful and the task of GDM Self-management is challenging given the circumstances that surround the diagnosis amidst the challenges of pregnancy. In Uganda, little is known about how women diagnosed with the condition manage it through pregnancy. The study assessed the prevalence of self-management goal setting and associated factors among women diagnosed with Gestational Diabetes Mellitus in a low-income setting in central Uganda.
Methodology:
A cross-sectional study was done among 245 women who attended antenatal care in the selected 16 health facilities within Wakiso district, central Uganda who were diagnosed with GDM during their visit to the Clinics from July 2021 to May 2022. Data was collected using telephone interviews, and analyzed using SPSS, the results were reported in the form of tables and figures. Data was collected from March 2023 to May 2023.
Results:
The majority 123(53.9%) of the respondents were aged between 28 to 37 years old. Only 17% (n=41) of women diagnosed with GDM managed to set a self-management goal. The common self-management goals set include doing 1-2 Ultrasound scans during pregnancy to monitor the baby 82.93%(n=34%), followed by doing regular exercises 63.41% (n=26) and eating a regular diet every day 53.66% (n=22).
Conclusion:
Only a small proportion of women diagnosed with GDM can set self-management goals with common goals being doing Ultrasound scans, regular exercise, and eating regular diets.
Recommendation:
There is a need for public health specialists to study the factors that might be associated with setting self-management goals in a low-income setting of Wakiso district, Uganda.
A CASE SERIES OF THE PIGGYBACK DISEASE CHARACTERIZED BY BLACK ESCHAR FOLLOWING COVID-19 RHINO-ORBITAL CEREBRAL MUCORMYCOSIS.
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This case series focused on examining the clinical profile of individuals suspected of having Post post-COVID mucormycosis. These patients were admitted with the presence of black eschar on their face and eyes.
Methods
This case series includes six individuals who were suspected to have post-COVID Mucormycosis. They presented with black eschar. The cases were examined over six months, from May 2021 to October 2021, at the Ophthalmology Department of Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Burla.
Results
All the cases included in the case series exhibited symptoms of black eschar and were in the age group of over 40 years. All the cases had a history of Type II Diabetes mellitus (T2DM) in their medical records. Two individuals had undergone oxygen therapy and steroid therapy as part of their treatment for COVID-19. In addition, one case had a previous admission to the Intensive Care Unit (ICU). Upon admission, all patients underwent Diagnostic Nasal Endoscopy (DNE) and were subsequently administered liposomal amphotericin B (AMB) for 21 days, followed by oral Posaconazole. Two patients underwent skin grafts, while another patient required exenteration. Unfortunately, four patients did not survive, but there were positive outcomes for three patients who experienced improved visual activity. Additionally, two patients only had the disease affecting one eye.
Conclusion
The simultaneous occurrence of T2DM, a history of steroid use, and oxygen therapy were significant factors contributing to the development of post-COVID Mucormycosis. Despite implementing timely interventions, the mortality rate for post-COVID mucormycosis was significant, reaching approximately 50%. Indeed, a fungus in the realm of viruses caused widespread devastation.
A CASE STUDY ON GRIN AND GLUCOSE: THE TWO-WAY STREET OF DIABETES AND ORAL HEALTH.
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The bidirectional association between diabetes and oral health affects the management of both, as high blood sugar promotes oral bacteria growth and gum disease, while periodontal issues can worsen diabetes control, emphasizing the need for integrated care. The study aimed to explore the mutual influence of diabetes and oral health on each other, particularly examining how gingival health and glucose levels impact the progression and severity of both conditions.
Methods
This multicenter study enrolled 120 type 2 diabetes mellitus patients, categorized by glycemic control status based on their HbA1c levels. Employing personal interviews with structured questionnaires, the study investigated demographic characteristics, periodontal treatment experience, self-care behaviors, oral health knowledge, attitude towards periodontal health, and oral health-related quality of life (OHQoL). Logistic regression models analyzed the relation between glycemic control status and various periodontal care behaviors.
Results
The study revealed a notable link between poor glycemic control and periodontal disease (OR = 2.5, p < 0.05), and showed that regular dental visits improve glycemic control (OR = 0.4, p < 0.05). Participants had a moderate understanding of oral health and positive attitudes toward it. Good glycemic control was also associated with better OHQoL scores (95% CI [1.5, 4.5], p < 0.001), yet the quality of periodontal care did not significantly alter OHQoL outcomes, indicating effective periodontal treatment does not negatively impact life quality.
Conclusion
The study underscores the bidirectional association between glycemic control and periodontal health, emphasizing the importance of integrated care approaches that incorporate both dental and diabetes management strategies.
Recommendations
Healthcare providers should foster closer collaborations between dental and health professionals to ensure comprehensive care for patients with T2DM. Further research should explore the effectiveness of integrated care models in improving both glycemic control and oral health outcomes
EXPLORING ANATOMICAL VARIATIONS OF RENAL ARTERIES THROUGH CADAVERIC STUDY, BIHAR, INDIA: A CROSS-SECTIONAL STUDY.
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The anatomical variations of the renal artery are of paramount importance in medical sciences, impacting surgical interventions, diagnostic imaging, and the understanding of renal pathologies. This study aims to document the variations in renal artery anatomy through cadaveric dissection, shedding light on their clinical implications.
Methods
A cross-sectional study was conducted involving 100 cadavers. Cadavers with intact renal arterial anatomy were included, while those with major congenital anomalies or damage were excluded. Standard dissection protocols were followed to observe and document variations in the renal arteries, including number, course, origin, and morphology.
Results
The demographic analysis of the 100 cadavers (55% male and 45% female) revealed a mean age of 67 years (± 8.2), indicating a broad age spectrum. Anatomical variations in the renal arteries were identified in 78 cadavers, showcasing a diverse range of alterations from the typical arterial anatomy. The study's detailed dissection process uncovered a notable prevalence of accessory renal arteries in 42% of the cases, with these arteries predominantly originating from the abdominal aorta (60%). Other origins included the inferior mesenteric artery (25%) and the common iliac artery (15%). The branching pattern analysis further highlighted a trifurcation pattern in 18% of the cases, contrasting with the more commonly observed bifurcation pattern in 62%.
Conclusion
The high prevalence of renal artery variations underscores the necessity for detailed anatomical knowledge among clinicians and surgeons to navigate these differences effectively during surgical and diagnostic procedures.
Recommendations
Further studies are recommended to explore the clinical implications of these variations in renal artery anatomy, particularly in the context of renal surgeries and interventions. Enhanced imaging techniques should be developed to better identify and characterize these variations preoperatively
A RETROSPECTIVE STUDY ON ACUTE RENAL DAMAGE DURING PREGNANCY AND PUBERTY, JHARKHAND, INDIA.
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Acute kidney injury is uncommon in young women while pregnant and post-delivery care, but it is linked via higher deaths and morbidity. This research aims to examine the prevalence, outcomes, and characteristics of AKI while pregnant and the post-delivery period in an Indian populace.
Methods
The present research examined pregnant women who were discharged from the hospital between 2022 to 2023. In expectant mothers who don't have a history of chronic kidney disease (CKD), AKI is described as serum creatinine levels exceeding 70.72umol/l. Acute-on-CKD is defined as a fifty percent rise in creatinine levels in the serum over baseline for individuals with pre-existing CKD.
Results
AKI was common (0.81%) during pregnancy and postpartum. There were 172 AKI patients throughout pregnancy and postpartum, including 10 severe and 11 acute CKD cases. Haemorrhage and toxaemia caused most acute kidney injury during pregnancy and postpartum. Some 17% of women with toxaemia and 60% with HELLP syndrome develop AKI problems. Unless amniotic fluid was blocked, the pregnancy prognosis was good. Four of the seven fatalities got kidney replacement. Amniotic fluid obstruction or haemorrhage after birth killed most AKI pregnant women.
Conclusion
Acute renal damage a pregnant women and post-delivery care is more common than was previously thought. Toxemia is the most prevalent cause of severe kidney disease during pregnancy and post-delivery care. However, the outcome is favorable. Blockage of amniotic fluid and bleeding after delivery are the most prevalent causes of maternal death. Major Acute kidney injury may indicate an inadequate result.
Recommendations
To improve AKI management during pregnancy, increase regular monitoring, provide specialized training, enhance healthcare access, and promote collaborative care. Additionally, encourage further research, develop national guidelines, and ensure adequate postpartum follow-up and support
EVALUATION OF FACTORS INFLUENCING LEAKAGE IN PRIMARY INTESTINAL ANASTOMOSIS WITHIN A TERTIARY CARE HOSPITAL: A CROSS-SECTIONAL STUDY.
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Intestinal anastomosis is a procedure carried out widely for various pathological conditions such as benign tumors, malignant tumors, and inflammatory conditions of a certain part of the intestine. The removal of such a part of the intestine requires the joining of the two other parts of the intestine. Postoperatively the occurrence of a leak in this joint can lead to sepsis and increase the occurrence of mortality and morbidity.
Method
The anastomosis cases of the patients at Sheikh Bhikhari Medical College, Hazaribag are studied retrospectively, and were conducted over two years. 110 cases were reviewed. Clinical and radiological examinations were recorded. The data was statistically analyzed and it was correlated with the occurrence of leakage.
Results
Among the 110 patients participating in the study it was observed that 10 patients had anastomosis leakage. 50% of the patients with leakage had diabetes. more than 70% of them had undergone either emergency surgery, with a duration of more than 2 hours, and required blood transfusion. 30% of the patients with leakage had colo-colic site surgery.
Conclusion
In the present study, it was found that patients who had undergone anastomosis with associated comorbidity, of the colo-colic region, with more than 2 hours of surgery, emergency surgeries, and the required blood transfusion during the surgery had higher chances of development of the anastomosis leakage.
Recommendation
Surgeons should critically analyze the occurrence of anastomosis leakage considering the predisposing risk factors, intraoperative conditions, and site of the surgery
A RETROSPECTIVE STUDY: COMPARISON OF OPTIC NERVE SHEATH DIAMETER TO EYEBALL TRANSVERSE DIAMETER RATIO (ONSD/ETD) WITH COMPUTER TOMOGRAPHY ROTTERDAM AND GLASGOW OUTCOME SCALE.
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This study aims to examine the correlation between optic nerve diameter, global transverse diameter, and correlation with CT Rotterdam score and GOS.
Methods
A retrospective study of head injury patients who underwent craniotomy was carried out to assess the optic nerve diameter, global transverse diameter, as well as the ratio of pre-and post-operative values. In addition to this, the study also noted the GOS and CT Rotterdam score of each patient, and the correlation between the measure parameters and the GOS and CT Rotterdam score using Pearson's correlation coefficient.
Results
The study revealed a strong positive correlation between the ratio of pre-and post-operative values and the CT Rotterdam score, as well as a strong positive correlation between the optic nerve diameter, global transverse diameter, and the CT Rotterdam score. Additionally, a moderate negative correlation between the optic nerve diameter, globe transverse ratio, and the GOS score was also noted.
Conclusion
The comparison of ONSD/ETD ratios in pre and post-operative TBI patients showed a significant reduction in the ratio following surgical intervention, indicating a decrease in elevated ICP. The preoperative ONSD/ETD ratio demonstrated a positive correlation with Rotterdam CT scoring, suggesting its potential as a marker of intracranial pathology. However, its utility in predicting functional outcomes as measured by GOS was not significant.
Recommendation
The study recommends further research to validate the clinical utility of ONSD/ETD ratio measurements in assessing brain injury severity and predicting outcomes
A CROSS-SECTIONAL ASSESSMENT ON SOLID WASTE MANAGEMENT PRACTICES IN MUBENDE MUNICIPALITY, UGANDA.
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Mubende Municipality is a developing municipality located in Uganda's central region. As a result of urbanization, the human population has increased. The rise in population due to industrialization and farming has resulted in increased municipal solid waste (MSW) accumulation. The purpose of this study was to assess solid waste management practices in Mubende municipality, Mubende District.
Methods:
A cross-sectional descriptive design was employed in the study. The South Division, West Division, and East Division are the three municipal divisions where the study was conducted. A simple random sampling technique was used in the investigation to select 400 respondents at random from each of the three divisions. The study's data was collected through observations, interviews, and questionnaires. Data were analyzed using descriptive statistics.
Results:
The sources of MSW in Mubende District were 50.5% households, 21.5% markets, 13.25% commercial areas, 11.5% industries, and 3.25% institutions. Organic waste accounts for the majority of solid waste generated in Mubende (34.50% agricultural waste and 23.0% food waste). Food scraps from households made up 23.00% of municipal solid waste. Plastics and polythene are also considered solid waste accounting for 16.75% and 13.75% respectively. The most common methods of waste management were landfills 45% and burning 27.50%.
Conclusion:
Organic waste accounts for the majority of solid waste generated in Mubende Municipality. Mubende Municipality's preferred solid waste management methods are landfilling, open burning, composting, and indiscriminate dumping. However, these methods are frequently mismanaged, as evidenced by the visible heaps of rotting garbage and scattered and uncollected solid waste.
Recommendation:
Mubende Municipality officials should consider building and maintaining solid waste collection points to prevent waste from spreading throughout open spaces, streets, and water streams. This will reduce the amount of solid waste dispersed and the resulting unsanitary conditions at central collection sites