Non Alcoholic Fatty Liver Disease (NAFLD) – An Emerging Challenge

Shahid Kamal

A rapidly emerging cause of Chronic Liver Disease (CLD) is Non-alcoholic Fatty Liver Disease (NAFLD). In the West, the prevalence of NAFLD is as high as 30% and it is postulated that it may affect one-third of the population by 2030 [1]. Various studies have shown that the prevalence of NAFLD in Pakistan ranges from 14% to 47% [2].
The spectrum of liver damage in NAFLD is wide-ranging and essentially involves non-alcoholic causes of fat accumulation in the cells of the liver. This can also occur in other conditions where there is more than 5% steatosis. These conditions include chronic liver disease (CLD) caused by drugs (such as Methotrexate, Amiodarone, Tamoxifen etc.) or viruses (such as HCV), exposure to environmental toxins, malnutrition, hemochromatosis, Wilson’s disease, and any autoimmune disease triggering 5% steatosis [3].
There is a strong association of NAFLD with obesity (in more than 40% of patients) [4], hypertriglyceridemia (in 20% or more), diabetes mellitus (in 20% or more), and insulin resistance – all components of the metabolic syndrome [5]. Over the last two decades, rising trends of DM, obesity and insulin resistance have gone hand in hand with increasing prevalence of NAFLD [6]. Pakistan has a 17.1% incidence of Type-2 diabetes and a 14% incidence of NAFLD. There is a 32% incidence of NAFLD in Pakistani type 2 diabetics [7]. The National Health Survey of Pakistan conducted way back in 2006 depicted an incidence of obesity in 25% of the Pakistani population, and since then, numbers have continued to rise.

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doi.org/10.21089/njhs.84.0140

Social and Cultural Norms; Still a Resistance to Nursing Care Homes for Older Patients in KPK, Pakistan

Muhammad Shoaib and Imran Uddin

Abstract: The percentage of the elderly population is increasing worldwide. The same trend is also observed in Pakistan. The elderly face many health problems in their advanced age. Elderly those who have chronic conditions like stroke need special and long-term care. So, for the provision of long-term care nursing care homes are crucial in a community. But, unfortunately in the province of Khyber Pakhtunkhwa, there is strong resistance to nursing care homes due to cultural and social norms.

Received: July 19, 2023
Revised: November 20, 2023
Accepted: November 20, 2023

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doi.org/10.21089/njhs.84.0142

The Experiences of Smokers Admitted to a Smoking Cessation Center in Samsun Regarding their Addiction: A Qualitative Study

Bektas Murat Yalcin, Gokce Celik Kara and Muge Ustaoglu

Abstract: Background: Primary care physicians have a vital opportunity to help their patients quit smoking. They need to provide an individualized approach to them while in the cessation process in order to help them understand.
Objective: The aim of this study is to investigate the individualized interacting factors and principles of starting, maintaining, quitting, and relapse of tobacco addiction among smokers.
Materials and Methods: This qualitative research performed between March and December 2015 involved 331 smokers who had applied to the Ondokuz Mayis University, Medical Faculty Family Medicine Cessation Clinic, Türkiye. In the first meeting, a workshop (lasting approximately 1 hour) was held for all the participants (31) and recorded. In this workshop the participants discussed how they started smoking and why they wanted to quit. They reported examples of successful quitting with which they were familiar, together with any precautions they took in order to protect themselves and the people around them. Every workshop was decoded and analyzed by the researchers.
Results: One hundred nineteen (35.7%) of the participants were women, and the mean age of the study group was 37.75 ± 12.41 years. Most of the participants (n=280, 85%) began smoking under the age of 18, with a close friend providing the cigarettes in the majority of cases (n=212, 64%). The main motivation differed between younger and older participants. In order to protect themselves, participants used external tar filters, smoked ‘light’ cigarettes, and refrained from smoking after eating or before sleeping. They also tended to smoke in the kitchen or on the balcony to protect other household members from their smoke. In addition, the participants increased their physical activity levels, requested more laboratory or screening tests from their physicians, and consumed healthier diets (honey, vitamin pills, and water).
Conclusion: The addiction dynamics of cigarette addicts differ very widely.

Received: April 11, 2023
Revised: July 10, 2023
Accepted: July 18, 2023

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doi.org/10.21089/njhs.84.0144


Factors Influencing Level of Anxiety and Pain in Patients’ Receiving Endodontic Treatment

Zehra Abdul Karim, Mehwish Feroz Ali, Gulrukh Askary, Hussain Askary and Umer Nisar Siddiqui

Abstract: Background: Dental anxiety is a vicious cycle in which avoidance of dental care, poor oral health, and psychosocial consequences are prevalent. It might be a significant impediment to receiving prompt dental care until absolutely required.
Objective: To evaluate the level of dental anxiety and pain in patients receiving root canal treatment and to identify factors that might increase anxiety levels.
Materials and Methods: This was a cross-sectional study conducted at Fatima Jinnah Dental College Hospital, Karachi, Pakistan from the period of August-December 2022. The study included participants who scheduled their first appointment for endodontic treatment during this period. Participants were included between the ages of 18 and 60, those who provided verbal consent. The sample size of 100 cases were calculated through power analysis at a 95% confidence interval. Data was analyzed by using SPSS version 20 software. P-value <0.05 was considered significant.
Results: According to the Modified dental anxiety scale, the average score was 12.7±4.53, which is considered to be a moderate anxiety. The Pearson correlation of mean anxiety score showed statistically significantly results such as gender (p<0.001), age (p<0.001), level of education (p=0.015), employment (p=0.029), ethnicity (p=0.009) and level of pain (p=0.008). The study showed a lower pain threshold among female patients than males with a statistically significant result (p=0.008). Conclusion: The incidence of dental anxiety among study participants ranged from mild to moderate. Women, young patients, and those with less education were more concerned than their male counterparts. Patients who need urgent root canal therapy more commonly experience dental pain and anxiety.

Received: April 19, 2023
Revised: September 19, 2023
Accepted: September 25, 2023

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doi.org/10.21089/njhs.84.0152


Minimal Invasive Plate Osteosynthesis for Distal Tibia Fractures

Muhammad Inam, Mian Asadullah, Suliaman Dawood and Waseeq Ur Rahman

Abstract: Background: Distal tibia fractures, challenging for surgeons due to unique anatomy, often result from high-energy trauma. Traditional treatments like ORIF entail significant soft tissue dissection. MIPO, a promising alternative, lacks sufficient empirical support for treating distal tibia fractures, warranting further study.
Materials and Methods: This Prospective case series study was conducted on 36 consecutive patients of either sex having age range of 18 and above seen between May 2017 and December 2020 at the Department of Orthopedic and Trauma, Government Lady Reading Hospital Medical Teaching Institute, Peshawar. The Effectiveness of the MIPO was assessed radiographically and functionally. Healing in bone as seen in three cortices out of four is called radiographic healing and pain free full weight bearing is called functional healing.
Results: A total of 36 individuals were investigated for this investigation. 27 men and 9 women, or a 75% to 25% gender split. The patients ranged in age from 18 to 60, with an average age of 36.36. The standard deviation of 13.749 indicates that the patients’ ages varied, but the results were usually reliable. Thirteen (36.1%) of the instances were falls, whereas 23 (63.9%) of the cases involved high-velocity trauma such automobile collisions. The AO/OTA categorization system allowed for the identification of several fracture forms. Type A fractures were recorded in 17 instances (47.25%) of all reported fractures. Type B fractures were found in 13 cases (36.15%), while Type C fractures were documented in 6 cases (16.7%). Of the patients who got treatment, thirty (83.3%) experienced no complications at all. Six patients experience rare problems. It’s noteworthy that conservative approaches were used to solve every one of these problems.
Conclusion: MIPO is a safe and effective treatment option for distal tibia fractures, providing adequate fracture reduction and favorable functional results. Because there is less soft tissue injury, patients heal more quickly and have fewer complications.

Received: August 15, 2023
Revised: November 10, 2023
Accepted: November 13, 2023

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doi.org/10.21089/njhs.84.0158


Impact of Outpatient Quality Services on Patient Satisfaction

Paras Azam, Ather Akhlaq, Mahwish Mumtaz Niazi and Sadaf Nawaz

Abstract: Background: The success and survival of any healthcare organization depends on the patient’s satisfaction and quality. Patient satisfaction plays a vital role in the performance of care.
Objective: To identify the factors influencing patient satisfaction with outpatient quality services in public and private hospitals.
Materials and Methods: The study was conducted on outpatient patients from different public and private hospital settings in Karachi, Pakistan. Data was collected through virtual tools such as Google Docs, asking about their experience of outdoor patients (OPD) in public or private hospitals. Using a non-probability, convenience sampling technique, a 5% margin of error and a confidence interval of 95%, the sample size was calculated as 377 participants rounded off to 400. Respondents were divided into males and females who visited any specialty department or general OPD. A self-administered questionnaire was designed to gather data, and a digital tool such as Google Docs was used to reach a wider audience. The reliability of the pre-validated tools has been assessed through Cronbach’s alpha. The Cronbach alpha for outpatient quality services is 0.717, and patients’ satisfaction is 0.98. The data were analyzed using the SPSS 25V by IBM Corporation.
Results: Most respondents were from the age group (26-35 years), making up 42% of the entire population. Data gathered showed private hospitals preference over public hospitals and satisfaction as well. All the quality service variables identified in the study had a direct relationship with patient satisfaction except waiting time, which had a negative relationship. Regression Analysis showed a positive impact on the availability of services; thus 1% increase in service will lead to a 0.484% change in patient satisfaction. A negative relationship was also witnessed with a 1% increase in waiting time patient satisfaction is down by 0.119%.
Conclusion: The level of satisfaction in public hospitals was not quite adequate, and the services were correspondingly rated as exceptional. The findings suggest that focusing on the nature of physician-related services, waiting for test results, and waiting for appointments are the most important factors impacting patient satisfaction in the outpatient division.

Received: October 13, 2023
Revised: December 16, 2023
Accepted: December 16, 2023

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doi.org/10.21089/njhs.84.0162


A Photographic Assessment of Smile by Modifying Crown Height, Width and Angulation of Maxillary Lateral Incisor among Orthodontic Patients of Karachi, Pakistan

Hana Pervez, Anam Sattar, Marium Iqbal, Nasreen Iqbal Nagani, Sadia Shabbir, Hareem Sultan, Khadija Zafar and Zainab Javed

Abstract: Background: Smile aesthetics vary culturally, influenced by media and the Golden Proportion in dental beauty. Challenges arise with missing lateral incisors, treated through composite build-up or canine substitution, highlighting the importance of crown dimensions and the need for clinician expertise in personalized treatments.
Objective: The objective of the study is to evaluate the influence of altering height, width and angulation of maxillary lateral incisors on the perception of smile.
Materials and Methods: This cross-sectional study was conducted at OPD of Jinnah Medical and Dental College, Karachi from January 2020 to June 2020, on 120 orthodontic patients (44 males and 76 females) aged between 15 and 35 years. Photoshopped photographs of an ideal smile were shown to the participants. In an ideal smile photo, the width of lateral incisor was 62% of the width of maxillary central incisors. The pictures showed to the participants had modifications in terms of crown heights, width and angulation of only maxillary lateral incisor without doing any changes to the other maxillary teeth. The responses of the participants were graded on the basis of perception of attractiveness.
Results: Mean score for height, width and angulation changes were obtained. The highest score by males was given to lateral incisor whose length was increased by 1mm (6.87±2.21) and in females; the highest score was given to lateral incisor which is modified by adding 0.5 mm increment (6.98±1.05). Both males and females preferred narrow lateral incisors as esthetically attractive. The mean highest scores for the decrease in width given by males were 6.52±2.52 and 6.8±2.217 by females, respectively. Both males (6.37±2.18) and females (6.64±1.81) preferred 10 degrees of mesial angulation of lateral incisor as more esthetically pleasing. Changes in distal angulation of more than 5 degrees are considered unattractive by both genders. Mean values were 6.04±2.15 for males and 6.00±1.99 for females.
Conclusion: In conclusion females are more concerned to the change in height, while in terms of width both genders preferred narrower maxillary lateral incisors over wider ones. Both genders perceived a 10 degree mesially angulated lateral incisor as more attractive.

Received: August 15, 2023
Revised: November 10, 2023
Accepted: November 13, 2023

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doi.org/10.21089/njhs.84.0168


Clinical Relationship of Blood Vitamin-C Levels and Age Related Cataract

Fehmina Nazir, Hafiz Muhammad Jahan Zaib, Nida Armoghan Khan, Mariam Noor and Amina Khalid

Abstract: Background: Cataract is an extremely important and ground source of the curable blindness around the globe. Lenticular Vitamin C is actual important ultraviolet filter and antioxidant that decreases entry of the light rays into lens and therefore preventing the lens from oxidative damage. Keeping this in sight, higher intake of the vitamin c and by consuming the diet rich in vitamin c can prevent the age-related cataract. The motive of this study is to analyze if high vitamin C levels can lead to decrease in the percentage of cataract in patients.
Objective: To determine occurrence of the senile cataract among Vitamin C deficient subjects and compare mean vitamin C levels among senile cataract and controls.
Materials and Methods: This comparative cross-sectional study was conducted at The Department of Ophthalmology, PIMS (Pakistan Institute of Medical Sciences), Islamabad, Pakistan, after being accepted by Ethical review Committee. Individuals were selected, in the age range between 45 to 75 years of age from the patients who visited Eye OPD, PIMS, and Islamabad. All participants undergone detailed ophthalmic examination that included visual acuity assessment through the Snellen’s chart, anterior segment examination on the slit lamp. Blood vitamin C level was assessed in both cases and controls. Information was recorded in the designated Proforma and data was analyzed using SPSS 23.0 version.
Results: We enrolled 100 patients 50 in each group. Average age of our individuals in our case set was 60.96±9.57 years and in control set remained 59.66±8.92 years. In study group 25(50.0%) remained male and 25(50.0%) remained female. similarly, in control group 19(38.0%) were male and 31(62.0%) were female. The mean value of level of serum vitamin C in study group was 0.55±0.06 mg/dl and average value of level of the serum vitamin C in control group was 0.87±0.07 mg/dl. There was significant difference as p value is less than level of implication (p < 0.05). In cataractous individuals the level of the serum vitamin C was low as compared to control set.
Conclusion: In this study, researchers determined that blood vitamin C may be a preventive component towards cataract development that is likely influenced by vitamin C consumption.

Received: March 01, 2023
Revised: September 26, 2023
Accepted: September 26, 2023

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doi.org/10.21089/njhs.84.0174

Assessment of Depression, Anxiety, and Stress among Health Care Professionals due to Covid – 19

Irfan Ali, Sameera Ali Rizvi, Khadijah Abid, Nida Shoaib and Haya Ul Batool Abbasi

Abstract: Background: The emergence of an undisclosed pneumonia outbreak in Wuhan, China, in December 2019 led to the global spread of Corona virus Disease (COVID-19), declared a pandemic by the WHO on March 12, 2020. Healthcare workers (HCPs) faced unprecedented challenges, with studies revealing elevated stress, depression, and anxiety. Despite differing roles, direct health care providers reported higher psychological distress. The absence of a definitive treatment compounded fears, resulting in anxiety, depression, and stress among patients, Healthcare professionals and normal subject.
Objective: To identify the level of anxiety, depression, and stress among health care professionals due to the wave of Covid- 19.
Materials and Methods: Analytical cross-sectional survey was done among health care workers who were working in a tertiary care hospitals, Sohail Trust Hospital Korangi Industrial Area, Karachi, and Medicare Cardiac and Dental Hospital, Tariq Road, Karachi from January 2022 to April 2022 in the third wave of Covid-19. The Depression, Anxiety, and Stress Scale-21 Items (DASS-21) self reporting scale based questionnaire was used to examine mental health. During data analysis, descriptive and inferential statistics were calculated in SPSS.
Results: Out of 416 participants, 56% were females and 56.2% were single. The mean age of the respondents was 29.36 years (± 5.5). The symptoms of anxiety were reported by 47%, depression by 35% and stress was reported by 21% of participants. The level of anxiety, depression, and stress was higher in male technicians, frontline workers, HCP with chronic illnesses, and those who got covid-19 infection. Based on the results, it was identified that male had higher odds of developing anxiety while female, HCPs belonging to age groups of above 25 years and those with work experience lesser than 5 years showed to have greater odds of having stress.
Conclusion: COVID-19 has caused Anxiety, Depression, and Stress among Pakistani healthcare workers. Early intervention with focused strategies and psychological therapies could help to prevent more serious problems.

Received: July 12, 2023
Revised: November 07, 2023
Accepted: November 07, 2023

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doi.org/10.21089/njhs.84.0179

Gender Based Comparison of Mean Arterial Pressure and Pulse Pressure after Stress Induction in Healthy Adults

Syed Shahmeer Raza, Attaullah Shah, Umema Zafar, Tooba Khan, Dur E Shehwar Ali and Farhan Ullah

Abstract: Background: Mean Arterial Pressure (MAP) and Pulse Pressure (PP) are both key parameters to diagnose and manage cardiovascular diseases and hypertension, a leading cause of mortality and morbidity globally. Men and women are physically different from each other.
Objective: Is to evaluate gender-based comparison of MAP and PP of healthy adults after stress induction.
Materials and Methods: This cross-sectional study was designed and conducted in the Institute of Basic Medical Sciences (IBMS) at Khyber Medical University (KMU) from January 2022 to April 2022. A total of fifty-two participants including twenty-six males and twenty-six females were selected using convenience sampling. Sample size estimation was carried out using G*Power. Healthy adults between the age of 18-40 years were included in the study. Blood Pressure (BP) and Heart Rate (HR) were checked both before and after the stress induction. MAP and PP were calculated using the formulas obtained from the literature i.e., MAP = DP + 1/3 (PP) and PP = SBP-DBP.
Results: The mean age of males was 27.16 ± 4.28 years and that of females was 23.15 ± 2.86 years. Both pre and post stress comparison of mean difference between healthy adult males and females, revealed no significant difference between MAP (Post-Stress p=0.97 and Pre-Stress p=0.61), PP (Post-Stress p=0.18 and Pre-Stress p=0.05) and HR (Post-Stress p=0.11 and Pre-Stress p=0.57). Males had a higher PP than females in both pre and post stress phase. Females had a slightly higher MAP than males in the pre stress phase. In the post stress phase, MAP showed a positive correlation with HR and PP. While in the pre stress phase, all the variables (MAP, PP and HR) showed no correlation with each other.
Conclusion: MAP and PP show no significant difference between healthy adult males and females, after stress induction.

Received: April 21, 2023
Revised: September 19, 2023
Accepted: September 28, 2023

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doi.org/10.21089/njhs.84.0185

Factors Affecting the Implementation of Nursing Care Plans in Patient Care

Imran Iqbal, Saima Kouser, Sadia Samreen and Gideon Victor

Abstract: Background: Nursing Care Plan (NCP) is used in practice as a systematic and scientific problem-solving method to determining the care needs of individuals. There is lack of research on factors affecting regarding utilization of nursing care plan in patient care.
Objective: The objective of this study were to evaluate the implementation of the nursing process and to determine the factors that may influence the implementation of the nursing process.
Materials and Methods: A cross-sectional survey was conducted at a private hospital during February to June, 2023. The study protocol was reviewed and approved. Permission from institutional heads was sought. Informed consent was obtained before data collection. Simple random sampling method was employed. The data were collected with structured questionnaires whose responses were rated on Likert scale. Data were coded and analyzed using SPSS v25.0.
Results: A total 108 nurses participated in the study. Study findings revealed 89% of the nurses were female nurses and 82% possessed diploma in nursing. The knowledge 50.5%, confidence 50.9% and willingness 54.2%, were at borderline good level. Whereas, assessment and diagnosis, planning, implementation, evaluation, and nurses’ views about nursing care planning implementation were at < 50% as poor. There was a moderate positive correlation between knowledge and implementation R-Value 0.312 and confidence and evaluation R-Value 0.246. Barrier to implement nursing process included uncooperative patients, lack of awareness about nursing process, lack of preparedness, low satisfaction level, lack of in-service training, lack of time, and high patient flow.
Conclusion: Study’s findings revealed knowledge, confidence and willingness of the nurses determine the use of nursing process in their nursing practice.

Received: July 31, 2023
Revised: November 21, 2023
Accepted: November 23, 2023

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doi.org/10.21089/njhs.84.0189

Gender-Based Violence and its Effect on Mother, Fetus and Newborn Baby: A Systematic Review

Sameera Rizvi, Sana Tariq, Amira M. Ali and Tazeen Saeed Ali

Abstract:Gender-based violence (GBV) is a major public health concern resulting in physical, psychological, sexual, and social issues. GBV during pregnancy may results in complicated and grave consequences for mother and unborn child. The prevalamce of GBV was reportedly higher in developing countries, indicating higher maternal and child mortalities. Effect of GBV on pregnancy has been reported to enhance the chances of prolonged labor, obstructed labor and in severe injuries higher incidents of miscarriages and abortions are also been reported. Moreover, fetal respiratory distress, diarrhea, small for gestaional age and Intra Uterine Growth Retardation (IUGR) have also been reported. This review aims to present a systematic view of genderbased violence and its association with adverse pregnancy outcomes and to contribute by filling the existing information gap. Review assessed the effect of GBV during pregnancy on fetal health, reporting infant diarrhea more frequently, along with fever, vomiting, and respiratory distress. The significant association between adverse maternal and fetal outcomes and gender-based violence has been evaluated extensively.

Received: June 26, 2023
Revised: October 07, 2023
Accepted: October 10, 2023

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doi.org/10.21089/njhs.84.0195


The Faces of Deceptive Healers: A Scoping Review of Titles and Traits Associated with Quacks across Regions

Ghulam Yaseen Veesar, Ather Akhlaq and Ahson Qavi Siddiqi

Abstract:Background:The progress in medical science and the increased accessibility of digital resources have enhanced the convenience for individuals in accessing appropriate treatments. Despite these advancements, quackery continues to persist as a global concern. Throughout history, people have been intrigued by miraculous treatments rooted in faith and trust theories. In ancient times, distinguishing between scientifically approved and unapproved medical practices posed challenges. Ever since medical practices have been taking place, service providers took advantage of people’s unawareness, exploiting patients for personal gain. Over time, in certain cultures and societies, their intentions became apparent, and they earned a reputation as deceivers in the medical field. The current research seeks to uncover the various traits utilized by quacks across different times and locations worldwide, aiming to expose their fraudulent practices.
Methodology:In this scoping review, the focus was on investigating various characteristics displayed by quacks during their practices. The study involved a comprehensive examination of 3740 published research articles and 400 pieces of gray literature such as websites of regulatory authorities, Acts, Laws. News items and reports which encompassed regulatory authority websites, news articles, and reports. From this extensive pool of sources, 45 articles and 4 excerpts were carefully chosen for in-depth analysis.
Result:The current study highlighted 90 terms used for quacks to define their characteristics. The data was analyzed and developed five different themes defining various traits according to the near association. The main theme covered the moral values of these practitioners followed by Modern quackery under complementary and alternative healthcare services, sorcery and mystic, ignorant of science, and contract to law.
Conclusion:Quackery, with its long-standing history, remains an ongoing health threat. Embracing modern technology, it utilizes the Internet and social media to propagate deceptive claims. Gaining insights into the traits of quacks is crucial for policymakers to address this issue effectively. Combating quackery necessitates heightened awareness, robust regulations, dissemination of authentic information and evidence-based healthcare involving all stakeholders.

Received: August 04, 2023
Revised: November 07, 2023
Accepted: November 07, 2023

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doi.org/10.21089/njhs.84.0203

Nephrotic Syndrome Secondary to Primary Membranoproliferative Glomerulonephritis in a 27 Years Old Nigerian Male

Peter K. Uduagbamen, Gbemi H. Ano-Edward, Sandra O. Idris, Tochukwu P. Ogbonna, Solomon Kadiri and Ayodeji Arije

Abstract: Membranoproliferative glomerulonephritis (MPGN) is not a common cause of nephrotic syndrome (NS) in adults unlike in children. It is commonly steroid-resistant in adults unlike in children. Tissue diagnosis needed for effective management could be unavailable due to cost, particularly in resource poor settings. Patient was examined, had urine analysis, serum biochemistry assay, kidney scan and a kidney biopsy for histological diagnosis.
The patient had generalized oedema, with ascites, elevated blood pressure (156/90 mmHg) and massive proteinuria (4.6 g/day). The haemogram showed haematocrit of 32%, with absolute lymphocytosis (72%). Fasting lipids showed hypercholesterolemia (533 mg/dl), elevated LDL (274 mg/dl), low HDL (27 mg/dl) and hypertriglyceridemia (302 mg/dl). Ultrasound showed enlarged kidneys. Histological findings were mesangial hypercellularity, double-contour formation along the glomerular capillary wall (tram track appearance) and endocapillary proliferation. He was managed with intravenous methylprednisolone, (followed by gradually reducing oral doses), frusemide, atorvastatin, antibiotics and had daily weighing. He responded well to treatment. He was counselled on good compliance and has been on follow-up visits. His clinical and laboratory parameters have been normal.
Nephrotic syndrome from MPGN should be looked out for in adults presenting with NS and their treatment with steroids could be very beneficial.

Received: February 23, 2023
Revised: July 20, 2023
Accepted: July 20, 2023

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doi.org/10.21089/njhs.84.0212

Delayed Presentation of Traumatic anterior Sternoclavicular Joint Dislocation – A Case Report and Literature Review

Muhammad Noman, Sajjad Ahmed, Saleha Bint e Shuaib, Taimoor Ali, Syed Bilal Ali and Muhammad Waqas Khan

Abstract: Traumatic sternoclavicular joint dislocations are uncommon, accounting for just 1% of all documented upper limb dislocations, despite the fact that upper limb dislocations are very common literature offers only a handful of documented instances of such dislocations. Among them, anterior dislocations are more frequently observed than posterior dislocations, owing to the robust ligamentous support in this area. We describe the case of a 35-year-old male patient who had isolated anterior sternoclavicular dislocation and a successful reduction procedure used on him. The rarity of such cases is emphasized by the satisfactory outcomes presented in our report.

Received: July 27, 2023
Revised: November 07, 2023
Accepted: November 08, 2023

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doi.org/10.21089/njhs.84.0216

 


2023 VOL 8 , Issue 4