Open Access Original Research Article

Oesophageal Foreign Bodies Impaction in Nigerian Adults: A Preventable Consequence

Abdullahi Mohammed, Stanley Baba Amutta

Asian Journal of Medicine and Health, Page 1-8
DOI: 10.9734/AJMAH/2018/38951

Background: Foreign body impaction in adults, is usually food related, with severe consequences when neglected.

Patients and Methods: A retrospective study of adults’ ≥ 18 years diagnosed with the impacted foreign body in the oesophagus, seen at the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria, from December 2011 to December 2016.

Results: The authors reviewed forty-four cases.  The age ranged from 18-90 years (mean age of 49.5±21.3), most of these patients 19(43. 2%) were above 60 years of age.

A sharp foreign body was the commonest impacted foreign body, and the majority of them were fish bones 19 (43.2%) followed by dentures 11(25%). Meat bolus 6(13.6%) was the most common impacted food bolus. Majority of the impactions occurred at the upper oesophagus 32 (72.7%).     The patients with fish bone impaction 19 (43.2%), commonly engaged in  Various manoeuvres      to dislodge the impaction. Of this, 15 (78.9%) patients were reportedly engaged in these manoeuvres: by drinking copious water 10 (52.6%), food bolus ingestion 3 (15.8%) and induced vomiting 2 (10.5%).

The identified risk factors include the duration > 24 hours (P < .05) of foreign body impaction, the presence of sharp objects 35 (79.5%) and self- medication 15 (34.1%). Mucosal abrasion with haemorrhage 12(28.6%) was the most common complication. We recorded no mortality during the study period.

Conclusion: The Risk Factors for foreign body ingestion and factors contributing to delay presentation are preventable by the creation of awareness, thus minimising the associated complications.

Open Access Original Research Article

Epidemiological Analysis of Infective Endocarditis at the Gold Coast Area Health Service, Australia

Manan Vaishnav, Rohan Jayasinghe, Sahan Bandara, Raj Mehta

Asian Journal of Medicine and Health, Page 1-7
DOI: 10.9734/AJMAH/2018/35798

Introduction: Infective endocarditis is known to be a condition which is associated with high mortality and morbidity. Some studies indicate an in-hospital mortality of 16% with a one-year mortality of 37% with infective endocarditis.

Aim: We aim to determine the risk factor profile, valve profile, complication rates, mortality, microorganisms involved and impact of antimicrobial resistance of patients with infective endocarditis at the Gold Coast area health service.

Design: We performed a retrospective single-center analysis on 111 patients of 18 years old and above with echo-proven infective endocarditis who were followed at the department of cardiology, Gold coast area health service from January 2011 to December 2015.

Place and Duration of Study: Department of Cardiology, Gold coast area health service, January 2011 to December 2015.

Inclusion Criteria: Age > 18 years, index hospital stay with infective endocarditis, echocardiographic evidence of endocarditis.

Results: Median age: 59 years, median length of stay: 21 days, male predominance (68% males, 32% females), mitral valve was the most commonly involved valve, surgical intervention in 20%, mortality 16%.

Risk factors: Intravenous drug use was the most common risk factor (28%).Presence of prosthetic heart valve (mechanical and bioprosthetic) was the second most common risk factor. Other risk factors-healthcare related endocarditis (14%), previous episodes of endocarditis (15%), rheumatic heart disease and intracardiac device (8%).

Methicillin-sensitive Staphylococcus aureus (MSSA) was the most commonly involved organism (46%) followed by streptococcus (26%), Enterococcus (11%). Methicillin-resistant Staphylococcus aureus (MRSA) was involved in 5% of the patients.

Septic emboli was the most common complication (42%). Heart failure which complicated endocarditis in 38% of patients had a relative risk of mortality of 2.83 (p=0.018, 95% [CI] 1.1-6.7). Arrhythmias happened in 11% of patients which posed a relative risk of mortality, (RR- 2.71, p=0.037, 95% [CI] 1.0-6.9). The RR for mortality in the non-surgical group was 2.09 (RR-2.09, 95% [CI] 0.5-8.4, P= 0.3) compared to the surgical group.

Conclusion: The key findings in our single center study were that intravenous drug use and health care related endocarditis were the most common reversible risk factors of endocarditis with complications of heart failure and arrhythmias posing a significant risk of mortality.

Open Access Original Research Article

Satisfaction with Quality of Health Care among Teaching Hospitals in Kathmandu, Nepal

Bhim Bahadur Chand, Shyam Bahadur Katuwal, Ramanand Pandit, Ashok Pandey

Asian Journal of Medicine and Health, Page 1-11
DOI: 10.9734/AJMAH/2018/39015

Aims: Patient satisfaction is an important indicator of healthcare quality and effectiveness of healthcare delivery and quality of medical care. Patients ‘perceptions about health services seem to have been largely ignored and it has been a subject of great interest to any health care organizations. The overall objective was to assess the satisfaction with the quality of health care among teaching hospitals in Kathmandu, Nepal.

Study Design: A cross-sectional descriptive study was in Kathmandu, Nepal to assess the satisfaction with the quality of health care.

Place and Duration of Study and Sample: The study site was Kathmandu medical college teaching hospital (KMC) and Kist medical college teaching hospital (KIST). Total 212 respondents were selected using simple random sampling technique from October 2016 to March 2017.

Results: Three-fourth (74.6%) of the respondents were satisfied with the services provided by both hospitals. Less than 10% of the respondents reported that they were not satisfied with the treatment. 43.9% of the respondents mentioned that they were completely satisfied with the treatment provided by hospitals. 

Conclusion: All the patient’s from both hospitals were satisfied on average; still, there is room for quality improvements for the satisfaction of the services. It is recommended that healthcare service providers continually capture, measure and evaluate patient satisfaction. 

Open Access Original Research Article

The Prevalence, Risk Factors and Awareness of Hypertension in an Urban Population of Dehradun, Uttarakhand, India

Anuj Nautiyal, N. V. Satheesh Madhav, Samir Bhargava, Abhijeet Ojha, Rajeev Kumar Sharma, Manmohan Singhal, Vijay Singh Rana, Harish Chandra, Sushant Kumar Gupta, Md. Habban Akhter, N. K. Kamboj, Yusra Ahmad, S. N. Uniyal

Asian Journal of Medicine and Health, Page 1-7
DOI: 10.9734/AJMAH/2018/39363

To determine the prevalence and possible risk factors for prehypertension and hypertension state in Dehradun City of Uttarakhand (Northern India) using Joint National Committee (JNC) VII criteria, team of five pharmacy professional of DIT University -Faculty of Pharmacy were trained to measure blood pressure visited the localities randomly. The blood pressure (BP) of the participants was measured twice and the average value of the two measurements was considered. A total of 499 individuals (198 males and 301 females), responded aged ≥30 years in the survey. Overall prevalence of hypertension was 18.03%, (n = 90); 81(16.23%) had stage-I hypertension, 9 (1.80%) had stage-II hypertension. Only 228(45.69) subjects participated was found to have normal BP, while 181(36.27) were prehypertensive. In conclusion, the hypertension prevalent in the study population was low and prehypertension was found to be more in the population under study, and early intervention is necessary so that major health benefits can be given to the population that is possible through the implementation of primary prevention strategies and the risk of development of chronic kidney diseases and heart diseases could be prevented.

Open Access Original Research Article

The Nature and Complications of Acute Traumatic Cervical Spinal Cord Injury in a University Hospital in Nigeria

Itodo C. Elachi, Williams T. Yongu, Joseph N. Kotor, Bassey E. Edem, Chukwukadibia N. Ahachi, Daniel D. Mue

Asian Journal of Medicine and Health, Page 1-7
DOI: 10.9734/AJMAH/2018/39928

Background: Traumatic cervical spinal cord injury is one of the most devastating types of injuries. It results in varying degrees of disabilities that adversely affect patients’ quality of life. This study aims to evaluate the nature and complications of traumatic cervical spinal cord injury in Benue State University Teaching Hospital, Makurdi, Nigeria (BSUTH).

Methods: A retrospective study of traumatic cervical spinal cord injury patients who presented to BSUTH from June 2012 to May 2017. Socio-demographic and clinical characteristics were extracted from hospital records and analyzed with SPSS version 21.0 (Armonk, NY: IBM Corp).

Results:  A total of 47 patients with traumatic cervical spinal cord injury were studied. There were 42 males (89.4%) and 5 females (10.6%). Their ages ranged from 17 to 77 years with a mean of 35±16. The common causes were road traffic accidents (n=29, 61.7%), falls from height (n=8, 17.0%) and falling objects (n=5, 10.6%). Most patients were transported to the hospital in saloon cars (n=34, 72.3%). Of these patients, 3 (6.7%) had atlanto-axial (C1–C2) injuries while 44 (93.3%) had subaxial (C3–C7) injuries. Associated injuries were identified in 48.9% of patients with head injury being the most predominant. Four cases had established pressure sores on presentation. Twelve patients (19.7%) had skull traction while the rest had orthosis. Majority of the patients had ASIA class A (n=31, 66.0%) at the time of discharge. One patient (2.1%) had no neurological deficits (ASIA class E). Complications were observed in 63.8% of the patients, with skin pressure ulcers being the most frequent (36.6% of all complications). Other complications included urinary tract infections, respiratory tract infections, depression, neurogenic pain, spasms and contractures.

Conclusion: Traumatic cervical spinal cord injury predominantly affected young male patients and caused by road traffic accidents. It mostly involved the subaxial spine. Majority of patients had American Spinal Injury Association Class A injury. Pressure ulcers and urinary tract infections were the most common complications encountered.