Archive : Volume - 2, Issue - 12, Month - December
1 Historical Overview of Nursing and Midwifery Education and Nursing Workforce in Rwanda
- Harerimana Alexis* ,
- N G Mtshali ,
- Donatilla Mukamana ,
- Julie Kimonyo ,
- Camille N. Kayihura ,
- John Mugarura
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Abstract : Nursing education in Rwanda is undergoing rapid transformation. The literature reveals that the training of nurses and midwives in Rwanda started during the colonial era. Many of the nursing schools were opened by religious institutions such as Catholics, Protestants and Adventists, some being public and private. During 1980s there was a great transformation in nursing education in Rwanda, mainly by phasing out medical assistants, and education was restructured and the secondary program was fixed to 6 years; the nursing program was integrated in secondary education. In 1994, the Genocide against the Tutsi has seriously affected all sectors of life especially nursing. After the 1994 Genocide against the Tutsi, the Government of Rwandan invested in training nurses at various levels, and many public and private nursing and midwifery schools were opened. In 2007, a competency based approach was introduced in nursing education, and Public nursing schools were permitted to train nurses and midwives with advanced diploma (A1). Today, with the support from the Government of Rwanda, Nursing and Midwifery profession is becoming a pillar and cornerstone of Rwandan Health system.
Keyword : History of nursing in Africa, Nursing education in Rwanda, transformation of education in Rwanda, Nursing work force in Rwanda.
2 Myasthenia Gravis And Rhabdomyolysis In A Patient With Advanced Renal Cell Cancer Treated With Nivolumab: A Case Report And Review Of The Literature
- Danova Andrea Lopez* ,
- Alejandro R Calvo ,
- Adam Fershko
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Abstract : Nivolumab is a fully human monoclonal antibody against programmed cell death 1 receptor (PD-1). Acting as an immune checkpoint inhibitor, it has emerged as a promising therapeutic method for advanced malignancy, inducing durable responses in patients with solid tumors. It can be associated to very unusual immune mediated toxicity against multiple tissues. Here, we describe a patient with metastatic clear cell renal cell carcinoma, who received nivolumab as fourth line therapy and experienced muscular weakness and pain secondary to rhabdomyolysis and myasthenia gravis. This case portrays a very uncommon yet potentially fatal side effect of nivolumab, seen in less than 1% of patients across all clinical trials. As immunotherapy evolves and its efficacy is proven in more tumor types, the overall use of this class of drugs will increase and their uncommon side effects may be evident more frequently. To our knowledge, this is the first case of fatal myasthenia gravis reported in a patient with renal cell carcinoma treated with anti-PD1 therapy.
Keyword : Myasthenia Gravis, Rhabdomyolysis, renal cell carcinoma, nivolumab, Anti PD-1 blockade immunemediated side effects
3 HEMANGIOMA OF PARASPINAL MUSCLES MASQUERADING COLD ABSCESS A RARE CASE REPORT
- Sohael M Khan* ,
- Mridul A Arora ,
- Shounak Taywade ,
- Shraddha K Singhania ,
- Pradeep K Singh ,
- Karan K Mane
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Abstract : Hemangiomas are abnormal proliferations of blood vessels, making up 7% of all benign soft tissue tumors. Their true incidence and prevalence are difficult to calculate, as the majority of lesions are small and asymptomatic. These lesions are largely congenital, but approximately 20% can be linked to trauma. They are very rare in paraspinal muscles. The prevalence of tuberculosis and cold abscess is quite high in our clinical setting. we are reporting a rare case report of hemangioma in paraspinal region mimicking as cold abscess. Intramuscular haemangiomas are very rare and paraspinal involvement being even rarer. Though tubercular abscess is common clinical problem, paraspinal Haemangioma should be considered as differential diagnosis.
Keyword : Hemangioma, Cold abscess, Paraspinal Muscle
4 Postprandial Hypertriglyceridemia among Type-2 Diabetes Mellitus Patients of Chittagong, Bangladesh
- Md Golam Abbas* ,
- Mizanur Rahman ,
- Mahmudul Haque ,
- Naila Al Mahmuda ,
- Abul Kashem
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Abstract : Diabetes mellitus (DM) is a metabolic disorder of multiple aetiology characterized by chronic hyperglycemia with disturbances of carbohydrate,fat and protein metabolism resulting from defects in insulin secretion, insulin action,or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessels. A case-control study was carried out in Chittagong Medical College, Chittagong, Bangladesh during the period of January 2012 to December 2012. The samples were collected from the department of Medicine, Chittagong Medical College Hospital. The age limits of the patients were from 30-70 years. The data were collected by a structured questionnaire including age, sex, blood pressure, total cholesterol. Total numbers of patients were 90 of which 50 were considered as cases (All type-II diabetic patients having (i) age 30-70 years (ii) Fasting blood sugar ≥ 7 mmol /L. (iii) Random blood sugar ≥11.1 mmol/L. (iv) 2 hrs. after oral glucose load is ≥ 11.1mmol/L and 40 controls (non-diabetic, age 30-70 years, absence of renal, liver and cardiovascular diseases). The study was designed to observe the postprandial triglyceride level in type-II diabetic patients. The mean fasting triglyceride level of cases was 210.70 (±19.5) and the 2hrs, 4hrs and 6hrs after test meals were 238.9 (±22.75), 260.5 (±15.36), and 260.32 (±5.94) respectively. At the same time the mean fasting triglyceride of the control was 173.75 (±19.86) and the corresponding mean of the control were 189.75 (±15.23), 174.38 (±16.49) and 173.88 (±15.79) mg/dl respectively. The fasting and postprandial (2hrs, 4hrs and 6hrs) triglyceride levels were significantly higher than that of corresponding control. There are also significant differences of triglyceride level in fasting and 2hrs, 4hrs and 6hrs after test meal among the cases which indicated that the triglyceride levels remained eleva
Keyword : Type 2 diabetes mellitus, Triglyceride (TG), Cholesterol
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