Pan African Medical Journal最新文献

{"title":"Early childhood development status and associated factors among preschool children attending routine well clinics in Temeke Municipal, Dar es Salaam-Tanzania: a cross-sectional study.","authors":"Mufida Ali Mshimba, Florence Salvatory Kalabamu, Maulid Fataki, Leonard Malasa, Felician Rutachunzibwa","doi":"10.11604/pamj.2024.49.137.45990","DOIUrl":"10.11604/pamj.2024.49.137.45990","url":null,"abstract":"<p><strong>Introduction: </strong>Early Childhood Development (ECD) is a social and public health concern especially in low- and middle-income countries whereby around 43% of children living in these countries are at risk of developmental delays. This may negatively affect their potential including reduced productivity in adulthood. Data from the 2022 Tanzania Demographic and Health Survey has shown that around 47.4% of children aged 24-59 months scored low in their early childhood scores. However, factors associated with low suboptimal ECD are not well understood. This study aimed to determine the magnitude and characteristics associated with low ECD scores among children aged 24-59 months attending RCH clinics in Temeke Municipal, Dar-es-salaam region.</p><p><strong>Methods: </strong>the study was a facility-based cross-section study design involving Children aged 24 - 59 months attending RCH clinics in Temeke District, Dar-es-salaam, Tanzania. An interviewer-guided questionnaire was used to collect basic demographic information while ECD scores among participants were determined using a standardized ECD-I2030 tool. Data analysis was conducted using Statistical Package for Social Sciences (SPSS). The magnitude of children not on track was expressed in frequency and percentages. Factors associated with poor ECD were determined by using binary logistic regression analysis. The alpha level of 0.05 or less was considered statistically significant.</p><p><strong>Results: </strong>a total of 422 children were enrolled in the study. Among participants, only 144(34.1%) were on track based on their childhood development scores while 278 (65.9%) were off track. Young age (AOR=0.149 (0.354-0.63); p-value=0.001), nutritional status (AOR=7.729(2.234-26.735); p value=0.010) and parents' employment status (AOR=3.730(1.937-7.184); p-value=0.001) were independently associated ECD scores.</p><p><strong>Conclusion: </strong>most children enrolled in this study were off-track in their ECD scores which may limit the realization of their full potential. Young age, malnutrition and unemployed parents were significant factors associated with EDC delays. Therefore, targeted interventions aimed at ensuring food security and nutrition, economic empowerment of families through formal employment, and early positive parenting practices may improve ECDs among this age group.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"49 ","pages":"137"},"PeriodicalIF":0.9,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A congenital case of vascular haemangioma of the right hand.","authors":"Shiwani Padmakar Dandade, Arati Raut","doi":"10.11604/pamj.2024.49.136.46020","DOIUrl":"https://doi.org/10.11604/pamj.2024.49.136.46020","url":null,"abstract":"","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"49 ","pages":"136"},"PeriodicalIF":0.9,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hope for the best prepare for the worst: acute kidney disease and catastrophic comorbidities (a case report).","authors":"Kübra Kaynar, Elif Çağlayan, Nil Bahar Atasoy, Betül Kekeç, Murat Küçükbirinci, Muhammed Bilal Bektaşoğlu","doi":"10.11604/pamj.2024.49.134.45331","DOIUrl":"10.11604/pamj.2024.49.134.45331","url":null,"abstract":"<p><p>It is evident that Acute Kidney Injury (AKI) is an independent risk factor for both the survival of patients and their kidneys. Here, we present a case of oliguric AKI secondary to blunt trauma-induced crush syndrome complicated with severe sepsis in which the patient had a complete recovery of kidney functions after 3 months of dialysis dependency. A 40-year-old male construction worker had a severe episode of work accident. He had fallen into the stream from a height of 6 meters and the concrete pillars of the bridge fell over him. He had an iliac artery injury, crush-related acute kidney failure, a ruptured bladder, multiple fractures in the lumbar vertebral spinous and transverse processes, bilateral pelvic rami, acetabulum, and bilateral iliac wings. Despite 3 months of dialysis dependency with multiple episodes of sepsis and nephrotoxic antibiotic applications, fortunately, recovery of kidney functions (creatinine clearance >20 mL/min) was achieved. The creatinine clearance of the patient was calculated as 78 mL/min one year after discharge from the hospital. It is well-known that severe trauma leading to severe sepsis and severe AKI has catastrophic effects on the survival of patients. In addition, nephrotoxic antibiotics and contrast media had to be given to our patient, which resulted in further injury. A multidisciplinary (including nursery care) approach, early and proper treatment of sepsis, pulmonary rehabilitation, enteral/parenteral nutritional support, and appropriate timing, prescription, and dose of dialysis are fundamental factors playing a major role in the recovery of prolonged AKI as in our patient.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"49 ","pages":"134"},"PeriodicalIF":0.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Iridoschisis: a rare condition].","authors":"Malek Kharrat, Yosra Maalej","doi":"10.11604/pamj.2024.49.135.45888","DOIUrl":"https://doi.org/10.11604/pamj.2024.49.135.45888","url":null,"abstract":"","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"49 ","pages":"135"},"PeriodicalIF":0.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of some determining factors of consanguinity in North Morocco: a cross-sectional epidemiological study.","authors":"Houria Hardouz, Mustapha Zghaid, Amine Arfaoui, Ali Quyou","doi":"10.11604/pamj.2024.49.133.34881","DOIUrl":"10.11604/pamj.2024.49.133.34881","url":null,"abstract":"<p><strong>Introduction: </strong>consanguinity represents a serious concern for public health. It represents 20 to 55% of unions in the Middle East, North Africa, and Central Asia. The present work aims to find out some determining factors of consanguinity and isonymy in the population of North Morocco.</p><p><strong>Methods: </strong>it consists of a cross-sectional epidemiological study conducted on 238 couples from the region of Tanger-Tetouan located northwest of Morocco. The studied variables were consanguinity, isonymy, union type, geographical origin, education level, profession, ethnicity, and belonging to Shorfas.</p><p><strong>Results: </strong>the results showed that consanguineous couples represent 45.4%. Among them, unions between first cousins are predominant with 91%, among which the union with the daughter of the father´s brother represents 56%. The risk analysis showed that both husbands and wives with higher education levels display significantly lower risk of being in a consanguineous union (OR=0,36; IC 95% = 0,19- 0,65). Furthermore, wives of urban origin have a significantly lower chance of being in a consanguineous union (OR=0, 51; IC 95% =0,26-1,011). Regarding isonymy, we found that belonging to Shorfas is significantly associated with isonymous unions in both husbands and wives (p=0.04 and p=0.001 respectively). Moreover, urban-origin males display a significantly lower chance of being in isonymous unions (OR=0.35; IC 95% =0.15- 0.80).</p><p><strong>Conclusion: </strong>health authorities should make more efforts to raise the awareness of young people of the health disorders caused by consanguineous marriages.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"49 ","pages":"133"},"PeriodicalIF":0.9,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reimplantation of a malleable penile prosthesis in a patient with urethral erosion: a case report.","authors":"Moussaab Rachid, Omar Lazrak, Hamza Rais, Ghassane El Omri, Younes Houry, Abdeljalil Heddat","doi":"10.11604/pamj.2024.49.131.45236","DOIUrl":"10.11604/pamj.2024.49.131.45236","url":null,"abstract":"<p><p>A 58-year-old man, initially treated for erectile dysfunction, presented with erosion of a penile prosthesis through the urethra one year after his surgical intervention. Clinical examination revealed the extrusion of the left penile prosthesis through the urethral meatus, associated with mild local inflammation and a fever of 39°C. The patient underwent manual extraction of the prosthesis, careful and delicate urethral catheterization, and antibiotic therapy. Two months later, he was readmitted for the insertion of a new penile prosthesis in the left corpora cavernosa and was discharged on the second postoperative day without complications. Thus, erosion of a penile prosthesis is a serious complication requiring prompt removal of the prosthesis, effective antibiotic treatment, and proper urethral healing.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"49 ","pages":"131"},"PeriodicalIF":0.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Kidney Disease-Epidemiology Collaboration (CKD - EPI) classification of kidney function and predictors of kidney dysfunction among type 2 diabetes mellitus patients in a tertiary hospital in Ghana.","authors":"Godsway Edem Kpene, Enoch Kwame Obuobi, Gifty Dzifa Aku Senoo, Priscilla Appiah Baffoe, Georgina Korankye","doi":"10.11604/pamj.2024.49.132.43686","DOIUrl":"10.11604/pamj.2024.49.132.43686","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 Diabetes Mellitus (T2DM) is a major global health concern frequently associated with Kidney Dysfunction (KD). Globally, approximately one in eleven adults have diabetes mellitus, with 90% of these cases being type 2 diabetes mellitus. About two-thirds of T2DM patients experience KD, which may progress to chronic kidney disease and end-stage renal disease. In Ghana, the burden of T2DM is substantial and continues to rise, with kidney failure accounting for approximately 10% of all deaths among individuals with T2DM. This study sought to investigate the predictors of KD among T2DM patients in Ghana and approximately 10% of deaths in people with T2DM are attributable to kidney failure.</p><p><strong>Methods: </strong>a hospital-based retrospective study design was employed. It involved the medical records of 141 T2DM patients. The data extracted was entered into Microsoft Excel version 16.0 and analyzed using STATA version 16.0. Chi-square test was used to establish associations between categorical variables and KD. Independent t-test was employed to analyze associations between parametric (normally distributed) variables and KD, while the Mann-Whitney U test was used for non-parametric (not normally distributed) variables. The strengths of the identified associations were evaluated using binary logistic regression analysis, with the results reported as odds ratios (OR) along with their 95% confidence intervals.</p><p><strong>Results: </strong>among the 141 patients, 99 (70.2%) had KD. Formal employment was associated with a 95% reduced odds of kidney dysfunction (aOR = 0.05 (95%CI: 0.004-0.645); p-value = 0.021), while every unit increase in creatinine level was linked to a 10% increased odds of KD (aOR = 1.10 (95%CI: 1.06-1.14); p-value = <0.001).</p><p><strong>Conclusion: </strong>the study revealed a significant proportion of T2DM patients experiencing kidney dysfunction. Crucially, both occupation and creatinine levels were found to be independent predictors of diabetic KD. This highlights an urgent need to educate T2DM patients, particularly those who are unemployed or informally employed, about preventive measures and the importance of regular monitoring of creatinine levels to safeguard kidney health. This emphasis is vital, as managing kidney disease in the region is notably costly, making early intervention and education key strategies in reducing the burden of KD among T2DM patients.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"49 ","pages":"132"},"PeriodicalIF":0.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cellular and immune response in fatal COVID-19 pneumonia.","authors":"Sylvia Nikolaeva Genova, Mina Miroslavova Pencheva, Tsvetana Ivanova Abadjieva, Nikolay Georgiev Atanasov","doi":"10.11604/pamj.2024.49.130.45739","DOIUrl":"10.11604/pamj.2024.49.130.45739","url":null,"abstract":"<p><strong>Introduction: </strong>the severity of COVID-19, causing fatal pneumonia, acute respiratory distress syndrome (ARDS), and thrombotic complications, is linked to intense inflammation. Elevated CD4+ and CD8+ cells in the lungs indicate harmful inflammation in severe cases. This study investigates immune responses in lung tissues of deceased patients across different stages of COVID-19 pneumonia.</p><p><strong>Methods: </strong>lung tissues from 160 fatal COVID-19 cases, diagnosed via Real-Time RT-PCR, were histologically analyzed to identify pneumonia stages. Inflammatory cell counts were assessed immunohistochemically. Non-parametric tests analyzed categorical variables, while regression analysis evaluated relationships between continuous variables.</p><p><strong>Results: </strong>the average patient age was 68.1 years (± 12.6). Microscopic analysis identified four pneumonia stages. CD4+, CD68 (macrophages), and IgG4 levels peaked by day 14, with notable elevation within seven days of symptom onset. CD4+ levels were significantly lower in DAD pneumonia (49.4% ± 15.7%) compared to ARDS (66.4% ± 19.3%) and thrombosis (70.2% ± 28.9%) (p < 0.05). Male patients had higher CD4+ values (68.5% ± 21.1%) than females (56.9% ± 22.4%) (p < 0.05). B cells (CD20) and NK cells were depleted across all stages. IgG4 expression reached 80-90% in acute phases but was nearly absent during organization and fibrosis stages.</p><p><strong>Conclusion: </strong>a sharp decline in CD4+ and CD8+ during acute pneumonia and sepsis reflects immune exhaustion, while their elevation in ARDS and thrombosis likely triggers cytokine storms, causing severe lung damage. Elevated IgG4 levels in acute lung tissue correlate with fatal outcomes in severe COVID-19.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"49 ","pages":"130"},"PeriodicalIF":0.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Familial multiple lipomatosis in a 13-year-old child.","authors":"Azzeddine Laaraje, Abdelhakim Ourrai","doi":"10.11604/pamj.2024.49.129.14033","DOIUrl":"https://doi.org/10.11604/pamj.2024.49.129.14033","url":null,"abstract":"","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"49 ","pages":"129"},"PeriodicalIF":0.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valvular thrombosis complicating tricuspid valve replacement: a case report.","authors":"Nugraha Teguh Palin, Achmad Lefi","doi":"10.11604/pamj.2024.49.127.45485","DOIUrl":"10.11604/pamj.2024.49.127.45485","url":null,"abstract":"<p><p>Valvular heart disease is cardiovascular pathology that affects over 100 million people worldwide and is associated with significant morbidity and mortality. Although tricuspid valve disease is the least common primary valve pathology, it is linked to a significantly increased mortality rate (up to 42% within 3 years). Valve thrombosis is a rare complication following mechanical valve replacement, characterized by thrombus accumulation on the valve leaflets, leading to limited valve movement, often in patients not achieving anticoagulation targets. Mechanical valve thrombosis is suspected in post-replacement patients presenting with acute or subacute symptoms. Rapid diagnosis relies on imaging modalities such as transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE), computed tomography (CT), and fluoroscopy. This case report describes a 52-year-old male presenting with sudden onset dyspnea 5 days prior to hospital admission. The patient had a history of tricuspid valve replacement with a mechanical prosthesis due to tricuspid valve destruction by infective endocarditis vegetation, along with large muscular-inlet ventricular septal defect (VSD) closure and atrial septal defect (ASD) creation. Upon arrival, the patient appeared weak and dyspneic with unstable hemodynamics and was diagnosed with mechanical tricuspid valve thrombosis. Immediate valve replacement surgery was performed, but the patient unfortunately deceased 4 days postoperatively due to septic shock. We highlight the poor outcomes of prosthesis valve thrombosis and the need of prevention with regular surveillance and adequate anticoagulation strategies. The case also emphasizes the need for rapid diagnosis and management of mechanical valve thrombosis and the challenges in distinguishing it from other conditions such as pannus formation, emphasizing the importance of combining clinical and imaging criteria for accurate diagnosis and treatment.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"49 ","pages":"127"},"PeriodicalIF":0.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}