European Journal of Medical and Health Sciences European Journal of Medical and Health Sciences European Open Science Publishing en-US European Journal of Medical and Health Sciences 2593-8339 The Forgotten Ganglion: Ganglion Sublinguale <p>This study is aimed to reming the presence of ganglion sublinguale. Currently, 4 parasympathetic ganglion have been mentioned in head and neck region. Although contemporary anatomy textbooks report the ganglion submandibulare, the ganglion sublinguale has not been described in these texts. However, the ganglion sublinguale was reported by earlier researchers. Recently, Takezawa and Kageyama showed a seperate sublingual gaanglion, related to the sublingual gland [1]. This information was supported by descriptions in 19th century anatomy textbooks. A thorough understanding of the ganglion sublinguale is very important for anatomy education and oral surgical procedures.</p> Birsen Ozyurt Copyright (c) 2022 Birsen Ozyurt 2022-01-25 2022-01-25 4 1 1 2 10.24018/ejmed.2022.4.1.1085 Normal Chest X-Ray in Patients with Pulmonary Embolism May Involve Increased Risk of Massive Pulmonary Embolism <div> <p class="Abstract"><em><span lang="EN-US">Purpose:</span></em><span lang="EN-US"> Chest radiography is normal in approximately 20-40% of acute pulmonary embolism (PE) patients without cardiopulmonary disease. The aim of this study was to determine whether there is any difference between the patients with normal chest X-ray and those with pathological findings in terms of clinical severity and prognosis. </span></p> </div> <div> <p class="Abstract"><em><span lang="EN-US">Methods:</span></em><span lang="EN-US"> 178 of PE patients were included in the study. 110 patients had no parenchymal pathology, whereas group 1 (n = 110); group 2 (n = 68) had various pathological parenchymal findings in 68 patients. Clinical and radiological parameters were compared between these groups. Following the diagnosis of PE, the cases were recorded in the fifth year.</span></p> </div> <div> <p class="Abstract"><em><span lang="EN-US">Results:</span></em><span lang="EN-US"> In 178 participants; those with normal chest X-ray (group 1), with parenchymal pathological findings on the chest X-ray (group 2); echocardiographic systolic pulmonary artery pressure (sPAP) (p = 0.68), gender (p = 0.9) and thrombus type (p = 0.41) were similar.</span></p> </div> <div> <p class="Abstract"><span lang="EN-US">The patients in group 1 were not different in terms of central thrombus detected in computed tomography pulmonary angiogram compared to the patients in group 2; however, the chest radiograph of the patients in group 1 had no parenchymal pathology. Central thrombus group 1, group 2, respectively; 97 (89.0%), 53 (77.9%), p = 0.07.</span></p> </div> <div> <p class="Abstract"><span lang="EN-US">There was no significant difference between the two groups in terms of mortality which was followed up in fifth year (p &gt; 0.05).</span></p> </div> <div> <p class="Abstract"><em><span lang="EN-US">Conclusions:</span></em><span lang="EN-US"> Normal chest X-ray in PE can determine mortality and may involve increased risk of massive PE.</span></p> </div> Hatice Kilic Habibe Hezer Berker Ozturk Muhammed Sait Besler Huseyin Cetin Hatice Canan Hasanoglu Aysegul Karalezli Copyright (c) 2022 Hatice Kilic, Habibe Hezer, Berker Ozturk, Muhammed Sait Besler, Huseyin Cetin, Hatice Canan Hasanoglu, Aysegul Karalezli 2022-01-04 2022-01-04 4 1 1 4 10.24018/ejmed.2022.4.1.910 Variation between Initial and Final Diagnosis as A Predictor of Adverse Obstetric Outcome among Post-Natal Women at Bungoma Hospitals, Kenya <p>Despite diagnosis being an important part of clinical or medical consultations, the diagnosis might fail leading to adverse effects. This is a global problem, where developed and developing countries go through. In sub-Saharan Africa, variations between initial diagnosis and final diagnosis lead to diagnostic errors with high maternal mortalities. In Kenya, a lot of measures have been put in place but still, variation in diagnosis appear to have become rampant. Bungoma county is one of the counties with a high mortality ratio, especially for pregnant women attributed to the variation between initial and final diagnosis. Therefore, it was crucial to investigate the variation between initial and final diagnosis in relation to obstetric outcomes at hospitals in Bungoma County. The cross-sectional research design was used (Bungoma and Webuye hospitals). Systematic sampling was used to obtain 384 respondents after proportionate allocation to each hospital, and purposive sampling to select 8 health care workers as key informants. Data was collected using a structured questionnaire and an interview guide. The pre-test was done with validity established through crosschecking and reliability calculated using the Cronbach method (0.89). Using a statistical package for social sciences version 25, descriptive and inferential statistics was run where chi-square and odds ratio was used to determine the influence between variables, significance and prediction. The study revealed a variation between initial diagnosis and the final diagnosis was 20.8% while diagnostic errors were significant predictors of obstetric outcomes among post-natal mothers at level five with a p-value of 0.045 at a significance of 5%(P=0.045). Demographic characteristics showed no relationship with obstetric outcomes (P=0.54&gt;0.05). Matched diagnostic had no variations (N=327, M=1.00, SD=0.000); while unmatched diagnostic had variations (N=327, M=1.82, SD=.384). There was a relationship between diagnostic errors and obstetric outcome (ꭓ2 (1) = 251.86, p&lt; .001). An association between diagnostic error with unsafe obstetric outcomes was significant at the odds ratio of 2.03(OR 2.03, 95% CI 1.31–2.16). The study demonstrates that a correct diagnosis is a viable strategy in preventing unsafe obstetric outcomes and by extension minimizing morbidity and mortality among pregnant women. The study concluded that there was a variation between initial diagnosis and final diagnosis which had an adverse obstetric outcome. it was recommended to build capacities for the health workers in order to address increased diagnostic errors.</p> David Nandebe Wafula Bernard Wesonga Maximilla Wanzala Nathan Shaviya Rose A. M. Nyang’au Copyright (c) 2022 David Nandebe Wafula, Bernard Wesonga, Maximilla Wanzala, Nathan Shaviya , Rose A. M. Nyang’au 2022-01-04 2022-01-04 4 1 5 10 10.24018/ejmed.2022.4.1.1170 Therapeutic Plasma Exchange in Guillain Barre Syndrome: An experience of Bangabanhu Sheikh Mujib Medical University, Bangladesh <p><em>Background:</em> Therapeutic plasma exchange (TPE) has been used as one of the treatment modalities of neurological diseases. Intravenous Immunoglobulin (IVIG) and Therapeutic Plasma Exchange (TPE)are treatment options in Guillain Barre syndrome (GBS). In developing countries IVIG is not easily available and it is also expensive, TPE is preferred for treatment of GBS as it is affordable. Study on TPE for GBS are scarce here. Most of the study regarding TPE in GBS has been conducted in high –income countries as it is expensive treatment modality. Reports on TPE in GBS is very scared from Bangladesh.</p> <p><em>Materials and Methods:</em> A retrospective analysis of TPE with a standard hemolysis equipment for the treatment of Guillain Barre syndrome (GBS) was conducted A 50 patients of GBS who received TPE conducted between January 2017 to December 2018 in the department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh were analyzed. All patients had underdone at least 2 cycles of plasma exchange. Volume exchanged in each cycle was one plasma volume.</p> <p><em>Results:</em> Out of 50 cases there were 43 (86%) male and 7 (14%) female. Age range of patients was from 11 – 50 years. Approximately 40% improved clinically of first cycle of PE &amp; 85% after second cycle, 95% after third cycle and 95-100% after 5 cycle. 1(2%) patient died, and 49(98%) patients survived and recovered.</p> <p><em>Conclusion: </em>The treatment is cost affection in Compassion to IVIG. TPE is and affection, safe and affordable treatment modality for GBS.</p> Sheikh Saiful Islam Jannatul Ferdous Ashraful Hoque Atiar Rahman Copyright (c) 2022 Sheikh Saiful Islam, Jannatul Ferdous, Ashraful Hoque, Atiar Rahman 2022-01-05 2022-01-05 4 1 11 13 10.24018/ejmed.2022.4.1.937 Prevalence, Knowledge and Treatment of Systemic Arterial Hypertension in A Campaign Day <div> <p class="Abstract"><span lang="EN-US">Hypertension affects 1.4 billion of the world population, being considered the main cause of cardiovascular diseases and, therefore, an important cause of premature and preventable mortality worldwide. It is associated with complications such as atherosclerotic coronary artery disease, congestive heart failure, stroke, intracerebral hemorrhage, and chronic kidney disease. Given this prevalence and risk, strategies were created to control the disease, such as changes in lifestyle and use of medications. However, non-adherence to treatment is a frequent concern and it is associated with adverse results and an increased number of complications. Therefore, the present study aims to present the incidence of arterial hypertension in the population of a city in the inland part of São Paulo, relating it to its risk factors, adherence to treatment and disease control. The objective is evaluating the incidence and rate of uncontrolled systemic arterial hypertension on a campaign day in a city in the inland part of São Paulo. The method is observational, cross-sectional, descriptive, population-based study, random sample of 545 individuals, 231 women and 314 men, collected in a city in the northwest of São Paulo on a campaign day. The study showed a prevalence of 46.24% for hypertensive patients, with 88.9% adherence to treatment and pressure loss of 34.23%. Among the analyzed hypertensive patients, there was a higher incidence among the elderly, obese, and people with diabetes mellitus. Regarding adherence and disease control, better results were noted among patients with complications such as AMI and thrombotic events, and less adherence among obese, alcoholics and smokers. The results of the present study are consistent with literature data, showing that even with knowledge of the disease, part of the population does not have adequate treatment, showing the need for integrated health policies for early diagnosis, distribution and treatment regulation, and actions to improve lifestyle.</span></p> </div> Elizabeth do Espirito Santo Cestario Anderson Aparecido Santim Beatriz Beretta Alves Beatriz Pereira Alcarde Beatriz Sanches Rodrigues Catarina de Souza Nascimento Fernanda de Almeida Spósito Lauane Carolina Maciel Fernandes Letícia Fernandes Garcia Roberta Bonamim Fiorilli Vinicius Cardoso de Leão Vinicius Cavallari Copyright (c) 2022 Elizabeth do Espirito Santo Cestario, Anderson Aparecido Santim, Beatriz Beretta Alves, Beatriz Pereira Alcarde, Beatriz Sanches Rodrigues, Catarina de Souza Nascimento, Fernanda de Almeida Spósito, Lauane Carolina Maciel Fernandes, Letícia Fernandes Garcia, Roberta Bonamim Fiorilli, Vinicius Cardoso de Leão, Vinicius Cavallari 2022-01-13 2022-01-13 4 1 14 20 10.24018/ejmed.2022.4.1.1126 Sexual Relationship, Power and Safe Sex Practices among Female Bar Workers in Kinondoni Municipality, Dar es Salaam, Tanzania <p><em>Background:</em> HIV and AIDS continue to challenge the health sector and economies in low and middle-income countries. Effectiveness condom use in preventing transmission of HIV is jeopardized due to recent reported decline in condom use. Alcohol serving venues are meeting points for sex partner which is a significant determinant of risk sexual practices while gender inequities impose challenges to women in negotiating safe sex.</p> <p><em>Methods:</em> Cross sectional exploratory study was conducted which deployed a qualitative method in data collection. Purposive sampling was used to select fourteen study participants. In-Depth Interview guide was used to gather information from female bar workers on perceptions and experiences in sexual relationships that are initiated following their interaction with male customers in alcohol serving settings and their negotiation for safe sex. This study explored sexual relationship power of Female Bar Workers (FBWs) in safe sex negotiations as they interact in alcohol serving venues in Kinondoni municipality in Dar es Salaam, Tanzania. Data was analysed manually by using thematic approach.</p> <p><em>Results:</em> Negotiation ability and sexual relationship power continue to be a key determinant of safe or unsafe sexual practices in sexual relationships of female bar workers. Although power to negotiate and make decisions towards safe sex was widely reported by female bar workers when they engage in casual sexual relationships, such power is outweighed by their own willingness to engage in multiple sexual relationships to supplement their meagre incomes.</p> <p><em>Conclusion:</em> Health promotion should continue to focus on behaviour change interventions with consideration of gendered roles and power in sexual relationships.</p> Mangi Job Ezekiel Judith Narlis Metta Idda Hubert Mosha Copyright (c) 2022 Mangi Job Ezekiel, Judith Narlis Metta, Idda Hubert Mosha 2022-01-13 2022-01-13 4 1 21 26 10.24018/ejmed.2022.4.1.1153 4th National Sero Survey of India: Vaccine Generated Antibodies Enhancement <div> <p class="Abstract"><span lang="EN-GB">The results of the fourth COVID-19 national serosurvey (June-July 2021) </span><span lang="EN-GB">of India </span><span lang="EN-GB">have been analysed. </span><span lang="EN-GB">M</span><span lang="EN-GB">uch needed data of </span><span lang="EN-GB">vaccine </span><span lang="EN-GB">generated antibodies have been </span><span lang="EN-GB">reported</span> <span lang="EN-GB">world first as recorded in Indian population on the ground in real. </span><span lang="EN-GB">More than two-third</span><span lang="EN-GB">s</span> <span lang="EN-GB">of </span><span lang="EN-GB">(67.6%) Indian population developed antibodies against the infection. This include</span><span lang="EN-GB">s</span><span lang="EN-GB"> natural immunity build up </span><span lang="EN-GB">due to infection</span><span lang="EN-GB"> and vaccine generated antibodies</span><span lang="EN-GB">.</span> <span lang="EN-GB">Eleven</span><span lang="EN-GB"> states: </span><span lang="EN-US">Madhya Pradesh, Rajasthan, Bihar, Gujrat, Chhattisgarh, Uttarakhand, Uttar Pradesh, Andhra Pradesh, Karnataka, Tamil Nadu, and Odisha ha</span><span lang="EN-US">d</span><span lang="EN-US"> sero positivity of &gt;67.6%</span><span lang="EN-US">which was </span><span lang="EN-US">the national average. </span><span lang="EN-US">Ten </span><span lang="EN-US">other states registered &lt; 67.6% </span><span lang="EN-US">seroprevalence </span><span lang="EN-US">were: Punjab, Telangana, Jammu and Kashmir, Himachal Pradesh, Jharkhand, West Bengal, Haryana, Maharashtra, Assam, and Kerala. </span><span lang="EN-US">Single dose vaccination of </span><span lang="EN-US">24% </span><span lang="EN-US">population </span><span lang="EN-US">added 19% seroprevalence in </span><span lang="EN-US">the </span><span lang="EN-US">population whereas 13% full vaccination increased 28% </span><span lang="EN-US">individuals registered</span><span lang="EN-US"> antibodies. The highest (90%) seroprevalence was registered </span><span lang="EN-US">among</span> <span lang="EN-US">the individuals </span><span lang="EN-US">who have taken both vaccine doses followed by HCWs (85%)</span><span lang="EN-US">.</span> <span lang="EN-US">S</span><span lang="EN-US">eroprevalence</span><span lang="EN-US"> in </span><span lang="EN-US">85-90% </span><span lang="EN-US">population might be the </span><span lang="EN-US">threshold </span><span lang="EN-US">for </span><span lang="EN-US">herd immunity which </span><span lang="EN-US">delayed or possibly </span><span lang="EN-US">stopped the third COVID-19 wave in India.</span></p> </div> Zameer Shervani Deepali Bhardwaj Roma Nikhat Aiman Ibbrahim Intazam Khan Umair Yaqub Qazi Ankira Agarwal Adil Ahmed Khan Sadia Hasan Abdullah Sherwani Copyright (c) 2022 Zameer Shervani, Deepali Bhardwaj, Roma Nikhat, Aiman Ibbrahim, Intazam Khan, Umair Yaqub Qazi, Ankira Agarwal, Adil Ahmed Khan, Sadia Hasan, Abdullah Sherwani 2022-01-19 2022-01-19 4 1 27 32 10.24018/ejmed.2022.4.1.1132 A Surgical Approach to Giant Cell Tumor of Lower End of Tibia with Curettage and Reconstruction by Bone Grafting Harvested from Left Iliac Crest and K-wire Fixation: A Case Report <p><em>Introduction:</em> Giant cell tumor (GCT) is a distinctive lesion characterized by the proliferation of multinucleate giant cells in a stroma of mononuclear cells; it is generally seen in skeletally mature individuals. GCT is usually found in the long bones around the knee or in the distal radius but distal end of tibia, proximal humerus, vertebrae of young adults are unusual location. We report a case of GCT of the distal end of tibia, with a secondary aneurysmal bone cyst, in a 26-year-old female. Based on our review of the medical literature, it appears that the occurrence of a GCT along with a secondary aneurysmal bone cyst (ABC) in distal end of tibia is less typical with challenging task for full tumor resection and restoration of ankle function to normal.</p> <p><em>Case Summary:</em> 26 year old female presented with pain&amp;swelling over left ankle since last six month. Biopsy was suggestive of GCT with ABC of lower third tibia. We managed this case with intralesional curettage using phenol and burr and bone graft harvested from left iliac crest for reconstruction of defect along with kwire fixation to achieve optimum anatomical restoration.</p> <p><em>Conclusion:</em> In cases of GCT, the management depends upon the various factors such as site, age, involvement of the bone, extent of bone involvement and whether there is articular involvement or not. Here Intra-articular GCT is managed with extended intralesional curettage with phenol. Bone graft plays a role of agent for reconstruction of the defect and kwire for anatomical reduction.</p> Pravakar Tripathy Mahesh Chand Bansal Rahul Upadhyay Copyright (c) 2022 Pravakar Tripathy, Mahesh Chand Bansal, Rahul Upadhyay 2022-01-05 2022-01-05 4 1 1 3 10.24018/ejmed.2022.4.1.971 A Case Report: Methotrexate and Etoposide as Adjuvant Therapy on Patient with Hydatidiform Moles that Have Growing Rapidly Becomes Gestational Trophoblastic Neoplasia <p>A hydatidiform mole is a type of placental abnormality that is associated with gestational trophoblastic disease (GTD). It can be complete or partial mole. They are typically considered benign, but they are also premalignant, with the potential to become malignant and invasive to other organs (gestational trophoblastic neoplasia/GTN). Management of the hydatiform moles is curettage therapy and suction, which aims to therapy and diagnostic. Follow-up post evacuation of moles must be tight with serum hCG and clinical examination. When there is evidence of vaginal bleeding and an increase in serum hCG, chemotherapy must be used as an adjuvant. This case report intends to persuade clinicians that adjuvant therapy with chemotherapy combination-based Methotrexate/MTX and etoposide can recover and eliminate vaginal bleeding disorders. On her first pregnancy, a woman of 27 years old develops a complete hydatiform mole. The curettage and suction procedure were then performed twice. She also receives chemotherapy in three series of single MTX and three series of MTX plus Etoposide. Following this therapy, the patient recovers, normal hCG level and has no vaginal bleeding problems.</p> Supriyono Copyright (c) 2022 Supriyono 2022-01-07 2022-01-07 4 1 4 7 10.24018/ejmed.2022.4.1.1116 Management and Outcome of Bilateral Elastofibroma Dorsi: 3 Cases Report and Review of Literature <p>Elastofibroma dorsi is a rare soft tissues benign tumor with very slow evolution, seen predominantly in females and elderly, It mostly occurs in the infrascapular region, and can be bilateral. The diagnosis is based on clinical presentation and imaging features but pathological study after excision is necessary for confirmation. We present the cases of 3 patients with bilateral elastofibroma dorsi to clarify the clinical features, radiological and therapeutic modalities to improve management, along with a literature review.</p> S. Karti A. Jalal A. Chfiri M. Diouri Copyright (c) 2022 S. Karti, A. Jalal, A. Chfiri, M. Diouri 2022-01-19 2022-01-19 4 1 8 10 10.24018/ejmed.2022.4.1.1148 Chronic Ruptured Abdominal Aortic Aneurysm <div> <p class="Abstract"><span lang="EN-US">Chronic rupture of Abdominal Aortic Aneurysm is a rare presentation although AAA and its frank rupture is well known phenomenon. Chronic rupture of AAA can be misdiagnosed due to non-specific presentation and absence of haemorrhagic shock. This case report discusses the presentation scenarios as well radiologic findings which may help diagnose a Chronic Ruptured AAA (CR-AAA) and will be helpful in prompt recognition and early management of the situation.</span></p> </div> Sohaib Bin Nawaz Copyright (c) 2022 Sohaib Bin Nawaz 2022-01-19 2022-01-19 4 1 11 12 10.24018/ejmed.2022.4.1.1161 Parsonage Turner Syndrome Following COVID-19 Vaccine <div> <p class="Abstract"><span lang="EN-US">Parsonage Turner Syndrome (PTS) presents with sudden onset arm pain followed by motor weakness and can be associated with surgery, infection, or vaccination. This case discusses an incidence of PTS following COVID-19 vaccination where symptoms resolved on their own progressively and extensive investigations ruled out cerebrovascular accident or vascular aetiology, and diagnosis of PTS was made. Incidence of such adverse effects is rare and awareness among clinical community can lead to recognition and prompt management of such cases.</span></p> </div> Sohaib Bin Nawaz Wathsala A. Raigam Copyright (c) 2022 Sohaib Bin Nawaz, Wathsala A. Raigam 2022-01-19 2022-01-19 4 1 13 14 10.24018/ejmed.2022.4.1.1158