Abdominal cocoon syndrome, a diagnostic challenge affecting the treatment. A rare case report from Somalia.

Abdominal cocoon syndrome is defined as idiopathic encapsulation of the bowel within a fibrocollagenous membrane and is considered as a rare cause of small bowel obstruction. A 15-year-old female presented complaining of right lower abdominal pain, distension and vomiting for 24 hours with previous similar attacks in the last four years. She had no another significant medical or surgical history. Computed tomography study revealed matted mildly distended bowel loops centrally with a suspicion of acute appendicitis. Next day, abdominal pain was the only clinical finding and acute appendicitis was the primary diagnosis. During surgery, most of the small bowel was found to be encapsulated within a cocoon-like fibrous membrane. The appendix was congested. Appendectomy, full resection of the membrane and dense adhesiolysis were performed. Herein, we will present the first reported case from Somalia and discuss the radiological findings affecting the management for such a rare disease.

Hypertension and its complications are also common in low-resource specialty clinics.

The spectrum of cardiovascular diseases in an outpatient low-resource rural specialty tertiary center is not well documented. The study aimed to determine the spectrum of cardiovascular diseases in this setting. We analyzed the medical records of 748 patients with complete data between June 1 and December 31, 2017. The mean age was 49.11 ± 14.47 years. The females were younger than the males (46.21 ± 14.78 vs. 53.64 ± 13.29 p value < 0.001). Hypertensive heart disease was the most common disorder (416 cases, 55.6%). Two hundred and five patients had heart failure (49.28%), while peripartum cardiomyopathy occurred in 8.33%. Seventy-five patients had valvular heart disease, 68% due to rheumatic heart disease.

Magnitude and associated factors of stillbirth among women who gave birth at Hiwot Fana Specialized University Hospital, Harar, eastern Ethiopia.

INTRODUCTION: According to WHO, there are nearly 2 million stillbirths every year, one every 16 seconds. The objective of our study was to assess the frequency and associated factors of stillbirth among women who gave birth at Hiwot Fana Specialized University Hospital, Harar, eastern Ethiopia, 2021. METHODS: An institution-based retrospective cross-sectional study of medical records was conducted among 336 women who gave birth from 1 January 2020 to 31 December 2020. Maternal medical records were selected by systematic random sampling technique and a pre-tested checklist was used to collect data. Data entry and analysis were done using SPSS-version 20. Bivariate and multivariate logistic regressions were performed to identify factors associated with stillbirth. Adjusted odds ratios with 95% confidence intervals are reported. RESULTS: The frequency of stillbirth was 12.5% (95% CI: 8.1-14.6). Preterm delivery (AOR=8.10; 95% CI: 3.01-21.79), non-booking for antenatal care (AOR=2.8; 95% CI: 1.14-6.88), antepartum hemorrhage (AOR=3.16; 95% CI: 1.10-9.04), obstructed labor (AOR=2.56; 95% CI: 1.85-7.93) and eclampsia (AOR=2.84; 95% CI: 1.45-6.98) were found to be statistically significantly associated with stillbirth. CONCLUSIONS: The frequency of stillbirth in this study was high. Prematurity, non-booking for antenatal care, ante-partum hemorrhage, obstructed labor and eclampsia were independently associated for stillbirth. Therefore, we recommend that the health professionals should better work on prevention of preterm birth, active emergency obstetrical and neonatal care by boosting focused antenatal care follow-up with health education on danger signs.

Hypokalemic Periodic Paralysis in Pregnancy: A Case Report.

Background: Myopathy is a disorder of skeletal muscles and has a rare occurrence in pregnancy. It may present with numbness/weakness. The occurrence of isolated weakness involving all the limbs is alarming to the patient and the diagnosis can be challenging to the Obstetrician. We present a case of hypokalaemic paralysis in pregnancy. Case report: A 32-year-old grand multipara presented at 31 weeks gestation with numbness in all limbs for nine days and one-day history of weakness in all limbs. She had a similar episode in her last pregnancy with complete resolution by the end of puerperium. On examination, she was conscious with a Glasgow Coma Scale score was 15/15, had no signs of meningeal irritation, and no cranial nerve palsy. She had normal muscle bulk; the power of 4/5 in both upper limbs and 3/5 in both lower limbs. There was no clearly defined sensory level. Planter reflex was flexor symmetrically. A review of other systems was unremarkable. Her PCV was 35% and random blood glucose was 4.2mmol/l. Serum biochemistry showed severe hypokalaemia of 1.8mmol/l with normal levels of sodium and chloride. Urinary potassium level was normal. She had parenteral correction of potassium with complete resolution of weakness, and she was maintained on oral potassium supplements. She had an uneventful delivery at 37 weeks gestation. Conclusion: Measuring the serum level of potassium should be part of the initial workup when evaluating pregnant women presenting with muscle weakness. Multidisciplinary management leads to early diagnosis, prompt management, and a good prognosis.

Personality and Subjective Well-Being: Towards Personalized Persuasive Interventions for Health and Well-Being.

Subjective well-being (SWB) is an individual's judgment about their overall well-being. Research has shown that activities that elevate people's sense of SWB have a significant effect on their overall health. There are two dimensions of SWB: Affective and Cognitive dimensions. However, studies on SWB usually focus more on one dimension, ignoring the other dimension. Also, most existing studies on SWB focused on individuals from Western cultures. Research has shown that the influence of personality on subjective well-being is moderated by culture. Thus, to advance research in personalizing persuasive health interventions, this study focuses on Africans (n=732). Specifically, we investigate the relationship between the Big-Five personality traits and both dimensions of SWB using the constructs: Happiness, Satisfaction with Life, Social, Psychological and Emotional well-being. Our results reveal that health informatics designers who design persuasive technologies to promote SWB would need to tailor designs along personality traits and SWB constructs. Accordingly, for users high in Agreeableness, the design should be focus on promoting their feelings of Happiness and Social Well-being. For users who exhibit Neuroticism, designers should focus on designing to promote Psychological well-being and Emotional well-being. Based on our findings, we offer guidelines for tailoring persuasive health interventions to promote individuals' SWB based on their personality. We thus highlight areas personal health informatics design can benefit. CCS CONCEPTS: • Human-centered computing → Personalization → HCI design and evaluation methods → User models.

Serum lipid profile and correlates in newly presenting Nigerians with arterial hypertension.

BACKGROUND: Arterial hypertension and dyslipidemia are modifiable cardiovascular risk factors. The multiplicative effect of these risk factors may worsen the atherogenic index of an individual. The objective of this study was to determine the pattern and prevalence of dyslipidemia in newly presenting Nigerians with arterial hypertension, as well as determine some of its correlates. METHODS: This cross-sectional study compared 115 newly presenting, age- and sex-matched individuals with arterial hypertension with 115 normotensive individuals. Fasting lipids, total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and fasting plasma glucose were estimated. RESULTS: Patients with arterial hypertension had higher body mass index (t=7.64; P=0.000), TC (t=2.95; P=0.006), and HDL-C (t=-5.18; P=0.000). The most common dyslipidemia was low HDL-C, found in both the hypertensive (44.3%) and normotensive (20.9%) patients. The prevalence of dyslipidemia in hypertensives and controls was 64% and 39%, respectively. In hypertensive patients, TC correlated positively to diastolic blood pressure (r=0.218; P=0.0019). Other positive correlates include LDL-C and age (r=0.217; P=0.020) and fasting plasma glucose (r=0.202; P=0.030) and body mass index (r=0.209; P=0.025). Among normotensive controls, TC correlated positively with LDL-C (r=0.63; P=0.000) but correlated negatively with tri glycerides (r=-0.30; P=0.001). CONCLUSION: Lipid abnormalities are common in newly presenting Nigerians with arterial hypertension. Screening of these risk factors, promotion of healthy lifestyle, and the institution of therapy is desirable to reduce their multiplicative effects.