European Journal of Medical and Health Research
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Relapse in Substance Use Disorder and Its Relation to Stigma: An Outpatient Based Cross Sectional Study
Get PDFBackground: One of the most crucial but discouraging features of the outcome of substance use disorder is relapse. The factors predicting this event must be understood to be considered for future interventions.Aim: This study aimed to assess factors related to relapse and stigma among patients with substance use disorder.Methods: A sample of 53 relapsed patients were recruited from the outpatient clinic of the addiction unit at Mansoura university hospital. Tools of data collection: Structured questionnaires were utilized. It included 3 parts. Part I: to assess socio-demographic characteristics. Part 2: Questionnaire about factors related to relapse among substance use disorder patients. Part 3: the perceived stigma of substance abuse scale.Results: It was found that relapse dimensions represented from the greatest to the lowest mean score as the following: unpleasant emotions, craving, good feelings, disruption of relationship, physical pain, peer pressure, and family problems, which was estimated as the following; 12.81±3.52, 5.94±3.15, 4.36±2.38, 10.21±5.45, 14.23±4.19, 11.00±4.00, 4.21±1.47, 10.13±3.06. A statistically significant positive correlation between stigma score and (craving, loss of control, peer pressure, pleased emotions, non-pleased emotions, physical pain, and disturbed relationship) domains of relapse scale.Conclusion: It was concluded that perceived stigma of patients with substance use disorder was one of the risk factors predicting relapse in these patients, also there was a significant positive correlation between all dimensions of relapse and some socio-demographic and clinical characteristics such as single marital status, unemployment, in debt economic status, and previous admission.Recommendation: Developing future preventive programs for protection against factors related to relapse including stigma
Laparoscopic Treatment of Bladder Prosthesis Exposure
Get PDFGenital prolapse surgery is a functional surgery aimed at restoring the anatomical position and functions of the pelvic organs. Currently, the gold standard is laparoscopic surgery with a polypropylene prosthesis. This is functional surgery involving the interposition of strips and their fixation to the spine. This technique avoids the need for a vaginal opening and is therefore less prone to infectious complications and prosthesis exposure. Exposure of the prosthesis several years after insertion calls for monitoring. We present the case of a patient operated on at our level for genital prolapse using the laparoscopic lateral suspension technique, with exposure of the sling three years after insertion. We describe the various lesions found and the therapeutic strategy
Trans-Jugular Portosystemic Shunt (TIPSS): A Study of 31 Cases
Get PDFThis scientific report presents a retrospective analysis of 31 cases undergoing Transjugular Intrahepatic Portosystemic Shunt (TIPSS) placement. The study, conducted at a single center, aimed to evaluate the efficacy and safety of TIPSS in managing complications of portal hypertension. The main indications for TIPSS placement included variceal bleeding, refractory ascites, and Budd-Chiari syndrome. The procedural success rate was high, with only a small number of cases requiring re-intervention due to shunt occlusion. Significant improvements were observed in controlling ascites and variceal bleeding, although complications such as hepatic encephalopathy were noted. Despite these challenges, TIPSS emerged as a valuable intervention for patients with advanced liver disease and its associated complications. This study underscores the importance of TIPSS in the management of portal hypertension and highlights the need for further research to optimize patient selection and refine procedural techniques
Acute Renal Infarction. A Case Report
Get PDFRenal infarction is a rare disease often overlooked due to its very unspecific clinical presentation. We report the particular case of an idiopathic bilateral acute renal infarction occurring in a young adult male. The diagnostic delay in our patient is significant: ten days. However, a Doppler ultrasound allows screening. The diagnosis of certainty is made by the angioCT scan: essential examination to make the lesional balance sheet and to evaluate the prognosis on the renal function. Anticoagulant treatment is the treatment of choice provided it is instituted early
Predictive Risk Modelling and Occupational Hazard Mapping in the United States Healthcare Sector: A Data-Driven Safety Surveillance Study
Get PDFA data-driven safety surveillance framework was developed in a study that incorporated supervised machine learning models and geospatial analytics to forecast and map occupational hazards in the United States healthcare sector. The incident records of 12,347 cases were de-identified in more than 500 facilities in the 30 states (2018-2022). There were four predictive models: logistic regression, support vector machines, random forest, and XGBoost, and the optimal one was XGBoost (AUC-ROC = 0.91, F1 = 0.85). The main predictive variables were the duration of a shift (importance score = 0.178), the type of department (0.154), and PPE compliance (0.139), as well as the ratios of staff to their patients and the time at which the incident occurred. The frequency of injuries was very high in some high-risk departments, i.e., the emergency and ICU, especially under morning and early shifts. Musculoskeletal injuries (31%), needlestick (22%), and infectious exposures (19%) were the most common hazards. Kernel density estimation and Getis-Ord Gi hotspot analysis on spatial mapping revealed the targeted areas of risk concentration within hospitals and long-term care facilities, but only in New York, California, Texas, and Ohio. These results validate the fact that occupational injuries within care are statistically predictable and spatially patterned, and that there should be a transition to real-time and predictive, geographically informed safety governance
Evaluation of Medical Technologies Used to Manage Malaria in Efoulan Health District of Yaounde-Cameroon
Get PDFPurpose: This study aimed at evaluating medical technologies used to manage malaria at Efoulan health’s district. Problem: With almost 3 million of confirmed cases per year, malaria is the disease that most affects Cameroonians. From March 2020, Cameroon witnessed the advent of massive cases of COVID-19, whose symptoms almost coincide with those of malaria, causing a mix of medical technologies meanwhile, populations and medical personnel are required not to get confused between malaria and Covid-19. Methods: We conducted a retrospective cross-sectional qualitative study for analytical purposes at three levels of comparative analyzes (Malaria protocol, Malaria equipment, and Malaria drugs) using Anova and Pearson correlation. Results: Our study revealed that Malaria protocol in hospitals was moderately and positively correlated to WHO (2023) [1] guidelines at 41.8% [r(30) = .41.8, 95%, p = .019]. Malaria equipment found within the community were statistically significantly different (F(2, 96) = [10.688], p = 0.00) from those recommended by Long (2009) [2] (p = 0.001, 95% C.I. = [-2.01, -0.41]). Antimalarial drugs used within the community and in hospitals were respectively moderately positively correlated at 43.5% [r(20) = .435, 95%, p = .043] and highly positively correlated at 53.3% [r(20) = .533, 95%, p = .011] to WHO (2023) [1] guidelines. Conclusion: To strengthen malaria control, health education on complete malaria protocol must be carried out, first aid medical centers must be better equipped, drugs must be prescribed according to patient’s histories and pre-referral treatments must be applied within the community while integrating traditional concoctions into modern medicine
Poplitea Artery Entrapment Syndrome
Get PDFPopliteal artery entrapment syndrome (PAES) is a rare pathological compression of the popliteal artery, mostly unilateral. Its diagnosis is a challenge due to low recurrence and confusion with other injuries that affect the lower limb. Delay in its repair can cause arterial stenosis, emboli, aneurysm, inability to perform physical activities, thromboembolism and acute limb ischemia. Young men without comorbidities who may exercise regularly with intermittent claudication that affects their daily activities should draw attention to research and treatment of the syndrome. Investigation is extremely important to rule out differential diagnoses, such as chronic compartment syndrome, neurogenic claudication, peripheral atherosclerosis and cystic disease of the popliteal artery
Effectiveness of Low Dose D-Penicillamine Therapy in Neurologic Wilson Disease - A Prospective Observational Study
Get PDFBackground: Wilson disease is an inherited disorder of copper metabolism that mostly manifests as hepatic and neurologic symptoms. Chelation therapy specially penicillamine is given as first line treatment in children with symptomatic Neurologic Wilson disease. Objective: Objective of the study was to assess the safety & the clinical outcome of treatment with low dose penicillamine in Neurologic Wilson disease. Methods: A longitudinal observational study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, a tertiary care Premier Postgraduate Medical Institution of Bangladesh. Thirty-nine (39) patients of Neurologic Wilson disease who fulfill the inclusion and exclusion criteria were evaluated at In-patient Department of Paediatric Neurology, during the period of January 2015 to December 2019. All study children were treated with low dose penicillamine (Cap Artamin 250 mg) rather with conventional dose penicillamine (Cap Artamin 500 mg or 20 mg/kg/day). Subsequent follow up examination was performed at 2 weeks, 1, 3 and 6 months. Follow up was done by global assessment scoring (GAS) and slit lamp examination to see the clinical improvement after treatment with low dose penicillamine therapy. Results: Total number of studied cases were 39. Mean age was 10.2 ± 3.1 year and male to female ratio was 2:1. Most of the patients (66.67%) were arrived from rural area and 20.51% children had history of consanguineous mating parents. Common presenting features were progressive deterioration of school performance (89.74%), gait disturbance (92.31%), dysarthria (92.31%) and dystonia (82.06%) of our studied children. Ophthalmological manifestations like KF ring (100%) found in all patients. Neuroimaging showed bilateral basal ganglia involvement in (63.63%) children followed by hyperintense signal changes (18.18%) and ventricular dilatation in (18.18%) of cases. Majority of the children (74.36%) were improved with low penicillamine therapy clinically and KF ring disappeared in (5.12%) cases after drug therapy on follow up. Commonest side effects were worsening of neurological symptoms in (25.64%) and rash & thrombocytopenia in (5.1%) cases after penicillamine therapy. Conclusion: About three-fourth children of studied Neurologic Wilson disease showed gradual improvement with low-dose penicillamine therapy. Moreover, one-fourth of cases experienced neurological deterioration, which was lower than previously used high dose penicillamine therapy. Therefore, low dose penicillamine may be beneficial as an initial therapy for Wilson disease with neurological manifestations
Prevalence of Urinary Schistosomiasis Infection among Women in Yala Local Government Area, Cross River State, Nigeria
Get PDFUrinary schistosomiasis is endemic in Nigeria and continues to be a threat to public health especially for inhabitants of rural areas. Women in villages may be ignorant of the cause of the disease. The main source of water in these areas in most parts of Nigeria is the streams with resultant spread of schistosomiasis. This study was conducted to investigate the prevalence of schistosomiasis infection among women in Yala L.G.A in Cross River State, Nigeria. Macroscopy, urinalysis, and microscopy were used to examine the 650 urine samples collected from two villages (Ugaga and Okpoma) to determine presence of Schistosoma haematobium eggs. Questionnaires administered to women provided information on socio-demographic data and water-contact activities. Out of the 650 urine specimens examined in the two villages, 202 (31.08%) were infected with the highest prevalence found among the 11-22 years age group, and the least (12.80%) among the 59-70 years age group. Statistical analysis at significance level (P<0.05) revealed that there is a significant relationship between occupation and infection rate of schistosomiasis in the area. Schistosomiasis is of serious public health importance. Hence, the need for an acceptable preventive and control intervention to be carried out in this study area to reduce this problem
Financially Sustainable Strategic Leadership and Management with Predictive Analytics to Strengthen Nationwide U.S. Healthcare Quality and Performance
No full textThis study proposes an integrated framework that combines predictive analytics, strategic leadership, and financial sustainability to strengthen nationwide U.S. healthcare quality and system performance. We constructed and assessed Gradient Boosting and Random Forest prediction models for high-risk clinical outcomes using a synthetic yet realistic healthcare dataset containing several factors. Gradient Boosting exhibited remarkable accuracy, displayed consistent learning curves, and excelled in category differentiation (AUC = 0.98). The training-validation evaluations revealed that the model functioned efficiently without overfitting, and the confusion matrix illustrated its capability in recognizing true positives and true negatives. This signifies that operational risk stratification is dependable. Feature importance analysis identified distinct indicators for quality enhancement initiatives, while calibration demonstrated a robust link between predicted probabilities and actual event rates, thereby validating the model's efficacy for decision assistance. The ROC study demonstrated that ensemble models surpassed conventional approaches in difficult healthcare prediction tasks. A speculative cost-savings curve depicted the potential financial advantages of reducing unnecessary readmissions. This illustrated the importance of predictive modeling for leaders in decision-making. The findings demonstrate that leadership processes utilizing advanced analytics can enhance quality and financial results. This study emphasizes the significance of integrating analytics with evidence-based management, transcending the constraints of merely technical model effectiveness. Predictive approaches are most effective in systems that improve governance, resource distribution, and policy consistency. The findings endorse a robust, data-driven healthcare system wherein executives employ real-time data to enhance treatment, minimize waste, and elevate performance based on value. Future research should employ varied empirical data, conduct equity evaluations, and integrate scalable digital frameworks. The U.S. healthcare system can attain enhanced stability and effectiveness by employing predictive analytics and strategic leadership