Rwanda Medical Journal最新文献

{"title":"Epidemiology of Hypertension in the Prefecture of Figuig, Morocco","authors":"E. Rida, A. Soulaymani, H. Hami, M. Abdelrhani","doi":"10.4314/rmj.v79i3.5","DOIUrl":"https://doi.org/10.4314/rmj.v79i3.5","url":null,"abstract":"\u0000 \u0000 \u0000BACKGROUND: Hypertension continues to be a public health problem with devastating consequences globally, particularly in developing countries where there is an acute paucity of hypertension data.The aim of this study was to describe the epidemiological, clinical, and treatment characteristics of hypertensive patients in the prefecture of Figuig, Morocco. \u0000METHODS: Retrospective analysis of hypertensive patients’ medical records from 2010 to 2020. The diagnosis, treatments, and complications were reported by physicians and cardiologists. Data analysis was made according to epidemiological, clinical complications, and treatments. RESULTS: Hypertension progressed from 871 cases in 2010 to 1785 cases in 2020 with an average annual incidence rate of 105.56/100,000 person-year, affecting more women than men (68% vs 32%). Hypertension was higher among rural residents compared to urban residents (54.0%vs 46%). Hypertension was noted in 65.4 % of patients aged 60+, and in 30.49% of patients aged 40-59. The incidence proportion of clinical complications is Ipcomplications=18.35/1000 person- year, principally cardiovascular diseases (45.42%), stroke (25.55%), retinopathy (17.98%) and nephropathy (10.41%). The most antihypertensive drugs used were Calcium channel blockers (33.39%), Angiotensin-converting enzyme inhibitors (21.13%), Angiotensin receptors blockers (21.21%), diuretics (19.4%), beta-blockers (5.38%) and central antihypertensive (10.46%) with an average coverage needs of treatments in the prefecture as (47.29%). \u0000CONCLUSION: Hypertension progresses gradually in the prefecture, higher among older individuals, women and rural residents. Large proportion of patients cannot find their treatments in health care structures which lead to poor blood pressure control, accelerating the appearance of complications. \u0000 \u0000 \u0000","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43758810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional intake in acute care surgery patients in Kigali, Rwanda- A single institution descriptive analysis","authors":"I. Jones, I. Niyongombwa, D. Karenzi, V. Muvunyi, J. Gashema, E. Abahuje, G. Rickard","doi":"10.4314/rmj.v79i3.2","DOIUrl":"https://doi.org/10.4314/rmj.v79i3.2","url":null,"abstract":"\u0000 \u0000 \u0000INTRODUCTION: Nutrition is essential for health and healing, especially in the perioperative period. However, little is known about the nutritional intake of hospitalized patients in low and middle-income countries.This paper aimed to characterize the composition and quantity of food in acute care surgery patients at a tertiary referral hospital in Rwanda. \u0000METHODS: Acute care surgery patients were queried about nutritional intake during hospitalization from May 21, 2018, to June 3, 2018, for 100 patient days. Calorie and protein intake were estimated and compared to standards for an average Rwandan adult.RESULTS: Median daily calorie intake was 1472 kcal/day (Interquartile range (IQR): 662, 2116). The median daily protein intake was 45.99 g (IQR: 24.38, 70.22). Assuming a calorie need of 25 kcal/kg/day and a protein need of 1g/kg/day, this is 98.1% of the estimated daily calorie needs and 76.7% of estimated daily protein needs. Estimating higher energy needs for a surgical patient, the daily intake is 70.0-81.9% of calorie needs and 51.1-63.9% of protein needs. \u0000CONCLUSION: Overall, the calorie and protein intake for the average Rwandan acute care surgery patient were low compared to the needs of a 60 kg surgical patient. More education and accessibility to high-quality foods are needed to ensure adequate nutrition in the postoperative period to optimize clinical outcomes. \u0000 \u0000 \u0000","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41885536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A collaboration to improve perioperative acute pain care at the University Teaching Hospital of Butare, Rwanda","authors":"J. Baumbour, G. Nyirigira, R. Wilson, W. Nsabiyumva, J. Parlow, A. Johnson, R. Egan","doi":"10.4314/rmj.v79i3.6","DOIUrl":"https://doi.org/10.4314/rmj.v79i3.6","url":null,"abstract":"\u0000 \u0000 \u0000BACKGROUND: A perioperative acute pain care program integrating standardized assessment and treatment forms into pain care was developed and implemented at an urban hospital in Rwanda through a collaboration between Rwandan and Canadian experts. This study evaluated the perioperative acute pain care program using a quality improvement lens. \u0000METHODS: Using the Model for Improvement: Plan, Do, Study, Act (PDSA) cycle, a mixed methods evaluation was performed. Over one year, 519 randomized patient chart audits were conducted and analyzed through control charts. Through purposeful sampling, focus groups comprised ofsurgeons and nurses (N=34) involved in pain care in surgery, obstetrics, and anesthesiology were performed and analyzed via thematic coding. \u0000RESULTS: The average attempted form completion rate across all forms varied monthly between 56-93% (mean=79%; median=81%). Across all forms, both the mean and median total number of errors per form were 12.5. Enablers of form use included improved pain care for patients and feelings of professional satisfaction. Program implementation was challenged by resource constraints, form integration, and health care provider training. \u0000CONCLUSION: Future quality improvement collaborations should identify and address improved pain care while working with local experts to ensure PDSA cycles are continuous, and evidence based. \u0000 \u0000 \u0000","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42439078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemispherectomy with corpus callosotomy in pediatric Lennox Gastaut Syndrome associated encephalomalacia cyst: The first case in Indonesia","authors":"P. Gunawan, W. Suryaningtyas","doi":"10.4314/rmj.v79i3.1","DOIUrl":"https://doi.org/10.4314/rmj.v79i3.1","url":null,"abstract":"\u0000 \u0000 \u0000Lennox-Gastaut syndrome (LGS) is a form of severe epileptic encephalopathy in children. LGS with encephalomalacia cysts is rare in children. We report a six-year-old mentally retarded boy who was referred for an intractable seizure. Seizures were tonic, atonic, and dialeptic in frequency. EEG showed generalized SSW discharges of 1.5-2 Hz, polyspikes, and burst suppression typical for LGS. Head MRI showed an encephalomalacia cyst in the right subcortical temporoparietal lobes with hemiatrophy in the right cerebral hemisphere. He was already treated with three antiepileptic drugs, but the seizures persisted. The patient was then performed right hemispherectomy and corpus callosotomy. It resulted in a good response. A combination of hemispherectomy and corpus callosotomy could be promising in this form of epilepsy disease. Seizure reduction was achieved and showed cognitive improvement and hemiparesis. \u0000 \u0000 \u0000","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43173870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socio-demographic correlates of childhood malnutrition in a rural community in Southwest Nigeria - A call for targeted interventions for vulnerable children","authors":"O. Fatunla, O. Olatunya, E. Ogundare, T. O. Fatunla, T. Agbesanwa, A. Taiwo, O. Oyelami","doi":"10.4314/rmj.v79i3.7","DOIUrl":"https://doi.org/10.4314/rmj.v79i3.7","url":null,"abstract":"\u0000 \u0000 \u0000BACKGROUND: Nigeria has the second-highest burden of stunted children globally. Yet, only two out of ten malnourished Nigerian children benefit from intervention programs to address malnutrition. This study describes some socio-demographic factors associated with malnutrition among children living in a rural community in Southwest Nigeria. \u0000METHODS: This study was a community-based cross-sectional study involving 364 children randomly selected from their homes aged 1–15 years. Factors such as socioeconomic status, birth order, and whether the mother was alive were obtained. Weights, heights, and body mass index (BMI) were measured and interpreted using the WHO z-scores. Chi-squared test of associations was used for categorical variables and an independent t-test was used to compare the mean BMI between both genders. The level of significance was set at a p-value <0.050. \u0000RESULTS: There were 185 (51%) females: 173(48%) belonged to the age group 1–5 years and 168 (46%) belonged to the lower socio-economic class. Over 80% of the participants had normal nutritional status: 19 (6%) were underweight, 36 (10%) were stunted, and 29 (8%) were thin (low BMI, <-2SD). Maternal demise was associated with thinness. Males from lower socio-economic classes and first-born males had a higher mean BMI than the females (p<0.050). \u0000CONCLUSION: Although malnutrition prevalence was low, there is a need to use targeted interventions to further reduce malnutrition among vulnerable children. There is also a necessity for more studies to identify and address the risk factors for stunting in the study area. \u0000 \u0000 \u0000","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42940785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of menstrual hygiene practices among in-school adolescent girls in Osun State, Nigeria: a comparative descriptive cross-sectional study","authors":"T. Akinreni, O. Okunloye","doi":"10.4314/rmj.v79i3.3","DOIUrl":"https://doi.org/10.4314/rmj.v79i3.3","url":null,"abstract":"\u0000 \u0000 \u0000INTRODUCTION: Adolescence in girls has been recognized as a special period that signifies the transition from girlhood to womanhood. This study was conducted to assess the determinants of menstrual hygiene practices among in-school adolescent girls in private and public secondary schools in Osun State, Nigeria. \u0000METHODS: A descriptive, cross-sectional study (comparative) involving 650 in-school secondary students (public and private), were selected via multistage stratified sampling technique, using a self-administered structured questionnaire. Relevant data was collected via a semi-structured questionnaire and analyzed using SPSS 23.0. Appropriate univariate analysis using frequency tables and charts, while bivariate analysis was done using a chi-square table. Multivariate analysis was done using logistics regression. \u0000RESULTS: The modal age range was middle adolescence (14-16 years old). There was a statistically significant difference between public and private school respondents in terms of age menarche: More students in private schools (81.8%) had their menarche before the age of 13 compared to those in public schools (73.2%). More respondents in private secondary schools (67.1%) have good menstrual hygiene practices compared to their counterparts (55.4%). Almost all the respondents in public secondary schools and private secondary schools have good management on menstruation Multivariate analysis, more of the respondents in junior classes among public school respondents were approximately two times less likely (1/0.506 = 1.97) to have good hygiene practice compared to their counterparts. \u0000CONCLUSION: Based on the findings in this study, it could be concluded that more of the respondents in private secondary schools had good hygiene practices compared to their counterparts. Hence, the need for all stakeholders to intensify efforts to provide accurate and adequate information as well as enable the environment to promote menstrual hygiene practices among in-school adolescent girls. \u0000 \u0000 \u0000","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48192131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Darier-White Disease with Sensorineural Hearing Loss – A Case Report","authors":"E. Henshaw, H. Ekpenyong, L. E. Ekafor","doi":"10.4314/rmj.v79i2.1","DOIUrl":"https://doi.org/10.4314/rmj.v79i2.1","url":null,"abstract":"\u0000 \u0000 \u0000Darier-White disease (keratosis follicularis) is a rare autosomal dominant genodermatosis characterized by hyperkeratotic papules and plaques in seborrheic areas, often presenting with nail abnormalities and occasionally mucous membrane changes.It has been associated with neurocognitive/psychiatric disorders, ankylosing spondylitis, hidradenitis suppurativa and nephritis. Affected individuals also have an increased tendency to cutaneous infections. \u0000However, a thorough literature search showed no association with sensorineural hearing loss. We herein report the case of a 34-year-old Nigerian man with disfiguring Darier-White disease (DWD) associated with spondyloarthropathy and sensorineural hearing loss. We affirm that early diagnosis, prompt and appropriate therapy and adequate patient education can avert undesirable outcomes. \u0000 \u0000 \u0000","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48713920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of ophthalmic registries in Africa – The shortage and importance","authors":"S. Adebusoye, O. Jagun, A. Betiku, O. Olajide, U. Aham-onyebuchi","doi":"10.4314/rmj.v79i2.6","DOIUrl":"https://doi.org/10.4314/rmj.v79i2.6","url":null,"abstract":"\u0000 \u0000 \u0000BACKGROUND: Clinical registries systematically collect standardized information for pre-defined purposes on patients with a particular condition of interest. The characteristics and quantity of ophthalmic registries in Africa are unclear.This study aimed to quantify ophthalmic clinical registries in African countries from published literature, and to supply an overview of the features and study outcomes of these registries. METHODS: A systematic search of the EMBASE, PubMed, and Web of Science databases was conducted to find ophthalmology clinical registries in Africa without time and language limitations. Relevant data elements about registry characteristics, nature, methodology, and outcomes were extracted for each individual registry identified. \u0000RESULTS: Six clinical eye registries were found with no substantial growth over time. The most common condition captured is ocular tumors (n=3), of which two were retinoblastoma-specific registries. Five of them were focused on retinal diseases and one on blindness and low vision. None addressed cataracts and glaucoma. A third of the registries originated outside Africa, and one was multinational. Only three African countries produced a registry data set, with South Africa having the majority of the registries (n=3), followed by Egypt (n=2), and Ghana (n=1). Ophthalmic registries in Africa are used to study the epidemiologic features of ocular diseases, treatment outcomes, and genetic analysis. \u0000CONCLUSIONS: The potential for clinical eye registries has not been adequately harnessed in Africa, as only a few ophthalmic registries exist. Findings from this study may help inform the planning and implementation of future ophthalmic registries and suggest focus areas that have not received due attention. \u0000 \u0000 \u0000","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44450865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective and practical recommendations to dental team when providing dental services in the era of COVID-19","authors":"G. Tuyishime, M. Dusabimana, M. C. Ineza","doi":"10.4314/rmj.v79i2.7","DOIUrl":"https://doi.org/10.4314/rmj.v79i2.7","url":null,"abstract":"\u0000 \u0000 \u0000Severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) is the coronavirus that causes COVID-19 (coronavirus disease 2019). It is an airborne virus and can spread through small droplets of saliva.Dental professionals work very close to the patient’s mouth, putting them at high risk of contracting SARS-CoV-2. This is because aerosols and splatter are generated when performing some dental procedures, which are known to be the possible potential sources of some other serious diseases to the dental team and patients in the dental settings. During the COVID-19 pandemic, dental professionals continued to provide dental services to patients; however, dental professionals are more likely to become contaminated due to the nature of their work. Hence a cautious emergency implementation of extra-protective measures is paramount to limit viral contamination between patients and the dental team. This research review was performed to summarize essential practical recommendations to be adopted by the dental team when providing dental services to the patient during the COVID-19 period, to minimize the risks of COVID-19. \u0000 \u0000 \u0000","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48862807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of phases of the menstrual cycle on biophysical and biochemical parameters of African black women with breast cancer","authors":"O. Ajayi, M. Charles-Davies, J. I. Inetor, A. Ademola","doi":"10.4314/rmj.v79i2.3","DOIUrl":"https://doi.org/10.4314/rmj.v79i2.3","url":null,"abstract":"\u0000 \u0000 \u0000INTRODUCTION: Many studies on female breast cancer patients do not consider the differences between the follicular and luteal phases when collecting blood samples for laboratory investigations. Therefore, this study was designed to investigate the effects of the phases of the menstrual cycle on reproductive and thyroid hormones, endocrine disruptors, blood pressure, and body adiposity. \u0000METHODS: Participants (n=107) aged 28-50 years, comprising 54 newly diagnosed breast cancer patients (cases were menstrual phase and age-matched to 53 seemingly healthy women without breast cancer that served as controls. Anthropometric indices and blood pressure (BP) were obtained. Serum hormones-estradiol, progesterone, luteinizing hormone (LH), free triiodothyronine (FT3), thyroid-stimulating hormone (TSH), stimulating follicle hormone (FSH), and free thyroxine (FT4) were quantified by enzyme immunoassay. Endocrine disruptors (EDs)- arsenic, lead and cadmium were quantified by atomic absorption spectrophotometry (AAS). Data were analyzed using Student’s t-test and Pearson correlation coefficient with p<0.05 considered significant. \u0000RESULTS: Bodyweight, hip circumference, waist-height ratio, and FT3 varied between the luteal and follicular phases, higher in cases than controls. EDs were significantly higher in cases than controls in both phases. Progesterone, estradiol and LH levels were significantly higher in luteal cases and controls when compared with follicular cases and controls.FT3 was significantly lower in luteal controls compared with follicular controls. There were significant direct and inverse correlations among adiposity measures, BP, EDs, and hormones in each phase in both cases and controls. \u0000CONCLUSION: The menstrual cycle appears to influence blood pressure, measures of adiposity, endocrine disruptors, and reproductive hormones in women with normal and cancerous breasts. This requires consideration in the collection of blood samples for investigations of these parameters. \u0000 \u0000 \u0000","PeriodicalId":38181,"journal":{"name":"Rwanda Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47483537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}