Open Access Review Article

Surgical Anatomy and Approach to the Abdominal Wall of Domestic Animals

Kabkia Dieudoné, Sahidi Adamou, Bilkiss V. N. Assani, Mireille Kadja, Agba Kondi

Asian Journal of Medicine and Health, Page 11-21
DOI: 10.9734/ajmah/2021/v19i530325

The variety of procedures that can be performed on the organs contained in the abdominal cavity is such that there are many different ways to approach them. The different laparotomies available are adapted to both the type of organ to be approached and the type of procedure to be performed; they must also take into account the anatomy of the abdominal wall, so as to be as minimally disruptive as possible. This article successively describes the surgical anatomy of the abdominal wall and the different types of laparotomies used in scheduled surgery.

Open Access Review Article

The Impact of Microorganisms in Pregnancy

Nastaran Ghandali, Hoda Sabati, Ali Emami, Masumeh Dadashaliha

Asian Journal of Medicine and Health, Page 22-38
DOI: 10.9734/ajmah/2021/v19i530326

The pregnancy process involves many physiological changes, including weight gain, hormonal, metabolic and immune changes. One of the effective factors in this process is infection caused by microorganisms. Originally, before the advent of antibiotics, pregnancy was known as a risk factor for severe complications of pneumococcal pneumonia. Among viral infections, the 2009 flu pandemic issued a newer warning that some infections may disproportionately affect pregnant women and cause miscarriage and its complications during pregnancy. Generalization of pregnancy as a condition of suppression of the general immune system or increased risk is misleading and prevents the establishment of adequate guidelines for the treatment of pregnant women during epidemics. Viral infection has also become an important factor in pregnancy conditions. The recent outbreak of Ebola and other viral outbreaks and epidemics shows how pregnant women show worse outcomes (such as preterm delivery and fetal adverse outcomes) than the general population and non-pregnant women. The purpose of this article is studying pathogenesis of microorganisms and the risks which pose to the mother and the fetus. In order to investigate these factors, from 120 article prepared from google scholar and Pub med, Elsevier database. Knowing these factors can increase the ability to treat the infections in a timely manner and prevent their effects on the fetus and the patient.

Open Access Original Research Article

Psychological Wellbeing of Healthcare Workers in Different Hospitals of Karachi (Pakistan) During COVID-19 Pandemic

Hamza Syed Muhammad, Sadaf Anwar, Angila Iqbal, Farah Ahmad

Asian Journal of Medicine and Health, Page 1-10
DOI: 10.9734/ajmah/2021/v19i530324

Background: With increasing morbidity and mortality rates throughout the world, COVID-19 has caused a universal psychological impact on the lives of people.

Aims: To examine psychological wellbeing of frontline healthcare professionals and compare mental health among doctors, paramedical staff and allied health workers.

Methods: This cross-sectional study included 225 healthcare professionals from 13 different hospitals in Karachi, Pakistan. The symptoms of depression, anxiety and insomnia were assessed using the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7) and the 7-item Insomnia Severity Index (ISI) respectively.

Results: Major findings of the study were that 44.7% participants had no depression, 38% were reported to have mild anxiety and 3.5% had severe insomnia. Insomnia was correlated with anxiety and depression leading to moderate correlation of 0.516 and 0.694 in both with a highly significant p value (p=0.001 and p=0.001). A significant association of depression was seen with healthcare providers and years of experience with (p=0.009) and (p=0.010) respectively. Levels of anxiety were associated with occupation and years of experience that led to the finding that doctors suffered more from mild anxiety (83.5%) whereas years of experience had no significant association. Correlation of insomnia with occupation and years of experience led to the finding that sub threshold insomnia was found in 29% participants, where majority of participants were allied health workers. However, borderline significant association was found between insomnia and the number of years of work experience (p=0.049).

Conclusion: It is concluded that frontline workers experienced different levels and symptoms of psychological distress in this pandemic.

Open Access Original Research Article

The Factors Related to Death of Trauma Preventable Death Patients in Rajavithi Hospital

T. Nopmanee, C. Sukrom, U. Teerachai, D. Jirapong, K. Nirutchara

Asian Journal of Medicine and Health, Page 39-44
DOI: 10.9734/ajmah/2021/v19i530327

Aims: To study the factors related to death of traumatic preventable death patients with probability of survival score more than 0.75

Methodology: A 1:4 case-control study was conducted on traumatic preventable death patients with probability of survival score more than 0.75 who received treatment at the Emergency Department and was admitted in Rajavithi Hospital between 2015 and 2018. Data were retrieved from Rajavithi trauma registry. Statistical analysis using Chi-square test, student t-test, and Multiple logistic regression was employed for factors associated with death of trauma.

Results: There were 36 cases (death) and 150 controls (survivors). In cases group,
21 (61.1%) were male with mean age of 61.36±20.23 years. 26 (72.2%) had underlying diseases. 22 (61.10%) of these injuries occurred at home. The cause of accidents are
categorized to fall injury occurring 21 (58.3%), and blunt mechanism of injury 35 (97.20%). The mean Injury Severity Score was 17.81±9.66. Factors significantly associated with increased death are age (Adjust OR: 1.05 (1.01-1.08), P = .02), pulse rate (Adjusted OR): 1.05 (1.01-1.08), P = .01), underlying disease (Adjusted OR): 12.0 (2.29-62.88), and Injury Severity Score (Adjusted OR): 1.29 (1.16-1.43), P < .001)

Conclusion: The factors related to death of traumatic preventable death patients with probability of survival score more than 0.75 were age, pulse rate, underlying disease, and Injury Severity Score.

Open Access Original Research Article

Radiological Diagnosis of Pediatric Pulmonary Infections and Follow up Protocols

Naglaa Elsayed, Haya Albibi, Shatha Msawah, Omnia Asiri

Asian Journal of Medicine and Health, Page 45-55
DOI: 10.9734/ajmah/2021/v19i530328

Background and objectives: Respiratory infection is the second most common disease in pediatrics presented to the emergency department. Imaging modalities used for diagnosis, and follow up duration of each type of infection should be studied for best outcome for those patients.

We aimed to find the optimum imaging follow up protocol for pediatrics with respiratory infections.

Methods and Results: Retrospective study included 500 pediatric patients ranging in age from one month to 15 years, presented with respiratory infection. Radiological findings, numbers and results of follow up were collected and statistically analyzed using SPSS program version 23.

Bronchitis represented the commonest finding (43%), followed by pneumonia (35%). All patients had initial chest X-ray. CT was done for 79 patients. 218 patients had radiological follow up. The number of follow up ranged from 1 to 51 with the average number was 26.

Interpretation and Conclusions: Bronchitis is a clinical diagnosis that does not usually need imaging. Pneumonia is diagnosed clinically aided with X ray in severe cases and follow up may be needed after 4 weeks. X ray and CT are mandatory for the initial diagnosis of TB and follow up should be done after 6 months. Cystic fibrosis needs clinical follow up and annual imaging unless complications arise. Pulmonary abscess needs follow up after treatment.

Open Access Original Research Article

Evaluation of the Knowledge Enhancement and Impact of Tele Mentoring on Liver Care, Using ECHO Platform on Nursing Professionals in India

Sabin Syed, Aayushi Rastogi, Pranav Keshan, Vinay Kumar, Ashish Kumar, Arpit Kumar, Akanksha Bansal

Asian Journal of Medicine and Health, Page 56-64
DOI: 10.9734/ajmah/2021/v19i530329

Aims: The objective of the study was to assess the effectiveness of the one-day training program on liver care among nursing professionals using online training platform of ECHO (Extension for Community Healthcare Outcomes). The study also aimed to assess the impact of one-day training program on liver care on their attitude and practice at least after four months.

Study Design: Pre-post design

Place and Duration of Study: Institute of Liver and Biliary Sciences New Delhi and 26th March 2019 till 22nd February 2020.

Methodology: A one-day training program titled “Approach to patients with liver diseases” on management of liver infections for nursing professionals was conducted. An online link for KAP and Pre-post knowledge assessment questionnaire consisting 32 (KAP) questions was shared with all registered participants. Same Knowledge questionnaire consisting 19 questions was shared with the participants after training. Four months after training impact assessment was conducted by sharing the online link with the participants of the conducted program. The data was extracted in MS excel. The continuous variable was presented as mean and standard deviation (SD) or median and Inter quartile range (IQR) as appropriate. The categorical variable was presented as frequency and percentages. Paired t-test was used to assess the difference in pre and post knowledge assessment. For performing the requisite analysis, knowledge score was divided as poor-to-moderate (<66.67%) and Good (≥66.67%). The analysis was performed in IBM-SPSS version 22.

Results: A total of 5974 nursing professionals were trained in 17 one day trainings and data for KAP and pre-post assessment data was available for 4647 and 3456 participants respectively, out of which 295 participants were analysed for impact assessment. Correlation coefficient between knowledge, attitude and practice score stated Pre-knowledge score was significantly correlated with attitude (r=0.19, p<0.05) and practice (r=0.20, p<0.05) whereas attitude and practice were also found to be significantly correlated (r=32, p<0.05) with each other.

Conclusion: The results from this study support the use of ILBS-ECHO model in tele mentoring the health care professionals by providing education and training in assessment and management of liver diseases. The technology used in ILBS-ECHO has demonstrated its utility in educating clinicians through co-managed care of underserved patients.

Open Access Original Research Article

Regulation of Biochemical Markers by Soymilk and Physical Exercise on Obese Rats

M. B. S. Dandji, F. N. Zambou

Asian Journal of Medicine and Health, Page 65-76
DOI: 10.9734/ajmah/2021/v19i530330

Background: Obesity is an excess of body fat that cause cardiovascular risk and it prevalence in Cameroon among adults is high.

Aims: This study took place in the animal house of the Department of Biochemistry of the University of Dschang between June 2020 and February 2021 and the purpose was to evaluate the effect of the association of soymilk, diet and swimming in the prevention and treatment of obesity.

Methodology: A cross-sectional study was conducted with 80 rats of 21 days old divided into 6 groups. Thus, we calculate Lee index every two weeks, blood glucose measure and lipid parameters have been dosed in blood sera conserved at -20°C after extraction.

Results: It appears that the high amount of lipid in hyperlipidic diet induces obesity in these rats after 45 days of treatment. This is shown by the body weight gained by hyperlipidic males and females (242.66 ±6.35g and 224.39 ±7.52g), which was significantly higher than that of the standard group (203.06 ±4.9g and 186.31 ±4.04g). This is also indicated in the hyperlipidic males with a Lee index of 301.38 ±0.495, which was significantly higher compared to standard males (296.33 ±1.977). The total cholesterol which was higher in the hyperlipidic subjects decreases significantly after treatment of 3.4 % and 26.8 % respectively at 30 and 60 days. Consequently, the other lipid parameters such as HDLc, LDLc and atherosclerosis index become normal within the duration of treatment.

Conclusion: The study results reveal that obesity was significantly prevalent mostly in males. Soymilk with its richness in phytosterols, coupled with swimming a priority source of fat dissipation, can be used efficiently to fight and prevent obesity and its consequences.

Open Access Original Research Article

Home Recording And Video Selection: Their use In A Low-Resource Setting For Epilepsy Diagnosis

Joseph. O. Yaria, Adesola Ogunniyi

Asian Journal of Medicine and Health, Page 77-86
DOI: 10.9734/ajmah/2021/v19i530331

Objective: In management of epilepsy, identification of an epileptic seizure, classification, epilepsy syndromes, and management decisions relies heavily on seizure semiology. However, since most seizures are not witnessed, obtained semiology has its limitations. This study aimed to determine how many patients could successfully submit a home recording of a seizure event and if adapted video compilations would improve epilepsy diagnosis and classification in a low resource setting.

Methods: A prospective cross-sectional study carried out at a neurology clinic in a teaching hospital in a low-resource setting. Sixty-seven randomly selected patients with recurrent unprovoked seizures and an informant who had regular observed the seizures and had access to video recording facilities were enrolled. Participants were required to fill an interviewer-administered questionnaire, select from a pre-designed video compilation what best described seizure witnessed, then encouraged on acquisition of video recordings at home. In the absence of video electroencephalography, information obtained was compared with a pre-defined algorithm which combined clinical history, physical examination, EEG results and neuro-images. Accuracy and reliability was calculated for different semiological signs and seizure classification.

Results: Sixty seven patients were recruited comprising of 30 females and 37 male patients. Only eight (12%) participants returned with an adequate home recording of seizure episode. Incorporating video selection with questionnaire obtained description improved accuracy for generalized seizure (0.85 vs 0.79) and focal onset seizure (0.84 vs 0.73). Test-retest reliability on video selections by informants showed kappa coefficients ranging from 0.88 – 1.000. 

Significance: Home video recording may not be as practical in our environment depending on the setting as adjustments may be required to make it routine. However, selecting videos from pre-selected video compilation may be a viable alternative to improve accuracy.