scholarly journals Clinical Characteristics and Associated factors of Trigeminal Neuralgia in Addis Ababa, Ethiopia: Experience from Addis Ababa, Ethiopia

2020 ◽  
Author(s):  
Biniyam Alemayehu Ayele ◽  
Abenet Tafesse Mengesha ◽  
Yared Zenebe Zewde
Keyword(s):  
Trigeminal Neuralgia ◽  
Associated Factors ◽  
Clinical Characteristics ◽  
Addis Ababa ◽  
Mandibular Nerve ◽  
Dental Extraction ◽  
Prior History ◽  
Number Of Patients ◽  
The Face ◽  
History Of

Abstract Background: Trigeminal neuralgia (TN) is considered one of the most painful illnesses known to medical practice. Little is known about TN in Ethiopia. Our study aimed to assess clinical characteristics, treatment, and associated factors of TN.Method: A cross-sectional study was conducted on a total of 61 patients with confirmed Trigeminal neuralgia visiting outpatient neurology clinics of two government teaching Hospitals and two private health facilities in Addis Ababa, Ethiopia between June 2019 and March 2020.Results: Our participants' age range between 21 and 78 years with mean ± SD age of 50.7 ± 14.2 years. Males accounted for 50.8%. Twenty-five (41%) reported a prior history of one or more tooth extraction on the painful side. In the majority (68.9%) of the patient's right side of the face was affected. The mandibular nerve was the commonly involved branch (47.5%). Fifty-five (90.2%) of patients fulfilled criteria for classical TN and 9.8% had symptomatic TN. The majority of the participants reported mixed types of pain such as burning, lancinating, and electric shock-like. Well defined trigger zone was identified in one-third (36%) of cases. Carbamazepine was the most commonly prescribed drug with a median dose of 600mg (IQR: 400 – 1000mg). Two-third of the patients reported prominent satisfaction. The mean (± SD) dose of carbamazepine used to control the pain was significantly higher among those with dental extraction history as compared to those with no history of dental extraction (736 ± 478.6mg Vs 661.1 ± 360.4mg, respectively, T = -2.06, p = 0.04 95% CI:-213.41 to -2.98). A statistically significant number of patients who had single branch involvement reported prominent satisfaction with their treatment as compared to those who had more than one branch involvement. (95% CI: 1.3-3.8: p = 0.006). Conclusion: The majority of our patients had Classical TN in the mandibular nerve distribution on the right side of the face and well satisfied with carbamazepine only treatment. Furthermore, we observed a higher proportion of dental extraction among our patients, hinting at the scale of miss and delayed-diagnoses. Thus, we recommend conducting a well-designed prospective study to support our findings.

scholarly journals 570. “I don’t know”: The Typical Response When Taking Pneumococcal Immunization Histories in Kidney Transplant Candidates

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S349-S351
Author(s):  
Jahanavi M Ramakrishna ◽  
Tambi Jarmi ◽  
Claudia R Libertin
Keyword(s):  
Infectious Disease ◽  
Kidney Transplant ◽  
Pneumococcal Vaccine ◽  
Patient Population ◽  
Pneumococcal Vaccination ◽  
Prior History ◽  
Vaccine Preventable Diseases ◽  
Number Of Patients ◽  
Order Completion ◽  
History Of

Abstract Background Vaccine-preventable diseases account for significant morbidity and mortality in the kidney transplant (KT) patient population. AST Guidelines support review and documentation of pneumococcal vaccines in KT candidate infectious disease (ID) evaluations. The objective of this study is to determine the number of KT candidates screened for prior pneumococcal immunizations and the frequency of vaccines ordered by providers when indicated at Mayo Clinic Florida’s (MCF) Transplant Center. Methods This study was an institution-based retrospective analysis of all KT candidates evaluated at MCF from December 2, 2019 – January 14, 2020. Data collection was obtained by electronic health record review. Outcomes included known history and documentation rates of prior pneumococcal vaccinations (both Prevnar 13 and Pneumovax 23) by infectious disease (ID) providers, as well as pneumococcal vaccine order frequency during ID pre-transplant evaluation when indicated. Data analysis was done using simple descriptive statistics. Results Sixty-one patients underwent KT evaluation during the study period. Among the 61 patients, 20 (32.8%) and 20 (32.8%) had a known prior history of receiving Prevnar 13 and Pneumovax 23 vaccinations, respectively. Vaccine history was unknown for Prevnar 13 and Pneumovax 23 in 39 (63.9%) patients. Vaccine status was not documented by ID providers in 2 (3.3%) patients. When appropriate, ID providers ordered Prevnar 13 and Pneumovax 23 in 38 (92.7%) and 41 (100%) patients, respectively. Orders included both electronic and written documentation to account for patients planning immunization elsewhere. Of the 38 patients advised to receive the Prevnar 13 vaccine, 17 (41.5%) patients were documented completing immunization. Pneumovax 23 order completion rates were not recorded since the study period only lasted six weeks due to closure by COVID-19. Table 1. Pneumococcal Vaccine History Documentation Rates Obtained by Patient Recall or Records Table 2. Pneumococcal Vaccine Order Rates at Pre-Kidney Transplant Consultations Table 3. Prevnar 13 Order Completion Rate by Documentation Conclusion The data reflect a high number of patients who either do not recall or have documentation of prior pneumococcal vaccination available at time of KT ID evaluation. Providers documented history of pneumococcal vaccinations extremely well, ordering immunizations when necessary. This study highlights lack of portability of immunization histories in a given patient population and opportunity for improved care. Disclosures Claudia R. Libertin, MD, Pfizer, Inc. (Grant/Research Support, Research Grant or Support)

scholarly journals Ezetimibe: An Unusual Suspect in Angioedema

2020 ◽  
Vol 2020 ◽  
pp. 1-3 ◽  
Author(s):  
Tiffany Lu ◽  
Tarundeep Grewal
Keyword(s):  
Clinical History ◽  
Prior History ◽  
African American Female ◽  
Drug Induced ◽  
Current Case ◽  
Normal Limits ◽  
Inhibitor Level ◽  
The Face ◽  
History Of ◽  
Esterase Inhibitor

We describe a case of new onset angioedema likely due to Ezetimibe therapy in an elderly patient with a prior history of drug-induced bradykinin reactions who had been on the medication for multiple years. This is the second reported incidence of Ezetimibe-associated angioedema in literature. A 90-year-old African American female presented with angioedema of the face and oral mucosa with associated difficulty speaking developing hours after taking Ezetimibe 10 mg PO. She denied adding any new or unusual foods to her diet. A thorough clinical history determined Ezetimibe was the likely culprit. Ezetimibe was immediately discontinued. The swelling subsided after administration of methylprednisolone 125 mg, epinephrine 1 mg/mL, injection 0.3 mL, diphenhydramine 25 mg, and famotidine 20 mg BID within 48 hours. The patient’s C1 esterase inhibitor level was measured to be within normal limits. Food panel allergy testing showed very low or undetectable IgE levels in all categories. Based on the limited reports in literature and our current case, we conclude that there is a likely association of angioedema with Ezetimibe. The mechanism, however, is unknown since it is not related to bradykinin or mast cell-mediated activation. Clinicians should advise patients taking Ezetimibe to report any swelling of the lips, face, and tongue and to immediately discontinue its use if these signs are present.

scholarly journals Clinical Study of Bell's Palsy at Tertiary Care: Our Experience

2019 ◽  
Vol 02 (01) ◽  
pp. 16-20
Author(s):  
M. B. Bharathi ◽  
Thanzeem Unisa ◽  
Swathi Chandresh ◽  
Venkatesh C. R. ◽  
Harsha S.
Keyword(s):  
Facial Nerve ◽  
Tertiary Care ◽  
Bell’S Palsy ◽  
Cross Sectional Study ◽  
Bell's Palsy ◽  
Cross Sectional ◽  
Tertiary Referral Center ◽  
Number Of Patients ◽  
The Face ◽  
History Of

Abstract Introduction Bell's palsy (BP) is the common cause of facial palsy. This study aims to report and analyze the age, sex distribution, symptomatology, site of lesion, and prognosis in 101 patients with (BP). Materials and Methods This is a cross-sectional study conducted at tertiary referral center, JSS Hospital, Mysuru. All patients consenting to participate in this study, of all ages, of either sex, both outpatients and inpatients with a diagnosis of BP during this study period were included. Results Of the 101 patients analyzed, maximum cases (25.7%) were in third decade of age; 55.4% were males, and both right and left sides of the face were equally involved. Maximum number of patients (50.5%) had a history of postaural pain at presentation Topodiagnostic tests showed majority of BP cases involving geniculate or suprageniculate regions (67.3%) in our study. 20.8% had lesion above the nerve to stapedius, and 11.9% had lesion below the nerve to stapedius. Electrodiagnostic test—electroneuromyography (ENMG)—was abnormal in 57 (67.1%) individuals at day 4. 50.4% of patients had a House-Brackmann (HB) facial nerve grade IV at presentation. 90% of the BP group in our study recovered normal to near-normal facial nerve function by the end of 28 days’ time. Conclusion Each case of BP should be evaluated with thorough clinical examination, topodiagnostic tests, and electrodiagnostic tests. Appropriate management will help in almost full recovery of disease.

scholarly journals Atypical Complete Femoral Fractures Associated with Bisphosphonate Use or Not Associated with Bisphosphonate Use: Is There a Difference?

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Sang-Min Kim ◽  
Youn-Soo Park ◽  
Young-Wan Moon ◽  
Seung-Hoon Kang ◽  
Ingwon Yeo ◽  
...  
Keyword(s):  
Associated Factors ◽  
Clinical Characteristics ◽  
Healing Rate ◽  
Demographic Data ◽  
Femoral Fractures ◽  
Delayed Union ◽  
Bony Union ◽  
Strong Correlations ◽  
History Of ◽  
Fracture Height

The purpose of this study is to compare clinical characteristics and surgical outcome of atypical complete femoral fractures associated with bisphosphonates (BPs) use and those of fractures not associated with BPs use. Seventy-six consecutive patients (81 fractures) who had been operatively treated for a complete atypical femoral fracture were recruited. Of the 81 fractures, 73 occurred after BPs medication of at least 3 years (BP group) while 8 occurred without a history of BP medication (non-BP group). There were no differences in demographic data and fracture- and surgery-associated factors between the two groups. Of 76 patients (81 fractures), 54 (66.7%) fractures showed bony union within 6 months after the index surgery and 23 (28.4%) showed delayed union at a mean of 11.2 months (range, 8–18 months). The remaining 4 fractures were not healed, even 18 months after the index surgery. There was no difference in healing rate between the BP group and the non-BP group. There were strong correlations between the fracture height and the degree of bowing regardless of BPs medication. All fractures except 1 occurred at the diaphyseal region of the femur when not associated with BP medication.

scholarly journals Prevalence of Anxiety Disorder and Associated Factors among Voluntary Counseling and HIV Testing Clients at Governmental Health Centers in 2017 in Addis Ababa, Ethiopia

2021 ◽  
Author(s):  
Abdissa Boka Dirriba
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Positive Result ◽  
Hiv Testing ◽  
Associated Factors ◽  
Addis Ababa ◽  
Health Centers ◽  
Voluntary Counseling ◽  
History Of ◽  
The Impact

Objective: More than 450 million people are considered to be suffered from mental problem in the world nowadays. In Ethiopia, these problems constitute for 12.45% of the impact of diseases and around 12% of individuals are estimated to be develop any form of mental problems, of which 2% are severe cases. One of the most psychiatric problem that cause substantial functional impairment and suffering is anxiety disorders. To assess the prevalence of anxiety disorder and associated factors among voluntary counseling and HIV testing (VCT) clients of Addis Ababa governmental health centers, Ethiopia, 2017. Method: An institutional based cross-sectional study was conducted at Addis Ababa governmental health centers from February 15 to March 10, 2017. A Cluster sampling technique was used and 770 study participants were interviewed. Data were entered into EPI INFO version 2002 and transferred to SPSS version 19.0 windows and was analyzed. The logistic regression of analyses was used. Results: The prevalence of anxiety disorder among VCT clients was 39.2%. Factors that statistically significant with an anxiety disorder: fear of stigma or social discrimination (AOR = 3.01, 95%CI: 1.67, 5.42), history of haven’t been tested before for HIV (AOR = 3.97, 95%CI: 2.32, 6.81), and fear of having a positive result (AOR = 2.60, 95% CI: 1.55, 4.36); the burden of family size was marginally significant at 0.05 level of significance (P = 0.075). Conclusion: The prevalence of anxiety problems among voluntary counseling and HIV testing clients of Addis Ababa governmental health centers was high. Fear of stigma, fear of having a positive result, and no history of a test before were the most factors associated with anxiety disorders. I recommended that increasing awareness in reducing stigma/discrimination, appropriate psychiatry counseling for individuals and community at the health center, and Addis Ababa Health Bureau should be arranged.

scholarly journals Prevalence of depression, anxiety and associated factors among patients with dental disease attending outpatient department in Addis Ababa public hospitals, Addis Ababa, Ethiopia: a multicenter cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bekele Seifu ◽  
Niguse Yigzaw ◽  
Kibrom Haile ◽  
Zahira Reshid ◽  
Henock Asfaw
Keyword(s):  
Associated Factors ◽  
Addis Ababa ◽  
Educational Status ◽  
Public Hospitals ◽  
Outpatient Department ◽  
Anxiety And Depression ◽  
Dental Disease ◽  
Dental Clinic ◽  
Cross Sectional ◽  
History Of

Abstract Background Anxiety and depression are widespread mental health problems in many populations. These problems can be major barriers to dental care and may be led to poor oral health. Objectives To assess prevalence of depression, anxiety and associated factors among patients with dental disease in Addis Ababa public hospitals outpatient department, Addis Ababa, Ethiopia, 2019. Methods An institution based cross sectional study was conducted from May 06 to June 06, 2019 among patients with dental disease attending outpatient department in Addis Ababa city administration public hospitals. Multistage sampling method was used to select study participants. Hospital Anxiety and Depression scale was used to assess anxiety and depression. Face to face interview was used to collect data and the collected data was entered into EPI data version 3.1 and analysis was done using SPSS (Statistical Package Software for Social Sciences) version 20. Bi-variable and multivariable binary logistic regression was carried out. Strength of association was determined using odds ratio with 95% CI (Confidence Interval) and p value less than 0.05 was considered as statistically significant association in the final model. Results From the total of 845 participants, 833 were studied with response rate of 98.6%. The median age of the respondent was 32 years with interquartile range (26–41 years). The prevalence of anxiety and depression were found to be 33.9% and 29.2% respectively. Being female [AOR (Adjusted Odds Ratio) 2.70 (95% CI 1.86, 3.89)], tooth extraction [AOR 3.24 (95% CI 2.11, 4.97)], history of repeat visit to dental clinic [AOR 3.21 (95% CI 2.25, 4.58)], chronic disease [AOR 2.95 (95% CI 1.98, 4.38)] and current alcohol use [AOR 3.40 (95% CI 2.28, 5.09)] were significantly associated with anxiety among patients with dental disease. Being female [AOR 2.22 (95% CI 1.53, 3.23)], Elementary educational status [AOR 2.15 (95% CI 1.28, 3.58)], periodontitis [AOR 1.74 (95% CI 1.18, 2.72)],history of repeated visit to dental clinic [AOR 4.07 (95% CI 2.84, 5.84)], current use of alcohol [AOR 4.01 (95% CI 2.68, 6.00)], current cigarette use [AOR 3.15 (95% CI 1.42, 7.00] and irregular tooth brushing [AOR 2.22 (95% CI 1.53, 3.23]were significantly associated with depression among patients with dental disease. Conclusion Anxiety and depression were high among people with dental disease. Tooth extraction and having chronic disease were significantly associated with anxiety. Elementary educational status, periodontitis, current cigarette smoking and irregular tooth brushing pattern were significant association with depression. History of repeat visit to dental clinic, current alcohol use and female sex were significantly associated with both depression and anxiety. Based on the finding of this study early screening and treating of anxiety and depression, also identifying those associated factors are important at dental clinic.

scholarly journals Clinical analysis of cardiac failure in post-myocardial infarction patients

2018 ◽  
Vol 5 (3) ◽  
pp. 587
Author(s):  
R. Jaya Prakash Reddy ◽  
P. Vijaya Narasimha Reddy
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Failure ◽  
Clinical Analysis ◽  
Cross Sectional Study ◽  
Anterior Wall ◽  
Prior History ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Number Of Patients ◽  
History Of

Background: Cardiac failure is one of the common complications of Acute Myocardial Infarction. As CAD is the leading cause of death and post MI Cardiac failure also causing increase in rate of Mortality. It directs us to assess the complications of MI and to evaluate the precautionary & preventive steps of cardiac failure.Methods: The present study comprises of 50 cardiac failure patients with history of MI in the past and who presented with myocardial infarction with cardiac failure were included in this study. We excluded the patients who presented with Cardiac failure without Prior history of MI. This hospital based cross sectional study was conducted at Rajiv Gandhi Institute of Medical Sciences (RIMS), Ongole, Prakasam District, Andhra Pradesh. The study was carried out for a period of 1 year with informed consent.Results: In present study majority number of patients (33) show hypokinesia and 10 are found to have dyskinesia and only 4 are akinesia. In this study More than 50% patients are with history of anterior wall involvement. 36(72%) patients have elevated JVP, 34(68%) have cardiomegaly, 38 patients presented with PND. 29(58%) patients are DM and 35(70%) are HTN and only 6(12%) patients are neither DM, nor HTN.Conclusions: Cardiac failure is a common complication after MI. Most common presentations are breathlessness, chest pain, PND, JVP etc. Anterior wall MI on ECG either isolated or associated with other walls is the leading cause of post MI cardiac failure.

A Review on Prevention, Transmission and Symptoms of the Covid-19

2021 ◽  
Author(s):  
Hamid Mohammadi ◽  
Yahya Ehteshaminia ◽  
Seif Ali Mahdavi
Keyword(s):  
Respiratory Tract ◽  
World Health ◽  
Definitive Treatment ◽  
Effective Vaccine ◽  
Upper Respiratory Tract ◽  
Number Of Patients ◽  
The Face ◽  
History Of ◽  
Health Organization ◽  
Respiratory Droplets

Introduction: Coronavirus belongs to a family of viruses that can cause symptoms such as pneumonia, fever, shortness of breath and lung infection. On December 29, 2019, the World Health Organization (WHO) coined the term New Coronavirus 2019 to refer to a coronavirus that affects the lower respiratory tract of patients with pneumonia in Wuhan, China. The new coronavirus was first identified in Wuhan, among a number of patients with an unknown form of viral pneumonia who also had a history of Huanan seafood market. Materials and Methods: In this study, the websites of PubMed, Google Scholar, SID, and Magiran were searched and related articles were reviewed. Results: Symptoms of COVID-19 occur after a period of 2 to 10 days and the period of symptoms resulting in death of patients varied between 6 to 41 days. Common symptoms at the onset of the disease are fever, cough, and fatigue. Each carrier is reported to infect an average of 3.77 others. Conclusion: Regarding the way of transmission of viral diseases of the upper respiratory tract, such as COVID-19, i.e., the transmission by respiratory droplets as well as close communication between individuals, solutions have been recommended by experts. Researchers are suggesting not touching the T-zone on the face, using a mask and following the principles of social distancing are the most effective ways to control the disease. Due to the lack of definitive treatment or effective vaccine for COVID-19 so far, following these principles has a significant role in combating this pandemic.

Dissecting Growth Factors Production in Patients with Agnogenic Myeloid Metaplasia (AMM).

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4749-4749
Author(s):  
Jen-Chin Wang ◽  
Kirugaval Hemavathy ◽  
Amit Goldberg ◽  
Tsong S. Chang ◽  
Allan D. Novetsky ◽  
...  
Keyword(s):  
Growth Factors ◽  
Growth Factor ◽  
Transforming Growth Factor ◽  
Prior History ◽  
Mrna Levels ◽  
Myeloid Metaplasia ◽  
Number Of Patients ◽  
History Of ◽  
Tgf Β1 ◽  
Marrow Fibrosis

Abstract Growth factors including Transforming Growth Factor-β 1 ( TGF- β1), Platelet Derived Growth Factor (PDGF) and Fibroblast Growth Factor (FGF) have been implicated as responsible for bone marrow fibrosis in AMM. Although TGF-β1 and FGF have been demonstrated to be increased in blood hematopoietic progenitor cells, a direct measurement of the production of these growth factors by megakaryocytes has not been performed. The current study was devised to study the production of these growth factors production directly in megakaryocytes and monocytes of AMM patients and correlate these with the clinical features. Twelve patients with AMM and 11 normal healthy volunteers used as controls, were studied. CD 34 + cells and CD 14+ cells were obtained from blood mononuclear cells by MACS Progenitor cell isolation kits ( Miltenyi Biotec, CA). The megakaryocytic (CD41+) cells were then obtained by growing the isolated blood CD34 + for 10 days in Iscove Modified Dulbecco Medium with Stem Cell Growth Factor and Thrombopoietin. The mRNA levels of TGF-β1, FGF and PDGF in the isolated megakaryocytes and blood monocytes were assayed by Real-Time RT-PCR. The results were as shown in Table 1. Among the AMM patients, a patient with prior history of Polycythemia Vera (PV) and a patient with Essential Throbocythemia (ET) were found to have elevated PDGF and FGF expression in their monocytes but the expression of growth factors was not elevated in their megakaryocytes.. These results demonstrate that megakaryocytes are the main source of growth factors responsible for marrow fibrosis. The study also suggests that growth factors produced by monocytes may be responsible for fibrosis in AMM patients with a prior history of PV or ET. Table-1 Megakaryocytes Monocytes * Denotes number of patients with elevated growth factor levels as compared with controls. ** Denotes numbers of patients tested. TGF- β 1 8*/10* 0/10 PDGF 8/10 3/7 FGF 6/10 2/7

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