European Journal of Medical and Health Research
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Prevalence of Therapeutic Non-Adherence in Type 2 Diabetic Patients at the Maradi Reference Hospital
No full textIntroduction: Type 2 diabetes (T2D) represents a major public health problem. Monitoring and control are hampered by the issue of therapeutic non-adherence. The objective of this work was to evaluate the level of therapeutic adherence in type 2 diabetic patients. Methodology. This was a descriptive, cross-sectional study involving type 2 diabetic patients followed as outpatients. Sociodemographic variables, those related to therapeutic adherence, and factors that could influence therapeutic adherence were collected and analyzed. Adherence was assessed using the Morisky questionnaire (also called MMAS for Morisky Medication Adherence Scale). The results were analyzed using SPSS software version 27.0.1. Results: We recorded 108 patients meeting our inclusion criteria. The mean age was 51.09 years with extremes ranging from 14 to 74 years. The 30 to 60-year- old age group was the most represented at 70.4%. The study population was predominantly female in 63.9% of cases, with a sex ratio of 0.56. Patients with secondary and higher education levels were the most represented at 38% each, and 55.6% of patients reported receiving family support. The majority of patients (66.7%) were treated with oral antidiabetic drugs alone. The consultation frequency was monthly in 48.1% of cases. The proportion of non-adherent patients is high (67.6%). Conclusion: Therapeutic adherence among type 2 diabetic patients at the Maradi Reference Hospital is low
A Study to Assess the Effectiveness of Computer Assisted Teaching Program (CATP) on Knowledge of Adolescent Students Regarding Psychological Problems Caused by Problematic Cellular Phone Usage in Selected College at Bangalore
No full textProblematic smartphone usage among adolescents has emerged as a growing public health concern, with negative psychological consequences including anxiety, depression, sleep disturbances, and addiction-like behaviors. A quasi-experimental one-group pre-test post-test design was adopted. The study was conducted among 45 adolescent students from a selected college in Bangalore using a structured knowledge questionnaire validated by subject experts. A pre-test was administered, followed by the CATP intervention on the same day. A post-test was conducted after 7 days. Data were analyzed using descriptive statistics, paired t-test, and Chi-square test. Pre-test results showed that 33.3% of participants had inadequate knowledge, 48.8% had moderate knowledge, and 17.8% had high knowledge (mean score: 19.62 ± 8.18; 49.1%). Post-test results revealed significant improvement, with 91.1% achieving high knowledge scores (mean score: 34.07 ± 2.71; 85.2%). Paired t-test showed a statistically significant difference (t = 15.94, p < 0.000). No significant association was found between pre-test knowledge scores and demographic variables. The CATP was highly effective in improving adolescents’ knowledge about psychological problems related to problematic mobile phone usage. Educational interventions of this type should be incorporated into college health programs to promote mental well-being among students
Diagnosis and Grading of the Chondromalacia of Patella using Axial Proton Density Spectral Attenuated Inversion Recovery (PD-SPAIR) and Axial Proton Density MRI Knee Sequences
Get PDFBackground: Chondromalacia of patella is a common disease characterized by softening and degeneration of the patellar articular cartilage and is a frequent cause of anterior knee pain in young adults. Objectives: The purpose of this study is to assess sensitivity, specificity and the accuracy of axial proton density –spectral attenuated inversion recovery MRI sequence in detecting and grading patellar cartilage in patients with chondromalacia patellae in comparison to axial proton density sequence. Patients and methods: Thirty patients with chondromalacia patellae would be included in our study, 18 patients were women and 12 were men, their ages ranged from 12-30 years old. Another thirty-one patients that underwent knee MRI for another knee problem will be included also as a standard control group, 23were males and 8 were females, their ages ranging from 13-36 years old. All these patients will be examined by MR imaging with 1.5 tesla imaging system using both the axial proton density- spectral attenuated inversion recovery (PD-SPAIR) and axial proton density (PD) sequences. The study was done in AL Emamain Alkadhmain medical city. All the results will be reviewed 2 radiologists; final grading of patellar chondromalacia was made with mutual agreement. Results: Sensitivity of PD-SPAIR and PD sequences was 86.7% and 70% respectively. Specificity was for PD-SPAIR 93.5% and 77.4% for PD sequences. Accuracy for detecting these lesions in comparison to the control groupwas90.1% for PD-SPAIR and 73.8% for PD sequence Conclusion: The axial proton density spectrum attenuated inversion recovery sequence may accurately and quickly detect and grade cartilage defects in chondromalacia patellae patients. Fat saturation and proton density–weighted sequences are sensitive to cartilage lesions and intramedullary osseous oedematous changes, thus they should substitute the traditional proton density sequence in these patients
Checkpoint Inhibitors and Immune-Related Adverse Events: A Focus on Autoimmune Endocrinopathies
Get PDFImmune checkpoint inhibitors (ICIs) have revolutionized cancer therapy by enhancing antitumor immune responses, particularly in malignancies such as melanoma, non-small cell lung cancer, and renal cell carcinoma. Despite their clinical success, ICIs are frequently associated with immune-related adverse events (irAEs), including a wide range of autoimmune endocrinopathies. These endocrine irAEs can involve the thyroid gland (thyroiditis, hypothyroidism, hyperthyroidism), pituitary gland (hypophysitis), adrenal glands (primary or secondary adrenal insufficiency), and, more rarely, the parathyroid glands (autoimmune hypoparathyroidism). These conditions often necessitate long-term hormone replacement and may impact quality of life and cancer treatment continuity. The mechanisms underlying these endocrinopathies are believed to involve autoreactive T cells and autoantibody production, although exact pathways vary across different glands. Emerging studies have revealed elevated CD4+ T-cell responses to thyroid antigens in patients with ICI-induced thyroiditis and a broader presence of autoantibodies. Additionally, genetic factors and gut-immune interactions may modulate susceptibility to these disorders. As ICIs become increasingly used in earlier stages of cancer and among patients with fewer comorbidities, early identification and management of endocrine irAEs are essential. Regular monitoring of hormone levels and prompt endocrine evaluation can minimize complications. Furthermore, increased awareness among oncologists and endocrinologists is crucial for timely diagnosis and intervention. This review highlights the current understanding of ICI-associated autoimmune endocrinopathies, emphasizing their clinical presentation, pathophysiology, and management. Future research is needed to identify predictive biomarkers and develop personalized strategies to mitigate these adverse effects without compromising the anticancer efficacy of ICIs
Phosphorus and Calcium Metabolism in Elderly Women in a Resource-Limited Setting
Get PDFIntroduction: Calcium and phosphorus are crucial to human physiology, participating in many metabolic processes. Phosphocalcic metabolism variations often go unnoticed in clinical practice, especially in the elderly. This study aimed to assess these metabolic abnormalities in women over 60 years old in Douala Cameroon. Method: We conducted a cross sectional study at two reference hospitals in Douala. We recruited women over 60 years old. Serum from participants was used for colorimetric determination of total calcium, albumin, phosphorus, and creatinine. PTH and total vitamin D were analysed using the 2-step sandwich immuno-enzymatic method with final fluorescence detection. Results: In total, 89 women were recruited for the study. The participants were mainly aged between 60 and 70 years (60.6%). Nearly 18% of them were taking calcium supplements. A small proportion (5.6%) of them were supplemented with vitamin D. Participants aged 70 - 75 years had the lowest vitamin D levels (22.95 ± 7.03 ng/mL, p < 0.05) compared to other age groups. Calcium supplementation was a protective factor (OR = 0.35, p = 0.0009) against calcium deficiency. Conclusion: This study indicates that phosphocalcic metabolism abnormalities are prevalent among elderly women from Cameroon. It also pinpoints the crucial role of calcium supplementation in preventing hypocalcaemia, particularly among women over 60 years old
A Life Threatening Stridor Due to Huge Retrosternal Goitre: A Case Report
Get PDFA retrosternal goiter, also known as a substernal gaiter, is an enlarged thyroid gland that grows downwards and extends through the thoracic inlet into the thoracic cavity. We present a case of retrosternal goiter that presented with recurrent attacks of breathlessness and was misdiagnosed as bronchial asthma for years and treated with steroids and bronchodilators. The patient presented with inspiratory stridor and the diagnosis was confirmed by a CT scan of the neck and chest. Total thyroidectomy was performed through a cervical approach and the stridor disappeared completely after surgery
Bigatti Shaver versus Bipolar Electrocautry for the Treatment of Endometrial Polyps in Infertile Women
Get PDFBackground: Heavy vaginal bleeding associated with endometrial polyps requires surgical treatment, including bipolar electrocautery. Although a resectoscope is often used for excision, this method has several problems, including inadequate imaging, incomplete removal, fluid intolerance, and uterine or bowel injury. Complete resection, constant fluid intake and deficit, direct visualisation and infrequent recurrence define the mechanical shaver, which is the new intrauterine shaver (IUS). Aim: To evaluate the safety and utility of the intrauterine Bigatti shaver as a hysteroscopic treatment for endometrial polyps compared with resectoscopic hysteroscopy. Methods: Between October 2023 and October 2024, sixty individuals underwent the study. All demographic and operative details - including set-up time, resectoscopic hysteroscopy and set-up time - were assessed; endometrial polyps were removed by two techniques - Bigatti shaver and resectoscopic hysteroscopy.Data were collected and analysed. Results: Two groups of sixty patients were formed for Bigatti shaver and resectoscope hysteroscopy. Apart from large differences in fluid consumption (1108.06±250.03, 1803.45 ± 431.14 respectively), Bigatti shaver and resectoscope have quite different running times: 2.46 ± 0.65 respectively. In contrast to the resectoscope, no patient experienced bleeding as a side effect with the Bigatti shaver. Conclusion: The Bigatti shaver is a highly effective tool for the removal of endometrial polyps and offers a minimally invasive alternative to traditional methods. It combines mechanical tissue resection with continuous visualisation, reduces the risk of uterine perforation and minimises trauma to surrounding tissue, promoting faster recovery and improved patient outcomes
Psychosocial Interventions in Adolescents with Emotional Dysregulation
Get PDFAdolescents with emotional dysregulation (ED) and related clinical pictures represent a group of patients characterized by extreme fragility in terms of development and in terms of scholastic and social adaptation. Children and adolescents with ADHD, mood disorders and borderline personality disorder share ED, which involves cognitive, adaptive and social difficulties. After diagnosis, non-pharmacological interventions in adolescence include psychotherapy, group Social Skill Training, parent training for parents, both single-family and group. The authors present an experience of taking charge of adolescents in a small group with group Social Skill Training combined with multi-family parent training
Stercoral Peritonitis Revealing Post-Traumatic Rectal Perforation: A Case Report
Get PDFOpen abdominal trauma can be complicated by serious digestive injuries, often delayed in their presentation. We report the case of a 49-year-old man, victim of a road traffic accident with hypogastric impact, who presented with stercoral peritonitis secondary to an unrecognized rectal perforation. The initially stable evolution quickly required emergency surgery with rectal suture, peritoneal cleansing and protective colostomy. This case illustrates the importance of early surgical exploration in the face of any clinical doubt after abdominal trauma
Demographic Characteristics of Keratoconus in a Sample of Iraqi Patients
Get PDFKeratoconus (KC) is a progressive, bilateral corneal ectasia that typically emerges in adolescence or early adulthood. It leads to thinning and protrusion of the cornea, resulting in visual impairment. Understanding the demographic and clinical characteristics of KC in Iraqi populations is essential for early detection and intervention. Objective: To evaluate the demographic distribution, clinical features, and potential risk factors associated with keratoconus in a sample of Iraqi patients. Methods: A cross-sectional study was conducted at Ibn Al-Haitham Teaching Eye Hospital in Baghdad from June 2024 to June 2025. A total of 170 patients diagnosed with KC were included. Data were collected on age, gender, education, residency, family history, consanguinity, systemic and ocular conditions, and prior treatments. Results: The majority of KC patients were aged 11–30 years (74.7%), with a slight female predominance (52.9%). Primary education was the most common educational level (56.5%). A significant proportion reported positive family history (30%) and consanguineous parentage (61.8%). Common ocular risk factors included eye rubbing (70%) and dry eyes (21.8%). Allergic and atopic conditions were present in 10.6% of patients. Surprisingly, none had received prior treatment or follow-up. Most patients (65.3%) resided in Baghdad. Conclusion: Keratoconus in Iraq is prevalent among younger individuals and strongly associated with genetic factors, including family history and consanguinity. The lack of prior management highlights the need for improved awareness, screening, and access to care within the healthcare system