Annals of African Medicine最新文献

{"title":"Susac Syndrome with Classical Triad: A Case Report and Literature Review.","authors":"Bashair Alshehri, Amaar Amir, Razan Alshehri, Hissah Alturki, Talal Aljudi, Asma Alzuabi","doi":"10.4103/aam.aam_234_24","DOIUrl":"https://doi.org/10.4103/aam.aam_234_24","url":null,"abstract":"<p><strong>Abstract: </strong>Susac syndrome is a rare microangiopathy affecting the brain, retina, and cochlea. Individuals affected typically present with a classical clinical triad of branch retinal artery occlusion (BRAO), encephalopathy or white matter lesions, and sensorineural hearing loss. Herein, we report an exceedingly rare case of a middle-aged female patient with multiple presentations related to her visual field complaints. The presence of multiple bilateral BRAOs, in addition to sensorineural hearing impairment and white matter lesions on the brain magnetic resonance imaging, led to the diagnosis of Susac syndrome. Cases of Susac syndrome are few and far between and have seldom been reported in detail. Awareness of this rare presentation by clinicians and radiologists is of utmost importance to aid in correctly diagnosing and treating such patients.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603550","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":"Prevalence and Various Risk Factors Associated with Suicidal Ideation Thoughts in Medical Students from a Medical College in Northern India.","authors":"Visesh Kumar, Azfar Mateen, Tarique Aziz, Ajay Kumar Singh, Abhas Kumar Singh, Mala Mahto, Reetesh Kumar Rai","doi":"10.4103/aam.aam_28_25","DOIUrl":"https://doi.org/10.4103/aam.aam_28_25","url":null,"abstract":"<p><strong>Introduction: </strong>In medical school, suicide ideation is an important issue that has garnered increasing attention in recent years. Students in the medical field have an environment full of stress. Medical students are subjected to dealing with problems that produce lots of mental distress due to the surrounding environment, dealing with patients' deaths, issues related to different ethical backgrounds, and witnessing death and human agony.</p><p><strong>Objective: </strong>In this study, we evaluated various risk factors that can cause suicidal thoughts.</p><p><strong>Materials and methods: </strong>A cross sectional study was conducted on medical students of a medical college in eastern Uttar Pradesh. A total of 423 study participants responded. The participants were asked to respond questionnaire on sociodemographic variables and risk factors and a Patient Health Questionnaire 9 (PHQ 9) through Google Forms.</p><p><strong>Results: </strong>A total of 18 (4.2%) respondents reported having suicidal ideation thoughts in the last 1 year and 12 students reported a cutoff score >9 in the PHQ 9 questionnaire. Depression, academic stress, use of alcohol, and abuse by physical or sexual means were the risk variables significantly linked to greater suicidal ideation thoughts. The prevalence of suicidal ideation among medical students is worrisome.</p><p><strong>Conclusions: </strong>The data suggests that the initial steps in preventing suicidal ideation are that students should get proactive student counseling and early treatment if needed.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596113","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":"Commentary on \"High-frequency Hearing Loss among Smart Mobile Phone Users: A Case-Control Study\".","authors":"Shariyar Ahmad Rahemtoola, Shadman Rahemtoola","doi":"10.4103/aam.aam_219_24","DOIUrl":"https://doi.org/10.4103/aam.aam_219_24","url":null,"abstract":"","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584388","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":"Comparison of Kettlebell and Cycling Exercise on Heart Rate Variability.","authors":"Aman Paisal, Ehsan Ahmad, Aaqib Husain Ansari, Dileep Kumar Verma, Shraddha Singh","doi":"10.4103/aam.aam_156_24","DOIUrl":"https://doi.org/10.4103/aam.aam_156_24","url":null,"abstract":"<p><strong>Background: </strong>Kettlebells, dating back to 1703 in Russia, offer a full-body workout for strength, endurance, and flexibility. They activate back and hip musculature, reduce low back injury risk, and improve postural coordination. Cycling induces muscle hypertrophy, guiding exercise prescription.</p><p><strong>Objective: </strong>The study evaluates the impact of kettlebell and cycling exercise on heart rate variability (HRV) in healthy young adults, assessing lifestyle, body mass index (BMI), and relationship with HRV.</p><p><strong>Methods: </strong>A pilot study at King George's Medical University's Department of Physiology in Lucknow, Uttar Pradesh over a period of 1 year, involved 64 participants, including healthy adults aged 18-35, consenting individuals, and those under 35 diagnosed with any medical conditions were excluded.</p><p><strong>Results: </strong>The study examined the impact of kettlebell and cycling exercise on HRV in 64 healthy individuals. The participants were divided into two groups, with no significant differences in height, weight, BMI, waist circumference, or blood pressure. After exercise, heart rate (HR) increased by 55%, but low frequency (LF) power and high frequency (HF) power decreased.</p><p><strong>Conclusion: </strong>The study found that combining kettlebell and cycling exercise can improve cardiovascular health and overall physical fitness in 64 healthy individuals, increasing HR by 55% but decreasing LF and HF power.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596065","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":"Association between Serum Uric Acid Levels and Islet Beta-cell Function in Type 2 Diabetes Mellitus.","authors":"Nitesh Shukla, Ashok Kumar, Lalit Kumar Tyagi, K P Sindhura","doi":"10.4103/aam.aam_190_24","DOIUrl":"https://doi.org/10.4103/aam.aam_190_24","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is a disease characterized by insulin resistance (IR) and insufficiency. Serum uric acid (SUA) is a biomarker of diabetes risk, with Indian populations having varying levels due to diet, lifestyle, and genetic susceptibility. However, the relationship between UA and T2DM is contentious due to its association with obesity. The study explores the relationship between serum uric acid levels and islet beta-cell function in type 2 diabetes patients, estimating the correlation, examining factors such as age, gender, or body mass index (BMI), and estimating the correlation between uric acid levels and IR.</p><p><strong>Methods: </strong>A study at Santosh Medical College in Ghaziabad involved 167 patients over 18 years old with type 2 diabetes, diagnosed based on fasting plasma glucose levels, and glycated hemoglobin (HbA1c). The patients underwent detailed history and physical examination, including fasting blood glucose, lipid profile, serum urea, creatinine, uric acid, HbA1c, insulin sensitivity index, and islet beta-cell function indices.</p><p><strong>Results: </strong>The study involved 170 patients, with 84 (49.41%) being male and 86 (50.59%) being female. The mean lipid profile was similar across genders, with no significant differences in HbA1c, random blood sugar (RBS), total cholesterol (TC), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-c), and homeostatic model assessment of IR (HOMA-IR). Smoking and alcohol consumption were significantly higher in males, while family history of T2DM was comparable between both genders. The relationship between SUA quartiles and other parameters and HOMA-IR in males was not significantly different, while in females, the mean age, BMI, waist circumference, waist-hip ratio, HbA1c, RBS, TC, TG, HDL-c, low-density lipoprotein-cholesterol, HOMA-IR, and creatinine were not significantly different. The correlation of HOMA-IR and uric acid was positive but not significantly associated.</p><p><strong>Conclusion: </strong>The study found a significant positive correlation between serum uric acid levels and IR in males and females and a positive but nonsignificant correlation with BMI, suggesting that SUA could predict islet β-cell activity.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584386","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":"Conundrum of Acute Liver Failure.","authors":"Battu Sai Vishnu, B Sai Surya Teja, I Lavanya Sri, Eswar Ganti","doi":"10.4103/aam.aam_9_25","DOIUrl":"https://doi.org/10.4103/aam.aam_9_25","url":null,"abstract":"<p><strong>Abstract: </strong>A 20-year-old male with fever, myalgia, and jaundice developed severe liver dysfunction, progressing to acute liver failure (ALF). Initial treatment for malaria and supportive care did not resolve symptoms, with persistent jaundice and elevated liver enzymes. Laboratory tests confirmed Plasmodium falciparum/Plasmodium vivax infection. Further evaluation revealed drug-induced liver injury (DILI) from prescribed medications and possible hepatotoxic effects of herbal supplements. Hepatitis A, exacerbated by malaria, DILI, and herbal toxicity, contributed to compounded hepatic dysfunction. Management included intravenous fluids, hepatoprotective agents, and antipyretics. This case underscores the importance of considering multiple etiologies, including infections, drug toxicity, and environmental factors, in ALF.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596067","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":"Assessing Autonomic Dysfunction in Diabetes: A Hospital-based Study in a Developing Country.","authors":"Khalid A Dafalla, Azza O Alawad, Tarig Hakim Merghani, Fathelrahman M Ahmed, Ahmed Alsiddig Ebraheem","doi":"10.4103/aam.aam_202_24","DOIUrl":"https://doi.org/10.4103/aam.aam_202_24","url":null,"abstract":"<p><strong>Background: </strong>Autonomic nervous system (ANS) dysfunction is a common complication in patients with diabetes mellitus, potentially affecting the various organ systems leading to significant morbidity. This study aimed to evaluate ANS dysfunction in diabetic patients attending Wad Madani Teaching Hospital, Sudan.</p><p><strong>Materials and methods: </strong>A cross-sectional and hospital-based study was conducted on a sample of 100 patients in Wad Madani Teaching Hospital in Sudan. For each participant, a data collection form was utilized to record the sociodemographic details, previous medical history, and patient assessment results including heart rate (HR), blood pressure (BP), weight, and height. Patients were assessed for the signs of autonomic dysfunction using the clinical examinations and standardized autonomic function tests. HR variability (HRV), BP response to standing, and deep breathing tests were the primary methods used to assess ANS function. The results were analyzed using the Statistical Package for the Social Sciences (SPSS) software version 26. 0.</p><p><strong>Results: </strong>The mean age of the participants was 63.4 ± 9.9 years, with males comprising 75% of the sample. Of the participants, 48% were overweight and 22% were obese, with 77% demonstrating poor glycemic control (hemoglobin A1c ≥ 7.0%). Only 11% of participants had normal HRV during deep breathing, while 56% showed abnormal values. For the HR response to standing, 27% of participants had abnormal results. Regarding BP response to standing, 19% had abnormal readings. Autonomic dysfunction was prevalent, with 89% of participants exhibiting some degree of dysfunction, including early parasympathetic (16%) and combined parasympathetic and sympathetic dysfunction (19%).</p><p><strong>Conclusion: </strong>Autonomic dysfunction is highly prevalent among diabetic patients in Wad Madani, with most exhibiting parasympathetic and sympathetic dysfunctions. This underscores the need for the early diagnosis and management of autonomic complications in diabetic patients to improve the outcomes and quality of life.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575613","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":"Echocardiographic Assessment of Structure and Function of Left Ventricle in Chronic Kidney Disease Along with its Determinants in a Tertiary Healthcare Center in Tribal Region of Jharkhand.","authors":"Anchal Kujur, Siddharth Kapoor, Usha Saroj, Abhay Kumar, Stuti Srishti, Sujeet Anand, Gregory Minj, Ajit Dungdung, Shishir Kumar Mahato","doi":"10.4103/aam.aam_191_24","DOIUrl":"https://doi.org/10.4103/aam.aam_191_24","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Chronic kidney disease (CKD) is a complex pathophysiologic process that leads to irreversible changes in kidney structure and function. The left ventricle (LV) remodeling, which is evident as LV hypertrophy (LVH) is highly prevalent in patients with CKD even in the early stages and has a strong association with cardiovascular mortality, multiple studies have suggested that there is a strong association between high albuminuria and LVH, which was found to be independent of low GFR, hypertension, and diabetes. The most commonly used noninvasive method for estimating cardiac function and size is 2D echocardiography. It has the benefit of being portable, available, and providing images of the heart in real time. In CKD patients, echo is the most important noninvasive method for predicting cardiovascular risk.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This was a cross-sectional observational study approved by the institutional ethics committee through memo no. 210/IEC, Rajendra Institute of Medical Sciences (RIMS) dated October 3rd, 2023. The study was conducted on patients with CKD admitted to the Department of Internal Medicine at RIMS, Ranchi, Jharkhand between November 2023 and July 2024. Taking the prevalence of 6.3%, the sample size comes out to be 95, and we have taken 114 patients for our study. Data were collected using Google Forms, and a template was generated in an Microsoft Excel sheet. SPSS software version 22.0 and JAMOVI software version 2.3 were used for data analysis. A Chi-square test with Fisher's exact test for cells &lt;5 was applied for the test of significance between variables. A multivariate analysis was performed for associations between variables. P ≤0.05 was considered statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study was conducted on 114 patients, of whom 69% were males and 31% were females. Among comorbidities, hypertension, diabetes, smoking, dyslipidemia and alcohol were studied. The majority of cases (63%) belonged to CKD Stage 5 compared to other stages of CKD. Most of the cases (33%) had a moderate reduction in the LV ejection fraction (LVEF), and 52% of the cases had concentric hypertrophy. Grade 1 LV diastolic dysfunction was the most common (76%). In Stage 5 CKD, 43% of the patients had a moderate decrease in the LVEF. Using the Chi-square test, a significant association was found between CKD stages and LVEF (P ≤ 0.023). The relationship between different variables and LVEF in the participants was evaluated, and the Chi-square test was used to determine the P value. P ≤0.05 was considered statistically significant. Alcohol, albuminuria, and dyslipidemia were found to be significant determinants of LVEF. Multinominal logistic regression analysis was applied to the above variables, and all three variables, including alcohol, albuminuria, and dyslipidemia, came out to be significant determinants of LVEF in patients with CKD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Car","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575617","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":"Percutaneous Nephrolithotomy in the Management of Renal Stone: An Audit of Outcomes and Complications.","authors":"Idorenyin Cletus Akpayak, Chukwudum Dennis Ikeh","doi":"10.4103/aam.aam_5_25","DOIUrl":"https://doi.org/10.4103/aam.aam_5_25","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous nephrolithotomy (PCNL) is considered one of the most significant advances in minimally invasive urologic surgery. It offers a better stone-free rate compared to other available treatment modalities of renal stones at a lower complication rate compared to open surgery. Despite the availability of extracorporeal shock wave lithotripsy and flexible ureteroscopy, PCNL remains the gold standard modality for large and complex renal stones. Here, we review our initial experience with standard PCNL in the prone position for renal stones >1.5 cm with respect to stone clearance rate and complications as seen in our patients.</p><p><strong>Patients and methods: </strong>Records of 24 patients who had standard PCNL and pneumatic lithotripsy between September 2020 and September 2023 were reviewed retrospectively. All the patients who had the standard PCNL for renal stones >1.5 cm were the subjects of this study. Data on patients' demographics, indication for the surgery, location of stone, size of stone, postoperative nephrostomy placement, nephrostomy tract size, complications, duration of surgery, duration of hospital stay, and status of stone clearance were obtained, and the data were subjected to statistical analysis.</p><p><strong>Results: </strong>A total of 24 patients underwent the standard PCNL. The mean age of the patients was 47.0 ± 10.28 years (16 males and 8 females; range: 17-68 years). Flank pain was the main indication for the surgery. The mean stone size was 2.5 cm (range: 1.6-3.3 cm). The mean Hounsfield unit was 1248.2 HU (range: 927-1502HU). At a single session, we achieved 100% stone clearance in 20 (83.3%) patients. Two (8.3%) of our patients required a second session of PCNL due to intraoperative bleeding and perforation of the pelvicalyceal system necessitating termination of the procedure and insertion of nephrostomy tube. In another 2 (8.3%) patients, the stones migrated and became inaccessible. One (4.2%) patient stayed for 10 days due to persistent urine leak, which eventually stopped after the insertion of a double-J stent and administration of antibiotics. The Clavien-Dindo grading system was used to classify postoperative complications. A total of 14 (58.3%) patients had Grade I complications, while 3 (12.5%) patients had Grade II and 1 (4.2%) had Grade IIIa complications.</p><p><strong>Conclusion: </strong>PCNL is an effective minimally invasive technique for the treatment of large renal stones. Our initial experience suggests that the complication rate in PCNL is well within the acceptable limit.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575678","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 Case of Cortical Venous Thombosis Secondary to Tuberculous Meningitis.","authors":"K M Srinath, Tanmay Kulkarni, K Nandini, M Basava Chethan","doi":"10.4103/aam.aam_242_24","DOIUrl":"https://doi.org/10.4103/aam.aam_242_24","url":null,"abstract":"<p><strong>Abstract: </strong>A male patient in his 20s presented with new-onset seizures. Computed tomography head plain was normal. However, in view of persistent occipital headache, magnetic resonance imaging brain with magnetic resonance venogram scan was done which showed left lateral sinus thrombosis. The patient developed fever spikes after admission. Hence, cerebrospinal fluid analysis was sent which was suggestive of a tuberculous etiology. The patient was started on intravenous steroids and antitubercular treatment along with low-molecular-weight heparin. The patient's general condition improved significantly following which the patient was discharged with antitubercular medications, newer oral anticoagulants, and a tapering dose of steroids. To the best of our knowledge, only few case reports have been documented in relation to tuberculous meningitis presenting as cortical venous thrombosis.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575594","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}