Annals of African Medicine最新文献

{"title":"Comparison of End-tidal Capnography, Chest Auscultation, and Upper Airway Ultrasonography for Rapid Confirmation of Endotracheal Tube Placement by Trainees among Patients Requiring Intubation for General Anesthesia.","authors":"Vallikanna Subramanian, Julie C R Misquith, Shilpa A Naik, Karl Nicholas Sa Ribeiro","doi":"10.4103/aam.aam_221_24","DOIUrl":"10.4103/aam.aam_221_24","url":null,"abstract":"<p><strong>Background: </strong>Ensuring proper endotracheal tube (ETT) placement is crucial during general anesthesia. Traditional confirmation methods include capnography and chest auscultation, but each has limitations. Ultrasound (USG) offers real-time visualization of ETT placement, potentially improving confirmation speed and accuracy.</p><p><strong>Objectives: </strong>To compare the feasibility of USG for early detection of esophageal intubation against capnography and chest auscultation in trainees.</p><p><strong>Methodology: </strong>This comparative observational study assessed the time for ETT placement confirmation using USG, capnography, and chest auscultation in 90 patients undergoing general anesthesia. Patients were divided into three groups: USG confirmation (Group A), capnography confirmation using the first or sixth waveform (Group B), and chest auscultation confirmation (Group C).</p><p><strong>Results: </strong>Group A had the fastest confirmation time (32.1 s), followed by Group C (bilateral: 46.97 s), and Group B (6th waveform: 48.23 s). Statistically significant differences were observed between Group A and Group B (6th waveform), and Group A and Group C (bilateral). Hemodynamic parameters showed significant changes during and after intubation compared to baseline.</p><p><strong>Conclusions: </strong>USG emerged as a faster and potentially more reliable method for ETT placement confirmation compared to capnography and chest auscultation. The real-time visualization offered by USG is valuable for novice trainees, enabling rapid confirmation, and potentially improving patient safety by facilitating early detection of misplacement.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881902","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":"Generalized Lymphadenopathy in a Young Boy: A Rare Presentation of Kikuchi-Fujimoto Disease.","authors":"Anand Nandkumar Dugad, Vivek Hitesh Lapsiwala","doi":"10.4103/aam.aam_218_25","DOIUrl":"10.4103/aam.aam_218_25","url":null,"abstract":"<p><strong>Abstract: </strong>Kikuchi-Fujimoto disease (KFD), or histiocytic necrotizing lymphadenitis, is a rare, benign, and self-limiting condition that typically affects young women and is uncommon in children or males. We report the case of a 15-year-old boy who presented with generalized lymphadenopathy involving cervical, axillary, submandibular, and inguinal nodes, along with mild fever and pain. A series of fine-needle aspiration cytology and lymph node biopsies over 3 years initially showed reactive and acute lymphadenitis. The diagnosis of Kikuchi's disease was eventually confirmed on histopathology of an axillary lymph node, which revealed necrotizing lymphadenitis without granulomas. The patient improved with symptomatic treatment using nonsteroidal anti-inflammatory drugs and antibiotics. This case highlights the diagnostic challenges of KFD in an atypical demographic and underlines the importance of repeated histopathological assessment in persistent or recurrent lymphadenopathy.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881905","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":"Quality of Life of Patients with End-stage Renal Disease Undergoing Hemodialysis in Morocco: Cross-sectional Study.","authors":"Badre Bakzaza, Hanane Lemmih, Saad Rachiq, Sidi Mohammed Raoui","doi":"10.4103/aam.aam_136_25","DOIUrl":"10.4103/aam.aam_136_25","url":null,"abstract":"<p><strong>Background: </strong>End-stage chronic renal disease and its long-term treatment by hemodialysis (HD) affect several aspects of life. This is a cross-sectional, descriptive, and analytical study of 80 patients undergoing chronic HD at the only public sector HD center in the Meknes prefecture of Morocco. This study's objectives are to evaluate the quality of life (QOL) of patients receiving chronic HD and to determine the factors associated with these patients' decreased QOL.</p><p><strong>Subjects and methods: </strong>To achieve the aims of this study, the short form of the Kidney disease quality of life short form (KDQOL-SF1,3), translated and validated in the Moroccan context, was the data collection instrument utilized to gauge these patients' QOL.</p><p><strong>Results: </strong>The overall mean KDQOL-SF™ score was 39.31 (standard deviation [SD] 7.56). The kidney disease component, mental component, and physical component scores were 47.84 (SD 11), 33.91 (SD 10.22), and 36.19 (SD 8.30), respectively. Scores considered satisfactory were in favor of social support. Similarly, this study revealed, using the Student's t-test, that there was no significant difference in the means between the subgroups in terms of age, sex, marital status, and duration of HD treatment, while it revealed a significant correlation, using the Pearson's test, between kidney disease component and the two physical health and mental health components.</p><p><strong>Conclusions: </strong>This study revealed that the QOL of chronic HD patients is impaired. It highlighted that an action on the effects of kidney disease could improve the physical and mental health and, consequently, the QOL of HD patients.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881910","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 Self-directed Learning and Didactic Lecture in Teaching Clinical Anatomy to 1st Year MBBS Students.","authors":"Samridhi Arora, Ranjana Shingne, Sathyanarayan Kelegere Ravi, Indira Jha","doi":"10.4103/aam.aam_104_25","DOIUrl":"10.4103/aam.aam_104_25","url":null,"abstract":"<p><strong>Introduction: </strong>Anatomy is an important basic science that lays the foundation for clinical courses in MBBS curriculum. To make it interesting and clinically useful, several innovative teaching-learning methods are introduced in competency based medical education, where the students take the responsibility for their learning. In health care professional studies, self-directed learning (SDL) is considered an indispensable learning parameter.</p><p><strong>Objectives: </strong>(1) To compare the effectiveness of SDL with didactic lectures in learning clinical anatomy among 1st year medical students. (2) To assess the retention of knowledge by students through SDL.</p><p><strong>Materials and methods: </strong>This was a comparative cross-sectional comparative observational study conducted on 124 Phase I MBBS between the ages of 18 and 25 years of both sex students of Dr Baba Saheb Ambedkar Medical College and Hospital, Rohini, Delhi. They were divided into 2 batches (Batch A and B) of 62 each. On the 1st day, Batch A was given a didactic lecture, while Batch B underwent an SDL session with all the study materials provided. A multiple-choice questionnaire (MCQ) was administered through a Google form after a didactic lecture and SDL session to each group. On the 2nd day, the batches were reversed, and another similar topic was dealt with, and assessment was done through the MCQ test. Knowledge retention was assessed by another MCQ test of the same topics, conducted 4 weeks after the SDL session. A paired t-test score comparing both methods reported that the after SDL was more compared than didactic lectures.</p><p><strong>Results: </strong>Mean ± standard deviation a paired t-test comparing both methods reported that the scores after SDL were more compared to didactic lectures.</p><p><strong>Conclusion: </strong>SDL as a teaching-learning method in anatomy is a more effective method for learning, improving, and retention of knowledge for students. Hence, students choose SDL as it improves the understanding of the subject and helps to clear up doubts.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881903","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":"Perception of Congenital Cataract among Saudi Parents in Saudi Arabia.","authors":"Abdullah M Aljaafari, Abdulrahman Tawfiq Al-Mulla, Suliman Salah Alsowaigh, Mohammed A Al-Medires, Hussain Ayad Alotaibi, Ahmed A Alarfaj, Abdullatif M Aljaafari, Abdulaziz A Al Taisan, Sayed Ibrahim Ali","doi":"10.4103/aam.aam_170_25","DOIUrl":"10.4103/aam.aam_170_25","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to assess the awareness of congenital cataract among parents in Saudi Arabia.</p><p><strong>Setting: </strong>Nationwide study conducted in Saudi Arabia.</p><p><strong>Design: </strong>This was a cross-sectional study.</p><p><strong>Study methodology: </strong>The target demographic consists of parents in Saudi Arabia; each participant anonymously completed the Google Forms questionnaire. Saudi citizens who are parents and have consented to participate in the study all met the requirements for inclusion criteria. The exclusion criteria included individuals without children, non-Saudi citizens, and those refusing to take part in the study. Data were analyzed using a statistical package for social science (SPSS).</p><p><strong>Results: </strong>Out of 1554 participants, 1422 have met the inclusion criteria. A majority (58.31%) have heard of congenital cataract before taking the survey. With most respondents (56.09%) able to identify it as the opacification of the eye lens, while a significant number (31.45%) are unsure. A substantial proportion of respondents (59.96%) believe that congenital cataract can be cured. Participants of the female gender (P = 0.016), aged above 60 (P < 0.01), and people with diplomas or higher educational degrees (P = 0.019 and < 0.01) were more aware about congenital cataracts and its treatment.</p><p><strong>Conclusion: </strong>Our study shows that parents in Saudi Arabia have an adequate understanding and awareness about congenital cataract and its treatment. However, awareness and educational programs regarding congenital cataracts are recommended to further improve their understanding of the disease.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881908","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":"Systemic Lupus Erythematosus with Hemophagocytic Lymphohistiocytosis Mimicking Tuberculosis in a Young Male: A Diagnostic Challenge.","authors":"Prakash Shende, Tejas Anil Kore, Vivek Lapsiwala, Pranavi Kalakota","doi":"10.4103/aam.aam_172_25","DOIUrl":"https://doi.org/10.4103/aam.aam_172_25","url":null,"abstract":"<p><strong>Abstract: </strong>Systemic lupus erythematosus (SLE) can rarely present with hemophagocytic lymphohistiocytosis (HLH), a severe hyperinflammatory state with high mortality if unrecognized. We report a 21-year-old male who presented with fever, ascites, pleural effusion, anemia, and acute kidney injury. Infectious causes were ruled out, and autoimmune markers confirmed SLE. Bone marrow biopsy showed hemophagocytosis, fulfilling HLH-2004 criteria for HLH. The patient responded well to corticosteroids and hydroxychloroquine, with plans for cyclophosphamide and renal biopsy. This case emphasizes the importance of early recognition of macrophage activation syndrome in SLE patients with systemic inflammation and cytopenias.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939570","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":"Unmasking Lichen Planopilaris in the Shadow of Female Pattern Hair Loss: A Diagnostic Pitfall.","authors":"Akanksha Jakhar, Vidhi Malu, Avinash Jadhav, Devayani Pol","doi":"10.4103/aam.aam_158_25","DOIUrl":"10.4103/aam.aam_158_25","url":null,"abstract":"","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881912","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":"Nebulized Dexamethasone versus Intravenous Dexamethasone in Prevention of Postoperative Sore Throat: An Interventional Study.","authors":"Debahuti Chatterjee, Shweta Sinha, Laxmi Shenoy, Aparna Satish, Malavika Kulkarni, Sushma Thimmaih Kanakalakshmi","doi":"10.4103/aam.aam_150_25","DOIUrl":"10.4103/aam.aam_150_25","url":null,"abstract":"<p><strong>Context: </strong>This study investigated the effects of preoperative dexamethasone, administered intravenously or through nebulization, on postoperative sore throat (POST) and glucose regulation in patients undergoing general anesthesia (GA) with endotracheal intubation.</p><p><strong>Aims: </strong>This study aimed to asses the effectiveness of nebulised versus intravenous dexamethasone in prevention of postoperative sorethroat in patients undergoing GA with endotracheal intubation.</p><p><strong>Settings and design: </strong>This study was a prospective, single-blind, randomized controlled trial with a sample size of 138 participants.</p><p><strong>Subjects and methods: </strong>A total of 144 patients were randomized into three groups (48 each): Group A (control), Group B (nebulized dexamethasone), and Group C (intravenous dexamethasone). Baseline characteristics, including age, gender, and ASA classification, were similar across groups. POST was assessed at multiple time points postoperation, whereas modified Cormack-Lehane grading and intubation attempts were recorded intraoperatively. Blood glucose (general random blood sugar [GRBS]) levels were measured pre- and postoperatively to assess the effect of dexamethasone.</p><p><strong>Statistical analysis used: </strong>Statistical analysis was performed using SPSS (Statistical Package for the Social Sciences) version 21 (IBM SPSS Statistics, IBM Corporation, NY, USA).</p><p><strong>Results: </strong>The gender distribution differed significantly across groups (P = 0.04), whereas other demographic factors were comparable. Group B reported the lowest incidence of POST across all time points, with significant reductions compared to Groups A and C (P = 0.001). Cormack-Lehane Grade 1 laryngeal view rates were similar across groups (P = 0.76), with no significant differences in intubation attempt numbers (P = 0.76). Postoperative GRBS was significantly higher in Group C than in Group B (P = 0.001), indicating increased glucose levels with intravenous dexamethasone.</p><p><strong>Conclusions: </strong>Preoperative nebulized dexamethasone effectively reduced POST incidence with minimal impact on postoperative glucose levels, whereas intravenous administration was associated with higher glucose levels. Nebulized dexamethasone may be a preferable option for sore throat prevention in patients undergoing GA with endotracheal intubation, balancing efficacy and metabolic impact. Further studies are recommended to confirm these findings.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881907","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":"Programmed Death Ligand-1 Expression and Its Determinants in Patients with Lung Cancer: A Tertiary Care Center Experience in India.","authors":"Mohammad Arif, Ved Prakash, Hemant Kumar, Saumya Shukla, Anurag Tripathi, Mrityunjaya Singh, Sachin Kumar, Ajay Kumar Verma","doi":"10.4103/aam.aam_147_25","DOIUrl":"10.4103/aam.aam_147_25","url":null,"abstract":"<p><strong>Background: </strong>Targeted therapy and immunotherapy have improved survival and quality of life in advanced lung cancer. In this study, we evaluated the frequency of programmed death ligand-1 (PDL-1) expression in lung cancer and its association with different clinical and histological subtypes.</p><p><strong>Materials and methods: </strong>It is a descriptive observational study, in which patients diagnosed with lung cancer were included. PDL-1 testing was done using the monoclonal antibody PDL-1 SP263 primary antibody. The association between the PLD-1 expression with the clinical parameters and histological grading of the disease was analyzed using the Chi-square test.</p><p><strong>Results: </strong>One hundred and fifty patients were included in our study. The majority of the patients had nonsmall cell lung cancer (90.7%). Among these, 78.7% had adenocarcinoma, 19.1% had squamous cell cancer, and only 2.2% had adeno-squamous cancer. Thirty percent were PDL-1 positive. In patients who were PDL-1 positive, high PDL-1 expression (tumor proportion score ≥50%) was seen in 40%. There was no significant difference seen in PDL-1 expression among different histological subtypes. A significant association of PDL-1 expression was seen with the young age group (34.8% below 60 years vs. 22% above 60 years), and history of tobacco chewing (42% vs. 27%). It was also seen more in men, nonsmokers, in those without history of biomass fuel exposure, less advanced stage, and with no history of pleural invasion. In patients with adenocarcinoma, significantly high PDL-1 expression was seen in those who were negative for EGFR mutation.</p><p><strong>Conclusion: </strong>Our study has found new and different associations between PDL-1 expression and patient outcomes.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881909","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":"https://doi.org/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":""},"PeriodicalIF":0.7,"publicationDate":"2025-08-04","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}