Background: Pre-eclampsia (PET) is a potentially devastating multi-systemic disorder resulting in the generation of oxidative stress. Platelet activation causes vasoconstriction and release of inflammatory cytokines, resulting in an intensified inflammatory response, endothelial damage, and coagulopathy which culminate in adverse pregnancy outcomes. Aim: To compare the platelet parameters between preeclamptic and normotensive pregnant women and their relationship to adverse outcomes in women with pre-eclampsia. Materials and methods: This was a case-control study of platelet indices of 60 pre-eclamptic and 60 normotensive pregnant women recruited at 28 weeks and followed till delivery. A blood sample was collected at entry into the study and just before delivery. The sample was analyzed within 1 h of collection using the Mythic 18 hematological auto-analyzer. Data were analyzed using IBM-SPSS version 22. A P-value of <0.05 was considered statistically significant. Results: The mean platelet count, Platelet distribution width (PDW), plateletcrit were statistically significantly different between normotensive and severe preeclamptic participants (p¼ <0.001). Statistically significant differences were not present in any of the platelet parameters between mild and severe PET. The odds of developing eclampsia was low at higher mean platelet count and plateletcrit levels above 161.36 AE 73.74 Â 10 9 /L [p ¼ 0.02, AOR ¼ 0.27, 95% CI (0.08-0.88)] and 0.13 AE 0.05% [p ¼ 0.001, AOR ¼ 0.22, 95% CI (0.08-0.58)] respectively. Eclampsia was strongly associated with P-LCR (platelet-large cell ratio) above 23.15 AE 4.92% [p ¼ 0.004, AOR ¼ 11.00, ]. Abruptio placentae had low odds at lower levels of mean plateletcrit. Pre-term birth was significantly lower at mean plateletcrit levels above 0.14 AE 0.05%; admission into neonatal intensive care unit was strongly associated with a mean PLC ratio above 22.73 AE 5.91%. Conclusion: This study demonstrated significant differences in platelet count, plateletcrit, platelet distribution width, and P-LCR between pre-eclamptic and normotensive women. Increase in P-LCR is a risk factor for eclampsia although the effect size is low.
Background/Objective: Both athletes with and without disabilities can develop burnout symptoms. However, athletes with disabilities may face different or more challenges compared to their counterparts without disabilities. The present study aimed at ascertaining the effect of digital storytelling intervention on burnout thoughts of adolescent-athletes with disabilities. Method: This study is a randomized controlled trial involving a total of 171 adolescent-athletes with disabilities who showed a high degree of burnout symptoms. These adolescent-athletes were randomly assigned to either an intervention group ( n = 85) or a waitlisted control group ( n = 86). The treatment intervention for the adolescent-athletes was digital stories which were created based on the framework of rational emotive behaviour therapy (REBT). The Athlete Burnout Questionnaire was used for gathering of data at three different times (baseline, post-test and follow up). Data were analyzed using repeated measure analysis of variance at a significant level of 0.05. Results: Results showed that the digital storytelling intervention based on REBT significantly reduced burnout thoughts among disabled adolescent-athletes in the intervention group compared to athletes in the waitlisted control group as measured by the Athlete Burnout Questionnaire. Additionally, at follow-up evaluation, it was observed that the decrease in burnout scores was maintained by those athletes in the digital storytelling intervention. Conclusion: Digital storytelling intervention based on rational emotive behaviour therapy shows great potentials in addressing burnout among adolescent-athletes with disabilities.
To determine the prevalence of venous thromboembolism (VTE) among adult sickle cell disease (SCD) patients in Nigeria. Methods This was a multicentre retrospective study in which the medical records of adult SCD patients were reviewed. Information on demographics, steady‐state haemogram, clinical phenotypes, duration of follow‐up, history of VTE including risk factors and management was collected. Results Of the 509 SCD patients with a median (IQR) duration of follow‐up of 2 years, 10 (2.0%) had VTE (9 DVT and 1 PE). Their median (IQR) age was 27 (22.8–30.3) years. Identifiable risk factors for VTE included positive family history (2, 20%) surgery, splenectomy, paraplegia and cancer (1, 10% each). No risk factor was identifiable in four persons. VTE had no significant association with age and gender. VTE was significantly associated with the following events: acute chest syndrome [p = .002, odds ratio (OR) 8, 95% CI 2.2–28.9], osteonecrosis [p = .012, OR 5.24, 95% CI, 1.45–18.91] and vaso‐occlusive crisis [p = .035]. Also significantly associated with VTE were pulmonary hypertension [p = .001, OR 23.3, 95%CI 5.18–105.06] and stroke [p = .032, OR 9.35, 95%CI 0.87–53.25]. Conclusion The prevalence of VTE among SCD patients in Nigeria is low. It is significantly associated with vaso‐occlusive crisis, pulmonary hypertension and stroke.
Anaplastic large cell lymphoma (ALCL) is a rare variety of non-Hodgkin’s lymphoma with diverse morphologic variants. Due to the similarity of the different variants with other lymphoma entities, misdiagnosis may be inevitable when immunohistochemical and cytogenetic techniques are not available and histology alone is employed. We report a case of a 43-year-old woman with a seven-month history of neck swelling which was complicated by ulceration of the mass and pathological fracture of the right clavicle after two months delay in arriving at a correct diagnosis. Several attempts to arrive at definitive diagnosis using histology alone gave divergent reports which all misdiagnosed the case until it was sent to a facility outside the country. Our report highlights the limitations and challenges of histology in making a definitive diagnosis of ALCL and the overt importance of immunohistochemical and cytogenetic techniques which are largely unavailable in resource-constrained environment typical of tertiary centers in Nigeria and most sub-Saharan Africa countries.
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