Latest Articles
Original Research Article
Exploring Factors Influencing Cancer Patients' Understanding of Diagnosis, Prognosis, and Emotional Well-being under Palliative Care: A Cross-sectional Investigation
Dr. Sabikun Naher Urmy, Dr. Shah Noor Sharmin, Dr. Rahat Noor, Md. Shaidur Rahman, Dr. Mossa. Nupur Aktar, Fahmida Sultana, Dr. Kazi Sanzida Haque, Dr. Rakiba Sultana
EAS J Med Surg, 2024; 6(3): 99-104
DOI: 10.36349/easjms.2024.v06i03.004
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22 Downloads | March 15, 2024
ABSTRACT
Introduction: The demographic characteristics of cancer patients correlate with their awareness of diagnosis, prognosis, and the psychological distress associated with their condition. Objectives: The purpose of this study was to evaluate patients' knowledge of psychological distress, diagnosis, and prognosis who were presenting to the palliative medicine department of a tertiary hospital in Bangladesh. Methodology: This cross‐sectional study was conducted among 377 patients living with cancer attending the Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Bangladesh from November 2021 and March 2022. Information on the clinical and sociodemographic aspects was gathered through a structured questionnaire and in-person interview, and the degree of distress was measured using a distress thermometer. After information was gathered, descriptive statistics were used to analyze it. Result: Approximately 16.2% of patients were unaware of their diagnosis, with two-thirds (68%) lacking awareness of prognosis. Over half (54.1%) reported significant distress. Gender, education, employment status, and head-and-neck cancer diagnosis were linked to diagnosis awareness, while educational level predicted prognosis awareness. Younger age, head-and-neck or hematological cancer diagnosis and lack of awareness regarding diagnosis and prognosis were associated with distress. Conclusions: Higher education and socioeconomic status correlate with patients' awareness of diagnosis and prognosis. However, distress remains higher among those unaware of prognosis.
Original Research Article
Obstetric Evacuations Received At the "Major Moussa Diakite" Referral Health Centre in Kati, Republic of Mali
Traoré Mamadou Salia, Camara Daouda, Sylla Yacouba, Sidibé Abdoulaye, Sima Mamadou, Ouologem Aly Daouda, Samaké Bintou, Saye Amaguiré, Diarra Dessé, Diarra Sirama, Koné Diakaridia, Koné Bocary Sidi, B
EAS J Med Surg, 2024; 6(3): 92-98
DOI: 10.36349/easjms.2024.v06i03.003
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14 Downloads | March 14, 2024
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The organisation of the evacuation referral system is an important strategy for reducing maternal and perinatal mortality in Mali. Objective: To study obstetric evacuations received in the gynaecology and obstetrics department of the "Major Moussa DIAKITE" referral health centre in Kati. Method: We conducted a cross-sectional, descriptive and analytical study. Data were collected retrospectively and prospectively over a 12-month period (from 1 January to 31 December 2020). Sampling was exhaustive and included all cases of obstetric evacuation received and managed on site during the study period. Results: Out of a total of 3050 deliveries, we received and managed 352 cases of obstetric evacuation, representing a frequency of 11.5%. The average age of the patients was 25 years, with extremes of 15 and 44 years, although the 20-34 age group was dominant, accounting for 73.6% of cases. The majority of evacuees were housewives (86.4%), married (92%), nulliparous and primiparous (52%). Dystocic labour was the most common reason for evacuation (51.1%), followed by ante-partum haemorrhage (13.4%). Nearly nine out of ten women evacuated came from Community Health Centres (89.8%) and the most common means of evacuation was by ambulance (52.1%). The average time from admission to the start of care was 26.5 minutes, with extremes of 3 and 50 minutes. Delivery by the vaginal route was carried out in almost eight out of ten cases (79%). Newborns were resuscitated alive (7.9%); stillbirths were fresh (3.7%) and stillbirths were macerated (06%). We recorded 2 cases of maternal death (0.6%) and the causes of maternal death were haemorrhage due to uterine rupture and eclampsia. Conclusion: The improved organisation of the evacuation referral system in our facility has improved the maternal and, above all, foetal prognosis of obstetric evacuations, but more needs to be done.
Case Series
Congenital Eversion of the Upper Eyelid: Conservative Treatment Approach at Sominé Dolo Hospital in Mopti
Bamanta, I, Tal, A, Keïta, F, Diallo, M, Fomba, S, Touré, M, Sylla, F, Théra, J, Traoré, L
EAS J Med Surg, 2024; 6(3): 88-91
DOI: 10.36349/easjms.2024.v06i03.002
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21 Downloads | March 9, 2024
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Congenital eversion of the eyelid is defined as an externalization of the palpebral conjunctiva, most often seen at birth but can also be revealed late. It can be unilateral or bilateral and is a rare condition that can be associated with other anomalies or malformative syndromes. We present our experience in the management of three cases according to conservative treatment. Two isolated cases, one uni and the other bilateral, and one bilateral case associated with ichthyosis. Our three patients benefited from conservative treatment with application of Rifamycin antibiotic ointment and pressure dressing every 24 hours without puncture of the chemosis with a needle until resorption of the chemosis. Conservative treatment is an effective alternative and early management is a guarantee of success.
Original Research Article
Insights into Placental Pathology: Analyzing Patterns and Fetal Outcomes in 205 Livebirths at Bugando Medical Centre, Mwanza, Tanzania
Ndulila Hadali, Dismas Matovelo, Richard Kiritta, Oscar Ottoman, Cosmas Mbulwa, Adolfine Hokororo, Edgar Ndaboine
EAS J Med Surg, 2024; 6(3): 80-87
DOI: 10.36349/easjms.2024.v06i03.001
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34 Downloads | March 6, 2024
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Background: The placenta facilitates vital nutrient exchange between fetus and mother, offering insights into fetal and maternal health. Despite its significance, research on placental histopathology in Tanzania is scarce. This study investigates placental features, maternal factors, and their impact on fetal outcomes at Bugando Medical Centre from January to May 2022. Methods: This 5-month cohort study included 205 mothers delivering at BMC. Fetal outcomes were evaluated at birth and after seven days, with maternal characteristics recorded at delivery. Participants were from the twenty-eighth week of gestation, excluding those with intrauterine fetal death or multiple pregnancies. Data on placental histology, maternal factors, and fetal outcomes were collected systematically, while statistical analysis employed STATA version 15, utilizing descriptive statistics. Results: In this study of 205 placentas, participants had a median age of 29 years and a mean gestational age of 38 weeks. Histopathological patterns were present in 61% of placentas, with acute inflammation (22%) and maternal vascular malperfusion (20.8%) being most common. Favorable outcomes were observed in 81% of newborns, while 19% experienced poor outcomes, including 1.9% early neonatal deaths. Most placental lesions were mild (53.6%), with severe pathology in 2.9% of cases. Acute inflammation correlated with various admission reasons, especially neonatal sepsis (60%). Maternal vascular lesions were associated with prematurity (63.6%) and birth asphyxia (40%). Chronic inflammation was more prevalent among low-birth-weight infants (18.8%), while very low birth weight was common in cases of maternal vascular lesions (68.8%). Conclusion: The majority of placentas showed normal or mild pathology, associated with positive fetal outcomes. Further research is needed to understand placental changes and their impact on maternal-fetal health.
Original Research Article
ABSTRACT
Introduction: Transverse fractures of the sacrum are rare and constitute less than 1% of all vertebral fractures. While the majority is longitudinal, only 3 to 5% are transverse fractures. Transverse fractures are usually seen following a fall by high-energy trauma, hence the name “Suicidal jumper’s fractures”. Neurological deficits involving the sacral roots are common and have been reported at rates of 96% to 100% in the literature. Material and Methods: We describe two uncommon cases of fracture-dislocation of the sacrum, the first at the S2-S3 level and the second at the S1-S2 level treated by isolated laminectomy without internal fixation with cauda equina syndrome, during the year 2020 in our department, including a review of the literature on the treatment of this type of fracture. Result: Our two patients on neurologically recovered at 7 months post laminectomy. Conclusion: Isolated decompression can be considered for patients who present a stable sacrum with non-displaced fracture or an old fracture that shows fracture healing. Favorable pelvic outcomes and neurological recovery, along with acceptable stability, can be acquired.
Original Research Article
ABSTRACT
Acute ischemia is a vascular emergency that involves the functional and sometimes vital prognosis of the patient, it can have several etiologies including infective endocarditis. We discussed an acute ischemia of the left lower limb secondary to infective endocarditis in a 17-year-old patient.
Original Research Article
Low Birth Weight in the Gynecology-Obstetrics Department of the Commune I Reference Health Center in the District of Bamako
Soumaré Modibo, Sylla Yacouba, Coulibaly Ouazoun, Keita Mahamadou, Diarra Issaka, Camara Daouda, Dicko Modibo, Diarra Salif , Sanogo Modibo, Koné Diakaridia, Keita Bakary, Koné Bocary Sidi, Coulibaly
EAS J Med Surg, 2024; 6(2): 75-79
DOI: 10.36349/easjms.2024.v06i02.013
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42 Downloads | Feb. 24, 2024
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Low birth weight is an important public health indicator because of the strong association between birth weight and infant mortality and morbidity. The objectives were to determine the frequency of low birth weight, to describe the sociodemographic characteristics, to determine the risk factors associated with low birth weight and to determine the neonatal prognosis in the gynaecology and obstetrics department of the reference health center in Commune I of the Bamako district. Material and Methods: This was a cross-sectional, descriptive and analytical study in the department from 31 December 2020 to 30 June 2022. We carried out exhaustive sampling, taking into account all live newborns with a low birth weight. All newborns born in the department weighing between 500g and 2499g during the study period were included. Results: We recorded 4,292 births, 180 of which were low birth weight, giving an overall incidence rate of 4.2%. Of the 180 low birth weight babies, we found 111 cases of prematurity (61.7%) and 69 cases of hypotrophy (38.3%). We found that the proportion of low birth weight babies was higher in the young mothers in our study, at 60.5% for the under-19 age group. Our study showed that the extreme ages of the mother were a factor favouring or even predisposing to the occurrence of low birth weight. We noted a high frequency of primiparous women (38.7%) followed by multiparous women (32.5%). Other maternal risk factors included hypertension (8%) and a body mass index of less than 18.5% kg/m2 in 41.2% of cases. Half of the new borns (47.8%) weighed between [1501-2000g]. Among the transferred newborns, 53.3% received kangaroo mother care and 6.8% of the newborns died during the first thirty days of life. We recorded a mortality rate of 6.8%. Conclusion: Low birth weight is a public health problem because of its high prevalence and its harmful consequences, especially for infants.