European Journal of Medical and Health Research
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Global Liver and Intrahepatic Bile Duct Cancer: A Comparative Study of the Survival Rate
No full textBackground: Cancer of the liver and intrahepatic bile ducts is considered one of the life-threatening cancers, one of the six most common sites of cancer, and the second leading cause of death after the pancreas, according to the publications of the World Health Organization. This paper looks for the most dangerous sites of cancers and the lowest survival rates, analyzing the data and giving indicators by continents and countries, with the most widespread shown in figures. Material & Methods: Publications from WHO, the International Agency for Research & Cancer, and Cancer Today 2024 on liver and intrahepatic bile duct cancer in global continents were discussed and illustrated with charts. Results: The results indicated that incidence and mortality for males were higher than for female, developed, high HDI, and high population countries had the highest cases. Very weak survival rates, especially in developing countries. Conclusion: The results of the analysis showed that the number of incidences and mortality of females were less than males; developed countries and countries with a high and very high HDI index were the most affected, as well as Asia, while the countries of the continent of Africa were the least affected by this site of cancer. Survival rates were very weak, especially for old age, and the best survival rates were in developed countries
Efficacy of Trigonal Electrofulguration for Women with Antibiotics Recalcitrant Recurrent Urinary Tract Infections
No full textBackground: recurrent UTIs represent one of the most common healthcare problems in women with multiple difficulties in treatment due to bacterial resistance to antibiotics and persistent infection in the urinary tract, so we search for alternative management to overcome this problem. One of the alternatives is the cystoscopic electrofulguration of bladder trigon to eradicate intracellular bacterial communities, which was proposed as one of the causative factors for bacterial persistence in the urinary tract. Aim of the study: To determine the efficacy of trigonal electrofulguration for women with antibiotics recalcitrant recurrent urinary tract infections including the rate of UTI recurrences, symptomatic improvement, and antibiotic sensitivity of bacteria following EF. Patients and methods: This study was a prospective interventional study conducted at Al-Kufa Urology Center, Al-sadder Medical City, al-Najaf al- Ashraf, Iraq in the period from December 2021 to October 2024. A total of 42 women above 15 years were included in this study were diagnosed with RUTI proved by culture and sensitivity do not respond to multiple courses of antibiotics with no other urological abnormalities, and normal upper tract imaging with cystoscopic findings of trigonitis, we did for them trigonal electrofulguration. Results: Clinical success was recorded in thirty-one (74%) women;17% were cured and 57% were improved while eleven (26%) patients had clinical failure. No adverse effects were reported by all the patients during the follow-up period. Conclusion: Cystoscopic electrofulguration is effective and safe in the treatment of antibiotics-recalcitrant recurrent urinary infections. A response rate of 74% with no adverse effects was recorded from our study
Correlates of Patient Satisfaction with the Chronic Care Model and Self-Determination Principles versus Usual Care among Patients with Type 2 Diabetes Mellitus in North-Central Nigeria
No full textBackground: This study assessed patient satisfaction with care delivered using the Chronic Care Model (CCM) integrated with Self-Determination Theory (SDT) principles compared with usual care among patients with type 2 diabetes mellitus (T2DM) in North-Central Nigeria. Patient satisfaction is a key indicator of quality of chronic illness care and adherence to long-term management. Methods: A single-blinded randomized controlled trial was conducted among 90 adults with T2DM attending the General Outpatient Clinic of the Federal University Teaching Hospital, Lafia. The study employed a mixed- methods approach, utilising both quantitative surveys to assess patient satisfaction scores and qualitative interviews to explore specific aspects influencing these scores within both care models. Participants were randomised to CCM-based care (n=45) or usual care (n=45). Patient satisfaction was measured using the Patient Assessment of Chronic Illness Care (PACIC) scale. Associations between SDT constructs (autonomy, competence, relatedness) and satisfaction were examined using Pearson’s correlation. Results: Patients in the CCM group reported significantly higher satisfaction scores across all PACIC domains than those in usual care (p < 0.001). Autonomy (r=0.62), competence (r=0.59), and relatedness (r=0.55) showed significant positive correlations with overall satisfaction (p<0.001). Socio-demographic factors such as age and educational status showed modest associations with satisfaction. Conclusion: The integration of Self-determination principles with the Chronic Care Model, significantly improves satisfaction among Nigerian patients with T2DM. Integration of SDT principles enhances motivation and engagement, supporting the adoption of CCM in resource-limited settings
Rare Adolescent Presentation of a Large Well- Differentiated Non-Functional Pancreatic Neuroendocrine Tumor
No full textPancreatic neuroendocrine tumors (PNETs) are rare pancreatic neoplasms and are even more uncommon in adolescents. Large PNETs often manifest with mass effect or complications, yet they may occasionally present with minimal symptoms or even discovered incidentally. We report an exceptional case of a 17-year-old girl who presented with minimal epigastric pain and was found to have a large, well-defined 9-cm mass arising from the pancreatic head. Exploratory laparoscopy with biopsy confirmed a well- differentiated Grade I non-functional PNET. The lesion was considered unresectable, and the patient was referred for systemic therapy. This case is remarkable for the young age at presentation and the unusually large tumor size despite minimal symptoms, highlighting the importance of considering pancreatic tumors in the differential diagnosis of subtle abdominal symptoms in young patients
An Unusual Cause of Recurrent Upper Gastrointestinal Bleeding: Duodenal Varices in Portal Hypertension
No full textDuodenal varices are an uncommon cause of upper gastrointestinal bleeding in patients with portal hypertension and may be overlooked during endoscopic evaluation. We report the case of a 44-year-old woman with portal hypertension secondary to alcohol-related chronic liver disease who presented with recurrent upper gastrointestinal bleeding manifested by hematemesis and melena. Emergency upper gastrointestinal endoscopy revealed three duodenal varices located in the duodenal bulb, one of which showed an adherent platelet-fibrin clot with active bleeding, while only a small gastroesophageal varix without high-risk stigmata was observed on retroflexion. Endoscopic band ligation of the bleeding duodenal varix was successfully performed, achieving immediate hemostasis without complications. The patient remained clinically stable with no recurrence of bleeding and was discharged on secondary prophylaxis. This case highlights duodenal varices as a rare but potentially life-threatening source of gastrointestinal bleeding and emphasizes the importance of careful endoscopic examination in patients with portal hypertension
Mental Disorders and Their Determinants among Internally Displaced Persons: A Review of Three States in North-Central Nigeria
No full textThis investigation assessed the prevalence and determinants of common mental health issues among residents of internally displaced persons' camps in Benue, Nasarawa, and Plateau States, North-Central Nigeria, with an emphasis on socio-demographic attributes and the prevalence, patterns, and determinants of mental health disorders. A multistage sampling approach incorporating proportional allocation yielded 829 participants from selected camps in these three North-Central states, which bear the greatest IDP burden. Data were collected via interviewer-administered tools, including a structured socio-demographic questionnaire, the Harvard Trauma Questionnaire, and the Hopkins Symptom Checklist-25. Descriptive analyses employed means and standard deviations, while multivariate analysis of covariance evaluated associations among socio-demographic factors, displacement-related stressors, and mental health outcomes. The results indicate a substantial prevalence of mental health disorders among IDPs, wherein 68.7% manifested anxiety symptoms, 59.8% depressive symptoms, and 36.1% trauma-related symptoms. Females, married and widowed individuals, and those with lower educational attainment were more likely to exhibit elevated symptom scores. Socio-demographic variables, namely sex, marital status, age, and education, significantly affected the prevalence and patterns of mental health disorders. Furthermore, exposure to displacement-related stressors was significantly associated with psychological distress, F = 21.45, p < 0.001, partial η2 = 0.072. This study revealed high levels of anxiety, depression and PTSD as well as a significant association between certain behavioural, socio-demographic, and environmental factors and mental health outcomes among residents of IDP camps. It recommends the implementation of integrated mental health services, gender-responsive psychosocial support, and trauma-informed counselling interventions
Glycemic Control and Duration of Diabetes in Relation to Albuminuria Progression in Type 2 Diabetes
No full textBackground: Diabetic kidney disease (DKD) is a progressive kidney disease linked to diabetes mellitus and a primary cause of renal failure worldwide. Early renal involvement is commonly detected through microalbuminuria, which indicates subtle glomerular damage before advanced deterioration occurs. Glycated hemoglobin (HbA1c) provides a reliable measure of long- term blood glucose control and reflects overall metabolic regulation. This study was designed to explore the relationship between microalbuminuria, HbA1c levels, and duration of diabetes, and to evaluate their combined significance in detecting patients at risk for the development of diabetic kidney disease. Materials and Methods: A case control study was carried out on 120 Individuals diagnosed with type 2 diabetes mellitus who visited Al Najaf Specialized Center for Diabetic and Endocrinology center, Al Hakeem General Hospital and Al Sadar Teaching Hospital in Najaf, Iraq hospital. Patients were stratified according to the measurements of the urinary albumin to creatinine ratio (UACR). HbA1c levels were measured by the fully automated AFIAS system, urinary albumin to creatinine ratio (UACR) using the fully Automated clinical chemistry analyzer [Cobas C 311(Hitachi High- Technologies Corp. Tokyo Japan)]. Statistical analysis included ANOVA test and chi-squared, Pearson correlation to determine the relationship between HbA1c and Duration of DM and albuminuria. Results: The mean age of the participants was 55.58 ± 7.95 years, with an equal ratio between males and females. A significant positive association was noticed between albuminuria and HbA1c (r = 0.382, p < 0.001), Duration of DM (r = 0.411, p < 0.001). The prevalence of moderate to severe albuminuria was significantly higher in patients with a diabetes duration of >10 years and HbA1c >8% than in those with a diabetes duration of <5 years and HbA1c <7%. Conclusion: The study indicated a positive association between albuminuria and HbA1 and diabetes duration. Furthermore the study show a higher risk of nephropathy are associated with poor glycemic control and longer diabetes duration
Solitary Axillary Schwannoma Mimicking a Lymph Node: A Case Study
No full textSchwannoma, also known as neurilemmoma or neurinoma, is a benign, encapsulated tumor of the peripheral nerve sheath that arises from Schwann cells. It is typically a slow-growing, solitary, firm, and well-circumscribed lesion, accounting for approximately 8% of all soft tissue masses. Axillary involvement is rare ; therefore, schwannoma should be considered in the differential diagnosis of axillary and peripheral nerve masses to ensure accurate diagnosis and appropriate management. The clinical presentation may remain asymptomatic for years but can include pain, a palpable mass, or neurological symptoms, particularly in larger lesions. Imaging plays a crucial role in diagnosis, especially magnetic resonance imaging (MRI), with ultrasound serving as a useful adjunct. In this study, we report a case of axillary schwannoma presenting as a painful swelling in the left axillary region, with the definitive diagnosis established postoperatively through histopathological examination of the excised specimen
Effect of Low-Dose Epidural Analgesia on Labor Progression and Maternal-Neonatal Outcomes in Nulliparous Women: A Cohort Study
No full textBackground: The influence of epidural analgesia on labor progression and cesarean delivery remains controversial. This study evaluated the effect of epidural analgesia on maternal and neonatal outcomes among nulliparous women in spontaneous labor. Methods: A cohort study was conducted at Al- Zahra’a Teaching Hospital in Al-Najaf City from April to October 2016. One hundred healthy nulliparous women at term with singleton vertex pregnancies were enrolled and divided into two groups: 50 women received epidural analgesia at cervical dilatation ≥4 cm, and 50 matched controls received no analgesia. The epidural regimen consisted of low-concentration bupivacaine (0.1%) with fentanyl (2 μg/mL). Outcomes assessed included duration of labor stages, mode of delivery, intrapartum and postpartum complications, Apgar scores, and NICU admission. Statistical analysis was performed using SPSS version 20, with p ≤ 0.05 considered significant. Results: There were no statistically significant differences between the two groups regarding the duration of the active first stage, second stage, or third stage of labor (p > 0.05). Cesarean delivery rates were comparable (14% vs. 18%, p = 0.590). Neonatal outcomes, including Apgar scores at 1 and 5 minutes and NICU admissions, showed no significant differences. Nausea, vomiting, and maternal anxiety were significantly lower in the epidural group (p < 0.05). Hypotension and urinary retention were infrequent and manageable. Motor block occurred in 20% of women receiving epidural analgesia. Conclusion: Low-dose epidural analgesia administered during active labor does not prolong labor stages or increase cesarean delivery rates and is associated with effective pain relief and favorable maternal and neonatal outcomes
Intestinal Pneumatosis Cystica Secondary to a Pyloric Hamartoma: A Case Report
No full textWe report the case of a 48-year-old man admitted with epigastric pain, late postprandial vomiting, and constipation evolving over twenty days. Imaging revealed massive gastric distension with intestinal pneumatosis cystica (IPC), characterized by the abnormal presence of gas-filled cysts within the intestinal wall, upstream of a pyloric stenosis. Endoscopy and histopathology confirmed a benign Brunner’s gland hamartoma, a disorganized proliferation of normal tissue without malignancy. Intraoperative exploration revealed yellow-citrine ascites, extensive IPC, a gas-filled hepatic nodule, and a large Meckel’s diverticulum. The patient underwent gastrojejunostomy and resection of the Meckel’s diverticulum, with an uneventful postoperative course. This case illustrates the rarity of IPC secondary to pyloric stenosis caused by a Brunner’s gland hamartoma and underscores the importance of multidisciplinary management