European Journal of Medical and Health Sciences

Vaginal Ozone Insufflation in Management of Vaginal Candidiasis

I Nyoman Hariyasa Sanjaya — 2023-09-22

The vagina of a woman is a sophisticated microecology system. Typically, the H₂O₂-producing Lactobacillus dominates the vaginal microbiota of healthy women. This bacterium converts glycogen in vaginal epithelial cells into lactic acid, sustaining the vagina's natural acidic environment. Understanding the substantial correlation between the vaginal and upper genital tract microbiota and vaginal and genital tract infections has led to an interest in these areas. However, the spectrum of microbial types consistent with a functioning genital tract and the variables influencing the flora remains perplexing. The most prevalent gynecological condition seen in primary care, vaginitis caused by Candida albicans, is a significant public health concern due to its high frequency. Candidal vulvovaginitis, also known as vaginal thrush and vaginal yeast infection, is an overgrowth of yeast in the vagina that irritates. Ozone treatment has made its way into German medical practice, where it is successfully applied to treat several disorders. Medical ozone's qualities, such as its bactericidal, virucidal, fungicidal, analgesic, and other effects, have been utilized in therapy, surgery, obstetrics and gynecology, dermatology, stomatology, and the treatment of infectious and venereal illnesses. During ozone treatment or therapy, a catheter was used to insufflate an ozone/oxygen gas mixture into the female reproductive system. They were completed continuously by attaching a catheter to the ozone output hose and allowing the ozone/oxygen gas mix to flow for the allotted time. Based on clinical and microbiological evidence, the effectiveness standards Complete clinical and microbiological recovery observable clinical symptoms that are objective. The vaginal mucous membrane was free of inflammatory disorders following treatment, and vaginal cultures were negative.

The Influence of Psychophysical Preparation of Pregnant Women on the Outcome of Childbirth and Postpartum Recovery

Nura Geko — 2023-09-08

The psychophysical preparation program for pregnant women includes physical exercises and theoretical lectures aimed at preparing the pregnant woman for childbirth and that the benefits far outweigh the risks. Exercise is an essential element of pregnancy, and OB-GYNs and other obstetric care providers should encourage their patients to continue or begin exercise. The aim of this work is to understand the impact of psychophysical preparation of pregnant women on health during and after pregnancy, birth outcomes and postpartum recovery. Twenty scientific research papers/articles including 5517 respondents were reviewed, based on databases: Web of Science, EBSCO, Scopus, Medline, PubMed, ScienceDirect, Google Scholar, and others. Works published from 2017-2022 were reviewed. The results of this study show that pregnant women who attended the program of psychophysical preparation for childbirth had a chance to experience childbirth in a more beautiful light, to be prepared, so that they would go to the maternity hospital with less fear, how to use breathing techniques during childbirth, and how to have the easiest and most beautiful childbirth without the use of drugs and interventions. Pregnant women had significantly more positive outcomes of childbirth as well as postpartum recovery and mental health. Psychological support and education have positive outcomes on the mental health of pregnant women because they reduce fear of the unknown and reduce the risk of postpartum depression. Higher rates of intact perineum, reduction of episiotomy and less damage of perineal tears are recorded. The preparation itself significantly affects the outcome of the test subjects’ births, where vaginal births are much more common, and the rate of instrumental methods of birth and caesarean section is reduced. A positive outcome was recorded during postpartum recovery.

Giant Hydatic Cyst in a 2-Year-Old Infant

Jihad Echnin — 2023-09-22

Background: Infantile cerebral hydatidosis is a serious infection and represents a major problem of public health that threatens the economy of countries in which it is endemic. It imposes a large-scale prophylaxis based on the interruption of the parasite cycle.

Case description: We present a case of a 2-year-old girl with no medical history living in a rural region (Sidi Ifni), where contact with dogs, sheep, and cattle is not uncommon. One month before her admission, increased intracranial pressure (ICP) symptoms appeared made of headaches, vomiting, and visual disturbances. 15 days later, motor deficits and impaired consciousness were installed. The clinical examination found a sleepy infant with a Glascow Coma Scale at 14, left hemiparesis at 2/5 (Medical Research Council score), and bilateral 6th nerve palsy, A brain CT scan was performed, showing a round hypodense intraparenchymal lesion at the right frontal lobe. The intervention was performed to remove the gliant hydatic cyst according to the Dowling-Orlando technique. Postoperatively the patient had no motor deficit. The histopathological exam confirmed the diagnosis of an echinococcus granulosis cyst.

Conclusion: Presentation of such a giant cyst in a 2-year-old infant is very rare. In such cases, genotype analysis of the parasite should be performed. The surveillance of dogs and periodic testing of their stools, with treatment if they are found to be infected, and preventing their access to raw offal at slaughterhouses and farms, will be effective in controlling the menace of hydatidosis.

Giant Occipital Encephalocele: Literature Review and Illustrative Case

Jihad Echnin — 2023-09-01

Background: Encephalocele is defined as a herniation of the neural tube due to skull defect. anterior encephaloceles are common in males while the occipital form occurs in females. We present in this article a case of a giant occipital encephalocele and provide a literature review on the subject.

Case description: We report a case of 8 months old female, the third child of a family of 3 children with notion of consanguinity of third degree, the mother had no notion of taking medication during pregnancy, this one was followed to term. the delivery was by caesarean section. on the clinical examination the infant mobilizes the 4 limbs, no sensitive or motor deficits, no occulomotor disorders, cranial perimeter at 37 cm, the general examination does not find any other malformations. we operated the patient with ablation of the encephalocele, the postoperative continuations were simple, the evolution was marked by the stability of the cranial perimeter, and the infant was hospitalized for 5 days, then declared out with a good postoperative evolution.

Conclusion: Occipital encephalocele is considered as a very common form of neural tube defect the diagnosis is based on neuroimaging techniques; we believe that its Management includes full investigations for optimum surgical plan.

When Thyroid Meets Ovary: A Case Report of Struma Ovarii

Hafsa Bilal — 2023-09-14

Struma Ovarii is not a common tumor. It is a mature ovarian teratoma, completely or predominantly composed of thyroid tissue. It belongs to a specialised monodermal variety. Struma ovarii may have an association with hyperthyroidism; however, it is a rare association and just in about 8% of cases. Its diagnosis is mostly delayed because most of the patients do not present any symptoms. Some patients may develop symptoms of specific conditions like ovarian torsion, hyperthyroidism, and ascites. Ultrasound, MRI, CT scan, and scintigraphic evaluation are necessary to differentiate benign from malignant variety. The first line treatment option is surgical removal. There are lesser chances that the tumor will recur and the quality of life is improved significantly. In this case report, we have discussed a unique case of struma ovarii. It was duly diagnosed and appropriate management was done. The tumor was different from malignant ovarian tumor on the basis of ascites and tumor marker assessments. Thyroid function investigations were also normal. The tumor is incidentally found on imaging in most cases. The definitive diagnosis is established by a histopathological study. The first line of treatment is surgical removal and it usually leads to a successful prognosis. We will determine the challenges that are faced to reach the diagnosis and management of this rare tumor. Misdiagnosis is common. The treatment options are debatable because it is a rare tumor. In fertile and young age groups, fertility conserving surgeries like ovarian cystectomy or unilateral salpingo-oophorectomy are advised. For the purpose of treatment, in postmenopausal cases, total abdominal hysterectomy with bilateral salpingo-oophorectomy may sometimes be indicated. The quality of life will improve if investigations are done early and appropriate management is done.

Characteristics of Gestational Trophoblastic Disease at Prof. Dr. I.G.N.G. Ngoerah Hospital, Denpasar from 1st January 2020 to 31st December 2021

I Nyoman Gede Budiana — 2023-09-22

GTD is a rare abnormal condition of pregnancy, where the condition occurs when trophoblast cells proliferate uncontrollably so that it develops into an abnormal pregnancy. Abnormal pregnancy can lead to various negative effects such as vaginal bleeding, shortness of breath, and others. The high incidence of GTD is still not well documented to date. It is important to manage GTD appropriately to minimize acute complications and identify gestational trophoblastic tumor promptly. In this study, studyers took data from the oncogynecology register book regarding GTD and then presented it as descriptive data so that descriptive data analysis was carried out in the form of tables and narratives. The results of this study showed that GTD was highest in the age range of 31-35 years, parity 2, clinical symptoms of vaginal bleeding, previous pregnancy history with hydatidiform mole, gestational interval of 4 months or less, β-HCG level more than 100.000 mIU/ml, no metastases, histopathology of complete hydatidiform mole, stage I GTD, and receiving metrotrexate chemotherapy.

User Satisfaction Profile of an Outpatient Physical Therapy Service

Natália Amoedo — 2023-09-26

Physical therapy is characterised as a health process with prolonged interactions between the professional and the user, involving close physical contact, the user’s active participation, and frequent visits. Evaluating user satisfaction is a priority for managing health services quality, being a good index for assessing clinical effectiveness. Therefore, establishing the profile of user satisfaction with the service is important for organisational management in health units.

This work aims to analyse the current satisfaction level of users of an outpatient physical therapy service, trace the satisfied user profile according to their sociodemographic and clinical characteristics, identify a set of best practices and aspects for improvement, and propose measures to improve satisfaction. Thus, a quantitative, observational, analytical-correlational, and cross-sectional study was carried out.

The application of the Physical Therapy Outpatient Satisfaction Survey and a sociodemographic and clinic questionnaire allowed the creation of a microeconomic database and the application of the econometric methodology of linear regression. It was possible to identify variables that increase satisfaction, such as location, professional situation, travel time, pathology, and salary range, and variables that decrease satisfaction as the place of residence, academic qualifications, health system, referral, professional status, and age. Based on the evidence, measures to improve the physiotherapy service are proposed.

A Case-Control Study of Behavioural and Social Predictors of Severe Leptospirosis in a Tertiary Care Centre, Central Kerala

Anjely Sukumaran — 2023-09-08

Leptospirosis is a globally important zoonotic disease. The disease is caused by pathogenic Leptospira species. Infections result from direct or indirect exposure to infected reservoir animals that carry the pathogen in their renal tubules and shed pathogenic leptospirosis in the urine. This study was conducted to assess the social and behavioural predictors of severe Leptospirosis and to study the clinical profile and outcome of patients with severe leptospirosis .148 patients with leptospirosis were divided into severe and non-severe groups. The majority of our study population had risk factors like contact with soil or water through barefoot, farming, swimming, cattle rearing, contact with sewage and stagnant rainwater. Conditions such as inadequate access to safe drinking water and sanitation services, poor personal hygiene practices, low levels of literacy, and lack of access to health services, contribute to increased vulnerability to infection and work against prevention efforts. Severity predictor factors are Cut or injury prior to symptoms, NSAID intake for fever and Myalgia from the periphery, late referral and late initiation of antibiotics, acute kidney injury, pancreatitis, myocarditis, thrombocytopenia, ARDS, acute liver injury, platelet less than 50,000 and prolonged INR. Knowledge about risk factors for severe leptospirosis can improve prevention and control measures to mitigate the incidence of severe cases.

Outcome of the Endoscopic Biliary Stenting for Irretrievable Common Bile Duct Stones in an Academic Hospital – A Prospective Study

Mohammad Iqbal Hossain — 2023-09-12

Background: Choledocholithiasis is characterized by the existence of a stone in the common bile duct. Based on findings published in the Medical Clinics of North America, around 10-15% of individuals with gallstones experience the development of choledocholithiasis. Presently, the established approach for addressing common bile duct stones involves the implementation of endoscopic papillotomy and stone extraction. The combined utilization of Dormia basket, balloon catheter, and lithotripsy achieves a success rate of approximately 90%. In cases where traditional endoscopic removal methods prove ineffective, biliary stenting plays a crucial role in the conservative management of CBD stones.

Objectives: The main goal of the study was to evaluate the outcome of biliary stenting in irretrievable common bile duct stones.

Materials and Methods: This observational study took place at the Department of Gastroenterology, Dhaka Medical College and Hospital, Dhaka, from January 2018 to December 2018. The study included consecutive patients who were 18 years or older and diagnosed with common bile duct stones. These patients underwent endoscopic retrograde cholangiopancreatography (ERCP) for stone extraction. The study specifically focused on patients who received biliary stenting for irretrievable common bile duct stones, and they were enrolled as participants in the study.

Results: Out of the 83 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) for stone extraction, 29 patients (35%) were deemed as having irretrievable stones, necessitating the implementation of stenting. Among these irretrievable stone cases, the average age was 46.69, and there was a predominance of females with 17 patients (58.6%). Of the 29 cases, 22 patients completed the follow-up. During the follow-up ERCP, a significant reduction was observed in both the average number of stones (3.14 vs. 1.9; P=0.002) and their size (16.32 vs. 12.4; P=0.005). Successful stone extraction was achieved in 14 patients (63.64%) during the second ERCP. In one patient (4.55%), spontaneous clearance of the stone occurred, while in 7 patients (31.81%), stone extraction was not possible during the second ERCP. The reduction in mean stone size was the only significant factor affecting the success of the second ERCP. However, there was no correlation found between the duration of stenting and the reduction in stone size (r=-0.193, p=0.401).

Conclusion: Our study shows that repeat ERCP can successfully extract stones regardless of stenting duration. Unlike Western data, we emphasize the effectiveness of endoscopic biliary stenting in a context with limited access to advanced techniques, where initial stone extraction rates are lower. This approach is particularly beneficial for patients with stone sizes over 15 mm, avoiding the need for complex surgical procedures.

A Study on Knowledge, Attitudes, Practice and Awareness towards Pre-Marital Carrier Screening of Thalassemia among the University Students of Biological Faculty in Bangladesh: A Cross-Sectional Study

Md. Al- Tareq Mia — 2023-09-15

Thalassemia is a hereditary hemoglobinopathies that results from the absence of a globulin chain and it is a very common problem in Southeast Asia. Like many other countries’ community based premarital carrier screening (PMCS) of thalassemia is extremely rare in Bangladesh. This study aimed to investigate knowledge, attitude, practice, and awareness towards PMCS among University students in Bangladesh. A cross-sectional study was conducted from January to March 2020 using a self-administered questionnaire which was distributed to 911 Jahangirnagar University students aged 18 to 24. The questionnaire was composed of five parts: personal information, knowledge, attitudes, practice, and awareness. On the basis of the answers, knowledge, attitudes, practice, and awareness towards PMCS were evaluated. About (88.80%) of the total participating students thought that PMCS is necessary before marriage. In the case of thalassemia carrier parents, 81.00% of students replied that prenatal screening is important before pregnancy. 610 students (66.95%) of the total 911 students considered that thalassemia can be caused by marrying between blood relatives. Most of the students (79.80%) supported that thalassemia screening should be an obligatory procedure and 91.98% would like to raise social awareness about PMCS and thalassemia. The students of Jahangirnagar University have good knowledge about PMCS program and a positive attitude but it is difficult to implement in real life without continuing practice. The outcome of this study suggested the necessity of increasing student’s awareness of Bangladeshi PMCS program.

Profile of Medico-Legal Cases in Accident & Emergency Department of SSKH, LHMC, New Delhi During Pre-Covid-19 and Covid-19 Periods

Rajesh Kumar — 2023-09-15

Medico-legal cases presented to the Accident & Emergency department vary from hospital to hospital. Profiling these cases from time to time provides an insight into the workload of medico-legal cases as well as what is going on in and around the locality. The present study was conducted at LHMC, New Delhi from January 2021 to June 2022 from the available records of MLCs from 1st January 2019 to 31st December 2021. Out of a total of 5702 MLCs, males were 85.77%. Victims of the age group 21–30 years formed the majority (36.30%) of the cases followed by age groups 31–40 years (25.44%). The time of incidence was between 6 p.m. and 11.59 p.m. in the majority (42.00%) cases. The time of reporting was between 6 p.m. and 11.59 p.m. in the majority (40.05%) of cases. A majority (56.92%) of the victims had reported within 1 hour of the incident. The cause was blunt force trauma in more than half (51.05%) cases, followed by RTA (17.93%) and poisoning (17.84%). In more than half (56.51%) cases, the manner was homicidal, followed by accidental including RTA (23.95%) and suicidal (19.35%). The surgery department was found involved in more than 2/3 (69.15%) cases, followed by Orthopaedics (31.85%), Medicine (20.199%) and ENT (19.52%). In 85.50% of cases, the victims were discharged within 24 hours. Hospital death in MLCs was 4.15% whereas 1.87% of victims were referred to other hospitals for further management.

Antecedent Factors Relating to Malaria Among Secondary School Students in Ibadan, Nigeria

Joy D. Famoyegun — 2023-09-19

Nigeria is a malaria-endemic country, and the disease is responsible for a high-rate of morbidity and mortality among various segments of the population. The aim of this study was to assess the living situation, knowledge, and perception relating to malaria among secondary school students. This descriptive cross-sectional study employed a multi-stage sampling technique to recruit 430 students from private and public secondary schools in Ibadan North Local Government Area, Oyo State, Nigeria. Data were collected using a semi-structured questionnaire that included questions on socio-demographic characteristics; respondents’ living conditions; a 66-point scale on knowledge of causes, transmission route, symptoms, prevention, and consequences of malaria; and a 22-point scale on perceptions of malaria. Data were analysed using descriptive statistics, t-test, and ANOVA at a confidence level of 95%. Respondents’ mean knowledge score was 27.0±7.9, with a majority (76.1%) having poor knowledge. The type of school attended influenced respondents’ knowledge. The mean perception score was 12.3±4.2 with 61.0% of the respondents having favourable perceptions. Students in private schools had a lower knowledge of malaria as compared to those in public schools (p<0.05). Age was significantly associated with perception as younger students had a better perception towards malaria compared to students in older age groups. Respondents had inadequate knowledge relating to malaria and several of them had perceptions that can put them at risk of the disease. Appropriate school-based health promotion strategies such as peer education, and training are needed to address the identified gaps in knowledge, and perceptions not in line with the biomedical worldview.

Sexual and Reproductive Health Knowledge of In-school Adolescents: A Comparative Study of Visually Impaired and Non-visually Impaired Students

Olufunmilayo O. Banjo — 2023-09-19

Adolescents’ Sexual and reproductive health (SRH) knowledge is important for preventing SRH problems and enabling young people to live a healthy sexual and reproductive life. This study assessed the differences in SRH knowledge between the visually impaired (VI) and non-visually impaired (N-VI) adolescents; and examined the factors contributing to the differences between the two groups. The study was conducted in Ondo State, Nigeria using a multi-stage sampling technique to select 394 visually impaired and non-visually impaired in-school adolescents aged 15-19 years. Quantitative data were collected using Open Data Kit (ODK). Models were fitted with Ordered Logistic Regression (OLR) using Stata 14. Results showed that 89% of N-VI compared with 66% of VI had good access to SRH information, while 63.4% of the VI and 40.3% of N-VI had poor SRH knowledge. Students with good access to information were more likely to have a better SRH knowledge, although the relationship is stronger for the N-VI than for the VI. The OLR results further showed that the respondents who had good access to information were about 116% more likely to have good SRH knowledge than their counterparts with poor access to information (OR = 2.163; C1:1.41–3.32). Also, the likelihood of the N-VI having good SRH knowledge more than doubled (138% more) that of the VI (OR = 2.377; C1:1.14 – 4.00). Extra-curricular activities also increased the likelihood of good SRH knowledge. The study therefore recommends advocacy efforts to provide adolescents with increased SRH knowledge with special focus on VI.