European Journal of Medical and Health Research
Not a member yet
578 research outputs found
Sort by
Accreditation of Specialties Across Departments for Postgraduate Medical Training at the Rivers State University Teaching Hospital
Get PDFBackground: Accreditation, a determination of institutional “fitness” for training, is a tasking exercise requiring participation of trainers, staff, learners, and the commitment of the administration. This study therefore evaluated the accreditation of specialty training programs across the Departments at the Rivers State University Teaching Hospital, focusing on the visits and outcome of visits by the accrediting colleges in the year 2024.Materials and Methods: A cross-sectional observational study was carried out among Heads of Departments (HODs) using a semi-structured self-administered questionnaire. Data obtained was analysed and presented in tables.Results: Thirty-two (32) out of the 35 medical/surgical clinical specialties available at the RSUTH applied for and obtained accreditation for postgraduate medical and surgical training of the WACP, WACS, and the NPMCN. There were 16 respondents who were heads of the clinical departments, male to female ratio 1:1, and their mean age was 49.13 years. There was 100% success in membership accreditations, and 93.75% success in Fellowship accreditations of the NPMCN-Physicians. The outcome of accreditation for WACP was 100% success in membership accreditation, and 95.8% success in Fellowship accreditations. The outcome of NPMCN-Surgeons was 100% for Memberships and 100% for Fellowships, and the outcome WACS 100% for Membership and 87.5% success for Fellowships.Conclusion: Thirty-three medical/surgical specialties underwent accreditation visits from two colleges across departments within a year in a single institution. There was 95.8% mean success rate in membership accreditations and a mean success rate 94.3% for fellowship accreditations. Sustained efforts in welfare and training matters are recommended to guarantee success in subsequent accreditations
Minimally Invasive Management of Temporomandibular Joint Disorders: Findings from a Prospective Clinical Study
Get PDFTemporomandibular Joint (TMJ) disorders are prevalent in jaw function and quality of life. Traditional surgical interventions, while effective, are associated with significant morbidity. This study investigates the efficacy of minimally invasive techniques—arthrocentesis, arthroscopy, and injectable therapies—in managing TMJ disorders. A prospective clinical trial was conducted with 150 patients randomized into three treatment groups. Outcomes were assessed based on pain relief, jaw function improvement, and patient satisfaction at 3, 6, and 12 months post-treatment. Results demonstrated significant improvements in all groups, with arthroscopy showing the highest efficacy (90% pain relief, 85% functional improvement), followed by arthrocentesis (85% pain relief, 80% functional improvement), and injectable therapies (75% pain relief, 70% functional improvement). Minimally invasive approaches are effective, safe, and viable alternatives to traditional surgery for TMJ disorders
Surgical Outcomes in Hepatic Hydatid Disease: A Case Series of 153 Patients
Get PDFHepatic hydatid disease, caused by Echinococcus granulosus, remains a significant public health concern in endemic regions. This retrospective study analyzed 153 cases treated surgically at the General Surgery Department of Ibn Rochd University Hospital in Casablanca from 2019 to 2022. The majority of patients were women from rural areas, with a mean age of 45. Right upper quadrant pain was the predominant symptom. Diagnosis was primarily based on ultrasound using the Gharbi classification, with CT and MRI providing further anatomical detail. The most affected hepatic segments were VI, VII, and VIII. All patients underwent open surgery, mainly via right subcostal laparotomy, with dome resection being the most common technique. Biliary fistulas were identified in 13.72% of cases. Postoperative recovery was uneventful in over 93% of patients, with a low recurrence rate. The discussion highlights the importance of imaging in diagnosis, the role of serology, and surgical principles, including intraoperative exploration and bile duct assessment. Although drug therapy and minimally invasive methods are evolving, open surgery remains the cornerstone of treatment in complex or advanced cases
Analysis of Costs and Trends of Antibiotic Consumption at the National Hospital of Obstetrics and Gynecology (NHOG) in 2019-2023
Get PDFObjective: Analyzing the cost and consumption of antibiotics at National hospital of Obsteric and Gynecogoly from 2019 to 2023.Subjects and methods: A cross-sectional descriptive study based on data on antibiotics used in inpatient treatment at the National hospital of Obsteric and Gynecogoly from 01/01/2019 to 31/12/2023, using cost analysis and DDD analysis methods.Results: The beta-lactam group accounted for the majority of consumption value (93.7%). Intravenous antibiotics accounted for 91.4% in value. The proportion of original and generic brand-name drug use values was 57.4% and 42.6%. The Department of Obstetric Pathology and department of Obstetric Infections were two departments that used the most antibiotics. The average total DDD/100 bed days of the hospital was 66.2; in which the penicillin and cephalosporin groups had the highest DDD/100 bed days. Antibiotics that need to be managed according to Decision 5631/QD-BYT account for a low proportion of consumption, while meropenem antibiotics tend to increase in consumption (p<0.05).Conclusion: The study shows an overall picture of the situation of antibiotic use at National hospital of Obsteric and Gynecogoly in the 5-year period from 2019 to 2023. It is the basis for proposing that the Drug Treatment Council implement a comprehensive antibiotic management program
Obesity and Cancer: Excess Body Fat as a Risk Factor in Carcinogenesis; Consequences Across Human Body Systems and Significance for Associated Medical Specialties
Get PDFObesity is a known risk factor for various cancers, influencing carcinogenesis through metabolic, hormonal, and inflammatory pathways. Excess adiposity leads to insulin resistance, chronic inflammation, and hormonal imbalances, all of which contribute to tumor development. Obesity increases the risk of cancers in the endocrine system (e.g., thyroid, pancreatic, adrenal) due to insulin resistance and altered hormone levels. In the reproductive system, it raises the risk of breast, ovarian, endometrial, and prostate cancers through hormone dysregulation and inflammation. Obesity is also linked to digestive system cancers, including esophageal, liver, and colorectal cancers, due to metabolic dysfunction and chronic inflammation. The role of obesity in lung cancer remains debated, but metabolic changes may influence tumor progression. Obesity contributes to hematologic cancers, such as leukemia, by altering immune function and promoting inflammation. Other systems show varying associations with obesity and cancer risk. Key mechanisms include metabolic dysregulation, chronic inflammation, epigenetic changes, and elevated insulin/IGF-1, which promote tumor growth. Early detection through imaging and biomarkers, along with lifestyle changes (e.g., diet, exercise) and pharmacologic treatments (e.g., metformin, GLP-1 agonists), can reduce cancer risk and improve outcomes. Personalized treatment for obese cancer patients requires adjustments in surgery, chemotherapy, radiotherapy, and immunotherapy. This review explores obesity’s association with cancers across body systems, overviews the mechanisms of obesity contributing to carcinogenesis, and summarizes clinical and public health implications, including screening, prevention, treatment, and policy interventions
Prevalence of Serum Vitamin D Levels in the Iraqi Population: A Cross-Sectional Study
Get PDFBackground: Vitamin D deficiency in children causes rickets. It prevents children from reaching their maximum bone mass and genetic height. Abnormal mineralization of the collagen matrix in bone, known as osteomalacia, occurs in adults with vitamin D deficiency. Aim: The aim of this study is to evaluate the prevalence of serum vit. D levels in the Iraqi population. Methods: This cross-sectional study collected data from October 2024 to January 2025.Data was collected by directly interviewing the participants, the time needed for each interview was 10-15 minutes and screening for vit. D level by measuring serum 25-hydroxyvitamin D (23[OH]D) concentration as a part of their routine laboratory tests. Results: The majority of individuals in this group are deficient in vitamin D3 (4.6%), with very few in the insufficient and sufficient categories (0.6% each). Primary education: A significant percentage of individuals in this group are deficient (13.4%), with 3.2% in the insufficient category and 1.2% in the sufficient category. Secondary education: This group has a relatively higher proportion of deficient individuals (23%), with 8.8% being insufficient and 4.6% being sufficient. College: The deficient category is most prevalent in this group (25%), with 6.8% insufficient and 4.4% sufficient. Higher education: This group has the lowest proportion of deficient individuals (2.4%), with 0.8% insufficient and 0.6% sufficient. Urban residents: A larger proportion of urban residents are deficient in vitamin D3 (41.4%), with fewer individuals categorized as insufficient (8%) or sufficient (4.4%). Rural residents: A smaller proportion of rural residents are deficient (27%), with a higher percentage categorized as insufficient (12.2%) and sufficient (7%). Individuals with chronic conditions (Yes): A significant proportion are deficient in vitamin D3 (20.6%), with smaller percentages classified as insufficient (3.8%) or sufficient (1.6%). Individuals without chronic conditions (No): A larger proportion are deficient (47.8%), with a higher percentage classified as insufficient (16.4%) and sufficient (9.8%). Conclusion: There was no statistically significant association between vitamin D levels and educational attainment, suggesting that vitamin D deficiency affects people in all educational groups. A significant association was found between place of residence and vitamin D levels. Urban dwellers had a higher prevalence of deficiency than rural dwellers. The association between the presence of chronic diseases and vitamin D levels was statistically significant
Impact of Antenatal Corticosteroid Administration on Respiratory Distress Syndrome, Morbidity, and Mortality in Preterm Infants: A Cross-Sectional Study at a Tertiary Center in Baghdad
Get PDFBackground: Preterm birth remains a leading cause of neonatal morbidity and mortality, with respiratory distress syndrome (RDS) being one of the most common and severe complications. Antenatal corticosteroids, particularly betamethasone and dexamethasone, are routinely used to accelerate fetal lung maturation and reduce the risk of RDS. This study evaluates the impact of antenatal steroid administration on the incidence and severity of RDS, as well as neonatal mortality, among preterm neonates delivered at Baghdad Teaching Hospital.Methods: A cross-sectional study was conducted involving 200 preterm neonates delivered between January and June 2024. Data were collected using a structured questionnaire covering maternal demographics, neonatal characteristics, and clinical outcomes. The primary outcomes included incidence and severity of RDS, need for respiratory support, and neonatal mortality.Results: Antenatal corticosteroid administration was associated with a significant reduction in both the incidence and severity of RDS. Infants whose mothers received steroids showed a lower need for mechanical ventilation and surfactant therapy. Moreover, neonatal mortality was significantly reduced in the steroid-exposed group. These benefits were most notable in neonates born at earlier gestational ages.Conclusion: Antenatal corticosteroids play a vital role in improving neonatal outcomes in preterm births, primarily by mitigating the severity of RDS and reducing mortality. Continued implementation of this intervention in preterm labor management is essential. Further studies are recommended to optimize dosing protocols and evaluate long-term outcomes
Renal Adverse Effects of Immune Checkpoint Inhibitors in Cancer Patients: Diagnosis and Management
Get PDF
The advent of immune checkpoint inhibitors (ICIs) has radically altered the prognosis of numerous cancers, but it has also introduced a spectrum of immune-related adverse events affecting multiple organs. This review covers the fundamentals of the antitumor immune response and the various ICIs (anti–CTLA-4, anti–PD-1/PD-L1), as well as the description, mechanism, and management of their toxicities, with a special focus on renal complications. We examine the incidence and timing of renal injuries (acute interstitial nephritis, acute tubular necrosis, glomerulopathies), the role of diagnostics (laboratory evaluation, urinary sediment analysis, and kidney biopsy), and emerging research on urinary biomarkers.
Risk factors—preexisting chronic kidney disease, metabolic comorbidities (e.g., diabetes), advanced age, concomitant use of nephrotoxic drugs, or combination ICI regimens—enable personalized monitoring and prevention of renal injury. Management of ICI-associated acute kidney injury involves early drug discontinuation, glucocorticoid therapy (intravenous and/or oral tapering over 4–6 weeks), and, in refractory cases, second-line immunosuppressants (mycophenolate mofetil, infliximab). Re-challenge is reserved for toxicities ≤ grade 2 with stable renal recovery, after a minimum interval of two months.
Clinical outcomes indicate that over 60% of patients regain baseline renal function, fewer than 2% require dialysis, and renal-related mortality is minimal, although ICI discontinuation may impact oncologic survival. The degree of interstitial fibrosis on biopsy and the promptness of intervention emerge as key prognostic factors. Finally, the need for multidisciplinary protocols (Oncology, Nephrology, Pathology) and prospective studies validating noninvasive biomarkers is emphasized to optimize renal safety without compromising the therapeutic benefits of immunotherapy. 
Evaluation of Clipping Versus Bipolar Electrocautery of Cystic Artery in Laparoscopic Cholecystectomy
Get PDFBackground: The widespread use of surgical clips in laparoscopic cholecystectomy has been associated with various complications, including clip slippage, dislodgement, migration, ulceration, and necrosis of the cystic duct, which may lead to bile leakage. In response to these risks, clipless laparoscopic techniques, particularly the use of electrocautery, have been explored. While both monopolar and bipolar diathermy are used for tissue cauterization, monopolar systems pose a higher risk of lateral thermal injury to surrounding structures such as the common bile duct, hepatic artery, and bowel. Bipolar electrocautery, although safer, is not without drawbacks, including smoke generation that may hinder visualization during surgery.Aim: This study aimed to evaluate the efficacy and safety of bipolar electrocautery for controlling the cystic artery during laparoscopic cholecystectomy, and to determine whether it is a suitable alternative to conventional clip application.Methods: A prospective study was conducted on 100 patients undergoing laparoscopic cholecystectomy, who were divided into two groups of 50. Group A underwent surgery with clip application to control the cystic artery, while group B used bipolar electrocautery. Postoperative outcomes were assessed over a two-week follow-up period.Results: Mean operative times were 35.19 minutes in group A and 34.18 minutes in group B. Median ages were comparable between groups. One case of intraoperative bleeding occurred in group B and was successfully managed. No major complications or postoperative bleeding were noted in either group.Conclusion: Bipolar electrocautery is a safe and effective alternative to surgical clips for cystic artery control in laparoscopic cholecystectomy
Pyrexia of Unknown Origin Caused by Toxoplasmosis: A Rare Case Report
Get PDFIntroduction: Toxoplasma gondii is an obligate intracellular parasite that causes infection in up to one-third of the world's population. It is essential to document every such case for the education of the clinicians for better treatment of the affected individuals. Case presentation: We present a 50-year-old individual of Bangladeshi lineage who presented as pyrexia of unknown origin who was ultimately diagnosed as acute Toxoplasmosis. The patient was treated conservatively with a range of antibiotics, he gradually became clinically and hemodynamically stable and was released. Conclusion: The case highlights the importance of extensive diagnostic measures for assessing the actual cause of the disease, as the presentation will be mostly non-specific. Such cases enhance the knowledge of the practitioners for implying proper diagnosis and offering effective treatment to the patients