Medicine
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Sickle cell anemia (SCA) is a hereditary blood disorder with profound implications for affected individuals, particularly in resource-limited settings such as Uganda. This review explores the multifaceted aspects of SCA in Uganda, focusing on epidemiology, challenges faced by individuals, coping strategies, healthcare disparities, and community support. The study incorporates a thorough examination of the genetic landscape, prevalence, and the impact of SCA on the quality of life in Uganda. ⋯ This review critically evaluates the various coping mechanisms employed by individuals in Uganda and the resilience demonstrated in the face of chronic illness. It explores the psychological, social, and cultural dimensions of coping and resilience, shedding light on adaptive strategies that contribute to improved quality of life. This article aims to contribute valuable insights into the specific challenges faced by individuals with SCA in Uganda, offering a foundation for targeted interventions, improved healthcare policies, and increased awareness within both the medical community and the broader society.
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Comparative Study Observational Study
Comparing the safety of a single balloon catheter to dinoprostone for inducing labor in pregnant women with group B Streptococcus vaginal colonization: An observational study.
Group B Streptococcus is a bacterium that colonizes in approximately 20% of pregnant women and can be vertically transmitted to newborns, leading to maternal-neonatal adverse outcomes, such as chorioamnionitis, neonatal sepsis, and pneumonia. However, there is currently no agreement on the optimal induction method for this specific population. This study aims to evaluate the safety of a single balloon catheter (BC) in comparison to dinoprostone for labor induction in term pregnant women with group B Streptococcus colonization. ⋯ When prophylactic antibiotics were administered, no significant differences were observed in terms of mode of delivery, clinical chorioamnionitis, puerperal infection, fetal distress, neonatal asphyxia, neonatal infection, neonatal sepsis, NICU admission, and neonatal pneumonia between the 2 induction methods (all P > .05). Additionally, there were no reported cases of neonatal group B Streptococcus infection following balloon induction in pregnant women with vaginal GBS colonization. In relation to maternal and neonatal adverse events, the study findings indicated that labor induction using a BC was deemed safe for women who were colonized with group B Streptococcus, provided that prophylactic antibiotics were administered either at the onset of labor or when the membranes ruptured.
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Observational Study
Optimal wearable camera mount locations for medical supervision during simulated out-of-hospital cardiopulmonary resuscitation.
The quality of the visual information transmitted from a scene is crucial for effective medical supervision in prehospital settings. This study investigated the influence of wearable camera mount locations on visibility during simulated out-of-hospital cardiopulmonary resuscitation. A prospective, observational, non-randomized simulation study was conducted to replicate a cardiac arrest scenario adhering to an advanced life support (ALS) protocol. ⋯ Wearable camera mount location significantly affected visibility during simulated resuscitation. Mounting cameras closer to eye level provided the most accurate visual data. Further research using objective measures, such as artificial intelligence, and evaluating the visibility of wearable cameras in real-world situations is warranted to optimize simulation-based training for prehospital care.
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Case Reports
Bilateral thalamic infarction with posterior cerebral artery variant (the arcade artery): A case report.
Bilateral thalamic infarction is a rare type of posterior circulation stroke, and it often presents with a reduced level of consciousness in the elderly. Arteriosclerosis is the primary etiology of bilateral thalamic infarction, including conditions such as native vessel stenosis or arterial-to-arterial embolism. Cardiogenic or paradoxical embolism can also lead to thrombosis of the perforator branches innervating the thalamus, and these emboli tend to disintegrate and lead to multiple lesions, even in elderly patients. ⋯ The elderly experiencing a sudden drop in consciousness should be evaluated for thalamic lesions, primarily cerebral infarction in the posterior circulation. Anatomical artery variations may be helpful in attributing multiple and bilateral lesions to a single source of embolism. Digital subtraction angiography and transesophageal echocardiography can help to clarify the etiological categorization and formulate a secondary prevention strategy for cerebral infarction. Paradoxical embolism is a diagnostic dilemma in the elderly population, and treatment principles must be integrated with guidelines, the prospectively validated patent foramen ovale-associated stroke causal likelihood risk stratification system, interdisciplinary collaboration and customized analysis.
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Observational Study
Evaluation of pediatric spinal ependymomas: A 25-year retrospective observational study.
This study aims to evaluate the clinical and radiological features, histopathological characteristics, treatment modalities, and their effectiveness, as well as long-term follow-up results of pediatric spinal ependymomas treated at a single institution. In this retrospective study, medical records of 14 pediatric patients (3 females and 11 males) who were surgically treated for spinal ependymoma in our institution between 1995 and 2020 were reviewed. Data regarding age, gender, presenting symptoms and signs, radiological findings, postoperative status, extent of resection, histopathological grading, recurrence, tumor growth, seeding, and adjuvant treatment were collected and analyzed. ⋯ One patient who had a grade III tumor and did not achieve gross total resection died during follow-up. Pediatric spinal ependymomas are uncommon tumors with relatively benign course. Gross total resection should be the primary goal of surgery since it may prevent disease progression, and in case it fails, progression occurs later than those that were treated with subtotal resection.