Annals of African Medicine最新文献

{"title":"Prevalence and Detection of Novel Thalassemia Variant hemoglobin J in Extensive Tharu Population.","authors":"Nitu Nigam, Ruchi Gupta, Madan Lal Brahma Bhatt, Swasti Sinha, Nishant Verma, Sanjay Kumar Nigam, Shailendra Prasad Verma, Kirti Upadhyay, Surbhi Gupta","doi":"10.4103/aam.aam_207_24","DOIUrl":"10.4103/aam.aam_207_24","url":null,"abstract":"<p><strong>Background: </strong>Thalassemia is an autosomal recessive genetic disorder that disrupts hemoglobin production, resulting in varying degrees of anemia and associated health problems. In the Terai region of southern Nepal and northern India, the Tharu people has a high prevalence of hemoglobinopathies, including beta and alpha thalassemia.</p><p><strong>Aims and objectives: </strong>This study sought to ascertain the prevalence of hemoglobinopathies in Tharu school-age children in Lakhimpur Kheri, Uttar Pradesh, as well as the associated hematological and demographic traits.</p><p><strong>Materials and methods: </strong>In cooperation with the National Medical Organization (NMO) and Rashtriya Swayamsevak Sangh (RSS), the study was carried out between February 22-26, 2023. 369 blood samples were taken from youngsters enrolled in school. The BIORAD VARIANT algorithm was utilized to diagnose thalassemia characteristics and hemoglobinopathies using High Performance Liquid Chromatography (HPLC). The relationships between hematological markers, diagnostic results, and demographic factors were assessed by statistical analysis.</p><p><strong>Results: </strong>(1) Normal cases: 78.8% of participants were classified as normal. (2) Beta thalassemia heterozygous: 6.2%. (3) HbJ Meerut heterozygous: 4.0%. (4) HbS heterozygous: 9.8%. Statistical analysis revealed a significant association between sex and diagnosis (p=0.001), while no significant association was observed between age and diagnosis ( P = 0.846). Hematological parameters, including Mean Corpuscular Volume (MCV) and Mean Corpuscular Hemoglobin (MCH), differed significantly across diagnostic groups ( P < 0.05). Variations in hemoglobin types Hb A, Hb F, and Hb A2 were statistically significant ( P < 0.001).</p><p><strong>Conclusion: </strong>The study highlights a high prevalence of hemoglobinopathies within the Tharu community, emphasizing the need for accurate diagnosis and awareness campaigns to manage the disorder effectively. By reducing stigma and empowering the community with knowledge, these efforts can improve outcomes for individuals with thalassemia and related disorders.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"796-803"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690911","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":"Hepatoprotective Activity of Red Ginger Extract on Acetaminophen-induced Liver Injury Models in HepG2 Cells.","authors":"Wahyu Widowati, Hanna Sari Widya Kusuma, Didik Priyandoko, Wahyu Surakusumah, Nindia Salsabila Mia Dewi, Deni Rahmat, Dian Ratih Laksmitawati, Diah Kartika Pratami, Rizal Azis, Dhanar Septyawan Hadiprasetyo, Rita Tjokropranoto, Philips Onggowidjaja","doi":"10.4103/aam.aam_91_24","DOIUrl":"10.4103/aam.aam_91_24","url":null,"abstract":"<p><strong>Introduction: </strong>The liver is a major organ that plays a crucial role in detoxifying drugs; however, exposure to hepatotoxic drugs can lead to liver damage. Some research indicates that Zingiber officinale , commonly known as red ginger, possesses various biological properties. The objective of this study was to examine the hepatoprotective effect of red ginger extract (RGE) against acetaminophen (APAP)-induced HepG2 cells.</p><p><strong>Materials and methods: </strong>HepG2 cells were induced with APAP to simulate liver injury and subsequently treated with RGE. Levels of nitric oxide (NO) and lactate dehydrogenase (LDH) were measured using a colorimetric assay, while the levels of interleukin (IL)-6, IL-1β, and IL-10 were measured using an enzyme-linked immunosorbent assay. Gene expression of caspase-3 (Casp-3), Casp-9, and c-Jun kinase (JNK) was assessed by quantitative real-time polymerase chain reaction.</p><p><strong>Results: </strong>APAP-induced HepG2 cells exhibited a noticeable increase in pro-inflammatory markers. Cells treated with RGE showed lower levels of IL-1β and IL-6, and higher levels of IL-10 compared to the positive control. RGE treatment also reduced NO and LDH levels and downregulated the expression of Casp-3, Casp-9, and JNK genes.</p><p><strong>Conclusions: </strong>These results indicate that RGE exerts hepatoprotective effects through increased IL-10 production, alongside the suppression of NO, IL-1β, IL-6, as well as Casp-3, Casp-9, and JNK gene expression.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"712-720"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526176","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":"Demystify Carbapenem-resistant Acinetobacter baumannii Pneumonia Burden: 2-Year Cohort Study.","authors":"Alfian Nur Rosyid, Pepy Dwi Endraswari, Firman Setiawan, Yessy Puspitasari, Tri Pudy Asmarawati, Brian Eka Rachman, Arina Dery Puspitasari, Ahmad Mufid Sultoni, Prastuti Asta Wulaningrum","doi":"10.4103/aam.aam_304_24","DOIUrl":"10.4103/aam.aam_304_24","url":null,"abstract":"<p><strong>Introduction: </strong>The World Health Organization has identified carbapenem-resistant Acinetobacter baumannii (CRAB) infections as the most important pathogens for which new antibiotics must be developed immediately. Therefore, this study aimed to analyze the comparison of epidemiology, microbial pattern, and antibiotic resistance in CRAB and carbapenem-sensitive A . baumannii (CSAB).</p><p><strong>Methods: </strong>A retrospective cohort study was used, with community-acquired pneumonia with A . baumannii bacterial culture results. Data were obtained from the patient's medical record and the results of antibiotic sensitivity testing with the culture method by planting sputum on blood agar and MacConkey medium for 24 h.</p><p><strong>Results: </strong>A total of 50 patients, CRAB ( n = 26) and CSAB ( n = 24), found that the average gender was male in CRAB compared to CSAB (69.2% vs. 48.2%). Complications of respiratory failure, sepsis, and acute respiratory distress syndrome were higher in CRAB compared to CSAB (30.8% vs. 20.8%, 46.2% vs. 25%, and 2% vs. 0%). The mortality rate in the CRAB group was 53.8% vs. CSAB 12.5%. The mean length of stay (LOS) in CRAB was 17.92, while CSAB was 11.00. The mean cost of hospitalization in CRAB was higher than CSAB ($6993.0615 vs. $3263.7375). The mean neutrophil-to-lymphocyte ratio value in the CRAB group was 20.4, while in CSAB was 10.6.</p><p><strong>Conclusions: </strong>The results indicated that CRAB infection carries a greater burden in terms of cost of treatment, mortality, LOS, and more serious complications, compared to CSAB infection.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"909-915"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774542","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":"To Compare the Efficacy of Preoperative Oral 50 g of Maltodextrin versus 50 g of Glucose in Reducing Postoperative Nausea and Vomiting, in Patients Undergoing Laparoscopic Cholecystectomy under General Anesthesia: A Randomized Controlled Double-blind Study.","authors":"Girish Bandigowdanahalli Kumararadhya, Akshay Hiryur Manjunatha Swamy, Darshini Shivaramu, Sonia Jacob, K N Archana, S Vyshnavi","doi":"10.4103/aam.aam_272_24","DOIUrl":"10.4103/aam.aam_272_24","url":null,"abstract":"<p><strong>Background: </strong>Postoperative nausea and vomiting (PONV) is the second most common complaint following general anesthesia. Despite multimodal strategies to reduce PONV, it still occurs in 20%-30% of patients. Major surgery induces metabolic changes, resulting in insulin resistance. Oral carbohydrate (CHO) loading 2 h before surgery modifies insulin resistance and improves postoperative patient comfort including reduction of PONV.</p><p><strong>Patients and methods: </strong>The present study was a prospective, randomized controlled double-blinded study. 105 patients aged 18-60 years undergoing laparoscopic cholecystectomy under general anesthesia were randomized into three groups: M (50 mg of oral maltodextrin in 100 ml water), G (50 mg of oral glucose in 100 ml water), and C (100 ml of plain water). Each group received the samples 2 h before induction and underwent routine induction and intervention. Their vital parameters were monitored perioperatively and were also evaluated for PONV and perioperative comfort levels.</p><p><strong>Results: </strong>Statistically significant relationship between the groups and postoperative comfort score (χ 2 = 34.56, P ≤ 0.001, Cramé's V = 0.41). Analysis of variance test showed difference between the different groups and postextubation General Random Blood Sugar (GRBS) ( F = 16.11, P ≤ 0.001). No significant difference was seen among the three groups in preoperative comfort scores (χ 2 = 0.72, P = 0.699, Cramé's V = 0.08) and preoperative GRBS ( P = 0.055).</p><p><strong>Conclusion: </strong>It was concluded that the oral intake of CHO drink 2 h before surgery improves the comfort of patients by reducing preoperative hunger and thirst along with smaller postoperative glucose spike in the maltodextrin group.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"864-869"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966344","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 Prospective Clinical Audit into the Management of Postoperative Pain in the Postanesthesia Care Unit of a Tertiary Care Teaching Hospital in Coastal Karnataka, India.","authors":"B T Jayanth, Rashmi R Aithal, Sumesh T Rao","doi":"10.4103/aam.aam_141_24","DOIUrl":"10.4103/aam.aam_141_24","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical audit forms part of clinical governance, which aims to ensure that patients receive the best quality of care. Optimizing pain management in recovery involves measuring a range of processes and outcome indicators. Reducing acute pain improves patient outcomes and reduces chronic postsurgical pain incidence.</p><p><strong>Aim: </strong>The aim of the study was to assess the practice and outcomes of the management of postoperative pain in the postanesthesia care units (PACUs) of our tertiary care teaching hospital.</p><p><strong>Methodology: </strong>We studied postoperative pain and management in patients posted for elective procedures and monitored in the PACU. The study design was a prospective audit conducted in the PACU of a tertiary teaching hospital. The data collected and analyzed were based on the best practice guidelines and suggested indicators as per the New Zealand College of Anesthetists (ANCZA) postoperative analgesia protocols.</p><p><strong>Results: </strong>The planned postoperative analgesia was peri- and postoperative intravenous administration of paracetamol or other nonsteroidal anti-inflammatory drugs (NSAIDs) in the majority of patients (83.3%); four patients (6.7%) were treated with epidural infusions, three with intravenous opioid infusions (5%); only one patient (1.7%) received a bolus nerve block for pain relief. Most of the patients audited underwent general anesthesia, and parenteral analgesia with NSAIDs was effectively used in the majority of patients in the PACU. Failure in the management of acute pain in PACU resulted in severe pain (5%). A review of anesthesiologist for change in treatment protocol was required in these patients and delay of discharge from PACU was minimized. Opioids were mostly used for rescue analgesia.</p><p><strong>Conclusion: </strong>Evidence-based best practice of acute management of pain was implemented with our current treatment protocol, with emphasis on increased utilization of peripheral nerve blocks for optimal postoperative analgesia.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"759-764"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954206","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":"Does Ongoing Inflammation in Recovered COVID-19 Disease Aggravates Preexistent Diabetes Mellitus or Unmasks New-onset Diabetes Mellitus? A Single-center Experience of 800 Cases at 6-month Follow-up.","authors":"Shital Patil, Devang Kulkarni, Gajanan Gondhali","doi":"10.4103/aam.aam_20_25","DOIUrl":"10.4103/aam.aam_20_25","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Although blood sugar abnormalities have been reported during the COVID-19 pandemic due to ongoing virus-related effects on insulin secretory effects on the pancreas and stress and steroids used during management, its long-term effects remain unknown. Real-world data on blood sugar abnormalities in follow-up with special emphasis on new-onset diabetes mellitus (DM) or unmasking ongoing DM is an issue of concern that remains underestimated and under-evaluated in clinical settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Prospective, observational cohort study conducted between January 2021 and December 2022 included 800 COVID-19 patients above 18 years of age, irrespective of their disease severity and comorbidity, after a valid written consent. All the study cases were followed for 6 months after discharge from the hospital. Protocolled recording of covariates such as blood sugar (fasting, postprandial, and random), HbA1c, blood pressure, anthropometric indices, electrocardiogram, lipid profile, and uric acid was done at the entry point. Documentation of indoor records such as computed tomography (CT) Severity scores into mild (score &lt;8), moderate (score 9-15), and severe (score &gt;15); inflammatory markers such as interleukin-6, ferritin, C-reactive protein, lactate dehydrogenase and D-dimer, and interventions used during hospitalization such as oxygen supplementation and oxygen plus BIPAP/NIV were done as a protocol. Statistical analysis was done using the Chi-square test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the present study, blood sugar abnormalities as preexisting DM with aggravation noted in 12.75% (102/800), post-COVID-19 transient hyperglycemia in 43.75% (290/800), post-COVID-19 new-onset DM in transient group in 17.14% (60/350), post-COVID-19 new-onset DM in 8.59% (60/698) and no DM or hyperglycemia in 43.5% (348/800) cases [ P &lt; 0.00001]. A significant association was observed between interventions used, such as oxygen and oxygen plus BIPAP/NIV requirement, and cases without interventions with blood sugar profile such as new-onset DM, preexistent DM with aggravation, post-COVID-19 transient hyperglycemia and no DM or hyperglycemia ( P &lt; 0.00001). A significant association was observed in blood sugar level switch from normoglycemic to transient hyperglycemic to DM range during pre-COVID-19 to post-COVID-19 state in follow-up ( P &lt; 0.00001). Covariates analysis such as age, gender, body mass index observed a significant association with cases with new-onset DM, preexistent DM with aggravation, post-COVID-19 transient hyperglycemia and no DM ( P &lt; 0.00001). Comorbidities such as hypertension and IHD observed significant association with blood sugar profile in study cases in post-COVID-19 setting ( P &lt; 0.00001). Inflammatory markers during hospitalization, high-resolution CT severity score, and uric acid analysis during follow-up documented significant association with new-onset DM, preexistent DM with aggravation, pos","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"888-897"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265094","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":"An Observational Study on the Comparative Analysis of Trans Abdominal Preperitoneal and Totally Extraperitoneal: A Single-center Experience of 105 Patients.","authors":"Manoj Kumar, Ashesh Kumar Jha, Deepak Kumar, Iqbal Hasan, Dhirendra Kumar","doi":"10.4103/aam.aam_183_24","DOIUrl":"10.4103/aam.aam_183_24","url":null,"abstract":"<p><strong>Background: </strong>Inguinal hernia repair remains one of the most common surgical procedures performed in the elective setting. trans abdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) are the two well-established laparoscopic methods of inguinal hernia repair. However, doubts still exist about their relative merits and risks. In this study, we are sharing our observations on the comparative analysis of TAPP versus TEP.</p><p><strong>Materials and methods: </strong>This retrospective analysis was carried out on 105 cases of inguinal hernia, repaired laparoscopically over the last 2 years. Patients within the age group of 20-60 years, operated for primary unilateral inguinal hernia using either TAPP or TEP were included in this study. All the repairs were done by a single surgeon in the same unit, having more than 3 years of experience in laparoscopic hernia repair.</p><p><strong>Results: </strong>Among 105 patients, who underwent laparoscopic hernia repair, 53 were operated on by TAPP and 52 by TEP. There was no significant visceral or vascular injury in either group. The mean duration of surgery in the TAPP group was 103.43 ± 12.24, and in TEP group 89.83 ± 14.25 min (P < 0.0001) Mean hospital stay was 2.47 ± 0.79 and 2.0 ± 0.65 days in TAPP and TEP groups (P = 0.001). Patients in the TAPP group were able to return to their work after 14.30 ± 1.60 and in TEP after 13.73 ± 1.24 days (P = 0.04).</p><p><strong>Conclusion: </strong>Both TAPP and TEP are well-established methods for laparoscopic hernia repair. In terms of outcome, we observed that TEP requires less operative time and is associated with a relatively shorter hospital stay and earlier return to work.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"755-758"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697360","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":"Excipient Lung Disease and Fatal Outcome Among Young Adults: A Case Series on the Hidden Dangers of Intravenous Drug Abuse in India.","authors":"Dhivya Prakash, R Vijay Balaji, R Raguram, S Narayanan, Venkatesh Janarthanan, Senthil Kumaran","doi":"10.4103/aam.aam_210_24","DOIUrl":"10.4103/aam.aam_210_24","url":null,"abstract":"<p><strong>Background: </strong>Excipient lung disease (ELD) arises from the intravenous (IV) injection of crushed oral tablets, leading to acute or chronic pulmonary complications. Despite its significance, ELD is under-recognized, particularly in countries like India, where over-the-counter availability of pharmaceutical drugs contributes to rising abuse rates. This study investigates sudden deaths among young adults due to ELD, emphasizing the need for increased awareness and preventive measures.</p><p><strong>Materials and methods: </strong>This case series examined 10 cases of sudden death in individuals aged 18-25 with a history of IV drug abuse. Data were collected from postmortem examinations, death scene investigations, and toxicological and histopathological analyses. The aim was to confirm ELD as the cause of death and understand its presentation.</p><p><strong>Results: </strong>Deaths in these cases were strongly associated with drug overdoses. Death scene investigations revealed signs of IV drug use, such as track marks and drug paraphernalia. External and internal examinations showed consistent pathological findings, including edematous lungs with frothy secretions, granulomatous reactions in the pulmonary vasculature, and right ventricular hypertrophy. Toxicological analyses detected substances such as tapentadol and tetrahydrocannabinol, with excipients linked to ELD found in histopathological examinations.</p><p><strong>Conclusion: </strong>When injected, excipients such as talc and microcrystalline cellulose lead to granulomatous reactions and pulmonary complications. The study highlights the prevalence of ELD among young adults in India and the challenges in diagnosing this condition due to its nonspecific presentation and lack of disclosure of drug abuse history. Effective public health measures and stricter regulation of prescription drugs are crucial in preventing ELD-related deaths. This study underscores the severe health risks associated with IV drug abuse of oral tablets, leading to ELD. The findings emphasize the need for enhanced awareness, accurate documentation, and preventive strategies to address the rising substance abuse among youth in India.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"804-810"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647194","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":"Sarcoidosis Presenting as Space Occupying Lesions in Liver.","authors":"Devansh Bajaj, Deepak Suvarna, H V Aradya, H P Nandeesh, Abhishek Kabra","doi":"10.4103/aam.aam_246_24","DOIUrl":"10.4103/aam.aam_246_24","url":null,"abstract":"<p><strong>Abstract: </strong>This case report illustrates a typical presentation of hepatic sarcoidosis, a granulomatous liver disease that often manifests as an extrapulmonary feature of systemic sarcoidosis. The patient, a 60-year-old female, exhibited dyspeptic symptoms and anorexia. An abdominal ultrasound revealed space-occupying lesions in the liver, and elevated levels of alkaline phosphatase and gamma-glutamyl transferase were noted. Liver biopsy findings showed Grade 2 macrovesicular steatosis and noncaseating granulomatous inflammation. In addition, significantly elevated angiotensin-converting enzyme levels were observed, further supporting the diagnosis. This case underscores the importance of recognizing hepatic granulomatous foci, which can be crucial in determining the etiology and facilitating the diagnosis of sarcoidosis. The combination of clinical, biochemical, and histological findings played a pivotal role in diagnosing systemic sarcoidosis with hepatic involvement.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"929-932"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633392","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":"The Outcome of Laser Ablation Hemorrhoidoplasty versus Conventional Hemorrhoidectomy.","authors":"Mohammed Yousef Alessa, Loai Saleh Albinsaad, Arshadullah Khan, Laila Zamil Alzamil, Raghad Mabrouk Alanazi, Najd Mabrouk Alanazi, Abeer Mabrouk Alanazi","doi":"10.4103/aam.aam_226_24","DOIUrl":"10.4103/aam.aam_226_24","url":null,"abstract":"<p><strong>Context: </strong>Hemorrhoids affect a significant proportion of the population, and the choice between laser hemorrhoidoplasty and conventional hemorrhoidectomy remains a crucial clinical decision.</p><p><strong>Aims: </strong>The aim of this study was to compare the outcomes of piles management with laser hemorrhoidoplasty versus conventional surgical hemorrhoidectomy.</p><p><strong>Settings and design: </strong>A retrospective data collection from hospital registry about 50 patients who underwent laser hemorrhoidoplasty and another 50 patients who underwent conventional hemorrhoidectomy.</p><p><strong>Subjects and methods: </strong>Demographic and clinical data were analyzed using descriptive and inferential statistics. Data were meticulously collected and analyzed, employing SPSS statistical software.</p><p><strong>Statistical analysis used: </strong>SPSS statistical software was used for statistical analysis.</p><p><strong>Results: </strong>The mean age was 40.45 years, with a balanced gender distribution. While no significant difference in age was observed between treatment groups, notable variations in gender and hemorrhoid degree distribution were evident. Laser hemorrhoidoplasty exhibited a higher percentage of patients with second-degree hemorrhoids, while conventional hemorrhoidectomy had a higher prevalence of more severe hemorrhoids (degree 3 or 4). Clinical outcomes revealed that laser hemorrhoidoplasty was associated with less postoperative pain and bleeding. Notably, all laser patients reported mild pain (1-3), while the conventional group exhibited a broader spectrum, including severe pain (7-9) in 96% of cases. Furthermore, bleeding outcomes were more favorable in the laser group, with 100% experiencing minor bleeding compared to the conventional group, which showed a higher incidence of both minor and moderate bleeding.</p><p><strong>Conclusions: </strong>The observed advantages of laser hemorrhoidoplasty in terms of reduced postoperative pain and bleeding suggest its potential as a favorable alternative, particularly in less severe cases.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"811-815"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504724","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}