European Journal of Medical and Health Sciences

Semaglutide-induced Subclinical Hypothyroidism: A Case Report

2023-05-27T09:56:06-04:00

Introduction/Background: Drug-induced hypothyroidism is well established in the literature. I describe the first case of symptomatic subclinical hypothyroidism (SCH) in a thyroidectomy woman with diabetes mellitus 2 receiving therapy with per os levothyroxine and sc semaglutide (Ozempic).

Case Presentation: A 37-year-old overweight and thyroidectomy woman with diabetes mellitus 2 was admitted to our hospital with complaints of increasing fatigue, weakness and shortness of breath. She received levothyroxine (150 μcg per day), sc semaglutide (1 mg per week the last six months), and rosuvastatin (20 mg per day). A detailed clinical examination and laboratory tests revealed, among others, an elevated TSH serum level (92-98 mIU/L) with normal serum FT3 and FT4 levels on first and next measurements. Based on the possible diagnosis of semaglutide-induced SCH, semaglutide was withdrawn. Thyroid dysfunction was restored (serum TSH: 1.8 mIU/L) after two months with a significant improvement in symptoms.

Conclusion: An influence of sc semaglutide on thyroid function is possible. Thyroid function tests are suggested in patients receiving both per os levothyroxine and sc semaglutide.

Ocrelizumab-induced Psoriasis in A Patient with Relapsing-Remitting Multiple Sclerosis

2023-05-02T09:53:43-04:00

Background: Ocrelizumab is widely used as a Disease Modifying Drug (DMD) in Multiple sclerosis. The complete side effects are yet not known.

Materials and Methods: We describe a 34-year-old female with longstanding relapsing-remitting Multiple Sclerosis for whom Ocrelizumab was started as an escalation therapy. She reported severe itchy and patchy lesions two months after the first full dose of Ocrelizumab. Pathohistological findings revealed the diagnosis of guttate psoriasis. Psoriasis continued to flare against treatment with topical steroids, and UV therapy and progressed to developed arthritis psoriasis.

Results: Treatment escalated to an IL-17 antagonist (Secukinumab), with a favorable outcome. Ocrelizumab was discontinued. After one year of follow-up, the patient remained stable from an MS standpoint.

Conclusion: This is the third report showing the possible cutaneous side effect of Ocrelizumab.

Acute Abdominal Pain Caused by Hemorrhagic Corpus Lutheum in Reproductive-Aged Women: A Case Series

2023-05-17T09:55:29-04:00

Hemorrhage of corpus luteum is a rare condition in women of reproductive age. It is possible for a woman's corpus luteum to have asymptomatic hemorrhaging as a result of blood vessel penetration through the wall of the corpus luteum during the second half of her menstrual cycle. There have been very few occurrences of it growing to be too large and then rupturing. Those who suffer from polycystic ovarian syndrome (PCOS) are at risk for developing this condition. Polycystic ovarian syndrome is characterized by an inflammation of the body's hormonal function, which results in the development of larger ovaries that also include a number of small follicular cysts. The development of cysts on the ovaries, which contribute to the appearance of larger ovaries, is brought on by an abundance of androgen hormones in the body. In a minority of cases, this enlargement also has the potential to rupture, which is an additional concern. The predominant symptom that presented clinically was sharp pain in the lower abdomen. Because to the fact that HCL may present similarly to other conditions, diagnosis might be difficult. We present and discuss three cases of young female patients who presented with acute abdominal pain, large-volume of hemoperitoneum, and anemia. Laparoscopic examination in each case showed a hemorrhagic corpus luteal cyst.

Determinants of Antenatal Consultation in The Health Districts of Kolda and Sédhiou (Senegal)

2023-05-27T09:56:20-04:00

Introduction: The ANC plays an important role in monitoring the health status of the fetus but also in the monitoring of the mother, by allowing the tracking of several conditions. It makes it possible to retain the woman with the health structure, thus promoting childbirth in ideal conditions. The objective of this study was to identify the determinants of ANC in the Kolda and Sédhiou regions.

Method: It was a descriptive and analytical cross-sectional survey. The study focused on women who gave birth between February 2013 and January 2014. Sampling was two-stage random. The data collected during an individual interview focused on the socio-demographic characteristics, knowledge and practices of the women surveyed. The data was analyzed using the R software.

Results: A total of 1216 women were surveyed. The results of the study show that 62.3% had no level of education, 48% had no IGA, 57.6% were within 5 km of a health facility and 44.1% were multiparous. Participation in awareness-raising activities involved 53% of women. The percentage of women who had completed their ANC was 24% while 34% had completed ANC₁ on time. The results of the multivariate analysis showed that timely ANC₁ practice was related to proximity to the health facility (1.7 [1.31-2.2)], simple multiparity (1.46 [1.14-1.89]) and participation in the awareness programme (1.4 [1.08-1.81]). Completion of all ANCs was associated with schooling (79 [1.34-2.39]), knowledge of the number and importance of ANC and the fact that the woman lived within 15 minutes of the structure (1.52 [1.14-2.04]).

Conclusion: The results of the study show that the useof reproductive health services for ANC was linked to environmental, economic, cultural and structural factors. Improving the accessibility of these services requires joint actions by the government, NGOs, community actors and the involvement of the population.

Comparison between Figo and Nichd Criteria in Assessing Fetal Heart Rate

2023-05-17T09:55:59-04:00

Assessing the fetal heart rate (FHR) is one of the most important aspects of antenatal care and delivery. Fetal heart rate is one indicator of fetal well-being. Assessing FHR can be done by auscultation or by using a cardiotocography (KTG) device, also known as an Electronic Fetal Monitor (EFM). In interpreting the results of the cardiotocography examination, there are two criteria used to interpret the condition of the fetus, namely the criteria issued by the International Federation of Gynecology and Obstetrics (FIGO) and the National Institute of Child Health and Human Development (NICHD).

Differences in Carrying Angle, Baumann’s Angle, Anterior Humeral Line and Dash Score between Children in the Age Group of Less than 5 Years and over 5 Years at 3 Months Post Open Reduction Internal Fixation Criss-Cross Wire Fracture Supracondylar Humerus Gartland Type III

2023-05-17T09:55:12-04:00

Introduction: Supracondylar humerus fracture is one of the most found fractures in children. In addition to adequate fixation, the role of age differences in the clinical outcomes of operative treatment of supracondylar humeral fractures is still a matter of debate. This study aimed to compare the clinical and radiological outcome of surgery in cases of Gartland type III supracondylar humerus fracture.

Materials and Methods: This study used a cross-sectional design on the population of patient with Gartland type III supracondylar fracture. Patients were divided into 2 groups: age <5 years old (Group 1) and >5 years old (Group 2). The evaluation was carried out 3 months after surgery with open reduction internal fixation crisscross wire. The parameters assessed were Baumann’s angle, carrying angle, and anterior humeral line, and Disabilities of the Arm, Shoulder, and Hand (DASH) Score. Difference between group were analyzed using the chi-square test.

Results: There were a total of 34 patients included in this study. Patients >5 years old had a 1.85 times greater chance to have a post-operative carrying angle of >15^o (95% CI 0.993-3.474; p = 0.037) and 2.75 times greater chance to result in post-operative Baumann’s angle >80^o (95% CI 1,089-6,943, p=0.037). There were no significant differences in anterior humeral line (p=1) and DASH score (p=0.244) between groups.

Conclusion: The result of surgery in supracondylar fracture of the humerus over 5 years old tend to have worse radiological outcome (carrying angle and Baumann’s angle) than patient younger than 5 years old. Thus, treatment of supracondylar fractures of the humerus aged more than 5 years requires more attention with adequate reduction and vigilance against complications that can affect the bone growth of pediatric patients.

Intravesical Prostatic Protrusion as A Predictor of Need for Surgical Therapy in Benign Prostatic Hyperplasia Patients

2023-05-18T09:55:11-04:00

Intravesical prostatic protrusion (IPP) can predict disease progression and development of complications in benign prostatic hyperplasia (BPH). The aim was to determine if IPP at initial evaluation can predict need for surgical therapy in BPH patients. A retrospective study of BPH patients at ESUT Teaching Hospital, Enugu. Patients were involved in a previous prospective study in which they had abdominal ultrasonography measurement of IPP and prostate volume (TPV). IPP was measured in millimeter and divided into < 10 mm and ≥ 10 mm. The clinicians were blinded about the patients’ IPP while making decision for therapy. After at least a 24-month follow up period, biodata, IPP, TPV, IPSS and therapy given/recommended were retrieved and analyzed. The odds ratio of having/awaiting surgery at IPP cut-off of 10 millimeters was calculated. P < 0.05 was considered significant. One hundred patients’ records were reviewed. Forty-four patients (44%) were still on medical therapy, 20 (20%) were awaiting surgery and 36 (36%) had prostatectomy. Eight (19.05%) of 42 patients with IPP < 10 mm had or were recommended for surgical therapy while 48 (82.76%) of 58 patients with IPP ≥ 10 mm had or were recommended for surgical therapy (p=0.000). There was a statistically significant odd for surgical therapy when IPP at initial evaluation was ≥ 10mm (OR=20.40, 95% CI [7.30,57.04]). IPP at initial evaluation ≥ 10 mm is a significant predictor of needing surgical therapy in BPH patients.

COVID-19 Vaccination Uptake in Kenya

2023-05-05T09:54:20-04:00

SARS-CoV-2 virus is the major cause of viral disease, COVID-19 which is highly infectious, WHO did its roll out for coordination, policy and technical guidance. About 64.5% of the population globally have had one dose of COVID-19 vaccine. Close to vaccines have been administered with 18.3 million daily. In low middle Countries, approximately 14.5% have received atleast a single dose. A number of researches have come up with vaccines to curb COVID-19 disease. A researches conducted among the exposed people -60 years and above, who are frontline workers, health care workers, persons with comorbidities. Different researches have been carried out in different cities like Quantitative data presented descriptively and qualitative, thematically. A number of factors dictated the willingness to take up the vaccine, these included confidence in the vaccine, more than personal factors of participants. The respondents revealed mistrust from most people both in developed and non-developed countries, believe in God’s protection and ignorance in vaccine development. On the other hand, peer pressure and effectiveness of the vaccination programmes among childhood diseases contributed to low uptake of the vaccine.

Conclusion: attention ought to be given to factors promoting vaccine uptake and misconceptions should be expelled concerning the disease.

Recommendations: Strengthen disease surveillance at all stages and regularly updating of COVID-19 data to national level by vaccinating counties, Counties are required to increase researches on more about the disease, use COVID-19 data for decision making in terms of curbing the disease and give refresher course on health care workers surveillance.

Trigeminal Neuralgia: A Brief Review

2023-05-05T09:54:03-04:00

Trigeminal neuralgia is a facial pain syndrome that occurs repeatedly and chronically on one side of the face following the distribution of the trigeminal nerve branches. Trigeminal neuralgia is estimated to be around 0.16%-0.3%, with an incidence rate of 4-29 people per 100,000 people/year, with a higher incidence in women than men (ratio 3:2). The incidence rate increases with age. The causes of trigeminal neuralgia are divided into two types, classic and symptomatic. The main mechanism of trigeminal neuralgia is compression by the intracranial blood vessels which causes damage to the protective covering of the nerves or is known as the process of demyelination. Treatment of trigeminal neuralgia is pharmacotherapy, non-pharmacotherapy, surgery should be considered if treatment is ineffective, and preventive education.