International Journal of Research in Medical Sciences
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Place of delivery and its determinants among women in rural and urban communities in Kano State, Nigeria
Get PDFBackground: Childbirth poses significant risks, particularly in Nigeria where many births occur outside health facilities and without skilled attendants, skyrocketing maternal morbidity and mortality. This study assessed and compared place of delivery and its determinants among women in urban and rural Kano State.
Methods: A cross-sectional study was conducted. A multistage sampling technique selected 292 urban and 300 rural women of reproductive age group. Quantitative data were analysed using SPSS 20.
Results: Overall, 32.1% of women delivered in health facilities, while 67.9% delivered at home. Hospital deliveries were higher in urban (39.7%) than rural areas (24.7%). Safety, avoidance of problems, and trust in health workers facilitate hospital delivery. Conversely, customs, quick labour, and fear of hospital staff were major reasons for home delivery. Mother’s education (Urban: aOR; 3.023 (95% CI; 1.459-6.264), p=0.003), (Rural: aOR; 2.311 (95% CI; 1.106-4.829), p=0.026) and spousal education level (Urban: aOR; 2.925 (95% CI; 1.357-6.306), p=0.006), (Rural: aOR; 2.183 (95% CI; 1.241-3.840), p=0.007) remained predictors in both areas with secondary and above likely to deliver in hospital. While occupation was significant in the urban communities (aOR; 2.392 (95% CI; 1.137-5.031), p=0.022), antenatal care visits in the rural communities (aOR; 2.427 (95% CI; 1.408 - 4.367), p=0.001).
Conclusions: The study found a high proportion of home deliveries with associated sociodemographic and socio-economic factors. Emphasis on hospital delivery and addressing sociodemographic and socioeconomic factors facilitating home deliveries is recommended
Impact of screen time on sleep quality among undergraduate medical students in Patna, Bihar: a cross-sectional study
Get PDFBackground: Digital screens have become omnipresent in the lives of young adults, especially medical students, raising concerns about the influence of extended screen exposure on sleep quality. Growing evidence suggests screen time, particularly near bedtime, adversely affects sleep parameters, potentially diminishing cognitive and academic performance. The objective of this study was to assess the association between total screen time and sleep quality among undergraduate medical students in Patna, Bihar, India.
Methods: A cross-sectional study was conducted in June 2025 among 510 undergraduate medical students from seven medical colleges in Patna. Data was collected using a pre-tested, semi-structured Google Forms questionnaire, which included socio-demographic details, screen use patterns, and the Pittsburgh sleep quality index (PSQI) for sleep assessment. Descriptive and inferential statistics were analyzed with statistical package for the social sciences (SPSS) trial version 25.
Results: The mean participant age was 22.4 years; 59.9% were male. Most students reported 2–4 hours (44.9%) followed by 5–8 hours (29.6%) of screen time per day. Only 16.3% reported sleeping more than 7 hours per night. Use of screens within 1 hour before sleep was reported by 46.7% of participants. PSQI scores showed that 68.2% of students experienced poor sleep quality (global PSQI >5). Extended and late-night screen time was significantly associated with higher PSQI scores, indicating poorer sleep.
Conclusion: High levels of screen exposure, especially at night, are associated with significantly reduced sleep quality among medical students. Responsible digital hygiene and structured interventions are crucial to prevent sleep disturbances in this vulnerable population
A prospective study on correlation of high-resolution computed tomography temporal bone and surgical findings in squamosal chronic otitis media
Get PDFBackground: Chronic otitis media (COM) is a common condition seen in patients attending ENT department. It is caused by persistent inflammation of the middle ear and mastoid cavity and when left untreated, can lead to significant complications, including the development of squamosal chronic otitis media (SCOM). The aim of this study is to assess the role of high-resolution computed tomography (HRCT) temporal bone in preoperative evaluation of squamosal chronic otitis media.
Methods: This study is a prospective study involving 50 cases of COM. All the patients underwent pre-operative HRCT followed by surgical exploration of middle ear cleft to compare the HRCT findings with the operative findings, thereby establishing a robust correlation between radiological assessment and surgical observations.
Results: The result of the study reveals varying levels of agreement between CT and operative findings across different structures, with generally high concordance rates and statistically significant p values, indicating the reliability of CT in diagnosing these conditions. All findings are statistically significant, emphasizing the consistency between CT and operative findings. The result also highlights that CT scans have high levels of reliability in detecting ossicular erosion, various types of malleus erosion, with good to very good agreement for head of malleus and handle of malleus erosion.
Conclusions: The study highlights the potential of HRCT to improve surgical outcomes by enabling more precise and targeted interventions, ultimately leading to better eradication of the disease from the middle ear cleft
Prevalence of postoperative complications in manual small-incision cataract surgery patients and its association with risk factors: a prospective cohort study in a tertiary eye care hospital
Get PDFBackground: This study aimed to determine the prevalence of postoperative complications in patients undergoing Manual Small Incision Cataract Surgery (MSICS) and to assess the associations of these complications with risk factors such as age, high myopia, and diabetes mellitus. This research sought to identify the most common postoperative complications and evaluate the prevalence of blindness due to these complications.
Methods: A prospective cohort study was conducted in GMCH Srikakulam over two months. The study included 100 patients who had undergone MSICS for senile cataracts. Patients were evaluated postoperatively for complications, and the presence of risk factors was recorded. Statistical analysis was performed using SPSS and SAS software, employing a multivariate regression model to identify significant associations between risk factors and complications.
Results: Out of 100 patients, 44 experienced postoperative complications. The most common complication was corneal edema, and no cases of blindness were reported. Age was found to be significantly associated with corneal edema, striate keratopathy, and posterior capsular opacity (PCO), while diabetes mellitus and high myopia were not significantly associated with the complications observed.
Conclusions: The study concluded that corneal edema is the most prevalent postoperative complication following MSICS, with older age being a significant risk factor. Improved surgical techniques and better training could reduce these complications. However, additional studies with larger sample sizes are needed to better understand the impact of diabetes mellitus and high myopia on postoperative outcomes
Study of catheter related infections in patients admitted in ICU of a tertiary care centre
Get PDFBackground: Catheter-related infections (CRIs) are a significant cause of morbidity and mortality in critically ill patients, particularly in intensive care units (ICUs). This study aimed to assess the incidence, microbiological profile, associated complications, and outcomes of CRIs in patients admitted to the ICU of a tertiary care hospital.
Methods: A facility-based longitudinal study was conducted in the ICU of a tertiary care center on patients >12 years old requiring indwelling catheters for >48 hours. Clinical, laboratory, and microbiological data were collected, with blood cultures analyzed using the BacT/ALERT 3D system. Statistical analysis was performed using SPSS v23.0, with p<0.05 considered significant.
Results: The mean age of 3.6±9.2 years (range: 21–80 years). The incidence of CRI was 28%, with an infection rate of 24.65 per 1000 catheter-days. The most commonly isolated pathogen was Staphylococcus aureus (32.14%), followed by Klebsiella pneumoniae (25%), Enterococcus (17.86%), Escherichia coli (14.29%), and Pseudomonas aeruginosa (10.71%). K. pneumoniae was significantly associated with Foley’s catheter (p<0.05). The most common complications included sepsis (17.86%), urinary tract infections (17.86%), and acute pyelonephritis (7.14%). The mortality rate was 14.29%, with renal failure (14.29%), multiple organ dysfunction syndrome (10.71%), and septic shock (7.14%) as major contributors. However, 35.71% of patients had favorable outcomes.
Conclusions: The findings underscore the need for strict aseptic techniques, routine catheter care, early catheter removal, and robust antimicrobial stewardship programs. Preventive measures, including infection control protocols and surveillance systems, can significantly reduce CRI incidence and improve patient outcomes
Diabetic foot infection versus non-infected diabetic foot: contemporary diagnostic criteria, management algorithms, and clinical pitfalls: a focus on differentiating infectious and ischemic etiologies in diabetic foot ulcers
Get PDFDiabetic foot ulcers (DFUs) represent a significant complication of diabetes mellitus, with infection (DFI) and critical limb ischemia (CLI) being key determinants of morbidity and amputation risk. Despite established guidelines from the infectious diseases society of America (IDSA) and the international working group on the diabetic foot (IWGDF), misdiagnosis between infected and non-infected (particularly ischemic) DFUs remains a frequent clinical challenge, leading to inappropriate antimicrobial therapy or delayed revascularization. This review examines the current diagnostic criteria for DFI, contrasts them with ischemic presentations, and highlights common errors in management, emphasizing evidence-based strategies to optimize outcomes. A narrative synthesis of IDSA/IWGDF guidelines, recent literature on DFU classification systems (e.g., SINBAD, WIfI), and clinical studies on biomarkers (e.g., procalcitonin, CRP) and imaging modalities (MRI, PET-CT) was conducted. Key discriminators between DFI and CLI include localized vs. diffuse erythema, systemic inflammatory response, and perfusion assessment (ABI, TcPO₂). Overreliance on superficial wound cultures and underutilization of bone biopsy in osteomyelitis are recurrent errors. Multidisciplinary teams (MDTs) integrating infectious disease, vascular surgery, and podiatry reduce misclassification rates. Distinguishing DFI from CLI requires systematic evaluation of clinical, laboratory, and vascular parameters. Enhanced clinician awareness of IDSA/IWGDF criteria and ischemic mimics may reduce diagnostic errors and improve limb salvage rates
Bacteriology of acute otitis externa in a tertiary care centre
Get PDFBackground: Acute otitis externa is a common bacterial infection of the external auditory canal, often associated with swimming or minor trauma. Understanding the bacterial communities and their antibiotic susceptibility patterns is crucial for effective treatment.
Methods: This hospital-based prospective observational study included 111 patients with acute otitis externa. Aural swabs were collected, and bacterial isolates were identified through gram staining and culture and sensitivity testing.
Results: The most common age group affected was 46-55 years, with a female predominance (56.76%). The most prevalent symptoms were ear pain (100%), swelling in the external auditory canal (85.58%), and otorrhea (78.37%). Gram-negative organisms (53.15%) were more common than gram-positive organisms (46.85%). Pseudomonas aeruginosa (44.82%) and Staphylococcus aureus (39.09%) were the most frequently isolated bacteria. Antibiotic susceptibility testing revealed that these organisms were susceptible to various antibiotics, including piperacillin/tazobactum, aztreonam, tobramycin, and ciprofloxacin.
Conclusions: This study highlights the importance of understanding the bacterial communities and their antibiotic susceptibility patterns in acute otitis externa. Pseudomonas aeruginosa and Staphylococcus aureus were the most common isolates, and targeted antibiotic therapy can effectively treat aural infections
Medial and extended medial gastrocnemius muscle flap: a literature review and technical approach
Get PDFKnee arthroplasty is a worldwide procedure to treat gonarthrosis, it is one of the most performed surgeries by the traumatology and orthopedics service and despite improvements in prosthetic material and refinements in surgical techniques, knee replacement complications can be devastating and can even lead to the loss of the limb. Some of these complications are mediated by factors such as diabetes mellitus, obesity, malnutrition, advanced age and smoking. Tissue loss is frequently secondary to infection or seroma and can affect 1 to 15%. If not treated promptly, the most serious complications occur. Treatment of tissue loss with muscle flaps is the most accepted therapeutic option. The objective of this article is to describe these effective techniques for the treatment of peripatellar defects secondary to complicated arthroplasties and our approach
Tubercular lymphadenopathy
Get PDFTubercular mediastinal lymphadenopathy is a condition characterized by the abnormal enlargement of lymph nodes in the mediastinum also known as tuberculous lymphadenitis which can be acquired from close contact with an infected person. Mycobacterium tuberculli is one of the main causative agents of this dreadful infectious disease. The symptoms usually present are weakness or fatigue, weight loss, chills, fever, and sweating at night. After ruling out the clinical diagnosis it is treated in 2 phases i. e.; intensive phase or the initial phase and continuation phase followed by initial phase. It is also called as RIPE regimen for treating tuberculosis. The therapy recommended as per body weight of the patient
Insight into ECG: the crucial contribution of ECG technicians in cardiological monitoring and diagnosis
Get PDFThe electrocardiogram (ECG) is an indispensable non-invasive diagnostic tool which measures the heart's electrical activity and through this, very crucial in diagnosis and management of cardiovascular diseases, responsible for more than half of global deaths. Whereas advanced ECG technology is instrumental in capturing the heart activity, the expertise of ECG technicians is important for yielding precise and reliable results. This paper describes the crucial role that ECG technicians play in the healthcare system. The responsibilities include preparing patients, lead placement, operating the ECG machine, ensuring data quality control and assisting in the diagnostic process. It is their attention to detail that provides quality ECG data, which is critical in the interpretation of heart conditions, including arrhythmias, ischemia and heart attacks. More so, ECG technicians play a part in the active monitoring of patients with cardiovascular diseases or those going through treatments that influence heart health. Along with the increasing prevalence of cardiovascular conditions, there is the increase in usage of ECG technology in clinical and research settings, creating a demand for highly skilled ECG technicians. Their expertise not only enhances the accuracy of cardiovascular diagnostics but also supports advancements in medical research, helping to develop new treatments and technologies. In a nutshell, ECG technicians are vital members of the healthcare team that directly impacts patient outcomes and the future of cardiological care. Their role is crucial in ensuring that ECG remains a reliable tool for diagnosing and managing heart diseases