-
Research Article
Evaluation of Endometrial Receptivity in Unexplained Infertility After Clomiphene Citrate by Shear Wave Elastography
Issue:
Volume 13, Issue 6, December 2024
Pages:
68-76
Received:
10 October 2024
Accepted:
28 October 2024
Published:
22 November 2024
Abstract: Objective: This study utilized shear wave elastography (SWE) to evaluate endometrial receptivity (ER) in cases of unexplained infertility (UI) following treatment with clomiphene citrate (CC). The aim was to establish a reliable imaging reference for clinical treatment. Methods: This investigation encompassed 68 patients with UI who attended our hospital from October 2023 to May 2024. Participants were allocated to either a CC group (28 participants) or a normal control (NC) group (40 participants) according to the treatment protocols they followed. During the LP phase (days 13-16) and the MP phase (6-9 days post-ovulation), both groups underwent transvaginal ultrasound and SWE assessments. The evaluated parameters included endometrial thickness (EMT), uterine artery parameters (UA-PI, UA-RI, UA-S/D), average endometrial elasticity (E-mean), and mean shear wave velocity (SWV-mean). Additionally, clinical pregnancy outcomes were tracked. Results: Significant variations were observed between the CC and NC groups in E-mean, SWV-mean, EMT, UA-PI, UA-RI, and UA-S/D during both evaluated phases, with statistical significance (P<0.05). Nevertheless, there were no significant variations found in clinical pregnancy rates among the groups (P>0.05). Significant statistical differences were observed in E- mean and SWV-mean between pregnant and non-pregnant patients within each group (P<0.05). Conclusions: After CC treatment, the endometrium in UI patients showed decreased thickness, increased hardness, reduced blood flow, and increased difficulty in implantation. Despite these effects, CC did not significantly impact clinical pregnancy rates. Future studies should expand the sample size to determine the threshold of endometrial hardness that optimally balances its effects.
Abstract: Objective: This study utilized shear wave elastography (SWE) to evaluate endometrial receptivity (ER) in cases of unexplained infertility (UI) following treatment with clomiphene citrate (CC). The aim was to establish a reliable imaging reference for clinical treatment. Methods: This investigation encompassed 68 patients with UI who attended our ho...
Show More
-
Methodology Article
Prevalence of Helicobacter Pylori Among Patients with Chronic Gastritis in Nigeria
Adamu Mohammad Ewa,
Yussuf Maisuna Abdulkadir*,
Yusuf Ibrahim
Issue:
Volume 13, Issue 6, December 2024
Pages:
77-82
Received:
12 November 2024
Accepted:
23 November 2024
Published:
12 December 2024
Abstract: Introduction: The stomach wall is made up of smooth muscles which are arranged in three layers: outer longitudinal, inner circular and innermost oblique layers. The mucosa is made up of simple columnar epithelium and is made up of several cell types which include: mucous cells which secrete alkaline mucous that protects the epithelium against acid and shear stress. Gastritis can involve the whole of the stomach, or a specific part of the stomach such as the fundus, body or the antrum and the distribution of gastritis may be related to an aetiologic factor. H. pylori causes passive inflammation inside the gastric epithelium and alters signal transduction pathways that serve as a platform for the pathogenesis, but it also develops antimicrobial resistance via genetic changes and biofilm development. The bacterium floats in the direction of the epithelial membrane when it enters the stomach, taking advantage of areas of the stomach wall that are injured. Method: The study was conducted in Kano, Nigeria from April 2021 to October 2021 and it is a Hospital-based Cross-sectional Descriptive study. Patients with dyspepsia referred for oesophagogastroduodenoscopy (OGD) at the endoscopy suite of the hospital constitute the study population, 197 patients that met the inclusion criteria were recruited and underwent OGD. Each patient were biopsied in accordance with the updated Sydney protocol. Data were collected and the report of both endoscopy and histological assessment for the presence of gastritis and H. pylori were documented and analyzed using the SPSS 20. Result: H. pylori was detected in 137 patients out of the 197 gastric biopsies sample of gastritis, the prevalence was 69.5%. Also, There was a statistically significant relationship between H. pylori and those aged 31-40years (p = 0.025), however, the relationship was not significant for the other age groups and no significant relationship was found between sex (p = 0.512). The most common site affected by histologic gastritis in this study was the antrum (99.4%) and the high predominance of antral involvement is probably due to the high rate of H. pylori infection in the study subjects which is known to be associated with antral affectation. Conclusion: The most predominant pattern of histologic gastritis was chronic H. pylori gastritis located in the antrum. The prevalence of H. pylori infection was 69.5%, and it had significant association with both endoscopic and histologic gastritis. Therefore, prevention and eradication program for the H. pylori infection are necessary in our environment.
Abstract: Introduction: The stomach wall is made up of smooth muscles which are arranged in three layers: outer longitudinal, inner circular and innermost oblique layers. The mucosa is made up of simple columnar epithelium and is made up of several cell types which include: mucous cells which secrete alkaline mucous that protects the epithelium against acid ...
Show More
-
Research Article
Adherence to Diabetic Self-Care Practice and Associated Factors among Patients with Type Two Diabetes at a Public Hospital in Addis Ababa
Issue:
Volume 13, Issue 6, December 2024
Pages:
83-94
Received:
15 November 2024
Accepted:
29 November 2024
Published:
16 December 2024
Abstract: Background: Self-care adherence is thought to be crucial for managing polygenic disease. This is frequently because there is a strong correlation between poor blood sugar control and self-care behaviors and the subsequent emergence of polygenic disease complications. By improving glycemic control, patients may be able to reduce their risk of developing those complications. Therefore, the purpose of this study is to evaluate the self-care behaviors of patients with type II diabetes who are attending a selected public hospital in Addis Ababa City, as well as the impact of demographic factors and clinical state on these behaviors. Methods: An institution-based cross-sectional study design was conducted using SPSS version 26, and multivariable binary logistic regression analysis was used. Result: A total of 397 study participants were interviewed with response rate of 99.25%. Data coming from this study reveals that (73.8%) of study participants has good practiced on the recommended self-care practices. Factors found to be significantly associated with adherence to diabetic self-care were BMI of respondent (AOR = 0.465, 95% CI = 0.229-0.947), diabetic compilation, place of respondent (AOR = 1.090, 95% CI =0.091-0.604), and monthly income (AOR =, 1.522 95% CI =0.871-2.659). Conclusion: the level of adherence to self-care practices among diabetic patients is lower compared to other areas. To improve this, the healthcare team should adopt a patient-centered approach when deliver diabetes messages, focusing on specific issues related to management practice. it is imperative to increase awareness of patients and the community as a whole in order to address important aspects such as medication adherence, glycemic control and diet management. By taking these steps, we can work towards improving self-care practice among diabetic patients and ultimately, their overall health and well-being.
Abstract: Background: Self-care adherence is thought to be crucial for managing polygenic disease. This is frequently because there is a strong correlation between poor blood sugar control and self-care behaviors and the subsequent emergence of polygenic disease complications. By improving glycemic control, patients may be able to reduce their risk of develo...
Show More
-
Research Article
Comparison of the Clinical Effects of Ciprofol, Propofol, and Etomidate in the Combined Painless Gastroscopy and Enteroscopy: A Randomized Controlled Trial
Zhifu Zhao
,
Leqiang Xia*
Issue:
Volume 13, Issue 6, December 2024
Pages:
95-100
Received:
27 November 2024
Accepted:
10 December 2024
Published:
25 December 2024
DOI:
10.11648/j.cmr.20241306.14
Downloads:
Views:
Abstract: Background: Propofol and etomidate are commonly used for sedation during painless gastroenteroscopy, but both have significant side effects. Cycline is a new sedative with minor side effects. This study aims to observe the clinical effects of ciprofol, propofol, and etomidate in the combined painless gastroscopy and enteroscopy. Methods: We randomly divided 600 outpatients aged 18-70 years, with a body mass index 18-30 kg/m2, and an ASA score of I-II, who underwent painless gastroenteroscopy, into three groups: propol group, etomidate group, and cyclizine group, with 200 cases in each group. All groups were pre-injected with 01 ug/kg sufentanil injection intravenously. The propofol group was given 2 mg/kg propofol injection intravenously, theomidate group was given 0.2 mg/kg etomidate injection intravenously, and the cyclizine group was given 0.4 mg cyclizine injection intravenously. The injection time for all groups was 30±5 seconds. The examination began when the MOAA/S score was 0-1 or the corneal reflex disappeared. 1. We observed the incidence of injection pain, onset time, sedation success rate, incidence of movement, incidence of respiratory depression, circulatory inhibition, awakening time, PACU time, and satisfaction of the examiner and the patient in all three groups; We observed the adverse reactions such as muscle pain and intraoperative awareness in the patients of all three groups. Results: 1. There were no differences in basic information of the patients in the three groups. The sedation success rate in all three groups was 100%. There were no significant differences in the time, awakening time, and PACU time among the three groups (P>0.05); 2. The incidence of injection pain, respiratory depression, circulatory inhibition in the propofol group was higher than that in the etomidate group and the cyclizine group, with significant differences (P<.05). However, there were no significant differences between the etomidate group and the cyclizine group. The satisfaction of the patients and the exam in the cyclizine group was higher (P<0.05); 3. Although there were no significant differences in the incidence of adverse reactions among three groups, the incidence of muscle tremor and muscle pain in the etomidate group was significantly higher than that in the propofol group and the cycline group, with significant differences (P<0.05). Conclusion: The clinical effect of ciprofol for painless gastroenteroscopy is significantly better than that of propofol and etomidate, and suitable for promotion in outpatient painless gastroenteroscopy.
Abstract: Background: Propofol and etomidate are commonly used for sedation during painless gastroenteroscopy, but both have significant side effects. Cycline is a new sedative with minor side effects. This study aims to observe the clinical effects of ciprofol, propofol, and etomidate in the combined painless gastroscopy and enteroscopy. Methods: We randoml...
Show More
-
Methodology Article
Analysing Liver Histology in Relation to Elevated HBV DNA Levels in Immuno-Tolerant Phase of Chronic Hepatitis B Viral Infection Patients
Issue:
Volume 13, Issue 6, December 2024
Pages:
101-106
Received:
26 November 2024
Accepted:
9 December 2024
Published:
30 December 2024
DOI:
10.11648/j.cmr.20241306.15
Downloads:
Views:
Abstract: Introduction: Chronic Hepatitis B viral infection is associated with significant health and financial challenges. An estimated 15-40% of the Chronic Hepatitis B infected patients would develop liver Cirrhosis and a quarter of which may result in Hepatocellular cancer. In Africa, about 65 million people are said to be chronically infected with HBV. Thus, Africa with 12% of the world’s population carries approximately 18% of the global burden of HBV infection. An elevated level of ALT is an important component in the consideration for treatment of CHB, however, the presence of normal level ALT levels with discordantly elevated HBV DNA levels may requires further evaluation with Liver histology. Method: All patients who were newly diagnosed with CHB infection and above 18 years of age were consecutively recruited from December 2019 to October 2020, into the study. Blood samples were taken for the Liver Function Test, HBV immunologic panel and HBV DNA levels. Liver biopsy was performed for 84 patients with variance elevated serum HBV DNA (>2000 IU/mls) and normal serum ALT defined as level <40 Unit/mls. The Data collected was entered and analyzed using the SPSS version 20. The clinical profiles and HBV DNA level of the respondents were presented using mean and standard deviation while frequencies, percentages and charts was used to summarize qualitative variables. Chi-square test and Fisher’s exact test were used to analyze factors associated with respondent’s HBeAg status and liver histology. Result: The Liver biopsy histology shows, mild inflammation (A1) was observed in 50 (60%), and moderate inflammation (A2) in 12% while the remaining 10 patients (28%) showed no inflammatory. Similarly, 20 patients (24%) had no fibrosis (F0), 8% had portal fibrosis without septa (F1), 24% had portal fibrosis with rare septa (F2) while the remaining majority (44%) had numerous septa (F3). Conclusion: Chronic HBV infection is Endemic in our region and studies had shown the importance of adequate evaluation and early treatment to avert the associated high morbidity and mortality. Also, significant number of patients with normal ALT levels had fibrosis on liver histology. Liver histology remains an important parameter in the evaluation of patients with CHB, as 57 patients would have missed the opportunity of early treatment. These findings are expected to provide a basis for an informed planning of national and International CHBV treatment guidelines.
Abstract: Introduction: Chronic Hepatitis B viral infection is associated with significant health and financial challenges. An estimated 15-40% of the Chronic Hepatitis B infected patients would develop liver Cirrhosis and a quarter of which may result in Hepatocellular cancer. In Africa, about 65 million people are said to be chronically infected with HBV. ...
Show More
