Internet Journal of Medical Update - EJOURNAL

Editorial: An overview of gamblers anonymous

Alka Shaji, Sanju George, Balan Rathakrishnan, Shabbir Amanullah — Tue, 03 Aug 2021 00:00:00 +0000

No Abstract.

Self-reported psychological distress and its relationship with religiousness of Nigerian physicians: A multicenter study

Tue, 03 Aug 2021 00:00:00 +0000

Physicians are prone to psychological distress, and this has been poorly studied in association with religiousness. As a result, the prevalence of psychological distress among physicians and its relationship with religiousness was investigated. The study was conducted at two neuropsychiatric centers, and two teaching hospitals in the South-South and South-West regions of Nigeria. Demographics and practice-related characteristics of 231 physicians were collected in addition to report on psychological distress using the 12-item General Health Questionnaire, and a religiousness measuring scale, Ironson–Woods Spirituality/Religiosity Index. Chi-square and t-test analyses were done using SPSS version 19. The prevalence rate of significant psychological distress among physicians was 19.05%. The physicians’ specialty of practice fell short of statistically significant association with religiousness (X2=9.02, p=0.06). There was no significant association between physicians’ state of health and religiousness. Psychological distress is fairly common among physicians and shows no relationship with religiousness.

Traumatic long bone fractures in children seen in a metropolitan tertiary hospital in Enugu, Nigeria

Wilfred O. Okenwa, Anthony J. Edeh — Tue, 03 Aug 2021 00:00:00 +0000

Injuries in children are a well-known occurrence and often lead to fractures. The fractures may affect long bones, occur in all ages and could be accidental or non-accidental with associated injuries that may cause disability or permanent deformity. Lack of epidemiological research on causes, mechanism of injury and site of long bone fractures in children in our environment prompted this study. The study evaluates variables that maybe responsible for long bone fractures in children and document them accordingly for use in planning injury prevention strategies in children. The study was carried out in a tertiary hospital in a metropolitan city (Enugu State University of Science and Technology [ESUT] Teaching Hospital, Enugu, Nigeria). Medical records of patients, ward admission register, accident and emergency register and theatre registers were used for data collection. Children under 16 years who presented to the hospital with long bone fractures between January 2015 and December 2017 were part of the study. Eighty-five children with 86 long bone fractures out of 258 children that presented and were admitted into the orthopedic service were noted. Mean age of patients was 7.2 years + 1.8 years. The commonest long bone fractured was the femur n- 23 (26.7%). Males-female ratio was 1.15:1. Fall from height was the commonest cause of injury and abrasion/laceration the commonest associated injuries. Long bone fractures in children occur mostly due to falls from height and affects the femur more than any other bone. Bimodal annual occurrence rate has been noted and caregivers ought to be more vigilant during those times to help reduce the rate of long bone fractures in children.

Seasonality in hyperglycemic emergencies in a Health Facility in Sub-Saharan Africa: The roles of geographic location, infection, and knowledge of diabetes mellitus status

Tue, 03 Aug 2021 00:00:00 +0000

Hyperglycemic emergencies (HEs) are acute complications of diabetes mellitus and they carry high morbidity and mortality. Studies have reported a seasonal pattern in the frequency of occurrence of both types 1 and 2 diabetes mellitus and even Gestational Diabetes Mellitus. No such association has been suggested for HEs. The study was conducted at the Asokoro District Hospital, Located in Abuja, Nigeria to examine a seasonal pattern in the frequency of hyperglycemic emergencies. The initial observation of an obvious fluctuation in the number of admitted cases of hyperglycemic emergencies motivated this prospective study which ran for a period of six years. It involved collecting the relevant information using a questionnaire from all HEs patients admitted to the medical ward from the first of January, 2008 to the 31st of December, 2013. Required investigations were done. The precipitating factors for HEs were looked for. The number of cases per month was noted for each year. The Statistical package used for analysis was STATA version 11. Round the year Abuja Climatic changes were monitored on the website of the Nigerian Meteorological station. Four hundred and fifty-one (451) patients with hyperglycemic emergency were enrolled for this study. Most of the patients, (55%), were in the middle-age bracket. Fifty-six per cent (56%), were not previously known to be living with diabetes mellitus. Infections, particularly of the respiratory and gastrointestinal tracks, were the commonest precipitating factors. Variation in the frequency of HEs was observed, with two peaks: one in April and a smaller peak in December. There is seasonal variation in the frequency of presentation of Hyperglycemic emergencies. This may have been influenced by exogenous factors such as geographic location, infection, and the fact that most of the patients never knew they had diabetes mellitus.

Laparoscopic colorectal cancer surgery - a prospective study of short-term outcomes of consecutive cases over 3 years

Nitin Patel, Vipul D. Yagnik — Tue, 03 Aug 2021 00:00:00 +0000

This study was carried out with the objectives to study the feasibility of laparoscopic colorectal cancer resection, to observe short term outcome such as recovery parameters, oncologic safety, morbidity and mortality, and to analyze the experience of laparoscopic colorectal surgery in a teaching hospital. Between January 2007 and July 2009, all consecutive adult cases admitted to our department for colorectal cancer were assessed for eligibility. The ethical committee approved the protocol at the Sterling Hospital. Out of 31 patients,17 were males and 14 females. The mean age was 59 years. The most common clinical presentation was weight loss and altered bowel habits. Rectum (51.61%) was the most commonly involved organ followed by cecum (22.58%). - median time to liquid diet was two days (range 1-22), and a solid diet was three days (range 3-30). The median time to first flatus was two days (range 1-5), and the first stool was five days (range 3-7). The postoperative stay was eight days (range 6-30) median time to mobilization was 2.5 days. The postoperative stay is cumulative and includes patients who underwent reoperation for the anastomotic leak. The median operating time was 240 mins (range 116 – 520). The median length of incision was 6 cm (range 4 – 10 cm). The median blood loss was 170 ml. Blood loss was higher in patients with hemorrhage and tumor adhesions, and both of them were converted to open. These patients incidentally had a more extended hospital stay. The laparoscopic technique for colorectal cancer is feasible and safe. Laparoscopic colorectal surgery (LCS) is associated with short term benefits like the earlier return of gastrointestinal function and shorter length of hospital stay. From the oncologic point of view, tumor resections are adequate, taking into context numbers of lymph nodes retrieved and resectional margins in context to oncologic safety. The decreased postoperative wound infections and early recovery facilitate appropriate adjuvant therapy. Advanced laparoscopic surgery requires a team approach with proper case selection. Transvaginal delivery of specimens can give scar-less surgery and the option for assisted natural orifice surgery.

Herpes encephalitis in an elderly immunocompetent lady – A case report

Koruth P. George, Geena Jacob, Santhichandra Pai, Salini Baby John — Tue, 03 Aug 2021 00:00:00 +0000

Herpes zoster encephalitis is a rare complication of varicella zoster virus infection. As its clinical presentation is usually non-specific, it often goes unrecognized. Advent of polymerase chain reaction test for detecting viral particles in the cerebrospinal fluid has enabled rapid and accurate diagnosis.

Book Review

Sushil Dawka — Tue, 03 Aug 2021 00:00:00 +0000

Comprehensive Healthcare Simulation: Surgery and Surgical Subspecialties, by Dimitrios Stefanidis, James R. Korndorffer Jr., Robert Sweet (Eds.), Publisher: Springer Nature, Year 2019, 401 pages