Terror-related injuries in Somalia: a retrospective cohort of 2426 hospitalized cases along 7 years.

Terrorism-related injuries and deaths have become a major threat to the Somalian population, as in the rest of the world. We aimed to characterize and compare firearm and explosion injuries caused by terrorist acts. This retrospective study reviewed the data of all patients injured by explosions and firearm attacks over seven years. Epidemiological characteristics, injury pattern, severity scores, hospital resource utilization parameters, length of stay, and death rates were evaluated. A total of 2426 patients were injured by 359 explosions and firearm attacks during the study period. Eighty-one percent of the patients (n = 1974) were male, while 19% of the cases were female. Multiple body site injuries occurred more frequently in explosion injuries (75%) than firearm wounds (48%) (P < 0.001). The relative frequency of internal injuries in explosion injuries was higher than in firearm wounds (46.7% vs. 36.2%). Patients injured due to the explosion have a greater rate of severe and critical injuries than those injured by firearms (30.2% vs. 21.2%, P < 0.001). About a quarter (24%) of the patients were hospitalized in the intensive care unit. The inpatient mortality rate was 11.6%. The findings of the study revealed that suicide bombings explosions are associated with multiple body site injuries, a greater rate of severe and critical internal injuries, and a higher mortality rate.

Analysis of the demographic characteristics and clinical profile of acute ischemic strokes admitted to the emergency centre in the Somalia population.

Background: Stroke is a leading cause of death and chronic disability worldwide. In Sub-Saharan Africa (SSA), which includes Somalia, stroke represents a significant part of the chronic disease burden. However, there is relatively little data on risk factors, demographics, and clinical profiles. This study aimed to define the etiological, demographic characteristics, classification of stroke and functional status of patients with acute ischemic stroke (AIS) admitted to the emergency centre, and to create projections to evaluate the incidence and genetic aspects of stroke. Methods: The study population consisted of patients who applied to the emergency centre between 1 May 2017 and 1 May 2021 and were diagnosed with acute ischemic stroke (AIS). Patient demographics, season of onset, risk factors, laboratory data, imaging results, infarct location, AIS subtype and treatment outcomes were collected, and compared. Results: A total of 3,968 patients diagnosed with ischemia stroke were included in the study. The mean age was 51.12 ± 16.43 years, and we reported male predominance (65.7%). While hypertension, hyperlipidaemia, Diabetes mellitus (DM) were more frequent among the risk factors, smoking history and alcohol consumption history were very low. HIV-infected ischemic stroke was detected at a high rate (20.9%) and was common in a relatively young age group (31.8 ± 14.3). Large-artery atherosclerosis (LAA) subtype was detected with a high rate of 67.7%. The most common clot localization was in Supratentorial location (74.3%), and according to OSCP classification, partial anterior circulation infarcts (PACI) subtype (56.3%) was the most common. And these results were again different from other studies. Discussion: While the incidence of stroke and especially HIV-associated youthful ischemic stroke continues to increase rapidly in developing countries such as Somalia, with the addition of inadequate primary health care services, stroke has become a major public health problem in African countries regarding its costs at social, psychological, and economic levels.

Prevalence of Acute Kidney Injury in Covid-19 Patients- Retrospective Single-Center Study.

Introduction: In December 2019, a coronavirus disease 2019 (COVID-19) disease outbreak started in Wuhan, Hubei Province, China, and spread rapidly to other regions of the world. Although diffuse alveolar injury and acute respiratory failure were the most prominent characteristics, further investigation of organ involvement is essential. Aim: In this study, we aim to determine the prevalence of acute kidney injury (AKI) in covid-19 patients and also the relationship between inflammatory markers, the severity of lung involvement, and acute kidney injury in COVID-19 patients. Methods: This was a retrospective analysis of 102 COVID-19 patients presented to a tertiary teaching hospital in Mogadishu during the second wave of Covid-19 2021. Patients' age, gender, comorbidities, hemoglobin, platelet, and white blood cell counts, glucose, urea, creatinine, sodium, potassium, CRP, ferritin, real-time polymerase chain reaction (RT PCR) Covid-19 test and CT scan findings were all collected. Results: The mean age of the patients was 58 (Range 23-91 years), including 64 men and 38 women. The prevalence of acute kidney injury was 12.7%. There was a significant association between acute kidney injury, CRP and ferritin with the p values of P<0.003 and P<0.004, respectively. For severity of lung involvement with computed tomography finding, 35 (34.3%) had mild, 35 (34.3%) had moderate and 32 (31.4%) had severe lung involvement. There was significant association between the lung involvement, Ferritin and CRP levels with P values of P<0.005 and P<0.007 respectively. Conclusion: Our findings indicate that acute kidney injury is common in covid-19 patients and can increase the morbidity and mortality of these patients. As a result, clinicians in low-resource countries such as Somalia should be more vigilant about kidney injury in patients with severe COVID-19.

Function of the waterfowl nests as reproduction and living areas for leeches (Annelida: Hirudinea).

Some species of leeches migrate into waterfowl nests and use these both as general habitats and to deposit cocoons, but ecological associations between leeches and birds are not well understood. In the present study, characteristics of waterfowl nests both as living area for leeches (Hirudinea) and as reproduction areas for select hirudinid leeches (Hirudo verbana and Haemopis sanguisuga) was investigated in both natural and controlled laboratory conditions. A total of 48 leeches were detected in 23 of the 51 nests surveyed in natural habitats. The leeches were detected more frequently but there were less dense populations in the nests of the great crested grebe (Podiceps cristatus) (frequency: 57 %, population density: 0.71 ± 0.76 leeches/nest), and leeches were detected less frequently but there were more dense populations in the nests of coots (Fulica atra) (frequency: 36 %, population density: 0.91 ± 1.70 leeches/nest). Although the hirudinid leeches naturally reproduce between June and September, cocoons were only detected in August and September, when the nests were not actively used by the waterfowl and when water depths were less. In laboratory conditions, gravid medicinal leeches prefer moist peat rather than waterfowl nests for cocoon deposition. Results from the present study indicate leeches more frequently use the nests of coots, which have both dry and wet layers, compared to the nests of the great crested grebe, which have only a wet layer. Leeches were also found to be more prevalent in bird nests during spring months, during the reproductive periods of the waterfowl.

Investigation on the Collection and Economy of Medicinal Leeches from Wetlands Around Lake Egirdir, Turkey.

OBJECTIVE: This study aimed to investigate the collection and economy of medicinal leeches from wetlands around Lake Egirdir, Turkey. METHODS: Data used in this study were based on findings, observations, and face-to-face interviews obtained from a research performed between January 2013 - February 2016 on medicinal leech populations. RESULTS: The leech collecting is carried out without any permission, by both local peoples and others especially who are from Afyonkarahisar. This causes legal problems among leech collectors. Leech collecting is not done as main job. Using small leeches (<1.5 g) that have not reached a mature size for medicinal purposes impacts the collected leech size and their market price. Leeches are sold for 40-1000 TL/kg (1 TL=0.25 €) according to season, product abundance, demand intensity, and leech size. Because of leech collecting is carried out without under an economic organization, there is no effect of leech collectors at determining the sale price of leeches. According to the catchable stock size, the export potential of medicinal leeches is approximately 1,200,000 € from wetlands around Lake Egirdir. CONCLUSION: The rational management of medicinal leech populations, socioeconomic benefits, sustainable products, and ecological balance will be provided by operating wetlands around Lake Egirdir according to stock estimation studies at regular intervals and by evaluating effective marketing options under a cooperative.

A Rare Cause of Acute Abdominal Pain: Splenic Infarct (Case Series).

Splenic infarcts are rare cases. It may not be noticed in the emergency department because the clinical picture is likely to mimic various acute abdominal pains. The splenic infarct is often the result of systemic thromboembolism associated with cardiovascular disorders. The aim of this study is to present an evaluation of the patients that presented to the emergency department (ED) with abdominal pain and were diagnosed with splenic infarct.