European Journal of Medical and Health Sciences

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EISSN : 2593-8339
Published by: Europa Publishing (10.24018)
Total articles ≅ 617
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Pravakar Tripathy, Mahesh Chand Bansal, Rahul Upadhyay
European Journal of Medical and Health Sciences, Volume 4, pp 1-3; https://doi.org/10.24018/ejmed.2022.4.1.971

Abstract:
Introduction: Giant cell tumor (GCT) is a distinctive lesion characterized by the proliferation of multinucleate giant cells in a stroma of mononuclear cells; it is generally seen in skeletally mature individuals. GCT is usually found in the long bones around the knee or in the distal radius but distal end of tibia, proximal humerus, vertebrae of young adults are unusual location. We report a case of GCT of the distal end of tibia, with a secondary aneurysmal bone cyst, in a 26-year-old female. Based on our review of the medical literature, it appears that the occurrence of a GCT along with a secondary aneurysmal bone cyst (ABC) in distal end of tibia is less typical with challenging task for full tumor resection and restoration of ankle function to normal. Case Summary: 26 year old female presented with pain&swelling over left ankle since last six month. Biopsy was suggestive of GCT with ABC of lower third tibia. We managed this case with intralesional curettage using phenol and burr and bone graft harvested from left iliac crest for reconstruction of defect along with kwire fixation to achieve optimum anatomical restoration. Conclusion: In cases of GCT, the management depends upon the various factors such as site, age, involvement of the bone, extent of bone involvement and whether there is articular involvement or not. Here Intra-articular GCT is managed with extended intralesional curettage with phenol. Bone graft plays a role of agent for reconstruction of the defect and kwire for anatomical reduction.
Sheikh Saiful Islam, Jannatul Ferdous, Ashraful Hoque, Atiar Rahman
European Journal of Medical and Health Sciences, Volume 4, pp 11-13; https://doi.org/10.24018/ejmed.2022.4.1.937

Abstract:
Background: Therapeutic plasma exchange (TPE) has been used as one of the treatment modalities of neurological diseases. Intravenous Immunoglobulin (IVIG) and Therapeutic Plasma Exchange (TPE)are treatment options in Guillain Barre syndrome (GBS). In developing countries IVIG is not easily available and it is also expensive, TPE is preferred for treatment of GBS as it is affordable. Study on TPE for GBS are scarce here. Most of the study regarding TPE in GBS has been conducted in high –income countries as it is expensive treatment modality. Reports on TPE in GBS is very scared from Bangladesh. Materials and Methods: A retrospective analysis of TPE with a standard hemolysis equipment for the treatment of Guillain Barre syndrome (GBS) was conducted A 50 patients of GBS who received TPE conducted between January 2017 to December 2018 in the department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh were analyzed. All patients had underdone at least 2 cycles of plasma exchange. Volume exchanged in each cycle was one plasma volume. Results: Out of 50 cases there were 43 (86%) male and 7 (14%) female. Age range of patients was from 11 – 50 years. Approximately 40% improved clinically of first cycle of PE & 85% after second cycle, 95% after third cycle and 95-100% after 5 cycle. 1(2%) patient died, and 49(98%) patients survived and recovered. Conclusion: The treatment is cost affection in Compassion to IVIG. TPE is and affection, safe and affordable treatment modality for GBS.
Hatice Kilic, Habibe Hezer, Berker Ozturk, Muhammed Sait Besler, Huseyin Cetin, Hatice Canan Hasanoglu, Aysegul Karalezli
European Journal of Medical and Health Sciences, Volume 4, pp 1-4; https://doi.org/10.24018/ejmed.2022.4.1.910

Abstract:
Purpose: Chest radiography is normal in approximately 20-40% of acute pulmonary embolism (PE) patients without cardiopulmonary disease. The aim of this study was to determine whether there is any difference between the patients with normal chest X-ray and those with pathological findings in terms of clinical severity and prognosis. Methods: 178 of PE patients were included in the study. 110 patients had no parenchymal pathology, whereas group 1 (n = 110); group 2 (n = 68) had various pathological parenchymal findings in 68 patients. Clinical and radiological parameters were compared between these groups. Following the diagnosis of PE, the cases were recorded in the fifth year. Results: In 178 participants; those with normal chest X-ray (group 1), with parenchymal pathological findings on the chest X-ray (group 2); echocardiographic systolic pulmonary artery pressure (sPAP) (p = 0.68), gender (p = 0.9) and thrombus type (p = 0.41) were similar. The patients in group 1 were not different in terms of central thrombus detected in computed tomography pulmonary angiogram compared to the patients in group 2; however, the chest radiograph of the patients in group 1 had no parenchymal pathology. Central thrombus group 1, group 2, respectively; 97 (89.0%), 53 (77.9%), p = 0.07. There was no significant difference between the two groups in terms of mortality which was followed up in fifth year (p > 0.05). Conclusions: Normal chest X-ray in PE can determine mortality and may involve increased risk of massive PE.
David Nandebe Wafula, Bernard Wesonga, Maximilla Wanzala, Nathan Shaviya, Rose A. M. Nyang’Au
European Journal of Medical and Health Sciences, Volume 4, pp 5-10; https://doi.org/10.24018/ejmed.2022.4.1.1170

Abstract:
Despite diagnosis being an important part of clinical or medical consultations, the diagnosis might fail leading to adverse effects. This is a global problem, where developed and developing countries go through. In sub-Saharan Africa, variations between initial diagnosis and final diagnosis lead to diagnostic errors with high maternal mortalities. In Kenya, a lot of measures have been put in place but still, variation in diagnosis appear to have become rampant. Bungoma county is one of the counties with a high mortality ratio, especially for pregnant women attributed to the variation between initial and final diagnosis. Therefore, it was crucial to investigate the variation between initial and final diagnosis in relation to obstetric outcomes at hospitals in Bungoma County. The cross-sectional research design was used (Bungoma and Webuye hospitals). Systematic sampling was used to obtain 384 respondents after proportionate allocation to each hospital, and purposive sampling to select 8 health care workers as key informants. Data was collected using a structured questionnaire and an interview guide. The pre-test was done with validity established through crosschecking and reliability calculated using the Cronbach method (0.89). Using a statistical package for social sciences version 25, descriptive and inferential statistics was run where chi-square and odds ratio was used to determine the influence between variables, significance and prediction. The study revealed a variation between initial diagnosis and the final diagnosis was 20.8% while diagnostic errors were significant predictors of obstetric outcomes among post-natal mothers at level five with a p-value of 0.045 at a significance of 5%(P=0.045). Demographic characteristics showed no relationship with obstetric outcomes (P=0.54>0.05). Matched diagnostic had no variations (N=327, M=1.00, SD=0.000); while unmatched diagnostic had variations (N=327, M=1.82, SD=.384). There was a relationship between diagnostic errors and obstetric outcome (ꭓ2 (1) = 251.86, p< .001). An association between diagnostic error with unsafe obstetric outcomes was significant at the odds ratio of 2.03(OR 2.03, 95% CI 1.31–2.16). The study demonstrates that a correct diagnosis is a viable strategy in preventing unsafe obstetric outcomes and by extension minimizing morbidity and mortality among pregnant women. The study concluded that there was a variation between initial diagnosis and final diagnosis which had an adverse obstetric outcome. it was recommended to build capacities for the health workers in order to address increased diagnostic errors.
Sana Abbas, Beenish Abbas, Haifsa Rafique, Aisha Rafique, Saima Zafar, Ramesha Azam
European Journal of Medical and Health Sciences, Volume 3, pp 39-43; https://doi.org/10.24018/ejmed.2021.3.6.1096

Abstract:
Objective: To determine the prevalence of Long Haul COVID–19 Syndrome among Pakistani Population. Methods: This cross-sectional analytical study was conducted after approval from the ethical review committee of the Foundation University College of Dentistry, Islamabad from June 2021 to September 2021. A non-probability consecutive sampling methodology was employed and a total of (168) participants after voluntary consent were enrolled in the study, after explaining the study protocol to the patients. The final Questionnaire is comprised of three sections. Section – I focused on the demographic profile (Age, Gender, Profession) of the participants. Section – II was designed to investigate COVID – 19 disease history, comorbid, coronavirus disease severity along with the number of individuals infected in the family, duration of positive polymerase chain reaction results, and management destination (Hospital or Home). Section – III addressed the frequency of persistent symptoms (Gastrointestinal, Systemic, Cardiovascular, Musculoskeletal, Immunological, Dermatological, Neuropsychiatric, Ophthalmological, Pulmonary, Otorhinolaryngological, Endocrine, Reproductive and Genitourinary systems). Results: 168 responders participated in this survey study,48 (28.6%) males while 120 (71.4%) females. About 36 (11.9%) were found to be suffering from comorbidity, 84 (50.0%) suffered from mild disease symptoms, while only 4 (2.4%) experienced the severe disease. The disease was managed at home for a major chunk of responders, 140 (83.3%).132 (78.6%) were found to have suffered from long COVID syndrome with the persistence of symptoms beyond four weeks of infection. The most common symptoms included fatigue (78.8%), fever (60.0%), loss of taste (57.8%), dry cough (45.5%), headache (42.4%), post-exertional malaise (45.5%), shortness of breath (39.4%), insomnia (39.0%), loss of smell (36.4%), loss of appetite (33.3%) and depression (33.3%).Male gender (p=0.009), with existing chronic illnesses (p<0.001), moderate and severe disease (p<0.001), higher age group (p<0.001) and isolated at hospital (p=0.002). Conclusion: In conclusion, this study has shown that persistence of COVID disease symptoms (most common symptoms included fatigue, fever, loss of taste, dry cough, headache, post-exertional malaise, shortness of breath, insomnia, loss of smell, loss of appetite, and depression) are common in Pakistani population. Male gender, existing chronic illnesses, moderate and severe disease, higher age group, and isolation at the hospital are the probable risk factors.
Hendro Sudjono Yuwono
European Journal of Medical and Health Sciences, Volume 3, pp 4-7; https://doi.org/10.24018/ejmed.2021.3.6.1077

Abstract:
The coffee powder has inherent capabilities as an antioxidant, anti-inflammatory, and antimicrobial. It is a topical wound dressing for acute and chronic wounds, encouraging results different from the wound dressing known today. It is named the new paradigm of wound management. The study of coffee powder since 2003 as a topical wound dressing has created an understanding condemn to disturb the cells in the wound bed. A thin layer of coffee powder should stay in place to ensure safety, covering superficial wound cells’ growth. The remained thin layer of coffee powder has created minimum detached wound cells. Wound healing provides effectiveness for acute and chronic wounds resulted in low cost, easy to get, acceptable scar, non-traumatic, pleasant scent, and not scary to the patients. The utilization of antioxidant, anti-inflammatory, and antibacterial capacities anticipates the injury of the new growth of epithelial cells at the wound bed. It makes better cell proliferation, proper scar formation and safe naturally. Its simplicity in wound management procedures helps improve public health efforts. Hence, it suggested that the coffee powder has the capabilities of the best topical wound dressing.
Sana Abbas, Beenish Abbas, Ayesha Maqsood, Syeda Rabia, Ramesha Azam, Hina Ishaq
European Journal of Medical and Health Sciences, Volume 3, pp 24-27; https://doi.org/10.24018/ejmed.2021.3.6.1106

Abstract:
Objectives: To gauge/evaluate the knowledge and skill of BLS trained and untrained teaching faculty members at postgraduate tertiary care training institute Materials and Methods: A prevalidated questionnaire comprising of 44 questions was distributed among teaching faculty of three big tertiary care, post-graduate institutes. The questions were focused on evaluating the knowledge and awareness of the participants. Total number of the participants was 345 Statistical Analysis: Data was entered and analyzed by using SPSS (version 23.0). Results: The mean knowledge score related to basic life support was 4.57±1.81 out of total 12 points and the mean score for level of awareness regarding BLS was 34.5 %. Moreover, only 28.15% were aware of the current AHA guidelines Conclusion: The low level of knowledge and awareness regarding BLS in the health care workers depicts that regular BLS hands-on- workshops should be conducted and should be a part of mandatory training.
Zameer Shervani, Deepali Bhardwaj, Abdullah Sherwani, Intazam Khan, Umair Yaqub Qazi
European Journal of Medical and Health Sciences, Volume 3, pp 1-5; https://doi.org/10.24018/ejmed.2021.3.6.985

Abstract:
The seroprevalence in the population of 8 big cities (Ahmedabad, Jaipur, Bangalore, Pune, Coimbatore, Surat, Visakhapatnam, and Nagpur) of India and the dynamics of the COVID-19 spread have been compared. The seropositivity data are of the self-referred residents only. The research is useful to know if the seroprevalence that occurred in the population has decreased the surge in infection in the second wave of the pandemic. The seroprevalence data are for the period July-December 2020 while the monthly new infections have been studied for July 2020-June 2021. For the cities: Visakhapatnam, Nagpur, Surat, Pune, and Coimbatore, the seropositivity of the population reached a plateau and then decreased. A decrease in seroprevalence did not result in higher infection rates. The seropositivity of Jaipur, Ahmedabad, and Bangalore showed a monotonous increase. A relationship between the plateau values of seroprevalence and infection rates could be established. More seroprevalence resulted in lower infection rates in cities (Bangalore, Visakhapatnam, Jaipur) and (Surat, Coimbatore, Pune) in the second wave of COVID-19 pandemic. The investigation of seroprevalence in the population will help in ramping up vaccination to eradicate the pandemic.
Rafael Rubio
European Journal of Medical and Health Sciences, Volume 3, pp 8-16; https://doi.org/10.24018/ejmed.2021.3.6.1070

Abstract:
In 1849, the first list of endocrine hormones was discovered and proposed that the synthesizing gland delivers it to the circulation. The circulatory hormone reaches the target organ, physically unimpeded acts directly on the parenchymal cells. Such a simplistic view persists despite new knowledge of an endothelial wall barrier and implications for every parenchymal cell in the body. This misconception leads to inadequate interpretations of data, wrong diagnosis and therapeutic expectations, erroneous hypotheses, and misleads further research work. The quest of this review is to play down this misconception by pointing out key overlooked findings of the vascular endothelial wall: 1) The selective endothelial barrier physically separates two same-hormone-containing compartments; the endocrine and the interstitial autocrine hormone compartments, 2) the hormone concentrations values in these compartments are independent of each other, 3) in each compartment the hormone acts solely on the receptors of that particular compartment, 4) multiple intravascular endocrine hormones act solely on their corresponding luminal endothelial membrane receptor (LEMR), without directly acting on the parenchymal cells, 5) Agonist-activation of LEMR triggers the release of specific paracrine endothelial agents that in conjunction with autocrine interstitial hormone modulate parenchymal function(s) and perhaps the turnover of the interstitial autocrine hormone, 6) these hormone compartments, functionally interact via paracrine exchange signaling, and the integrated intercourse of all these events result in the final hormonal organ effect. The present challenges to achieving more rationale therapeutic effects are to design agonists or antagonists that exclusively gain access to a target compartment and have high specificity for the receptor of the cells in that compartment.
Hassan Naji
European Journal of Medical and Health Sciences, Volume 3, pp 56-58; https://doi.org/10.24018/ejmed.2021.3.6.1162

Abstract:
Several variants of concern (VOCs) of SARS-CoV-2 have emerged after its first outbreak in 2020. These VOCs possess mutations in the spike protein that confers enhanced rate of infection and transmission of these VOCs. Among these VOCs, the delta/B.1.617.2 variant was identified in late 2020 in India and soon spread to several countries around the globe. Currently, it is the most widely sequenced variant among new infected individuals with SARS-CoV-2 infection. This variant is also found to be associated with COVID-19 infection in vaccinated individuals, but the severity of disease and rate of hospitalization are low among these individuals as compared to unvaccinated individuals. With the emergence of new variants of SARS-CoV-2 due to continuous mutations, it is suggested that vaccination plays a significant role in preventing the transmission of disease and disease severity.
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