Annals of African Medicine最新文献

{"title":"Bilateral Pyosalpinx Mimicking Acute Appendicitis: An Uncommon but Critical Diagnostic Challenge.","authors":"Rishika Mishra, Sarang Gotecha, Prabhat Bhaskarrao Nichkaode","doi":"10.4103/aam.aam_75_25","DOIUrl":"https://doi.org/10.4103/aam.aam_75_25","url":null,"abstract":"<p><strong>Abstract: </strong>A perforated appendix has been believed to be a potential risk for damage to adnexal structures that may escalate the chances of infertility in girls in future. Acute complications that are uncommomly described postperforation of appendix may be salpingitis, hydrosalpinx, and pyosalpinx. A pyosalpinx or tubal abscess is the acute inflammation of the fallopian tube that fills up and swells with pus, which commonly results from inadequate or delayed treatment of pelvic inflammatory disease (PID). Pyosalpinx may present with common symptoms such as lower abdominal pain, vomiting, nausea, per vaginal discharge, and lesser noted symptoms such as fever and chills or remain silent. Primay pyosalpinx might occur as a severe sequelae of PID that is characterized by the inflammation of upper genital tract incorporating endometritis, salpingitis, and pelvic peritonitis. Secondary pyosalpinx, on the other hand, arises from adjacent pelvic structures such as appendix, colon, urinary bladder or may be from a pelvic malignancy. Herein, we report the case of acute appendicitis with bilateral pyosalpinx.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697361","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":"Clinico-epidemiological Patterns, Risk Factors, and Seroprevalence of Hepatitis C in Patients Attending a Tertiary Care Center in North India.","authors":"Sana Islahi, Sweta Singh, Shefali Gupta, Altaf Ahmad Mir, Arti Dwiwedi, Akhalesh Kumar Shakya, Priyanka Dwiwedi, Somdatt Sen","doi":"10.4103/aam.aam_216_24","DOIUrl":"https://doi.org/10.4103/aam.aam_216_24","url":null,"abstract":"<p><strong>Introduction: </strong>The hepatitis C virus is an important cause of chronic hepatitis and primary hepatocellular carcinomas. Early treatment of HCV infection, especially in the acute phase, can facilitate elimination of the virus and prevent chronic infection. This will limit HCV-related liver damage and mortality. This study provides the current clinical-epidemiologic pattern, risk factors and seroprevalence of hepatitis C in clinical suspected cases attending different departments of a tertiary care centre.</p><p><strong>Methods: </strong>The study was conducted for a period of 1 year (March 2023 to March 2024) in the Department of Microbiology, AIIMS, Raebareli. After obtaining ethical clearance, serum samples were collected from all patients referred to the Department of Microbiology to determine antibodies against HCV. An ELISA was performed for anti-HCV antibodies and HBsAg. The results and relevant clinical information were noted and analysed.</p><p><strong>Results: </strong>Of the 16911 samples, 127 (0.75%) were positive for anti-HCV antibodies. Of the 127 anti-HCV positive samples, 88 (69.3%) samples had an S/Co ratio >5.0, while 39 (30.7%) samples had an S/Co ratio <5.0. Majority of the cases were in the age group 46-60 years (31%), followed by the age group 31-45 years (26.%) and 61-75 years (26.%). The number of male cases (55.91%) was slightly higher than female cases (44.09%). In our study, serum bilirubin was elevated in 29.8% (29/127) of anti-HCV seropositive patients, alanine transaminase (ALT) was elevated in 56.7% (72/127) of seropositive patients and 49.6% (63/127) of seropositive patients had elevated aspartate transaminase (AST). A history of surgery (30.9%) was the most important risk factor in the seropositive patients.</p><p><strong>Conclusion: </strong>The study shows the seroprevalence of hepatitis C virus in patients with clinical suspicion, with 0.75% of samples testing positive for anti-HCV antibodies. Most positive cases were observed in adults aged 46-60 years, with elevated ALT and AST levels found in several seropositive patients. Surgical history has emerged as a notable risk factor.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697363","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 Comparative Study of the Profile of Cognitive Impairment and Associated Factors among Subsets of Human Immunodeficiency Virus Patients in a Special Human Immunodeficiency Virus Clinic in South-East Nigeria.","authors":"Olisaeloka Ginikachi Ebeogu, Paul Osemeke Nwani, Harriet Chinwe Nwadimkpa, Obiora Daniel Anaje, Nnamdi Joseph Morah, Ifeoma Adaigwe Amaechi, Stephen Okorafor Kalu, Linda Ifunanya Eze, Azuoma Lasbrey Asomugha, Maduaburochukwu Cosmas Nwosu, Ogunniyi Adesola","doi":"10.4103/aam.aam_36_25","DOIUrl":"https://doi.org/10.4103/aam.aam_36_25","url":null,"abstract":"<p><strong>Context: </strong>The human immunodeficiency virus (HIV) is a neurotropic virus with several neurological manifestations including cognitive impairment.</p><p><strong>Aims: </strong>This study aimed to determine and compare the frequency of cognitive impairment and associated factors among subsets of HIV-positive patients and matched controls using neuropsychological test battery.</p><p><strong>Settings and design: </strong>This was a comparative cross-sectional descriptive study conducted in a Southeastern Nigerian Special HIV clinic.</p><p><strong>Subjects and methods: </strong>Two subsets of HIV patients; the combination antiretroviral therapy (CART) experienced patients and the CART naïve patients and matched HIV negative subjects were surveyed using the World Health Organization/University of California, Los Angeles neuropsychological test battery.</p><p><strong>Statistical analysis: </strong>Statistical Package for the Social Science version 20.0 was used.</p><p><strong>Results: </strong>The overall frequency of neurocognitive impairment was 76.1% (mild 44.6% and moderate-to-severe cognitive 31.5%). Although there was no statistically significant difference in the percentages of CART naïve patients (76.3%; n = 29/38) and CART-exposed (75.9%, n = 41/54) that had cognitive impairment, severe cognitive impairment was more among the CART naïve patients (44.4%; n = 24/54) and mild cognitive impairment more among CART-exposed (63.1%; n = 24/38). CART-exposed patients had better scores in most of the subtests of the battery compared to CART-naïve patients but the observed difference was not statistically significant. The observed relationship between cognitive impairment and age, sex, or level of education was also not statistically significant.</p><p><strong>Conclusion: </strong>HIV-associated neurocognitive impairment is still common in HIV patients and treatment with ART may reduce its severity.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697359","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":"Evaluating Experiential Learning versus Traditional Instruction for Snakebite Treatment Protocols in Toxicology Training.","authors":"Harshal R Thube, Manish Shrigiriwar, Mandar Sane, Shailesh Raut, Devendra Jadav","doi":"10.4103/aam.aam_117_25","DOIUrl":"https://doi.org/10.4103/aam.aam_117_25","url":null,"abstract":"<p><strong>Background: </strong>In contemporary medical education, students must possess multifaceted skills including critical thinking, practical applications, and effective communication. This study explored the integration of role play, an innovative teaching method, in teaching snakebite treatment protocols in the toxicology curriculum for medical students.</p><p><strong>Materials and methods: </strong>Using a case-control study design, 122 2nd-year Batchelor in Medicine and Batchelor in Surgery students were divided into two groups: A control group receiving conventional interactive lectures and a case group exposed to role-play activities following lectures. This study assessed cognitive and psychomotor domains through written exams and objective structured practical examinations, respectively. Feedback questionnaires gauged students' perceptions of role-play effectiveness.</p><p><strong>Results: </strong>The results indicated a significant improvement in academic performance and skill demonstration among students exposed to role-play. Feedback from participants overwhelmingly supported the utility of role-play in enhancing the understanding, participation, and practical application of toxicology concepts.</p><p><strong>Conclusion: </strong>This study underscores the efficacy of role-play as a pedagogical tool in toxicology education, offering valuable insights for curriculum enhancement.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697365","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":"Evaluation of Intraoperative Findings and the Role of Biliary Mapping Using Methylene Blue in Laparoscopic Cholecystectomy: A Cross-sectional Study.","authors":"Ravendra Kumar, Faraz Ahmad, Sanjeev Kumar, Akshay Anand, Surender Kumar","doi":"10.4103/aam.aam_307_24","DOIUrl":"https://doi.org/10.4103/aam.aam_307_24","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic cholecystectomy (LC) is the most effective treatment for gallstones. Anomalies in the biliary tree provide a risk and increase the probability of bile duct injury. The use of methylene blue for bile duct mapping may enhance intraoperative visibility; nevertheless, its efficacy and feasibility remain uncertain.</p><p><strong>Aim: </strong>The aim of this study was to evaluate intraoperative findings during LC and assess the role of biliary mapping using methylene blue in identifying biliary anatomy and reducing complications.</p><p><strong>Materials and methods: </strong>A total of 84 gallstone patients scheduled for LC were included. After obtaining informed consent from the patients, methylene blue was injected into the gallbladder to visualize the architecture of the bile ducts. The intraoperative results, anatomical changes, and complications were analyzed.</p><p><strong>Results: </strong>The majority of intraoperative findings consisted of short cystic ducts (55.95%), followed by normal ducts (13.10%) and elongated ducts (8.33%). Uncommon observations included intrahepatic gallbladder (4.76%), colonic adherent gallbladder (2.38%), and twisted common bile duct. No significant adverse effects of methylene blue were noted. Methylene blue bile mapping enhanced the visibility of the bile duct architecture, particularly in cases with anatomical anomalies, and reduced the likelihood of bile duct injury.</p><p><strong>Conclusion: </strong>Methylene blue bile mapping is a cost-effective and practical tool for LC that identifies bile duct architecture and reduces problems. This study suggests that it may be safer than intraoperative cholangiography in resource-limited situations.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697366","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":"Type 2 Diabetes in Morocco: Toward a Precision Diabetology, from Pathogenesis to Treatment.","authors":"Ahmed Anas Guerboub, Jade Issouani, Ikhlass Lakssir, Hajar Srifi, Malak Riznat, Mohamed Malad, Mustapha Asfour, Abderrahaman Tadlaoui, Yassine Errahali","doi":"10.4103/aam.aam_87_25","DOIUrl":"https://doi.org/10.4103/aam.aam_87_25","url":null,"abstract":"<p><strong>Background: </strong>The traditional classification of diabetes into types 1 and 2 does not reflect its heterogeneity in presentation, progression, treatment response, and complications.</p><p><strong>Methods: </strong>This study explores a new classification based on five distinct subgroups to enhance understanding and management. Its applicability was tested in 1002 newly diagnosed Moroccan type 2 diabetes patients and compared with the Indian \"WellGen\" and Swedish \"ANDIS\" cohorts.</p><p><strong>Results: </strong>Newly diagnosed Moroccan type 2 diabetics were mainly classified into four subgroups designated as: severe insulin deficiency diabetes (SIDD), severe insulin resistance diabetes (SIRD), mild obesity-related diabetes (MOD), and mild age-related diabetes (MARD). One thousand and two patients were included in our study with a sex ratio of 1. Patients were classified into the subgroups of MARD (42%), MOD (21%), and SIDD (19%), while SIRD was 14%. In our study, retinopathy and neuropathy were more prevalent in the SIDD subgroup, while nephropathy in the SIRD, while patients in the MARD group had a higher prevalence of cardiovascular complications.</p><p><strong>Conclusions: </strong>Our results provide useful clues as to the pathophysiological mechanisms and susceptibility to complications of type 2 diabetes in the Moroccan population, and suggest a need to review management strategies. Our results confirm the new diabetic subgroups proposed by similar studies, suggesting a possible generalization of this diabetes classification to Africa and the MENA region.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697442","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":"Clinical and Angiographic Profile of Acute Coronary Syndrome in Adults Under 40 Years: A Cross-sectional Observational Study.","authors":"Tushar Pancholi, Pradnya Diggikar, Madineni Madhukar, Yammanuru Bhavya Sri, Sreevidya Yekkaluru, Shivraj Patil, Priyanka Aher, Prashansa Gupta","doi":"10.4103/aam.aam_129_25","DOIUrl":"https://doi.org/10.4103/aam.aam_129_25","url":null,"abstract":"<p><strong>Background: </strong>Acute coronary syndrome (ACS) in young adults presents unique clinical and diagnostic challenges, with limited data from the Indian subcontinent.</p><p><strong>Aim: </strong>This study aims to assess the clinical profile, risk factors, and diagnostic findings of ACS in adults aged ≤40 years.</p><p><strong>Materials and methods: </strong>This hospital-based, cross-sectional study included 60 patients aged 18-40 with confirmed ACS. Clinical symptoms, laboratory investigations, Electrocardiography (ECG), echocardiography, and coronary angiography were analyzed. Associations were tested using the Chi-square test, with P < 0.05 considered statistically significant.</p><p><strong>Results: </strong>The median age was 35.5 years; 96.7% were males. Breathlessness and palpitations were reported in all cases, while chest pain was present in 81.7%. Hypertension (40%), diabetes (31.7%), smoking (28.3%), and drug use (55%) were common risk factors. Single-vessel disease was the predominant angiographic finding (61.7%). Smoking correlated significantly with ECG abnormalities (P = 0.0382), and diabetes with severe coronary involvement (P = 0.0429).</p><p><strong>Conclusions: </strong>ACS in young adults is more prevalent in males and often presents with nonclassical symptoms. Diabetes and smoking are significantly associated with diagnostic severity. Early risk identification and preventive strategies are essential in this population.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697362","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":"Role of Thoracic Epidural Anesthesia in Providing Adequate Intraoperative and Postoperative Opioid-free Analgesia for Breast Cancer Surgeries.","authors":"Nitu Puthenveettil, Sunil Rajan, Jerry Paul","doi":"10.4103/aam.aam_130_25","DOIUrl":"https://doi.org/10.4103/aam.aam_130_25","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is the most common malignancy in women. Postoperative pain and opioid analgesics are suspected to influence cancer recurrence. In this study, we try to assess the feasibility of providing complete opioid-free surgical anesthesia and postoperative analgesia for breast cancer surgeries.</p><p><strong>Methodology: </strong>This prospective observational study was performed on 30 patients posted for breast cancer surgery under thoracic epidural anesthesia. The epidural catheter was placed in the upper thoracic space. A titrated bolus of 10-12 mL of 2% lignocaine with adrenaline followed by an infusion of 0.2% ropivacaine at 5-10 mL/hour was used. Time taken from epidural bolus to skin incision, the total dose of local anesthetic and propofol required, postoperative pain score, the patient and surgeon satisfaction score, and adverse events were noted.</p><p><strong>Results: </strong>Opioid-free epidural anesthesia was successful in all patients. The average time required to start the surgery after placement of the epidural catheter was 17.8 ± 2.5 min. The average total dose of local anesthetic and propofol supplemented was 6.9 ± 4.5 mL and 18.9 ± 11.8 mg, respectively. Postoperative pain scores were <4 at all time points. The average surgeon and patient satisfaction scores were 9.1 ± 0.2 and 9.1 ± 0.2, respectively. Thirteen percent of patients required treatment for hypotension. There were no episodes of bradycardia or airway compromise.</p><p><strong>Conclusions: </strong>Based on our data, it appears to be safe to perform opioid-free breast cancer surgeries under thoracic epidural anesthesia with complimentary sedation and local infiltration. Epidural infusion of local anesthetic provides excellent intra- and postoperative analgesia, which helps avoid the use of opioids.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697439","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":"Traditional Aqueous and Ethanol Maceration of Hamelia patens Leaves: A Phytochemical and Pharmacological Exploration.","authors":"Anita Devi Krishnan Thantry, Kosuri Kalyan Chakravarthi, Ashwathy Varadarajan Thundakattil, Kalidasan Vasodavan","doi":"10.4103/aam.aam_152_25","DOIUrl":"https://doi.org/10.4103/aam.aam_152_25","url":null,"abstract":"<p><strong>Background: </strong>Hamelia patens Jacq., commonly referred to as firebush, is a tropical shrub belonging to the Rubiaceae family. It has been traditionally employed in various ethnomedical practices to address ailments such as dermatological infections, inflammatory conditions, and gastrointestinal disturbances. These therapeutic applications are attributed to its diverse array of bioactive phytoconstituents, including alkaloids, flavonoids, and phenolic compounds. Despite extensive studies on organic solvent extracts, there remains a paucity of data concerning the efficacy and phytochemical composition of traditional aqueous extracts.</p><p><strong>Objective: </strong>This investigation aims to delineate the maceration-based extraction methodologies utilizing aqueous and ethanol solvents for H. patens leaves and to underscore the significance of each method in isolating pharmacologically active compounds.</p><p><strong>Materials and methods: </strong>Freshly harvested H. patens leaves underwent thorough washing and were subsequently dried either by air in a shaded, well-ventilated environment or using an oven maintained at 40°C-50°C to preserve thermolabile constituents. The desiccated leaves were then pulverized into a coarse powder. For extraction, 5 g of the coarsely powdered material were subjected to maceration with 100 mL of distilled water and 50 mL of ethanol (70%-95%) for a duration of 24-72 h at ambient temperature, with intermittent agitation to facilitate solvent penetration. Postmaceration, the mixtures were filtered to obtain the respective aqueous and ethanol extracts. Comprehensive phytochemical screening was conducted to detect the presence of alkaloids, flavonoids, tannins, saponins, phenolics, glycosides, triterpenoids, phytosterols, and carbohydrates.</p><p><strong>Results: </strong>Phytochemical analyses revealed that the aqueous extract evaluated positive for alkaloids, saponins, phytosterols, phenols, flavonoids, carbohydrates, glycosides, and triterpenoids, while tannins were absent. Conversely, the ethanol extract demonstrated the presence of phytosterols, phenols, flavonoids, carbohydrates, glycosides, and triterpenoids but evaluated negative for tannins, alkaloids, and saponins. These findings suggest that solvent polarity plays a pivotal role in the selective extraction of phytochemicals, with aqueous extraction favoring polar compounds and ethanol extraction being more efficacious for semi-polar constituents.</p><p><strong>Conclusion: </strong>Maceration employing aqueous and ethanol solvents effectively isolates distinct profiles of bioactive compounds from H. patens leaves. The aqueous extract, enriched with polar phytochemicals, aligns with traditional medicinal preparations, whereas the ethanol extract, containing a broader spectrum of semi-polar compounds, holds considerable promise for pharmaceutical applications.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697440","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":"Study of Motor Evoked Potential on Intraoperative Neurophysiological Monitoring Cases of Neurosurgeries.","authors":"Deepshikha, Manish Bajpai, B K Ojha, Dileep Kumar Verma, Afreen Saif, Akhilesh Kumar Verma","doi":"10.4103/aam.aam_133_24","DOIUrl":"10.4103/aam.aam_133_24","url":null,"abstract":"<p><strong>Background: </strong>Motor evoked potential (MEP) monitoring is crucial in intraoperative neurophysiological monitoring (IONM) during neurosurgeries, but its effectiveness is influenced by factors such as anesthesia type, patient condition, and surgical technique. Interpreting MEP changes requires expertise due to technical issues and neural injury. Clinical studies show MEPs reduce permanent motor deficits, improving surgical outcomes and patient safety. This study aims to evaluate the efficacy and outcomes of MEP monitoring in IONM during neurosurgeries.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at King George's Medical University, Lucknow, involving 132 patients undergoing elective surgery and above 2 years of age. The study excluded trauma patients, severely ill patients, morbidly ill patients, and those under 2 years old patients. The study involved subjects from the Department of Neurosurgery at King George's Medical University, Lucknow. Intraoperative neuromonitoring was performed using the Medtronic Nim-Eclipse System. MEP was used to monitor the functional integrity of corticospinal tracts by stimulating the patient's motor cortex transcranially and recording the activity in selected muscles.</p><p><strong>Results: </strong>Out of 132, a total of 75 (59.09%) patients were male and 57 (40.91%) patients were female. Patient distribution is based on age group, with ≤20 years being the most common age group, followed by 21-30 years, 31-40 years, 41-50 years, 51-60 years, and >60 years, respectively. The neurological impairments observed after surgery in the form of MEP waveforms. Of the 39 patients, 2 individuals (5.13%) had neurological impairment at the end of the procedure.</p><p><strong>Conclusion: </strong>The study suggests that monitoring evoked potentials can detect and address neurological issues, improve postoperation function, and enhance patient safety and surgical outcomes in neurosurgery. It emphasizes the importance of MEP monitoring for assessing motor pathway integrity and recommends further studies with larger cohorts.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"617-620"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12380134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186327","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}