BACKGROUND:Hyponatremia is one of the most common electrolyte abnormalities in hospitalized patients and is associated with increased mortality. AIMS:The study aimed to determine the prevalence of hyponatremia, risk factors and aetiology in elderly people. SUBJECTS AND METHODS:A cross-sectional study was conducted in hospital settings between March 2023 and November 2024 in 69 male and female participants with hyponatremia. Patients' blood samples were tested for predicted factors (creatinine, blood sugar and hypervolemia). Statistical analysis was performed and P < 0.05 was considered statistically significant. RESULTS:The mean age of the participants was 66.10 years, with 36 (52.2%) male and 33 (47.8%) female patients, while the mean age of severe hyponatremia patients was 59.5 years ( P = 0.04). Hyponatremic patients displayed a depressed serum sodium level (117.35 mEq/L), creatinine level of 0.94 mg/dL and blood sugar level of 140.29 mg/dL. Mean hospital stay duration was 5.96 days, 37 (47.8%) patients had mild hyponatremia, 24 (34.8%) patients had moderate hyponatremia and 8 (17.4%) patients had severe hyponatremia. Patients with severe hyponatremia had significantly higher blood sugar levels, 174.25 mg/dL ( P < 0.001), with no significant correlation with creatinine. A significant association was observed between aetiology and severity of hyponatremia, particularly for the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and cardiac causes. Severe hyponatremia (β =0.08, P = 0.83), serum creatinine (β =0.68, P = 0.58) and cirrhosis (β = -0.04, P = 0.73) were not significantly associated with length of hospital stay. CONCLUSION:Aetiological factors, especially the SIADH and cardiac causes, demonstrated a significant association with hyponatremia severity. Multivariable logistic regression did not identify any independent predictors of severe hyponatremia.
Abstract Conflicts are unavoidable aspect of human existence, causing disruptions in livelihoods, infrastructure, socioeconomic systems and healthcare access. Among the most severe effects of conflict are those on maternal and child health (MCH) services, on which there is a notable scarcity of research. Consequently, this scoping review examines the impact of conflict on the accessibility of MCH services and their associated treatment outcomes and identifies limitations. A review was conducted in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews and the Joanna Briggs Institute Methods Manual for scoping review to map works of literature regarding the effects of conflict on MCH across nine databases (PubMed, Scopus, MEDLINE, CINAHL, Web of Science and Google Scholar) published in English between January 2000 and May 2024. The quality of the studies was evaluated using NIH tools, resulting in 17 classified as good, 5 as fair and 1 as poor, which was subsequently excluded. A narrative synthesis was employed to categorise the findings based on predisposing, enabling and need factors. Out of 612 records, 23 studies (from 15 countries, predominantly qualitative) confirmed that conflict limits access due to insecurity and displacement (enabling factors, n = 18 studies), modifies health-seeking behaviours (predisposing, n = 12) and increases mortality and malnutrition rates (need, n = 15). (NGO) Non-Governmental Organisation and community outreach efforts were found to alleviate some of these effects (notably in Pakistan and Afghanistan). In addition, three studies examined the intersections of pandemic and conflict, highlighting compounded disruptions. Given the prevalence of ongoing conflicts, it is crucial to comprehend their effects and mitigate the health repercussions for women and children, a topic that warrants significant academic inquiry.
BACKGROUND:Anaesthesia for open abdominal myomectomy is customised to provide a comfortable and pain-free surgical experience for the patient, taking into consideration their medical history, personal preferences and the results of the pre-anaesthesia assessment. OBJECTIVE:The aim of this audit is to assess our current anaesthesia protocols, identify any improvements made since the previous audit and examine the factors that may have contributed to these changes. METHODOLOGY:An analysis was conducted on the various types of anaesthesia techniques administered during open abdominal myomectomy surgeries, based on operating theatre records from 1 January 2014 to 31 December 2023. Patients undergoing gynecological procedures other than open abdominal myomectomy were excluded from the study. The findings were presented in the form of figures, proportions and percentages. RESULTS:Our institution provided anaesthesia for 559 open abdominal myomectomies. The predominant technique utilised was Combined Spinal-Epidural Anaesthesia (CSEA), which constituted 44% of the cases, followed by spinal anaesthesia (SA) at 29%, GA at 19% and EA at 8%. Furthermore, as the proportion of the Senior Anaesthesia Registrars and Consultant Anaesthetists increases, the proportion of highly skilled anaesthesia techniques like CSEA and EA increases, while GA and SA techniques reduce. CONCLUSION:Our study reveals a notable evolution in anaesthesia techniques for open abdominal myomectomy at our institution, driven by post-graduate medical training, advances in medical research and the strategic use of available resources to enhance safety and care quality.
Abstract Pineoblastoma (PB) is a rare malignant embryonal tumour arising from the pineal gland. It commonly affects the paediatric age group with a slight male predilection. The typical clinical features include symptoms and signs of raised intracranial pressure, but extracranial metastasis may be seen in poorly differentiated tumours. We present a 5-year-old male who presented with clinical features suggestive of raised intracranial pressure. Radiological investigations revealed a pineal region tumour, and histopathological evaluation confirmed the diagnosis of a PB. The patient was optimised, and he had a right occipital craniotomy and microscopic surgery decompression via interhemispheric transplenial with ventriculoperitoneal shunt inserted. Fever, as a post-operative complication, was noted which necessitated removal of the shunt. The patient did well and was followed up bi-weekly. Unfortunately, the patient presented 5 months later with a recurrence, and he succumbed to his illness. Highlights (Key Messages ) • Pineoblastoma is a high-grade aggressive embryonal tumour arising from the pineal gland • It typically affects the paediatric population with a slight male preponderance • Prognosis is poor with high rates of mortality • Imaging studies are necessary but prompt histopathological evaluation is required for a definitive diagnosis of this tumour
BACKGROUND:The pooled cohort equation (PCE) for predicting the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) has been utilised in Black populations to predict cardiovascular events. OBJECTIVE:We explored the relationship between PCE ASCVD risk and left ventricular hypertrophy (LVH). MATERIALS AND METHODS:A total of 934 hypertensives from the Federal Medical Centre Abuja Hypertension Registry were analysed for this study. The participants were divided into two groups: those with low ASCVD risk (<7.5%) and those with elevated ASCVD risk (≥7.5%). Electrocardiographic (ECG) LVH was defined by the presence of any of Sokolow-Lyon, Cornell voltage or Gubner-Ungerleider criteria. Echocardiographic LVH was defined as an elevated LV mass index using the linear cube formula of the American College of Cardiology. RESULTS:Participants with elevated ASCVD risk were older (59.2 ± 9.0 years) than those with low ASCVD risk ( P < 0.001). Among participants with elevated ASCVD risk, 299 (42.1%) and 181 (26.3%) had echocardiographic and ECG LVH compared with 75 (32.3%) and 44 (19.6%) in those with low ASCVD risk, respectively ( P < 0.05). Those with elevated ASCVD risk had higher odds of having echocardiographic (odds ratio [OR]: 2.02, 95% confidence interval CI 1.39-2.93) and ECG LVH (OR: 2.00, 95% CI 1.29-3.08) compared to those in the low-risk group ( P < 0.05). CONCLUSION:In this study, an elevated 10-year ASCVD risk was associated with a two-fold increase in the risk of echocardiographic and ECG LVH in a population of Nigerian hypertensives. In resource-limited settings, the use of the ASCVD risk score may facilitate timely referrals for the diagnosis and management of LVH.
