Journal of Medical Research and Health Sciences http://jmrhs.info/index.php/jmrhs <p>Journal<strong> of Medical Research and Health Sciences</strong> aims to improve health status and quality of care for individuals, families and communities. The Health Science Journal (Print ISSN : 2589-9023, Online ISSN: 2589-9031) aspires to provide the scientific knowledge through the publication of peer-reviewed, high quality, scientific papers and other material on all topics related to Biochemistry, Biotechnology, Health engineering, Epidemiology, Genetics, Nursing, Pharmacology, Pharmacy, Public health, Psychology, Physical therapy, and Medicine ensuring a rapid turn-around time possible for reviewing and publishing of articles freely for research, teaching and reference purposes.</p> <p><strong>Volume 5 Issue 01, January 2022 </strong></p> <p><strong>Submission Open: 25-12-2021 - 25-01-2022 for January issue 2022 <br /></strong></p> <p><strong> </strong></p> <p> </p> en-US Sonia.Sayedalhosseini@cnsu.edu (Dr. Sonia Sayyedalhosseini) suoport@jmrhs.info (Mr Gaurav Daga) Thu, 01 Sep 2022 00:00:00 -0400 OJS 3.2.1.2 http://blogs.law.harvard.edu/tech/rss 60 Clinical features of colorectal carcinoma at the Jinnah Postgraduate Medical Centre, Karachi, Pakistan: a cross-sectional study. http://jmrhs.info/index.php/jmrhs/article/view/631 <p><strong>Introduction; </strong>Colorectal carcinoma is the third most common cancer worldwide. The risk factors for colon carcinoma include age, family history, obesity, dietary factors etc. Incidence of rectal carcinoma has been found to vary in different geographic. The current study was aimed to evaluate the clinical features, pathological features, association of age, gender, marital status, CEA level with lymph node involvement, metastasis and grading in colorectal carcinoma patients treated at Jinnah Post-graduate Medical Centre, Karachi.</p> <p><strong>Methods; </strong>This was an observational retrospective study conducted at the Oncology department of Jinnah Post-graduate Medical Centre Karachi. All the patients diagnosed with colorectal carcinoma whether having synchronous, metachronous or recurrent rectal carcinoma were included. Binary and mutinominal logistic regression model was implied to assess the association of lymph node involvement, metastatic disease at presentation and tumour grading with different covariants. IBM SPSS V.20 was used for statistical analysis.</p> <p><strong>Result; </strong>A total of 174 patients were included. Majority of the patients were males 112 (64.4%). The mean age of the patients was 44.43±14.02 years. Urdu speaking people made the greater part of study population 65 (34.5%). Sigmoid colon was the site involved in majority 65 (34.5%) of the cases and Mucinous adenocarcinoma was found in 174 (98.9%) of the patients. People with normal CEA levels were found more prone to have lymph node involvement than patient with raised CEA level (OR-3.727, 95% CI-1.437-9.668). Unmarried people were found to have less chances of a metastatic disease at presentation than married people (OR-0.351, 95% CI-0.126-0.976).</p> <p><strong>Conclusion:</strong> Higher incidence of colorectal carcinoma was observed in younger population in our study. &nbsp;Therefore, measures should be taken to promote screening of young population to detect patients in early phase of the disease and improve survival and decrease morbidity and mortality.</p> <p><strong>Keywords; </strong>Colorectal Neoplasms, Adenocarcinoma, Developing countries.</p> Dr. Rabisa Batool, Dr. Kanwal Jamal, Dr. Muhammad Waqaruddin Sheroze, Dr. Irtiza Ahmed Bhatti, Dr. Nazish Jaffar, Dr. Ghulam Haider, Dr. Mohammad Ali Faridi Copyright (c) 2022 Journal of Medical Research and Health Sciences http://jmrhs.info/index.php/jmrhs/article/view/631 Sat, 03 Sep 2022 00:00:00 -0400 Alteration Perimetriques Glaucomateuses Au Depistage : Experience Du Cades/O Donka De Conakry http://jmrhs.info/index.php/jmrhs/article/view/630 <p style="font-weight: 400;"><strong>INTRODUCTION&nbsp;:</strong> Le glaucome se définit comme une neuropathie optique dégénérative avec une perte progressive de cellules ganglionnaires rétiniennes, et un élargissement croissant de l'excavation du nerf optique avec des déficits du champ visuel concordants. La périmétrie permet de réaliser la cartographie du champ visuel et de repérer les zones où un déficit visuel localisé ou scotome est présent&nbsp;; notre objectif était d’étudier les altérations périmétriques glaucomateuses au cours du dépistage au CADES/O.</p> <p style="font-weight: 400;"><strong>METHODOLOGIE&nbsp;:</strong> Il s’agissait d’une étude prospective de type descriptive d’une durée de 05 mois allant du 01 Juillet au 31 Décembre 2021 dans laquelle nous avons dépisté 194 glaucomateux ayant réalisé la périmétrie au dépistage soit 388 yeux examinés.</p> <p style="font-weight: 400;"><strong>RESULTATS&nbsp;:</strong> La fréquence de nouveaux cas de glaucome était de 8,2%, L’âge moyen des patients était de 40,9±17,3 ans et la tranche d’âge la plus représentée était celle de 21 à 30 ans. Le sexe féminin prédominait avec un sex-ratio (H/F) de 0,9. 55,7% des yeux D et 54,1% des yeux G présentaient des déficits généralisés diffus alors que les scotomes absolus étaient de 66,5% à droite et 60,8% à gauche. Le Ressaut nasal constituait le déficit localisé le plus représenté à droite et à gauche avec respectivement 36 et 34% ; suivi du déficit temporal en forme de coin avec 23,7% à droite comme à gauche. Le stade 1 d’altérations était le plus représenté aux deux yeux soit 37,6%. Il existait une association statistiquement significative entre l’excavation papillaire et le stade d’altérations à l’œil droit ainsi qu’à l’œil gauche avec une p-value ‹0,001 dans les deux cas.</p> <p style="font-weight: 400;"><strong>CONCLUSION&nbsp;</strong>: Les altérations périmétriques glaucomateuses décelées au dépistage permettrons de réduire le taux de cécité en ayant comme repère ces altérations pour apprécier l’évolution de la maladie sous traitement à travers des champs visuels de contrôle et ainsi adapter le traitement.</p> Abdoul Karim Balde, Diané S, Koukpoliyi K B C, Barry A K, Bah T M, Hanne F, Sovogui D M, Magassouba A Copyright (c) 2022 Journal of Medical Research and Health Sciences http://jmrhs.info/index.php/jmrhs/article/view/630 Sat, 03 Sep 2022 00:00:00 -0400 Impact de l’immunothérapie dans la prise en charge du cancer du poumon « Etude rétrospective menée à l’Hôpital Militaire d’Instruction Mohammed V- Rabat » http://jmrhs.info/index.php/jmrhs/article/view/634 <p>Lung cancer is one of the most common cancers in the world, it usually occurs between the ages of 50 and 65. <span data-language-for-alternatives="en" data-language-to-translate-into="fr" data-phrase-index="1" data-number-of-phrases="9">The main culprit being smoking, incriminated in nearly 9 out of 10 cases.</span> <span data-language-for-alternatives="en" data-language-to-translate-into="fr" data-phrase-index="3" data-number-of-phrases="9">There are two main types of bronchopulmonary cancers: small cell lung cancer (SCLC) which represents around 15 to 20% and non-small cell lung cancer (SCNLC) which represents the most frequent histological form with around 80 to 20%.</span> <span data-language-for-alternatives="en" data-language-to-translate-into="fr" data-phrase-index="4" data-number-of-phrases="9">85% of all bronchial cancers.</span> <span data-language-for-alternatives="en" data-language-to-translate-into="fr" data-phrase-index="6" data-number-of-phrases="9">The determination of the histological type and the stage is important for the choice of the therapeutic strategy.</span> <span data-language-for-alternatives="en" data-language-to-translate-into="fr" data-phrase-index="8" data-number-of-phrases="9">For the management of bronchial cancer, a distinction is made between local treatments, precisely targeting the tumor (surgery, radiotherapy) and systemic treatments (chemotherapy, targeted therapies and immunotherapy).</span></p> <p>Immunotherapy, which has become a standard treatment for advanced or metastatic lung cancer, is based on the use of immunological checkpoint inhibitors. <span data-language-for-alternatives="en" data-language-to-translate-into="fr" data-phrase-index="1" data-number-of-phrases="6">Anti-checkpoints are synthetic monoclonal antibodies that will allow them to reach their targets and block certain tumor resistance mechanisms.</span> <span data-language-for-alternatives="en" data-language-to-translate-into="fr" data-phrase-index="2" data-number-of-phrases="6">This is how we have seen the development of monoclonal or anti-PD-1/PD-L1 antibodies, currently a major target in the treatment of NSCLC.</span> <span data-language-for-alternatives="en" data-language-to-translate-into="fr" data-phrase-index="4" data-number-of-phrases="6">The objective of our retrospective observational study is to show the positive impact of immunotherapy in the management of lung cancer, and more specifically metastatic NSCLC, by reviewing the use of anti-PD-</span> <span data-language-for-alternatives="en" data-language-to-translate-into="fr" data-phrase-index="5" data-number-of-phrases="6">1/PDL1 within the HMIMV between March 2019 and October 2021.</span></p> <p>To do this, we sought to describe the population having received immunotherapy comprising an anti-PD-1 or an anti-PD-L1 for the management of metastatic NSCLC, and to obtain survival data which will be compared. to those of a population treated with chemotherapy. The two immunotherapies in our study are pembrolizumab (anti-PD-1 antibody) and atezolizumab (anti-PD-L1 antibody). The most represented age group was 60 to 69 years old with a male predominance and a positive smoking status of 83%. The factors that motivated the consultation were mainly the association of respiratory signs and those of locoregional extension in patients with a respective frequency of 96% and 90%. All the patients included in our study had metastatic pathology, respecting the Marketing Authorization and the inclusion criteria. Adenocarcinoma was the most frequently diagnosed in the patients of our cohort, and therefore the form mainly found in this study.</p> <p><strong>&nbsp;</strong>Tolerance was assessed, 90% of patients presented adverse effects with a grade ranging from 1 to 2, which confirms the good tolerance of immunotherapies. Nausea-vomiting, diarrhea and skin rash are the most common adverse events. The best progression-free survival rate was observed in the pembrolizumab group with a mean PFS of 7.6 months and a 95% CI of [6.8 – 8.3], the worst in the chemotherapy group with a mean PFS of 5.42 months and a 95% CI of [4.6 – 6.2]. The group treated with atezolizumab presents an intermediate PFS with a mean of 7 months and a 95% CI of [6.3 – 7.8]. It should be noted that the very small number of patients treated with atezolizumab made it impossible to produce a reliable curve. We sought to compare the PFS of the groups according to the tumor expression of the PD-L1 marker. There is no predictive value of benefit in terms of survival or objective response rate, regardless of the PD-L1 positivity threshold (?5% or ?5%). While this work has enabled us to take stock of the positive impact of immunotherapy in the management of lung cancer within our establishment, it nevertheless has certain limitations: the very small number of patients included in the study and the lack of information available in the patient record given the retrospective nature of the study.</p> Yassine ATBIB, Ayoub Essad, Hajar Zhar, yasmina Tadlaoui, Mina AIT EL CADI, Yassir BOUSLIMAN Copyright (c) 2022 Journal of Medical Research and Health Sciences http://jmrhs.info/index.php/jmrhs/article/view/634 Mon, 12 Sep 2022 00:00:00 -0400 Problématique du traitement de limbo-conjonctivite et endémique des tropiques http://jmrhs.info/index.php/jmrhs/article/view/635 <p><strong>Résumé&nbsp;:</strong></p> <p>Le glaucome cortisonique est un glaucome secondaire à angle ouvert iatrogène induit par les corticoïdes administrés par voie locale ou générale pour des affections chroniques le plus souvent inflammatoires. Il ressemble cliniquement au glaucome primitif à angle ouvert (GPAO), caractérisé par une augmentation progressive de la tension oculaire secondaire à une augmentation de la résistance à l’écoulement de l’humeur aqueuse, une excavation papillaire et des altérations du champ visuel.</p> <p>On estime qu’environ 30 à 40% de la population générale serait susceptible de présenter une hypertension oculaire liée à la prise de corticoïdes mais que cette proportion augmente à 90% dans une population d’individus présentant par ailleurs un glaucome primitif à angle ouvert.</p> <p>Le meilleur traitement à l’heure actuelle reste la prévention, en assurant un monitorage adéquat à toute corticothérapie locale ou systémique.&nbsp;&nbsp;</p> <p>Nous rapportons le cas d’un glaucome cortisonique de l’enfant à propos d’une observation. Le but de notre travail est de présenter un cas un bilatéral déjà très évolué lors de la prise en charge initiale et de faire une mise au point sur la question.</p> <p><strong>Mots Clés&nbsp;: </strong>Glaucome cortisonique, LCET, Corticoïdes</p> <p><strong>&nbsp;</strong></p> <p><strong>ABSTRACT&nbsp;:</strong></p> <p>Corticosteroid is an iatrogenic secondary open-angle glaucoma induced by corticosteroids administered locally or systematically for chronic condition, most often inflammatory.</p> <p>It clinically resembles primary open –angle glaucoma (POAG), characterized by a progressive inrease in ocular pressure secondary to increased resistance to aqueous humor out flow, papillary cupping, and visual field alterations.</p> <p>It is estimated that about 30 to 40% of the general population would be likely to present with ocular hypertension lied&nbsp; to the intake of corticosteroids , but that this proportion increases to 90%in a population of individuals also presenting with primary open-angle glaucoma.</p> <p>The best treatment&nbsp; at the present remains prevention, ensuring adequate monitoring with any local or systemic corticosteroid therapy.</p> <p>We report&nbsp; the case of cortisonic glaucoma in children about a case. The purpose of our work is to present a bilateral case that is already very advanced during&nbsp; the initial treatment and to clarify the issue.</p> <p><strong>Key words&nbsp;:</strong> Corticosteroid, Glaucoma, Corticosteroids,LCET</p> Sonassa DIANE, Abdoul Karim Baldé, Fremba Camara, Mohamed Habib Diane Copyright (c) 2022 Journal of Medical Research and Health Sciences http://jmrhs.info/index.php/jmrhs/article/view/635 Mon, 12 Sep 2022 00:00:00 -0400 Prevalence of Post-Operative Anaemia and its Complications among Obstetric and Gynaecological Patients in Enugu http://jmrhs.info/index.php/jmrhs/article/view/636 <p><strong>Background: </strong>Anaemia is a common condition among patients especially in the developing world. The prevalence of post-operative anaemia varies widely from centre to centre across all surgical specialties. It is often a reflection of pre-operative anaemia and poor pre-operative work-up. Some modifiable risk factors associated with anaemia include ignorance, illiteracy and poverty, and these factors are more in the developing countries of the world. Post-operative anaemia is associated with various complications which may include wound sepsis, poor wound healing, pneumonia, venous thrombosis, stroke, delirium, acute myocardiac infarction and cardiac failure. The consequences of these complications could range from increased cost of treatment to increased length of hospital stay and to mortality.</p> <p><strong>Aim: </strong>To determine the prevalence and complications of post-operative anaemia among obstetric and gynaecological patients in a tertiary hospital</p> <p><strong>Materials &amp; method:</strong> It was a prospective, cohort study of 320 women who had surgery in the department of obstetrics and gynaecology for either obstetric or gynaecological indications. Data was collected using a structured proforma and analyzed using Statistical Package for Social Sciences(SPSS) version 20.0 for Windows and the results presented in tables, charts, means, frequencies and percentages</p> <p><strong>Results:</strong> The results showed that 320 participants were recruited into the study and they all completed the surgery. Majority of them were aged 36 years and above (37%), married (67.2%) and self-employed (53.1%). The prevalence of post-operative anaemia was 53.8%. The mean post-operative PCV was 28.84± 3.67 and p-value of 8.06(.001). Out of the 320 participants, 194(60.06%) had elective surgeries and 59(46.5%) of them had post-operative anaemia. On the other hand 126(39.4%) had emergency surgeries of which 68(53.5%) had post-operative anaemia (p-value of 0.001). Furthermore, 40(12.5%) of the 320 participants had surgical wound infections; 32(80%) of them had anaemia while 8(20%) had normal, acceptable pcv levels.</p> Onyekpa IJ, Odugu BU, Nweze SO Copyright (c) 2022 Journal of Medical Research and Health Sciences http://jmrhs.info/index.php/jmrhs/article/view/636 Fri, 23 Sep 2022 00:00:00 -0400 Functional results of cataract surgery using the phacoemulsification technique "The CADES/O experience http://jmrhs.info/index.php/jmrhs/article/view/637 <p><strong>Introduction: </strong>The practice of phacoemulsification remains exceptional in low-income countries, unlike in developed countries.</p> <p>The general objective was to study the functional results of cataract surgery using the phacoemulsification technique with posterior chamber implant at CADES/O located at&nbsp; University hospital Center Donka.</p> <p><strong>Material and methods: </strong>This was a prospective observational study for three months from 1<sup>er </sup>&nbsp;July to 30 September 2021. We included in our study all patients who performed cataract surgery per phacoemulsification technique with intra ocular lens (IOL) at CADES/O. Pre and post-operative visual acuity, intra and post-operative complications and factors related to poor outcomes were determined.</p> <p>We classified postoperative visual acuities according to World Health Organisation recommendations into: good (VA ? 3/10), fair (1/10 ? VA ? 3/10) and poor (VA ? 1/10).</p> <p><strong>&nbsp;</strong></p> <p><strong>Results:</strong>During the study period, we were able to study the functional results of 159 eyes of the 159 operated patients. The average age was 64.28±12.5 years with extremes from 10 to 92 years. The most affected age group was 60-69 years (35.2%). The male sex dominated with 54.7% against 45.3% and a sex ratio of 1.2.&nbsp; At 30 days post-op without correction, our results were good with 82.4%, average with 14.5% and bad with 3.1%.</p> <p>Intraoperative, early postoperative and late postoperative complications were dominated by posterior capsular rupture with 10.7%, corneal oedema with 64.8% and posterior capsule opacification with 0.6% respectively.</p> <p><strong>Conclusion: </strong>At the end of this study, our results show that phaco-E offers a better visual recovery after cataract surgery with nevertheless a rehabilitation time of at least one month. It offers a good level of operative safety with a low complication rate.</p> <p>&nbsp;</p> Sonassa DIANE, Abdoul Karim Baldé, Campel Balla Inapogui, Abdoulaye Kéita, Moussa Diawara Copyright (c) 2022 Journal of Medical Research and Health Sciences http://jmrhs.info/index.php/jmrhs/article/view/637 Fri, 23 Sep 2022 00:00:00 -0400