Postoperative vital sign monitoring is essential for early detection of inpatient hemodynamic and respiratory complications. Although conventional bedside monitors serve as the clinical gold standard, their fixed design limits patient mobility and continuous ambulatory monitoring, which hinders early rehabilitation after orthopedic surgery. Wearable monitoring devices have shown great potential for postoperative vital sign surveillance due to their mobility and continuous data collection capabilities, yet real-world validation data in orthopedic postoperative patients remain insufficient, and wearable blood pressure measurement accuracy remains controversial. This study aimed to evaluate the agreement between a wearable monitor and a standard bedside monitor for heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, and peripheral oxygen saturation (SpO 2 ) in patients undergoing knee arthroscopy. A total of 100 elective knee arthroscopy patients were prospectively enrolled. Paired vital sign data were collected simultaneously via the two devices at four daily time points over two postoperative days. Intra-class correlation coefficient (ICC), Lin’s concordance correlation coefficient, Bland-Altman analysis, temporal trend analysis, and clinical acceptability evaluation were performed for statistical assessment. After excluding five missing values, 3995 paired observations were analyzed. The wearable device showed excellent agreement for heart rate (ICC = 0.994, bias = −0.63 bpm, 95% LoA: −2.97 to 1.70 bpm), good agreement for respiratory rate (ICC = 0.940, bias = −0.51 breaths/min, 95% LoA: −2.71 to 1.68 breaths/min), and moderate-to-good agreement for SpO2 (ICC = 0.872, bias = −0.85%, 95% LoA: −3.50 to 1.80%). Diastolic blood pressure showed moderate agreement (ICC = 0.827, bias = −1.42 mmHg, 95% LoA: −12.90 to 10.06 mmHg), while systolic blood pressure demonstrated the lowest agreement (ICC = 0.811) with a prominent positive systematic bias of 5.63 mmHg. Temporal trends remained stable across postoperative days, with consistent inter-device bias over time. The clinical acceptability rates of heart rate, respiratory rate and SpO 2 exceeded 99.5%, compared with 92.2% for diastolic blood pressure and only 79.6% for systolic blood pressure. In conclusion, the wearable monitor provides reliable heart rate, respiratory rate, and SpO2 measurements and is suitable for routine postoperative monitoring after knee arthroscopy. However, blood pressure measurements, particularly systolic blood pressure, show notable systematic deviation, and targeted algorithm calibration is needed to improve its blood pressure monitoring performance.
Depression is common among patients diagnosed with advanced or metastatic breast cancer (BC), with the diagnosis often associated with severe emotional and psychological decline that may result from the disease or from treatment-related toxicity. Cognitive Behavioral Therapy (CBT) has emerged as one of the most evidence-based and effective psychotherapeutic approaches for the management of depression and anxiety in cancer populations but its implementation, use and role in the management of depression among advanced BC patients in low resource settings remains limited. Therefore, this study aimed to evaluate the effectiveness of CBT in reducing depressive symptoms among patients with advanced breast cancer patients receiving treatment at the University of Nigeria Teaching Hospital, Enugu. This study investigated the role of a six (6) week group CBT on depression among advanced BC patients. The study adopted randomized controlled Pre-test Post-test design. Forty two (42) advanced breast cancer patients were randomly divided into two groups: CBT group (n= 20) and control group (n= 22). The CBT group received a 6 week, 90 minutes CBT sessions once a week and the control group only received their cancer treatment and patient navigation assistance. Assessment was carried out for both groups at baseline (Pre-test) and the intervention. A total of BC patients were accessed for depression of which 42 patients recruited and 27 patients completed the study. Baseline assessment of participants showed mean depression scores of 12.05 ± 1.61 for CBT group and 12.77 ± 1.95 for the control groups (p=0.20). Post intervention assessment result showed that participants in the CBT group reported a significantly greater decrease in depression (3.50 ± 0.94) compared to participants in the control group (13.23 ± 1.78) (p<0.001). Cognitive behavioral therapy has been shown as an effective treatment for clinical depression. Implementing CBT into practice may appear challenging at first, but efforts to help these patients in achieving better all-around health are efforts well spent.
The aim of our work was to identify the indications and to assess complications of tracheostomy in the intensive care setting. This work to retrospectively analyze the files of patients with tracheostomies in the multipurpose intensive care unit of the Gabriel Toure university Hospital in Bamako over 4 years from January 2016 to December 2020, including all patients with tracheostomies in intensive care or in operating room by surgical teams. The parameters taken into account were: the reasons for admission to intensive care unit, the history, the duration of intubation and ventilation before tracheostomy, the duration of total cannulation, the complications that arose during the performance of the procedure, immediately postoperatively and late. The mean age of our patients was 31.97 ± 19.03 years with extremes of 0.25 and 79 years. The sex ratio was 2.25 in favour of the male. The circumstances of hospitalization in intensive care are dominated which are neither respiratory nor neurological. The tracheotomy was performed in 52 patients, 21 patients in the operating room by an otolaryngologist including 2 in trans-isthmic and 31 times in the intensive care unit (intensive care) by an otolaryngologist team including 11 case in trans-isthmic. Tracheostomy was performed on average 2.6 ± 5.03 days after MV initiation (Median = 2 days), with extremes ranging from 0 to 45 days. Among the 52 patients included in our study, 27 patients (51.9%) underwent a tracheostomy during the first two days of MV (early tracheostomy group) and 25 patients (48.08%) underwent a tracheostomy beyond the second day of VM (Late tracheostomy group). During our study, no decanulation was carried out in the intensive care unit, the number of places reduced, does not allow hospitalized patients of which tracheostomies remain there after a slight improvement. The postoperative consequences were simple in 12 patients, or 23.1%.
Introduction: Vallecular cyst is a mucous retention cyst that forms between the base of the tongue and the lingual surface of the epiglottis. Our objective was the diagnostic, therapeutic and progressive aspects. Case report: This was a 6-year-old female patient, a student, residing in Kayes with no medical or surgical history, who was admitted for progressive pharyngeal discomfort that had been developing for 3 months. At the nasofibroscopy we highlighted a soft, oval, transluminal mass, with regular contours, non-painful, non-bleeding on contact, measuring approximately 5 cm in diameter at the level of the right vallecula. The rest of the examination of the other devices was normal. We concluded that it was a vallecula cyst. A coordinated airway management plan was established by the anesthesiologist-surgeon before the procedure. Excisional surgery was performed under general anesthesia with orotracheal intubation. The histological result of the surgical specimen concluded that there was fibrous and inflammatory squamous tissue. After six months of follow-up, we have not noted any recurrence. Conclusion: Vallecular cyst is a rare and potentially fatal condition in children due to narrowness of the laryngeal passage. vallecular cyst can be discovered at any age. Laryngeal endoscopy allows diagnosis to be made and treatment is surgical either by endoscopic route or by external cervical route
Cirrhosis is a serious, progressive disease and constitutes a public health problem. The objective of this study was to examine the role of ultrasound in the diagnosis of cirrhosis at the Hospital of Mali. This was a prospective cross-sectional study conducted from February 2024 to February 2025. The study included all patients admitted to the department for abdominal ultrasound as part of the diagnosis of liver cirrhosis. Data were analyzed using SPSS version 21.0. Patient participation was voluntary. Patient confidentiality and anonymity were guaranteed. We identified 121 cases of cirrhosis diagnosed among 3,142 abdominal ultrasounds performed, representing a prevalence of 3.85%. Male patients accounted for 70% of cases. The mean age was 51.34 ± 13.86 years. The predominant clinical symptom was abdominal pain in 89.3% of cases. Hepatomegaly with a sharp lower border was recorded in 80.88% of cases. On ultrasound, hepatomegaly was present in 55% of patients. The echogenicity of the liver was heterogeneous in 96.7% of cases. The liver margins were irregular in 73% of cases. Hepatic dysmorphism was present in 74% of cases. Nodules were present in 60% of patients, and portal vein dilation in 58.7% of patients. Cirrhosis remains a common and serious condition. Ultrasound is an essential tool for screening and diagnosis.
