Management of a huge cystic multi-nodular goiter with retro-sternal extension. Case report.

Introduction And Importance: Surgical management of huge multi-nodular goiters present clinical and surgical management dilemma among practicing surgeons. Thyroidectomies pose huge risk potential when performed by relatively inexperienced and junior operators.

Case Presentation: We present a case of a 40-year-old lady who had presented at our center with a ten-year history of painless anterior neck swelling.

Association of Opioid Use Disorder-Related Service Trajectories during Pregnancy and Postpartum Health Service Use: A Group-Based Multitrajectory Modeling Study.

Objective: The aim of the study was to examine the relationship between opioid use disorder (OUD)-related service trajectories during pregnancy and postpartum emergency department (ED) and hospitalizations.

Methods: We used the Merative MarketScan Commercial Claims and Encounters Database (2013-2021) to identify a cohort of pregnant individuals with OUD. We used group-based multitrajectory modeling to identify opioid-related treatment and service trajectories during pregnancy and examined their association with postpartum ED and hospital utilization.

Geriatric spontaneous trans-mesenteric herniation leading to death. Case report.

Introduction And Importance: Spontaneous trans-mesenteric hernia is a rare entity in adults. Its pre-operative diagnosis is challenging even with Computed Tomography Scanning. Most cases are diagnosed as incidental findings during laparotomy or postmortem.

Infection prevention and control of highly infectious pathogens in resource-limited countries: an experience from Marburg viral disease outbreak in Kagera Region - Tanzania.

Marburg viral disease (MVD) is a highly infectious disease with a case fatality rate of up to 90%, particularly impacting resource-limited countries where implementing Infection Prevention and Control (IPC) measures is challenging. This paper shares the experience of how Tanzania has improved its capacity to prevent and control highly infectious diseases, and how this capacity was utilized during the outbreak of the MVD disease that occurred for the first time in the country in 2023.In 2016 and the subsequent years, Tanzania conducted self and external assessments that revealed limited IPC capacity in responding to highly infectious diseases.

Antibiotic utilization patterns in Tanzania: a retrospective longitudinal study comparing pre- and intra-COVID-19 pandemic era using Tanzania Medicines and Medical Devices Authority data.

Background: Antimicrobial resistance (AMR) is a growing public health concern globally, and misuse of antibiotics is a major contributor.

Objective: This study investigated antibiotic utilization patterns before and during the COVID-19 pandemic in Tanzania using data from the Tanzania Medicines and Medical Devices Authority (TMDA).

Methods: This retrospective longitudinal study analysed secondary data.

Comparison of knowledge, attitude, practice and predictors of self-medication with antibiotics among medical and non-medical students in Tanzania.

Self-medication with antibiotics (SMA) is a widespread problem in developing nations, including Tanzania. This study compared knowledge, attitudes, practices, and factors influencing antibiotic SMA among medical and non-medical students. The prevalence of SMA among medical students was 49.

Medieval (arrow) weapon injuries in contemporary surgical practice: Impaled posterior thoracic wall arrowhead leading to haemo-thorax: Management protocols. Case report.

Introduction And Importance: Arrow injuries are rare in modern surgical practice. However, there are still case reports in tribal and guerrilla conflicts in rural settings were arrows are still used as weapons. Since the discovery of gun powder, guns and explosives have been the preferred effective assault weapons.

Management of a road traffic accident poly-trauma patient in a limited regional resource hospital setting in Tanzania: Review of literature and case report.

Introduction And Importance: Poly-trauma is among the top ten leading causes of mortality and morbidity in developing countries. Road traffic injuries are the major cause of mortality in the overall burden of deaths related to injuries. The aim of this publication is to show how important are the principles of management in saving life even in austere limited resource settings.

National Antibiotics Utilization Trends for Human Use in Tanzania from 2010 to 2016 Inferred from Tanzania Medicines and Medical Devices Authority Importation Data.

Antimicrobial use (AMU) is one of the major drivers of emerging antimicrobial resistance (AMR). The surveillance of AMU, which is a pillar of AMR stewardship (AMS), helps devise strategies to mitigate AMR. This descriptive, longitudinal retrospective study quantified the trends in human antibiotics utilization between 2010 and 2016 using data on all antibiotics imported for systemic human use into Tanzania's mainland.

Lycium barbarum Polysaccharide Ameliorates Sjögren's Syndrome in a Murine Model.

Scope: This study aims to evaluate the therapeutic efficacy and mechanisms of Lycium barbarum polysaccharide (LBP) in primary Sjögren's syndrome (pSS).

Methods And Results: Non-obese diabetic mice (the pSS model) are randomly divided into four groups: Low dose LBP (LBP.L, 5 mg kg  d ), high dose LBP (10 mg kg  d ), low dose interleukin (IL)-2 (25 000 IU/d), and control (saline water).

Standard Urine Collection Bag as an Improvised Bogotá Bag as a Temporary Abdominal Closure Method in an Open Abdomen in Preventing Abdominal Compartment Syndrome.

Primary abdominal wall closure post laparotomy is not always possible. Certain surgical pathologies such as degloving anterior abdominal wall trauma injuries and peritoneal visceral volume and cavity disproportion render it nearly impossible for the attending surgeon to close the abdomen in the first initial laparotomy. In such surgical clinical scenarios leaving the abdomen open might be lifesaving.

Surgical Approach in Management of Posttraumatic Diaphragmatic Hernia: Thoracotomy versus Laparotomy.

Breach in diaphragmatic musculature permits abdominal viscera to herniate into the thoracic cavity. Time of presentation and associated injuries determines the surgical approach in management. This case report sets to highlight the challenges in clinical diagnosis, radiological interpretation, and surgical management approaches of posttraumatic diaphragmatic hernia.

Clinical profiles of diabetic foot ulcer patients undergoing major limb amputation at a tertiary care center in North-eastern Tanzania.

Background: Diabetic foot ulcers complications are the major cause of non-traumatic major limb amputation. We aimed at assessing the clinical profiles of diabetic foot ulcer patients undergoing major limb amputation in the Surgical Department at Kilimanjaro Christian Medical Centre (KCMC), a tertiary care hospital in North-eastern Tanzania.

Methods: A cross-sectional hospital-based study was conducted from September 2018 through March 2019.

Major publications in the critical care pharmacotherapy literature: 2019.

Purpose: To summarize selected meta-analyses and trials related to critical care pharmacotherapy published in 2019.

Materials And Methods: The Critical Care Pharmacotherapy Literature Update (CCPLU) Group screened 36 journals monthly for impactful articles and reviewed 113 articles during 2019 according to Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria.

Results: Articles with a 1A grade, including three clinical practice guidelines, six meta-analyses, and five original research trials are reviewed here from those included in the monthly CCPLU.

Point prevalence survey of antimicrobial use in three hospitals in North-Eastern Tanzania.

Background: Antimicrobial resistance (AMR) is one of the most urgent global health threats with low-resource countries being disproportionately affected. Targeted interventions require insight in antibiotic prescription practices. A point prevalence survey (PPS) is a well-known tool to get insight in antibiotic dispensing practices in hospitals and identify areas for improvement.

The utility of smartphone-based, ecological momentary assessment for depressive symptoms.

Background: Major Depressive Disorder (MDD) is a common and debilitating mood disorder. Individuals with MDD are often misdiagnosed or diagnosed in an untimely manner, exacerbating existing functional impairments. Ecological momentary assessment (EMA) involves the repeated sampling of an individual's symptoms within their natural environment and has been demonstrated to assist in illness assessment and characterization.

Divergent Roles of Kupffer Cell TLR2/3 Signaling in Alcoholic Liver Disease and the Protective Role of EGCG.

Background & Aims: Toll-like receptor 2 (TLR2) and TLR3 regulate hepatic immunity under pathological conditions, but their functions and potential drug targets in alcoholic liver disease (ALD) remain poorly understood.

Methods: ALD-associated liver injury were induced in TLR2 knockout (TLR2), TLR3, TLR2 bone marrow transplanted (BMT), TLR3 BMT, IL-10 mice, and their wild-type littermates through ethanol challenge with or without co-administered epigallocatechin-3-gallate (EGCG). Moreover, Kupffer cells were depleted by GdCl injection to evaluate their pathogenic roles in ALD.

Aberrant brain structural-functional connectivity coupling in euthymic bipolar disorder.

Aberrant structural (diffusion tensor imaging [DTI]) and resting-state functional magnetic resonance imagining connectivity are core features of bipolar disorder. However, few studies have explored the integrity agreement between structural and functional connectivity (SC-FC) in bipolar disorder. We examine SC connectivity coupling index whether could potentially provide additional clinical predictive value for bipolar disorder spectrum disorders besides the intramodality network measures.

Wolfberry-Derived Zeaxanthin Dipalmitate Attenuates Ethanol-Induced Hepatic Damage.

Scope: Besides abstinence and nutritional support, there is no proven clinical treatment for patients with alcoholic fatty liver disease (AFLD). Here, the therapeutic effects and mechanisms of action of wolfberry-derived zeaxanthin dipalmitate (ZD) on AFLD models are demonstrated.

Methods And Results: The hepatoprotective effects of ZD are evaluated in vitro and in vivo.

Depression Characterization and Race Among Stroke Survivors Receiving Inpatient Rehabilitation.

Race and ethnicity play a significant role in poststroke outcomes. This brief report describes the presence of depression among stroke survivors who received inpatient rehabilitation and whether depression differs by race. Data from eRehabData and electronic medical records were analyzed for patients who received rehabilitation after an acute ischemic or hemorrhagic stroke.

Garlic-derived compound -allylmercaptocysteine inhibits hepatocarcinogenesis through targeting LRP6/Wnt pathway.

Whether and how garlic-derived -allylmercaptocysteine (SAMC) inhibits hepatocellular carcinoma (HCC) is largely unknown. In the current study, the role of low-density lipoprotein receptor (LDLR)-related protein 6 (LRP6) in HCC progression and the anti-HCC mechanism of SAMC was examined in clinical sample, cell model and xenograft/orthotopic mouse models. We demonstrated that SAMC inhibited cell proliferation and tumorigenesis, while induced apoptosis of human HCC cells without influencing normal hepatocytes.