International Journal of Medicine and Medical Sciences

International Journal of Medicine and Medical Sciences | Vol. 11, No. 3, March 2021 | pp. 17–24

DOI: 10.46882/2021/IJMMS/110017

Original Research Article

A Retrospective Trend Analysis of Neonatal Mortality and Proximate Clinical Determinants in a Regional Referral Hospital

Blessing N. Chukwu¹, Patrick E. Lawson², Evelyn M. Kamau¹*

¹Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, University of Port Harcourt, Port Harcourt, Nigeria.

²Department of Community Health, College of Health Sciences, Moi University, Eldoret, Kenya.

Abstract:

Neonatal mortality rates remain high in sub-Saharan Africa, serving as a key indicator of regional health equity and medical care quality. This retrospective clinical study analyzed the five-year trend (2015–2019) and proximate clinical causes of neonatal mortality at a regional referral hospital. De-identified clinical data of all neonates who died within 28 days of life were extracted. Out of 11,500 live births recorded over the study duration, 322 neonatal deaths occurred, resulting in an institutional neonatal mortality rate (NMR) of 28.0 per 1,000 live births. Early neonatal deaths (within the first 7 days of life) accounted for 76.4% (246/322) of the cases. The primary direct clinical causes of death were prematurity and related low birth weight complications (34.2%), birth asphyxia/hypoxic-ischemic encephalopathy (29.8%), and severe neonatal sepsis (21.1%). Congenital anomalies accounted for 6.8% of the deaths. Maternal factors significantly associated with increased neonatal mortality risk included a lack of antenatal care attendance (OR = 3.6, 95% CI = 2.1–6.2, p < 0.01), maternal hypertensive disorders of pregnancy (OR = 2.4, p < 0.05), and prolonged obstructed labor (OR = 2.9, p < 0.01). Neonatal mortality remains elevated, driven primarily by preventable or manageable intrapartum and postpartum clinical conditions. Strengthening maternal care quality during the intrapartum window, establishing specialized neonatal care units, and training healthcare staff in neonatal resuscitation are essential actions.

Keywords: Neonatal Mortality, Birth Asphyxia, Prematurity, Neonatal Sepsis, Antenatal Care, Intrapartum Care

Manuscript Timeline: Received: November 11, 2020; Revised: December 19, 2020; Accepted: January 12, 2021; Published: March 10, 2021.

Citation: Chukwu BN, Lawson PE, Kamau EM. A Retrospective Trend Analysis of Neonatal Mortality and Proximate Clinical Determinants in a Regional Referral Hospital. International Journal of Medicine and Medical Sciences, 2021, 11(3): 17–24. DOI: 10.46882/2021/IJMMS/110017

International Journal of Medicine and Medical Sciences ISSN 2167-0404 Vol. 11 (3), pp. 001-003, March, 2021. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Case Report

Exploring a Unique Case of Uterine Leiomyosarcoma with Chronic Inversion: Insights and Implications

Rekha Sachan¹*, Pooja Gupta1 and ML Patel²

¹Department of Obstetrics and Gynaecology, CSM Medical University, Lucknow, India.
²Department of Medicine, CSM Medical University, Lucknow, India.

Accepted 22 October, 2020

Sarcomatous change in uterine fibroid is termed leiomyosarcoma. The tumor originates from smooth muscle cells and is rare, accounting for 2 to 5% of all uterine malignancies. The said patient had the history of irregular bleeding, but not typical menorrhagia, which is the usual presentation in this tumor. A 40 year old, P4+0 women of North Indian origin, was admitted with huge polypoidal fungating mass with bosselated surface and variegated mass protruding from introitus consistently. It was 12 ×10 cm in size with fundal cuping and cervical rim around the mass, which indicates inversion of the uterus. Total abdominal hysterectomy with bilateral salpingoophorectomy and bladder repair was done via abdomino-perineal route and the histopathology confirmed the diagnosis of leiomyosarcoma. Because of their rarity, uterine sarcomas are not recommended for routine screening. Surgery is the only treatment modality of leiomyosarcoma and prognosis depends upon the stage of the cancer.

Key words: Leiomyosarcoma, inversion, hysterectomy.
 

International Journal of Medicine and Medical Sciences ISSN 2167-0404 Vol. 11 (2), pp. 001-004, February, 2021. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

From Procedure to Recovery: Understanding Quality of Life Changes After Septal Surgery

Mohammed Ayub Musani*, Itrat Javed, Yousuf Khambaty, Faheem Ahmed Khan and Syed Wadood Ul Hasnain

Department of ENT, Karachi Medical and Dental College, KARACHI, Pakistan.

Accepted 30 November, 2020

Abstract

To assess the quality of life in patients who have been through the surgical intervention related to nasal septum in ENT department of Abbasi Shaheed Hospital, Karachi. This study was done from January 2008 to August 2008. Case based study, with post-interventional quality of life assessment questionnaire. One hundred patients undergoing nasal septum related surgery, after their full informed and written consent, were included in this study. The age limit was above 18 years and both the sexes were included. They were given a questionnaire (Glasgow benefit inventory score-GBI) to be fulfilled on the first follow up day after a week’s time from the day of surgery and then subsequently on the second visit that is, at about two week’s time from their first visit and the last one after the lapse of 1 month from the time of second visit. Average score of patients as per the GBI on the first follow up visit was 17; on second subsequent visit was 39 and on the last visit it was 50 thereby showing a positive correlation between the improvement in quality of life and septal surgery. Septal surgery has a definite and positive impact on improving the health related quality of life of patients.

Key words: Quality of life (QOL) after surgery, outcome assessments.
 

International Journal of Medicine and Medical Sciences ISSN 2167-0404 Vol. 11 (1), pp. 001-005, January, 2021. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Case Report

Neonatal Immature Gastric Teratoma: Pathophysiology and Treatment Outcomes

Ahmed H. Al-Salem

Department of Pediatric Surgery, Maternity and Children Hospital, Dammam, Saudi Arabia.
E-mail: [email protected].

Accepted 25 October, 2020

Gastric teratomas are very rare embryonal neoplasms and accounts for less than 1% of all teratomas occurring in infants and children. It is usually seen in male infants who present with upper abdominal mass and commonly it is benign. This report describes a large immature grade II gastric teratoma in a male newborn. The tumor was treated with total excision including part of the stomach.

Key words: Gastric teratoma, newborn, immature.
 

International Journal of Medicine and Medical Sciences | Vol. 10, No. 12, December 2020 | pp. 91–98

DOI: 10.46882/2020/IJMMS/100091

Original Research Article

Psychological Distress, Burnout, and Coping Mechanisms among Mental Health Providers during the COVID-19 Pandemic

Grace E. Akpan¹, David O. Mensah², Sarah W. Ndlovu¹*

¹Department of Psychiatry and Mental Health, School of Medicine, Kenyatta University, Nairobi, Kenya.

²Department of Psychiatry, University of Ghana Medical School, Accra, Ghana.

Abstract:

The unprecedented scale of the COVID-19 pandemic placed severe emotional and structural strain on mental health infrastructure and clinical staff. This cross-sectional online-based psychometric survey evaluated the prevalence of psychological distress, workplace burnout, and personal coping mechanisms among frontline mental health professionals (psychiatrists, clinical psychologists, and psychiatric nurses). A total of 220 practicing mental health clinicians responded to a comprehensive study tool incorporating the General Health Questionnaire (GHQ-12), the Maslach Burnout Inventory (MBI), and the Brief-COPE inventory. The psychometric outcomes revealed a high burden of psychological distress, with 54.5% (120/220) scoring above the threshold on the GHQ-12. High levels of emotional exhaustion and depersonalization (burnout dimensions) were recorded in 48.2% and 36.4% of the participants, respectively. Psychiatric nurses reported significantly higher emotional exhaustion scores compared to psychiatrists (p < 0.05). Risk factors strongly associated with severe distress included female gender (OR = 2.1, p < 0.05), personal history of chronic health conditions (OR = 2.4, p < 0.05), and prolonged weekly working hours > 50 hours (OR = 3.1, p < 0.01). The most frequent positive coping mechanisms were active coping, religious coping, and positive reframing, while substance use and behavioral disengagement were linked to higher distress scores. The high prevalence of burnout and distress highlights the heavy psychological toll of the pandemic on mental health workers. Hospital leadership should implement institutional support programs, workload modifications, and formal psychological counseling systems to preserve the health workforce.

Keywords: COVID-19, Psychological Distress, Burnout, Mental Health Providers, Coping Mechanisms, MBI

Manuscript Timeline: Received: August 24, 2020; Revised: October 02, 2020; Accepted: November 04, 2020; Published: December 16, 2020.

Citation: Akpan GE, Mensah DO, Ndlovu SW. Psychological Distress, Burnout, and Coping Mechanisms among Mental Health Providers during the COVID-19 Pandemic. International Journal of Medicine and Medical Sciences, 2020, 10(12): 91–98. DOI: 10.46882/2020/IJMMS/100091

International Journal of Medicine and Medical Sciences | Vol. 10, No. 11, November 2020 | pp. 83–90

DOI: 10.46882/2020/IJMMS/100083

Original Research Article

Evaluation of D-Dimer Levels as a Prognostic Marker for Severe Respiratory Failure in Hospitalized COVID-19 Patients

Ibrahim K. Diallo¹, Victoria N. Eke², Jean-Baptiste M. Diop¹*

¹Department of Haematology, Faculté de Médecine, de Pharmacie et d'Odontologie, Université Cheikh Anta Diop, Dakar, Senegal.

²Department of Hematology and Blood Transfusion, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.

Abstract:

Coagulopathy characterized by microvascular thrombosis is a prominent feature of severe COVID-19 illness. This retrospective observational study examined the clinical utility of sequential serum D-dimer monitoring for predicting the progression toward severe acute respiratory distress syndrome (ARDS) and mechanical ventilation requirements. We evaluated the clinical files of 150 adults admitted with moderate SARS-CoV-2 infection. Patients were grouped based on whether they clinical progressed to severe respiratory failure requiring intensive care unit (ICU) admission (n = 45) or remained stable in general medical wards (n = 105). Baseline and serial daily D-dimer values were extracted and analyzed. The mean baseline D-dimer level was significantly higher in patients who subsequently required intensive care and mechanical ventilation (1.85 ± 0.42 μg/mL) than in the non-ICU cohort (0.62 ± 0.15 μg/mL, p < 0.001). Serial analysis showed a rising kinetic pattern of D-dimer in the severe group, spiking over 3.0 μg/mL 48 hours prior to acute clinical deterioration. Receiver operating characteristic (ROC) analysis showed that a baseline D-dimer cutoff value of 1.5 μg/mL had a sensitivity of 84.4% and a specificity of 81.0% for predicting respiratory failure (Area Under the Curve = 0.88, 95% CI = 0.81–0.94). Elevated D-dimer at admission and rising concentrations over time are highly predictive of hypercoagulability-induced pulmonary failure. Early risk assessment using this assay can help identify high-risk patients who could benefit from early, targeted therapeutic anticoagulation.

Keywords: COVID-19, Coagulopathy, D-Dimer, Acute Respiratory Distress Syndrome, Prognostic Marker, Anticoagulation

Manuscript Timeline: Received: August 01, 2020; Revised: September 10, 2020; Accepted: October 05, 2020; Published: November 12, 2020.

Citation: Diallo IK, Eke VN, Diop JBM. Evaluation of D-Dimer Levels as a Prognostic Marker for Severe Respiratory Failure in Hospitalized COVID-19 Patients. International Journal of Medicine and Medical Sciences, 2020, 10(11): 83–90. DOI: 10.46882/2020/IJMMS/100083