International Journal of Medicine and Medical Sciences

International Journal of Medicine and Medical Sciences | Vol. 15, No. 3, March 2025 | pp. 17–24

DOI: 10.46882/2025/IJMMS/150017

Original Research Article

A Retrospective Trend Assessment of Surgical Site Infection Prevalence and Antibiotic Susceptibility Profiles in Major Vascular Surgeries

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

¹Department of Surgery, Faculty of Clinical Sciences, University of Port Harcourt, Port Harcourt, Nigeria.

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

Abstract:

Surgical site infections (SSIs) following major vascular reconstructions are critical complications associated with high risks of graft failure, limb loss, and mortality. This retrospective clinical study evaluated the overall prevalence, specific clinical risk factors, and microbiological resistance trends of SSIs following elective lower-limb vascular bypass surgeries over a five-year period (2020–2024). De-identified medical charts of 550 patient files were extracted and analyzed using the Centers for Disease Control and Prevention (CDC) wound criteria. Out of 550 vascular procedures reviewed, 38 cases of confirmed SSIs were identified, resulting in an overall prevalence rate of 6.91%. The annual infection rate remained high, peaking in 2023 at 8.2%. Staphylococcus aureus was the predominant bacterial pathogen isolated from wound cultures (44.7%), with 35.3% of these strains confirmed as methicillin-resistant (MRSA). Gram-negative bacilli, led by Pseudomonas aeruginosa, accounted for 31.6% of infections. Antibiogram mapping revealed high resistance rates among Gram-negative isolates to ceftazidime (68.4%) and ciprofloxacin (63.2%), while all strains remained susceptible to amikacin and imipenem (100%). Multivariate logistic regression analysis demonstrated that an operative duration > 180 minutes (OR = 3.2, 95% CI = 1.5–6.8, p < 0.01), pre-existing diabetes mellitus (OR = 2.8, p < 0.05), and an emergency reoperation procedure (OR = 2.4, p < 0.05) were independent predictors of SSI. Post-vascular surgery SSIs present significant management challenges due to multidrug-resistant pathogens, underscoring the necessity of strict perioperative wound care and optimized antibiotic prophylaxis bundles.

Keywords: Surgical Site Infection, Vascular Surgery, Staphylococcus aureus, MRSA, Antibiotic Resistance, Risk Factors

Manuscript Timeline: Received: December 08, 2024; Revised: January 15, 2025; Accepted: February 10, 2025; Published: March 14, 2025.

Citation: Chukwu BN, Lawson PE, Kamau EM. A Retrospective Trend Assessment of Surgical Site Infection Prevalence and Antibiotic Susceptibility Profiles in Major Vascular Surgeries. International Journal of Medicine and Medical Sciences, 2025, 15(3): 17–24. DOI: 10.46882/2025/IJMMS/150017

International Journal of Medicine and Medical Sciences | Vol. 15, No. 2, February 2025 | pp. 9–16

DOI: 10.46882/2025/IJMMS/150009

Original Research Article

Evaluation of Viscoelastic Coagulation Changes using Thromboelastography to Predict Postoperative Hemorrhage in Major Hepatic Resection Surgery

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:

Major hepatic resections disrupt balance in the clotting system, causing complex changes that increase the risk of severe postoperative bleeding. This prospective cohort study evaluated the accuracy of Thromboelastography (TEG) compared to conventional coagulation assays (CCA) for predicting significant postoperative hemorrhage following partial hepatectomy. We evaluated 120 adult patients undergoing elective hepatic resection for primary or metastatic liver tumors. Baseline and postoperative day 1 TEG parameters (reaction time [R], maximum amplitude [MA], and lysis at 30 minutes [LY30]) and CCA profiles (INR, prothrombin time, and platelet count) were measured, and blood loss volumes were tracked. Within 7 days post-surgery, significant postoperative hemorrhage requiring blood transfusions occurred in 18.3% (22/120) of the patients. In the bleeding group, postoperative day 1 TEG profiles showed hypocoagulability, characterized by a significantly prolonged R-time (9.4 ± 1.5 minutes vs. 5.2 ± 0.8 minutes in non-bleeding patients, p < 0.001) and a reduced MA value (38.4 ± 4.2 mm vs. 58.6 ± 5.1 mm, p < 0.001). Preoperative CCA values did not show significant differences between groups (p > 0.05). Receiver Operating Characteristic (ROC) analysis showed that a postoperative day 1 TEG MA cutoff value < 42 mm predicted severe hemorrhage with a sensitivity of 90.9%, a specificity of 84.7%, and an Area Under the Curve (AUC) of 0.92 (95% CI = 0.85–0.97). Viscoelastic monitoring via TEG provides superior prediction of postoperative bleeding risk in liver surgery compared to standard testing, serving as a valuable tool to guide targeted hemostatic therapies.

Keywords: Thromboelastography, Hepatic Resection, Postoperative Hemorrhage, Hypocoagulability, Maximum Amplitude, Blood Transfusion

Manuscript Timeline: Received: November 11, 2024; Revised: December 20, 2024; Accepted: January 14, 2025; Published: February 18, 2025.

Citation: Diallo IK, Eke VN, Diop JBM. Evaluation of Viscoelastic Coagulation Changes using Thromboelastography to Predict Postoperative Hemorrhage in Major Hepatic Resection Surgery. International Journal of Medicine and Medical Sciences, 2025, 15(2): 9–16. DOI: 10.46882/2025/IJMMS/150009

International Journal of Medicine and Medical Sciences | Vol. 15, No. 1, January 2025 | pp. 1–8

DOI: 10.46882/2025/IJMMS/150001

Original Research Article

A Retrospective Assessment of Treatment Outcomes and Predictors of Mortality in Inpatient Childhood Tuberculosis

Evelyn N. Kamau¹, Tunde O. Adebayo², Sarah M. Touré¹*

¹Department of Paediatrics and Child Health, School of Medicine, University of Nairobi, Nairobi, Kenya.

²Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.

Abstract:

Pediatric tuberculosis (TB) presents notable diagnostic and therapeutic challenges, resulting in high mortality among hospitalized children in endemic regions. This retrospective institutional cohort study evaluated clinical treatment outcomes and specific predictors of mortality among children admitted with confirmed or highly probable pulmonary or extrapulmonary TB over a five-year period (2020–2024). De-identified medical files of 320 children aged 0 to 14 years were extracted and analyzed. Clinical outcomes were classified according to World Health Organization (WHO) definitions. Over the five-year study duration, successful treatment (cure or completion) was achieved in 74.4% (238/320) of the cases, the default rate was 8.1%, and the inpatient mortality rate was 14.4% (46/320). Extrapulmonary TB—primarily tuberculous meningitis and miliary TB—was identified in 38.8% of the cohort. The primary direct clinical cause of inpatient death was advanced respiratory failure complicated by severe malnutrition. Cox proportional hazards regression modeling demonstrated that an age under 2 years (HR = 2.9, 95% CI = 1.4–5.8, p < 0.01), concurrent severe acute malnutrition (HR = 3.4, 95% CI = 1.8–6.5, p < 0.001), and HIV co-infection without antiretroviral therapy (HR = 2.4, p < 0.05) were independent predictors of inpatient mortality. Mortality among children hospitalized with TB remains elevated, driven primarily by late clinical presentation and diagnostic delays. Improving outcomes requires the integration of sensitive molecular diagnostic tools, active contact tracing, and aggressive nutritional support systems.

Keywords: Pediatric Tuberculosis, Inpatient Mortality, Tuberculous Meningitis, Severe Acute Malnutrition, HIV Co-infection, Treatment Outcomes

Manuscript Timeline: Received: October 05, 2024; Revised: November 11, 2024; Accepted: December 04, 2024; Published: January 15, 2025.

Citation: Kamau EN, Adebayo TO, Touré SM. A Retrospective Assessment of Treatment Outcomes and Predictors of Mortality in Inpatient Childhood Tuberculosis. International Journal of Medicine and Medical Sciences, 2025, 15(1): 1–8. DOI: 10.46882/2025/IJMMS/150001

International Journal of Medicine and Medical Sciences | Vol. 14, No. 12, December 2024 | pp. 89–96

DOI: 10.46882/2024/IJMMS/140089

Original Research Article

Efficacy and Tolerability of Intravenous Ferric Carboxymaltose versus Oral Ferrous Sulfate for the Treatment of Severe Iron Deficiency Anemia in Postpartum Women

Fatima Z. Bello¹, Kwaku A. Mensah², Grace N. Ojo¹*

¹Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, Bayero University, Kano, Nigeria.

²Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Abstract:

Postpartum iron deficiency anemia compromises maternal quality of life and impairs neonatal bonding, requiring rapid iron replenishment strategies. This randomized, open-label, comparative clinical trial evaluated the therapeutic efficacy, safety, and tolerability of a single dose of intravenous ferric carboxymaltose (FCM) versus standard oral ferrous sulfate in postpartum women. We evaluated 140 postpartum women presenting within 48 hours of delivery with severe iron deficiency anemia (hemoglobin [Hb] between 6.0 and 8.0 g/dL and serum ferritin < 15 ng/mL). Participants were randomly assigned to receive either a single intravenous infusion of FCM (1000 mg, n = 70) or oral ferrous sulfate (200 mg three times daily for 6 weeks, n = 70). The primary endpoint was the mean increase in Hb levels at week 3 and week 6 post-intervention. Data analysis revealed that the mean increase in Hb at week 3 was significantly higher in the intravenous FCM arm (+2.85 ± 0.42 g/dL) compared to the oral iron arm (+1.42 ± 0.31 g/dL, p < 0.001). By week 6, target Hb normalization (≥ 11.0 g/dL) was achieved by 91.4% of the FCM group versus 68.6% of the oral ferrous sulfate group (p < 0.01). Serum ferritin replenishment was significantly higher in the FCM cohort (p < 0.001). Adverse events were generally mild; however, severe gastrointestinal side effects were significantly more frequent in the oral iron arm (28.6%) than the FCM arm (4.3%, p < 0.001). Intravenous ferric carboxymaltose achieves faster hemoglobin recovery and superior iron store replenishment with better gastrointestinal tolerability than oral ferrous sulfate in postpartum women.

Keywords: Postpartum Anemia, Iron Deficiency, Ferric Carboxymaltose, Ferrous Sulfate, Hemoglobin Recovery, Ferritin

Manuscript Timeline: Received: September 10, 2024; Revised: October 18, 2024; Accepted: November 12, 2024; Published: December 16, 2024.

Citation: Bello FZ, Mensah KA, Ojo GN. Efficacy and Tolerability of Intravenous Ferric Carboxymaltose versus Oral Ferrous Sulfate for the Treatment of Severe Iron Deficiency Anemia in Postpartum Women. International Journal of Medicine and Medical Sciences, 2024, 14(12): 89–96. DOI: 10.46882/2024/IJMMS/140089

International Journal of Medicine and Medical Sciences | Vol. 14, No. 11, November 2024 | pp. 81–88

DOI: 10.46882/2024/IJMMS/140081

Original Research Article

Prevalence of Microalbuminuria and its Relationship with Carotid Intima-Media Thickness in Adult Patients with Metabolic Syndrome

Chidi O. Okafor¹, Amina J. Hassan², Samuel K. Appiah¹*

¹Department of Medicine, College of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.

²Department of Medicine and Therapeutics, Korle Bu Teaching Hospital, Accra, Ghana.

Abstract:

Metabolic syndrome accelerates subcirculatory endothelial dysfunction, increasing the risks of early atherosclerosis and progressive chronic kidney disease. This cross-sectional analytical study evaluated the prevalence of microalbuminuria and explored its operational relationship with carotid intima-media thickness (CIMT) in asymptomatic adult patients with metabolic syndrome. We evaluated 160 adult patients diagnosed using the National Cholesterol Education Program (NCEP) ATP III criteria. Urinary albumin-to-creatinine ratios (UACR) determined microalbuminuria status, while high-resolution B-mode ultrasonography measured bilateral CIMT profiles, with values ≥ 0.90 mm defined as subclinical atherosclerosis. The mean age of the cohort was 52.4 ± 6.8 years, and 56.3% were female. The overall prevalence of microalbuminuria (UACR between 30 and 300 mg/g) was 34.4% (55/160). Patients with microalbuminuria exhibited a significantly higher mean CIMT (0.98 ± 0.12 mm) compared to the normoalbuminuric cohort (0.72 ± 0.08 mm, p < 0.001). Pearson correlation analysis demonstrated a significant positive correlation between UACR levels and structural CIMT values (r = 0.58, p < 0.001). Multivariate logistic regression modeling revealed that an elevated CIMT ≥ 0.90 mm (OR = 3.4, 95% CI = 1.8–6.8, p < 0.001) and poor blood pressure control (OR = 2.8, p < 0.01) were independent predictors of microalbuminuria. Microalbuminuria is highly prevalent in metabolic syndrome and is strongly linked to early macrovascular structural changes. Routine screening for microalbuminuria and carotid ultrasonography are valuable tools for subclinical cardiovascular risk stratification in this demographic.

Keywords: Metabolic Syndrome, Microalbuminuria, Carotid Intima-Media Thickness, Endothelial Dysfunction, Atherosclerosis, Cardiovascular Risk

Manuscript Timeline: Received: August 12, 2024; Revised: September 20, 2024; Accepted: October 08, 2024; Published: November 14, 2024.

Citation: Okafor CO, Hassan AJ, Appiah SK. Prevalence of Microalbuminuria and its Relationship with Carotid Intima-Media Thickness in Adult Patients with Metabolic Syndrome. International Journal of Medicine and Medical Sciences, 2024, 14(11): 81–88. DOI: 10.46882/2024/IJMMS/140081

International Journal of Medicine and Medical Sciences | Vol. 14, No. 10, October 2024 | pp. 73–80

DOI: 10.46882/2024/IJMMS/140073

Original Research Article

Ameliorative Actions of Mondia whitei Crude Root Extract on Alcohol-Induced Testicular Cytotoxicity and Oxidative Stress in Wistar Rats

Mustapha T. Gidado¹, Rose C. Obi², Elizabeth W. Wanjiku¹*

¹Department of Pharmacology and Toxicology, Faculty of Pharmaceutical Sciences, University of Maiduguri, Maiduguri, Nigeria.

²Department of Pharmacology and Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi, Kenya.

Abstract:

Chronic ethanol consumption induces severe testicular damage by generating reactive oxygen species, suppressing steroidogenesis, and elevating lipid peroxidation markers. This experimental animal study examined the protective and restorative potential of a methanolic extract of Mondia whitei roots (MEMW) against ethanol-induced testicular toxicity in male Wistar rats. Thirty-five adult rats were randomly assigned to 5 equal groups: Normal Control, Toxicity Control (ethanol 4.0 g/kg body weight orally), Testosterone reference control (10 mg/kg subcutaneously), and two treatment groups receiving MEMW (200 and 400 mg/kg) orally for 28 consecutive days alongside ethanol administration. Reproductive markers, epididymal sperm parameters, testicular tissue lipid peroxidation indicators, and histopathological architecture were evaluated. Oral administration of ethanol caused severe reproductive harm, evidenced by a significant reduction in serum testosterone levels (from 4.52 ± 0.35 ng/mL to 1.12 ± 0.15 ng/mL, p < 0.01) and a sharp drop in sperm motility. Ethanol also significantly increased testicular tissue malondialdehyde (MDA) levels and reduced superoxide dismutase (SOD) and catalase activities (p < 0.01). Daily oral treatment with 400 mg/kg MEMW significantly protected against reproductive injury, raising serum testosterone concentrations to 3.24 ± 0.28 ng/mL (p < 0.01 vs. toxicity control) and restoring sperm motility parameters. Furthermore, MEMW reduced testicular MDA levels and preserved endogenous antioxidant enzyme activities (p < 0.01). Histopathology confirmed these findings, showing a preservation of seminiferous tubule structures, reduced cellular desquamation, and active spermatogenesis. Mondia whitei roots possess potent antioxidant and androgenic properties that protect testicular tissue from ethanol-induced oxidative injury.

Keywords: Mondia whitei, Ethanol Toxicity, Testicular Damage, Oxidative Stress, Testosterone, Spermatogenesis

Manuscript Timeline: Received: July 15, 2024; Revised: August 24, 2024; Accepted: September 10, 2024; Published: October 15, 2024.

Citation: Gidado MT, Obi RC, Wanjiku EW. Ameliorative Actions of Mondia whitei Crude Root Extract on Alcohol-Induced Testicular Cytotoxicity and Oxidative Stress in Wistar Rats. International Journal of Medicine and Medical Sciences, 2024, 14(10): 73–80. DOI: 10.46882/2024/IJMMS/140073