European Journal of Medical and Health Research
Not a member yet
578 research outputs found
Sort by
Scenario of Colorectal Cancer at a Tertiary Care Hospital in Bangladesh: A Retrospective Observational Study
No full textBackground: Colorectal cancer is an increasing health problem in developing countries including Bangladesh, as local data on patient characteristics and treatment patterns remain limited. This study aimed to describe the sociodemographic profile, disease characteristics, and treatment patterns of colorectal cancer patients treated at a tertiary care hospital in Bangladesh. Methods: This retrospective observational study was conducted at the Department of Oncology, Combined Military Hospital, Dhaka, over a four- year period from 2020 to 2023. Medical records of 100 patients with histologically confirmed colorectal cancer were reviewed. Data on demographic characteristics, clinical and pathological findings, treatment regimens, and treatment-related toxicities were analyzed using descriptive statistics. Results: Most patients were middle-aged (46%) adults, with a clear male predominance (74%) and a majority coming from rural areas (85%). Adenocarcinoma (62%) was the most common histological type, and most tumors were of moderate grade (87%). While colonic involvement was more prevalent (72%), adjuvant chemotherapy was the most commonly used treatment approach (41%). Treatment-related toxicities were common, with hand and foot syndrome (35%) being the most frequently reported adverse effect. Conclusion: Colorectal cancer patients in this setting commonly present at a relatively younger age and with more advanced disease. The predominance of moderate to high-grade tumors and the frequent need for systemic therapy highlights delayed presentation. These findings emphasize the need for improved awareness, early detection strategies, and strengthened cancer care services in Bangladesh. Abbreviation: Colorectal cancer: CRC; Adenomatous Polyposis Coli: APC; Kirsten-ras: K-ras; Fecal Immunochemical Test: FI
Mucinous-Type Adenocarcinoma Arising from a Chronic anal Fistula: About 4 Cases
No full textPerianal mucinous adenocarcinoma is a rare and aggressive tumor, most often arising from chronic anal fistulas, which makes early diagnosis difficult due to nonspecific symptoms. Objective: To report, through clinical cases, the clinical, therapeutic, and outcome aspects of mucinous adenocarcinoma developing on chronic anal fistulas. Materials and methods: A retrospective study conducted over a 3-year period (June 2022 to May 2025), including patients with mucinous adenocarcinoma arising from an anal fistula confirmed by biopsy. Results: Four patients with a mean age of 46.8 years presented with an anal fistula with a mean disease duration of 11.3 years. MRI revealed perianal tumor masses in continuity with the fistulous tracts. Histological examination of the fistulous tracts confirmed mucinous adenocarcinoma. All patients underwent a diverting colostomy followed by neoadjuvant chemoradiotherapy. The outcome was unfavorable in two cases, with early death, highlighting the aggressive nature and poor prognosis of this disease. Conclusion: Mucinous perianal adenocarcinoma is aggressive and often diagnosed late. This condition should be suspected in cases of chronic fistula. Treatment must be multidisciplinary. 
Factors Associated with Therapeutic Non-Adherence in Type 2 Diabetes 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 non- adherence to treatment. The objective of this study was to identify the factors associated with non-adherence to treatment in patients with type 2 diabetes. Methodology. This was a descriptive, cross-sectional study of outpatients with type 2 diabetes. Sociodemographic variables, variables related to treatment adherence, and factors that could influence it were collected and analyzed. Adherence was assessed using the Morisky Medication Adherence Scale (MMAS). The results were analyzed using SPSS version 27.0.1. The dependent variable to be explained was non-adherence to treatment. For all statistical tests, the significance level (p-value) was set at 0.05. Results. The mean age was 51.09 years, with a range from 14 to 74 years. The 30-60 age group was the most represented, at 70.4%. The study population was predominantly female (63.9%), with a sex ratio of 0.56. Almost all patients were married, and 77.6% lived in urban areas. Secondary and higher education levels were the most represented, at 38% each. 55.6% of patients reported receiving family support. At the end of our study, we recorded 32.4% of patients with good adherence, 38.9% with moderate adherence, and 28.7% with non-adherence, giving us a prevalence of non-adherence (moderate adherence and non- adherence) of 67.6%. Family support and physical activity were significantly associated with poor compliance; however, neither smoking nor alcohol consumption, nor the use of traditional treatments, nor self-monitoring of blood glucose showed a statistically significant link with non-adherence to treatment. Conclusion. Therapeutic non- adherence is a problem affecting a large proportion of our included patients. The factors found to be significantly associated with poor compliance were family support and physical activity
Beyond the Low-FODMAP Diet: A Review of Emerging Nutritional Therapies for Irritable Bowel Syndrome (IBS)
No full textAs a chronic disturbance of gastrointestinal activity, Irritable Bowel Syndrome (IBS) plays a substantial role in reducing quality of life. The low- FODMAP dietary approach has emerged as a fundamental component in the therapeutic management of IBS; its restrictive nature raises concerns about long-term adherence and nutritional adequacy. This study aims to explore alternative and emerging nutritional therapies that may offer effective symptom management with improved sustainability. A qualitative literature review design was employed to systematically analyze and synthesize findings from 60 peer-reviewed articles published between 2015 and 2025. Data were collected through purposive sampling using databases such as PubMed, Scopus, and ScienceDirect, guided by inclusion criteria focused on clinical trials, cohort studies, and systematic reviews. Thematic analysis was applied to identify major trends and therapeutic mechanisms. The results highlight several promising interventions, including tailored fiber supplementation (e.g., psyllium), targeted probiotic and prebiotic regimens, elimination diets based on immunological markers, fermented food intake, and personalized nutrition strategies such as nutrigenomics. These therapies target multiple IBS pathophysiological pathways, including dysbiosis of the microbiota, immune activation, and dysfunction of the gut-brain axis. The review concludes that emerging dietary therapies offer diverse, mechanistically grounded options that may complement or surpass traditional low-FODMAP approaches in effectiveness and tolerability. To enhance the credibility and effectiveness of current strategies, upcoming research should emphasize robust randomized trials and the formulation of holistic, individualized nutritional models
Epidemiological, Etiological, Therapeutic, and Evolutionary Profile of Upper Gastrointestinal Bleeding in Adults at the Ibn Rochd University Hospital Center in Casablanca, Morocco
No full textIntroduction: Upper gastrointestinal bleeding is a frequent medical and surgical emergency, associated with significant morbidity and mortality. The etiologies of upper gastrointestinal bleeding are dominated by gastroduodenal lesions, particularly peptic ulcers, followed by esophageal varices. Upper gastrointestinal endoscopy remains the first-line examination for etiological investigation. The study has for aim to evaluate the epidemiological, etiological, therapeutic, and prognostic profile of upper gastrointestinal bleeding in adults at the Hepatogastroenterology Department of the Ibn Rochd University Hospital in Casablanca. Materials and methods: It was a retrospective study conducted on the medical records of adult patients hospitalized for upper gastrointestinal bleeding, from January 1, 2023 to December 31, 2024, who underwent endoscopic gastrointestinal exploration. Data were entered into an Excel file and analyzed using Jamovi software. Results: Out of 1,565 admissions for all conditions, 362 cases involved upper gastrointestinal bleeding (23%), of which 20.8% (n = 327) met the inclusion criteria. The mean age was 55 years (range: 16–97 years), with a male-to-female ratio of 1.59. The majority of patients, 77% (n = 252), required hospitalization for more than 72 hours. Concomitant hematemesis and melena was the most frequent reason for hospitalization, observed in 41% (n = 134) of cases. Risk factors for esophageal variceal rupture were the most common, present in 29.4% (n = 96) of patients, including cirrhosis in 23.5% (n = 77) and portal hypertension in 5.8% (n = 19). Toxic habits were reported in 22.9% (n = 75) of patients. A hemorrhagic-risk iatrogenic drug interaction was identified in 16.8% (n = 55), including the use of gastrotoxic drugs in 12.2% (n = 40) and anticoagulants in 4.6% (n = 15). Esophageal and/or gastric variceal rupture accounted for 38.5% (n = 126) of cases, and gastroduodenal ulcers for 30.3% (n = 99), making them the main etiologies. Regarding management, 61.5% (n = 201) of patients received blood transfusions, among whom 30.6% (n = 100) received more than two units of packed red blood cells. Esophageal variceal ligation was performed in 32.4% (n = 106) of patients. Outcomes were marked by cessation of bleeding in 75.2% (n = 246) of cases. Early rebleeding and in-hospital mortality rates were 9.8% (n = 32) and 5.8% (n = 19), respectively. The causes of death were mainly hepatic encephalopathy in eight cases (2.4%), hemorrhagic shock in four cases (1.2%), respiratory distress in three cases (0.9%), and underlying malignant disease in four cases (1.2%). At discharge, 73.1% (n = 239) of patients had a hemoglobin level between 7 and 10 g/Dl and Two patients were transferred to the hematology department. Furthermore, chronic kidney disease, although present in only 1.8% (n=6) of cases, is recognized as an independent risk factor for gastrointestinal bleeding. Conclusion: Upper gastrointestinal bleeding remains a frequent and severe medical–endoscopic emergency. In Casablanca, the main causes are esophageal variceal rupture and gastroduodenal ulcers, often associated with cirrhosis and the use of gastrotoxic medications, reflecting the significant burden of chronic liver diseases and drug-induced complications in our population. These findings highlight the importance of screening for liver diseases, monitoring high-risk treatments, and improving access to specialized care in order to reduce morbidity and mortality
Synchronous Endometrial and Ovarian Tumors: Diagnostic Challenges and the Role of Integrated Molecular Classification – A Case Report
No full textBackground: Synchronous endometrial and ovarian tumors (SEOC) are rare, representing approximately 3–10% of gynecologic cancers [1]. They are defined by the simultaneous occurrence of malignant tumors in both the endometrium and the ovary and constitute the most common form of synchronous gynecologic malignancies [2,3]. It’s associated with a better prognosis than metastatic forms affecting a single organ [4]. Case Presentation: We report the case of a 49-year-old nulligravid woman with a family history of colorectal cancer in a first-degree relative. She presented with chronic pelvic pain. Clinical examination was unremarkable. Pelvic ultrasound revealed endometrial thickening of 15 mm with an intracavitary lesion, a left solid-cystic adnexal mass with papillary projections, a cystic right ovary, and minimal ascites. Serum CA-125 level was elevated at 357 IU/mL. Pelvic magnetic resonance imaging confirmed a non-invasive endometrial mass and bilateral ovarian masses suspicious for malignancy, associated with moderate ascites without visible peritoneal implants. Diagnostic hysteroscopy and laparoscopy revealed an exophytic endometrial mass, an enlarged exophytic left ovary, a cystic right ovary, and ascites. Endometrial, ovarian, and peritoneal biopsies suggested a FIGO stage II endometrioid endometrial carcinoma associated with an undifferentiated ovarian carcinoma, FIGO stage IC. The patient underwent total hysterectomy with bilateral salpingo- oophorectomy, pelvic and para-aortic lymphadenectomy, omentectomy, and appendectomy. Final pathology confirmed an endometrioid carcinoma infiltrating two-thirds of the myometrium, bilateral ovarian involvement, and omental carcinomatosis, with negative lymph nodes and positive ascitic cytology (pT3c). Postoperative pathological staging was performed according to the pTNM classification, resulting in a final stage of pT3c.Four cycles of adjuvant chemotherapy were administered, with no evidence of recurrence on follow-up imaging. Conclusion: SEOC remains a diagnostic and therapeutic challenge. Accurate diagnosis requires an integrated approach combining histopathology, molecular analysis, and clinical features to guide optimal management
Ingestion of a Metallic Foreign Body in an Adult Patient with Psychosis: Case Report
Full text linkForeign body ingestion is a common gastrointestinal emergency that can lead to serious complications, including perforation, obstruction, and infection. This study reviews current management strategies for gastrointestinal foreign body ingestion, emphasizing the importance of prompt assessment and intervention. Both flexible and rigid endoscopy techniques are evaluated, with recent evidence suggesting that flexible endoscopy may be preferred due to its lower complication rates. The consequences of delayed intervention, particularly with sharp objects, are discussed, as delays can result in increased complications. A thorough clinical evaluation, including patient history and appropriate imaging studies, is essential in guiding treatment decisions. This review underscores the necessity of adhering to updated guidelines and optimizing intervention timing to improve patient outcomes in cases of foreign body ingestion. Future research should focus on refining management protocols to further reduce morbidity and mortality associated with gastrointestinal foreign body ingestion
Executive Functions and Emotional Regulation in Autism Spectrum Disorder: Clinical Implications
Full text linkCognitive neuroscience has shown that the development of emotional regulation is closely linked to several basic executive functions, such as attention control, inhibition of inappropriate behaviour and decision-making, all of which are activated in emotionally demanding situations [95,101]. Executive functions (EF) are, in fact, a fundamental element of self-regulation, defined as the ability to regulate cognition, emotions and behaviour [19,55]. In people with autism spectrum disorder (ASD), deficits in EF are frequently observed. They are related to difficulties such as theory of mind, social cognition, and repetitive and restricted behaviour patterns, which negatively affect the quality of life (Pugliese et al., 2015). Furthermore, these difficulties in EF can compromise social skills, mainly regulating behaviour in social contexts. Despite numerous studies, the role of EF in ASD is still unclear, with conflicting results due to factors such as age, functioning profile, comorbidities (e.g. ADHD) and assessment methodologies used [33].The identification of an executive dysfunction profile through neuropsychological assessment, together with targeted interventions to enhance executive functions, could not only improve the understanding of the neural mechanisms underlying ASD but also offer new opportunities to promote better emotional regulation and to improve diagnosis, assessment and clinical treatment
Edentulism Leading to Foreign Body Ingestion with Small Bowel and Bladder Perforation: A Case Report
Full text linkIntroduction: Foreign body ingestion is an uncommon but recognized cause of gastrointestinal perforation. While most cases resolve without incident, complications such as enteric fistulas and organ injuries can arise in exceptional scenarios.Case Presentation: We report the case of a 42-year-old edentulous male who presented with signs of generalized peritonitis. Clinical examination revealed abdominal rigidity, and despite a CT scan identifying a linear hyperdense object within the jejunum suggestive of a foreign body, no clear signs of perforation were seen. Urgent surgical exploration revealed a chicken bone responsible for small bowel perforation, multiple entero-enteric fistulas, and a bladder injury. The patient's edentulism and financial inability to obtain dental prostheses contributed to the accidental ingestion of the bone.Management and Outcome: A segmental resection of 1.8 meters of small bowel was performed with creation of a double-barrel ileostomy. The bladder breach was identified intraoperatively using a Betadine test and repaired in two layers with Vicryl 3/0. The patient recovered well and was discharged on postoperative day five.Conclusion: This case highlights the importance of clinical judgment over imaging, especially in emergency abdominal conditions. It also underlines the significance of addressing social determinants of health, such as edentulism and poverty, in preventing life-threatening complications. Multidisciplinary collaboration, timely surgical intervention, and intraoperative vigilance were pivotal to the favorable outcome
Exploring HIV Status Awareness, Perceived Risk, and Stigmatization in Nigerian Urban Youths
Full text linkBackground: HIV continues to pose a serious global public health threat, with young people remaining particularly at risk. Although HIV testing is essential for effective prevention, treatment, and care—as well as for combating stigma and discrimination—testing uptake among youths remains suboptimal. This study aimed to assess HIV status awareness, perceived risk, and attitudes toward stigmatization among youths in an urban area of Rivers State, Nigeria.Methods: A cross-sectional survey was conducted among 291 youths aged 15 to 24 years, selected through a multistage sampling approach in an urban local government area of Rivers State. Data were analysed using SPSS version 27.Results: Of the respondents, 184 (63.2%) were aged 15–19 years, and 171 (58.8%) were male. Over half (159; 54.6%) had never undergone HIV testing and were unaware of their status. Only 87 (29.9%) considered themselves at risk of HIV infection, and 59 (20.3%) believed they were at high risk. Stigmatizing attitudes were prevalent, with 250 (85.9%) expressing negative views toward people living with HIV/AIDS. Additionally, 145 (49.8%) felt that such individuals should have some restrictions on their freedom, while 124 (43.1%) were unwilling to maintain friendships with someone living with AIDS. No statistically significant association was found between socio-demographic variables and stigmatizing attitudes (p ≥ 0.05).Conclusion: HIV testing rates and awareness of HIV status among youths in this community remain inadequate. A considerable proportion perceive themselves to be at risk of infection, while stigmatizing attitudes toward individuals living with HIV/AIDS are alarmingly high. There is a pressing need for targeted interventions—such as health education and awareness campaigns—to encourage safer sexual practices, promote routine HIV testing, and address stigma