Sina Hospital Research Articles

Monitoring of Hemophilia A in Morocco

Hemophilia A is a hemorrhagic disorder caused by a deficiency in factor VIII coagulation. Its incidence is 1 to 2 per 10,000 male births. Hemophilia A is characterized by intra-articular, mucosal, or cutaneous bleeding, and its management relies on the substitution of factor VIII with plasma derived or recombinant products. However, the major complication of treatment is the development of anti-factor VIII inhibitors, rendering substitution therapy ineffective. The aim of this study is to investigate the prevalence of anti-factor VIII inhibitors, the severity of hemophilia, and the follow-up of hemophilia patients developing anti-FVIII inhibitors in a hemophiliac population by presenting their epidemiological and biological characteristics. We conducted a retrospective descriptive cross-sectional study at the Central Hematology Laboratory of the Ibn Sina Hospital Center in Rabat (Morocco) over a period of 37 months, from December 1, 2020, to December 31, 2023. The study included 172 hemophilia A patient, with a mean age of 25 years. 55 patients developed anti-FVIII inhibitors (32%). The majority of positive inhibitor hemophiliacs were severe hemophiliacs (87%), including 23 cases of low responders (42%) and 32 cases of high responders (58%). The results obtained partly agree with most national studies (H. Mamad 2021, Y. El Aissaoui 2016, and F. Zizi in 2011), and international ones. However, the development of inhibitors varies from one individual to another according to several criteria (genetic and non-genetic).

Relationship of Stress and Insomnia with Depression among Health Care Workers in Hamadan, Iran: Application of Path Analysis

Objectives: Various causal pathways play a role in the occurrence of depression in healthcare workers. This study aimed to assess the effect of perceived stress and insomnia on depression in healthcare workers using path analysis in Hamadan, Iran. Methods: In this cross-sectional study, healthcare workers from Shahid Beheshti and Sina hospitals in Hamedan in 2023 were recruited. Perceived stress with two subscales of perceived helplessness and perceived self-efficacy, as well as insomnia and depression, were investigated using validated questionnaires. The path analysis was applied to assess the association. Results: In total, 235 healthcare workers (35.7% nurses) were included. Gender, age, monthly working hours, and number of night shifts per month had a significant impact on depression (P<0.05). Path analysis demonstrated that except for the effect of perceived self-efficacy on insomnia, all standardized regression weights for relationships were statistically significant (P<0.05). The effect size of perceived helplessness on depression was the strongest compared to other relationships (standardized regression weight = 0.40). The direct effect of perceived helplessness and perceived self-efficacy on depression or insomnia as a mediator had a good fit to the data. Conclusion: As evidenced by the obtained results, with the implementation of intervention and preventive programs to reduce stress and improve sleep, the occurrence of depression in healthcare workers is expected to decrease significantly.

COMMUNITY SERVICE TO INCREASE PATIENT AWARENESS IN OSTEOARTHRITIS DISEASE PREVENTION AT IBNU SINA HOSPITAL, PANAKUKANG DISTRICT MAKASSAR

This study aimed to investigate the relationship between Presbycusis, Elderly, Osteoarthritis Audiometry, and risk factors such as obesity, lack of physical activity, and injury to the joints. The research method used was a survey using questionnaires distributed to the elderly at Ibnu Sina Hospital, Panakkang District, Makassar. The results showed a significant correlation between the conditions of presbycusis, osteoarthritis, and the mentioned risk factors. The implication of this research is the importance of increasing public awareness and knowledge of osteoarthritis prevention and management through targeted and interactive education, such as using banners that are easy to understand and involve direct discussions with the community. This is expected to reduce the incidence of osteoarthritis and reduce the burden of medical costs and improve the quality of life of the elderly.

Correlation Between Heart Disease Clinics Based on NYHA Classification and CTR on Thorax Photos at Ibnu Sina Hospital Makassar

Heart disease is caused by damaged heart muscle cells that pump blood throughout the body. The cause is due to a lack of oxygen carried by the blood to the blood vessels in the heart or because spasms in the heart muscle result in failure of the heart's function to pump blood. The heart cannot carry out its function properly, as many as 48% of Indonesians experience heart disease. To determine the level of heart disease, the New York Heart Association (NYHA) is used. Increasing NYHA in heart disease can result in an increase in heart size. To determine the correlation between clinical heart disease based on the NYHA classification and CTR results on chest x-rays. Total sampling through secondary data with certain criteria. NYHA 1 (P = 20.2), NYHA 2 (P = 33.3), NYHA 3 (P= 32.3), NYHA 4 (P= 14.1). The heart grade levels based on CTR examination results, no cardiomegaly (<50%) (p= 22.2), mild cardiomegaly (>50-55%) (p= 76.8), moderate cardiomegaly (56-60) (p=0 .0), severe cardiomegaly (>60%) (p=1.0) while symptoms of weakness (n = 57%), palpitations (n = 47%), no shortness of breath (n = 68%), no chest pain ( n = 50%). So there is a significant relationship between NYHA classification and CTR results on Thorax photos. In conclusion, there is a significant relationship between NYHA classification and CTR results on Thorax photos.

Characteristics of Hypertension Patients with Chonic Kidney Disease at Ibnu Sina Hospital, Makassar City Year 2022-2023

Hypertension is a condition where the systole is more than or equal to 140 and the diastole is more than or equal to 90 mmHg. In Indonesia the number of hypertension sufferers reaches 70 million people. The prevalence of hypertension in adults is 6-15%. Hypertension that has been going on for a long time and is not controlled, impacts the blood vessels in the kidneys and causes sclerosis of the blood vessels resulting in glomerular damage and tubular atrophy leading to kidney damage. methods: This is a descriptive study with a cross design sectional Results : Hypertension sufferers with the highest incidence of chronic kidney disease are aged 55-64 years (32.9%), the gender is mostly male (57.6%) while female (424%), with a long history of suffering from hypertension is ≥5 year (63,5%), the highest blood pressure control was found in uncontrolled blood pressure (56.5%), and the use of antihypertensive drugs in the form of CCB drugs (51.8%).Conclusion: Hypertensive patients with the incidence of chronic kidney disease at Ibnu Sina Hospital, Makassar City in 2022-23 are mostly at the age of 55-64 years, male with a long history of suffering from hypertension of 5-10 years and control of uncontrolled blood pressure and use of other types of antihypertensive medication, namely Calcium Channel Blocker (CCB).

Les agressions sexuelles sur mineurs : bilan d’activité de l’unité de médecine légale du CHU Ibn Sina de Rabat en 2022

Introduction: Child sexual abuse is a public health problem. The challenge for the forensic doctor is to correctly interpret the forensic examination findings.Objective: To study a population of victims of child sexual abuse who consulted at the forensic medicine unit of Ibn Sina Hospital in Rabat in 2022.Material and methods: Were collected demographic data, aggression modalities and victims’ examination findings.Results: Out of 125 children, there were 92 girls and 33 boys. The median age was 14 [8;16] years old. Normal genital examinations concerned 23 (36.4%) victims who had undergone vaginal penetration. When abnormal, genital examination showed recent hymeneal tearing in 5% of cases (n = 3) and non-specific signs in the rest of the cases. Normal anal examination concerned 51.2% (n = 42) of the victims who had undergone anal penetration. When abnormal, anal examinations showed a recent anal fissure in three victims (6.97%) and non-specific signs in the rest of the cases. Clinical examinations were considered compatible with the reported facts for 32 victims (25.6%).Conclusion: In child sexual abuse, the examination is frequently normal. The lesions, if present, must be interpreted taking into account several factors (inter alia, consultation time) and, at best, by an experienced forensic doctor.

FACTORS ASSOCIATED TO BURN-OUT AMONG IBN SINA HOSPITAL PUBLIC HEALTH PROFESSIONALS

Burn-out or exhaustion syndrome is caused by a prolonged exposure to a chronic professional stress. Public Health Professionals are the most exposed to this kind of risk. The ulti- mate goal here is to determine the prevalence of the burn-out and search for factors associated with this pathology among those who work in the field of health.Our sample, which is from the Ibn Sina Hospital in Rabat, consists of 150 nurses, 80 doctors, and 40 administrators. A self-questionnaire was employed, the Maslach Burnout In- ventory (MBI) as well as a clinical interview.The results of this study show a high degree of burnout. Moreover, 56.66% of participants show a high level of emotio - nal exhaustion, 45.18% suffer from a high level of depression. Meanwhile, the loss of a sense of personal accom plish ment is high among 48.51% of those surveyed. The emotional exhaustion observed among people who have worked for a long time ago is associated with the means of transportation used and to the unsuitable hours of work. Depersonalization exists among elderly people and the oldest at work.This study confirms the existence of a high level of burnout among health professionals. Many socio-demographic and socio-professional factors contribute to the increase in the level that people are affected. These factors encourage the promotion of better working life conditions.

Knowledge, attitude, and practice of pre-diabetic older people regarding pre-diabetes.

One of the risk factors of diabetes is the pre-diabetes stage which is significantly prevalent in older people. Knowledge, attitude, and practice of the pre-diabetic stage are of great importance and can decrease complications. The present study aimed to determine the knowledge, attitude, and practice of the pre-diabetic older people. This cross-sectional study was conducted from April 2022 to August 2022 on 219 pre-diabetic older people referring to Sina Hospital in Tabriz, one of the most populated cities in the northwest of Iran. Data were collected using questionnaires of Knowledge, Attitude, Practice-Prediabetes Assessment Questionnaire (KAP-PAQ). The data were analyzed by SPSS 21. The mean scores of knowledge (in the range of 0-17), attitude (in the range of -10, + 10), and practice (in the range of 0-26) were 1.72 ± 1.0, 2.24 ± 1.92, and 5.76 ± 2.61, respectively. The older people's knowledge and practice levels in the pre-diabetes stage were low and about 50% of them had negative views. According to the Spearman correlation test, there was a positive significant relationship between the older people's knowledge and practice (p < 0.001, r = 0.234). The older people in the pre-diabetes stage had low knowledge and attitude and a negative viewpoint towards correcting lifestyle on diet, exercising and physical activity, weight control, diagnostic and screening methods. Increased knowledge about pre-diabetes and strengthened positive attitude towards correcting lifestyle through counseling as well as empowering the pre-diabetic older people can increase the efficiency of pre-diabetes prevention and control programs and prevent its progression to the diabetes stage.

Characteristics of Acute Diarrhea Patients in Toddlers at Ibnu Sina YW-UMI Hospital Makassar in 2021-2022

Acute diarrhea is defined as passing stool more than 3 times a day with a change in consistency to liquid, with or without mucus and blood, and lasting less than one week. Diarrhea remains an endemic disease and a significant contributor to mortality in Indonesia, especially among toddlers.The purpose of this research is to determine the characteristics of acute diarrhea patients in toddlers at Ibnu Sina Hospital Makassar in 2021-2022. The results showed the highest incidence of acute diarrhea found in the age group of 1 - &lt;3 years (53.1%), predominantly in males (53.1%), with good nutritional status (60.5%), experiencing vomiting symptoms (41.5%), experiencing dehydration (75.3%), and receiving exclusive breastfeeding (51.9%). The findings of this research lead to the conclusion that acute diarrhea in toddlers is most prevalent in the age group under three years old, predominantly in males, with good nutritional status, experiencing vomiting symptoms, suffering from dehydration, and receiving exclusive breastfeeding.

Comparison of The Effectiveness of E-C Positive Pressure Ventilation Technique and Modified Chinlift Positive Pressure Ventilation Technique in Mppd at Ibnu Sina Hospital

Mask ventilation skills are essential competencies for MPPD to master. According to SKDI, these skills include competency 4A, which is the ability to perform independently by mastering the theory, principles, indications, and steps. To date, there have been few studies evaluating the effectiveness of modified chinlift and E-C techniques regarding the tidal volume delivered (TV). Therefore, the researchers were interested in comparing the effectiveness of the E-C method and modified chinlift positive pressure ventilation technique in mask ventilation (MV) use. This study is a quantitative research with an observational analytical cross-sectional design. Researchers observed the treatments given by MPPD, totaling 22 individuals, to 6 research subjects. Data analysis for this research used Mann-Whitney and chi-square tests as Independence Tests. After applying the E-C technique, 43.8% out of 100% were successful, and 56.3% were not successful. Meanwhile, with the MCL technique, out of 100%, 40.6% were successful, and 59.4% were not successful. The E-C technique showed better results compared to the Modified Chinlift technique in MV, although statistically, the test results for the difference in success scores between the two techniques did not show any significant difference.

Oral Verrucous Carcinoma: Case Report

Verrucous carcinoma is usually considered a low-grade variant of squamous cell carcinoma. Our case is a 56-year-old woman presented to our department of maxillofacial surgery of Ibn Sina hospital in Rabat with a budding lesion of the upper lip evolving 2 years ago. The diagnosis retained was that of well-differentiated squamous cell carcinoma of the verrucous type with infiltration of the chorion. The therapeutic decision was to perform a surgical excision with a safety margin of 1 cm followed by suturing of the defect and commissuroplasty. Its diagnosis is based on clinical and histological features. The treatment is not well codified. Surgery remains the treatment of choice.

Evaluation of Carbapenemase-Resistant Enterobacteriaceae by Disk Diffusion Test and Polymerase Chain Reaction

Background: Carbapenemase-resistant Enterobacteriaceae is a major threat to public health. These microorganisms are resistant to all types of beta-lactam antibiotics. Methods: This cross-sectional study was conducted on 51 Enterobacteriaceae isolates from clinical samples in Sina Hospital and Tehran Heart Center in Iran from 2016 to 2018. Antibiotic susceptibility test was performed by disk diffusion method. Carbapenem-resistant isolates were identified by the Modified Hodge Test (MHT) and Polymerase Chain Reaction (PCR) for surveying the presence of VIM, NDM, IMMP, and OXA-48 genes. Results: Out of 51 clinical samples, 38 isolates were positive for both MHT and PCR tests, and 5 isolates were negative in both tests. The results of both tests are similar in 84.3% of the isolates. Conclusion: The MHT is an appropriate and easy method for approving carbapenemase production. Also, a laboratory can detect the carbapenemase production by identification of the KPC genes.

Implementation of Interprofessional Collaboration (IPC) in Patient Safety Efforts at Ibnu Sina Hospital, Makassar City

Implementation of Interprofessional Collaboration (IPC) in Patient Safety Efforts at Ibnu Sina Hospital, Makassar City

Relation of Serum Level of Tramadol With Consumption Dose and Time

Background: This study aimed to find out the relationship between the serum level of tramadol and consumption dose and the time interval between the drug consumption and arrival at the emergency department (ED). Methods: This was a prospective cross-sectional study that included all patients who came to the ED of Sina hospital, a poisoning center, due to the consumption or abuse of tramadol within 6 months. Among these patients, those with unreliable history and history of drug use, those whose primary toxicologic screening in the ED indicated opioids and buprenorphine, and those who used tramadol chronically due to underlying disease were excluded from the study. Demographic characteristics of the patients, the type of consumed drug, the reason for use, the type of complication, and the outcome of the patient extracted from the documentation, blood samples obtained from the patients after obtaining informed consent, and the serum level of tramadol were checked and recorded using the capillary electrophoresis (CE) device. Results: The study investigated the serum levels of tramadol in 43 male patients presenting to the ED due to tramadol consumption or abuse. The median age was 30 years. All patients were male, and the median dose of utilized tramadol was 2000 mg. The average time from consumption to referral was 6 hours, and 14% of patients experienced seizures after taking the medication. The median serum level of tramadol was 46.12 mmol/dL. Furthermore, quadratic regression analysis revealed no significant relationship between tramadol serum levels with the dose (P=0.233) and the interval (P=0.682) between drug consumption and seeking medical attention. Conclusion: These findings suggested that serum levels of tramadol do not correlate with the administered dose or the time elapsed before seeking medical help.

Malignant Adnexal Carcinoma of the Face: A Case Report

Malignant adnexal tumors (MAT) form a group of rare, typically low-grade- malignancy carcinomas with follicular, sebaceous, apocrine, or eccrine differentiation or a combination of the first 3 subtypes, the biopsy is required to establish the differentiation subtype and the definitive diagnosis. our case is a 67 years old female presented to our department of maxillofacial surgery of Ibn Sina hospital in Rabat with a left frontal skin lesion that had begun evolving 6 months ago. An excisional biopsy was performed afterwards using an elliptical excision with 1 cm of margins laterally and including the periost deeply, and then the sking defect was sutured in 3 layers. Malignant pilosebaceous tumors are more rare, especially those of the hair follicle. Sebaceous gland carcinoma commonly arises in the periorbital area. Surgical resection is the most commonly implemented treatment modality in MATs.

Is identification and dissection of the external laryngeal nerve necessary during thyroidectomy? A prospective study

BackgroundCompared to the recurrent laryngeal nerve, the EBSLN (or external laryngeal nerve) is less studied in terms of its course and relationship with the thyroid gland. This is a prospective intraoperative study designed to identify the anatomical variations of the EBSLN in relation to the IPC, the superior thyroid pedicle, and the point where the nerve crosses the STA. Additionally, the study aims to propose a technical procedure for its preservation.MethodsWe conducted a prospective study of 50 patients (total of 100 nerves) undergoing total thyroidectomy at the Department of Surgery ‘B’ in Ibn Sina Hospital, Rabat. Intraoperatively, the EBSLN was visually identified and preserved before ligating the superior thyroid vessels. Each nerve was categorized using established classification systems.ResultsThe overall pooled EBSLN identification rate was 82%. Cernea type IIa (nerves crossing the STA less than 1 cm above the upper edge of the superior thyroid pole) and Friedman type II (nerves piercing the lower fibers of the IPC) were the most prevalent (64% and 44%, respectively). Kierner type IV (nerves crossing the branches of the STA immediately above the upper pole of the thyroid gland) was represented in 27% of cases.ConclusionA better understanding of surgical anatomy of the neck allows for better results of thyroidectomy by preserving the external and recurrent laryngeal nerves.

Organizational Citizenship Behavior to Improve Nurse Performance in the Inpatient Department at Ibnu Sina Hospital Makassar

Organizational Citizenship Behavior to Improve Nurse Performance in the Inpatient Department at Ibnu Sina Hospital Makassar

Segmentation and classification of lungs CT-scan for detecting COVID-19 abnormalities by deep learning technique: U-Net model.

Artificial intelligence (AI) techniques have been ascertained useful in the analysis and description of infectious areas in radiological images promptly. Our aim in this study was to design a web-based application for detecting and labeling infected tissues on CT (computed tomography) lung images of patients based on the deep learning (DL) method as a type of AI. The U-Net architecture, one of the DL networks, is used as a hybrid model with pre-trained densely connected convolutional network 121 (DenseNet121) architecture for the segmentation process. The proposed model was constructed on 1031 persons' CT-scan images from Ibn Sina Hospital of Iran in 2021 and some publicly available datasets. The network was trained using 6000 slices, validated on 1000 slices images, and tested against the 150 slices. Accuracy, sensitivity, specificity, and area under the receiver operating characteristics (ROC) curve (AUC) were calculated to evaluate model performance. The results indicate the acceptable ability of the U-Net-DenseNet121 model in detecting COVID-19 abnormality (accuracy = 0.88 and AUC = 0.96 for thresholds of 0.13 and accuracy = 0.88 and AUC = 0.90 for thresholds of 0.2). Based on this model, we developed the "Imaging-Tech" web-based application for use at hospitals and clinics to make our project's output more practical and attractive in the market. We designed a DL-based model for the segmentation of COVID-19 CT scan images and, based on this model, constructed a web-based application that, according to the results, is a reliable detector for infected tissue in lung CT-scans. The availability of such tools would aid in automating, prioritizing, fastening, and broadening the treatment of COVID-19 patients globally.

Risk assessment for mortality in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: A retrospective cohort study.

Primary percutaneous coronary intervention (PCI) is the treatment of choice in ST-elevation myocardial infarction (STEMI) patients. This study aims to evaluate predictors of in-hospital and long-term mortality among patients with STEMI undergoing primary PCI. In this registry-based study, we retrospectively analyzed patients with STEMI undergoing primary PCI enrolled in the primary angioplasty registry of Sina Hospital. Independent predictors of in-hospital and long-term mortality were determined using multivariate logistic regression and Cox regression analyses, respectively. A total of 1123 consecutive patients with STEMI were entered into the study. The mean age was 59.37 ± 12.15 years old, and women constituted 17.1% of the study population. The in-hospital mortality rate was 5.0%. Multivariate analyses revealed that older age (odds ratio [OR]: 1.06, 95% confidence interval [CI]: 1.02-1.10), lower ejection fraction (OR: 0.97, 95% CI: 0.92-0.99), lower mean arterial pressure (OR: 0.95, 95% CI: 0.93-0.98), and higher white blood cells (OR: 1.17, 95% CI: 1.06-1.29) as independent risk predictors for in-hospital mortality. Also, 875 patients were followed for a median time of 21.8 months. Multivariate Cox regression demonstrated older age (hazard ratio [HR] = 1.04, 95% CI: 1.02-1.06), lower mean arterial pressure (HR = 0.98, 95% CI: 0.97-1.00), and higher blood urea (HR = 1.01, 95% CI: 1.00-1.02) as independent predictors of long-term mortality. We found that older age and lower mean arterial pressure were significantly associated with the increased risk of in-hospital and long-term mortality in STEMI patients undergoing primary PCI. Our results indicate a necessity for more precise care and monitoring during hospitalization for such high-risk patients.

Prostate Cancer in Patients with Enlarged Prostate, Ibn Sina Hospital, 2020

Prostate Cancer in Patients with Enlarged Prostate, Ibn Sina Hospital, 2020