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Research Article
Risk Factors Associated with Diphtheria Outbreak Among Patients Under 5 Years Attending de Martino Hospital Mogadishu, Somalia
Issue:
Volume 1, Issue 1, March 2026
Pages:
1-6
Received:
20 September 2025
Accepted:
2 February 2026
Published:
25 February 2026
Abstract: Background: In areas with poor vaccination rates, diphtheria, a dangerous acute infectious disease brought on by Corynebacterium diphtheria, remains a threat. Due to low vaccination uptake and undeveloped immunity, children under five are especially at risk. Objective: risk factors and describing the clinical characteristics of diphtheria in children under five who were enrolled in De Martino Hospital in Mogadishu were the objectives of this study. Methods: Eighty confirmed cases of diphtheria participated in a descriptive cross-sectional investigation. Structured questionnaires and a review of medical records were used to gather data. Age, gender, immunization status, clinical characteristics, complications, and results were among the variables evaluated. Findings: Of the 80 children, 43.8% were younger than two years old, and 35.0% were between three and four years old. With 50.0% of the population being female and 48.8% being male, the gender distribution was almost equal. Only 15.0% of people were fully vaccinated, 21.3% were partially vaccinated, and 63.8% were not immunized. The two most common symptoms were fever (100%) and sore throat (100%). The following conditions were also quite common: dysphagia (93.8%), respiratory distress (98.8%), cervical lymphadenopathy (96.3%), and pseudo membrane development (98.8%). 25% of patients had myocarditis, and 75% of patients experienced respiratory problems. Residence of the patients (45.0%) resided in Yaqshid, followed by 16.3% from Karaan and 8.8% from Shibis. Smaller proportions of patients came from Dharkenley (6.3%), Celasha Biyaha (5.0%), Deynile (3.8%), Hodan (3.8%), and other areas including Kaxda, Hilwa, Sh. Dhexe, Hirshabele, Balcad, and Tabelaha, each contributing 2.5% to 1.3% of cases. This distribution indicates that Yaqshiid and Karaan were the most affected areas, suggesting a potential geographic clustering of cases., 76.3% recovered from the disease, while 23.8% did not. 77.5% was survived, while 22.5% was died, children who were not vaccinated having a higher death rate. Conclusion: diphtheria is still a serious public health issue in Somalia affecting children under five. The most frequent clinical symptoms were fever, sore throat, and pseudo membrane formation, while the main risk factors were found to be incomplete immunization, malnutrition, and delayed healthcare-seeking behavior. Improved immunization campaigns, early diagnosis, and prompt treatment treatments are critically needed, as highlighted by the high case fatality rate.
Abstract: Background: In areas with poor vaccination rates, diphtheria, a dangerous acute infectious disease brought on by Corynebacterium diphtheria, remains a threat. Due to low vaccination uptake and undeveloped immunity, children under five are especially at risk. Objective: risk factors and describing the clinical characteristics of diphtheria in childr...
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Review Article
Septocolumellar Anchorage in Secondary Rhinoplasty:
A Cartilage-Sparing, Closed-Approach Strategy
Issue:
Volume 1, Issue 1, March 2026
Pages:
7-12
Received:
15 September 2025
Accepted:
10 February 2026
Published:
25 February 2026
Abstract: Background: Secondary rhinoplasty is recognized as one of the most technically demanding procedures within the domain of facial plastic surgery. This complexity arises primarily from the presence of distorted anatomical structures, scar contracture, and compromised structural support resulting from prior surgical interventions. Such alterations frequently result in diminished nasal tip projection, malrotation, columellar retraction, deviation, and dysfunction of the internal nasal valve. Conventional revision techniques often require open surgical approaches and structural grafting, including the utilization of costal cartilage, thereby increasing both the complexity and morbidity associated with the procedure. Purpose: This study aims to assess the clinical efficacy and reproducibility of septocolumellar anchorage as a cartilage-preserving technique for the restoration of nasal tip support and biomechanics in secondary rhinoplasty, primarily conducted through a closed endonasal approach. Methods: A retrospective descriptive study was conducted involving 26 consecutive patients who underwent revision rhinoplasty between April 2022 and October 2024, subsequent to primary surgery performed by a different surgeon. The indications for revision included diminished tip projection or rotation, columellar retraction, tip deviation, and functional airway compromise. Surgical intervention was performed under general anesthesia, primarily employing intercartilaginous and hemitransfixion incisions. Following the release of scar tissue and mobilization of the lower lateral cartilages, septocolumellar sutures were anchored to the anterosuperior angle of the caudal septum to ensure stable tip support. Selective use of adjunctive septal cartilage grafts was implemented, while no costal cartilage grafts were harvested. The minimum follow-up period was 12 months. Results: The patient cohort ranged in age from 20 to 64 years, with a mean age of 42.7 ± 12.1 years, and an average of 1.34 prior rhinoplasty procedures. A closed surgical approach was utilized in 73% of the cases. Restoration of nasal tip projection, rotation, and alignment was successfully achieved in all patients, accompanied by a consistent enhancement in nasal airflow in instances where preoperative obstruction was present. No major complications, structural failures, or requirements for tertiary revision were reported. Conclusions: Septocolumellar anchorage represents a dependable and reproducible cartilage-sparing technique in secondary rhinoplasty. It offers predictable biomechanical control over nasal tip dynamics while minimizing tissue dissection and obviating the necessity for costal cartilage grafting in appropriately selected patients.
Abstract: Background: Secondary rhinoplasty is recognized as one of the most technically demanding procedures within the domain of facial plastic surgery. This complexity arises primarily from the presence of distorted anatomical structures, scar contracture, and compromised structural support resulting from prior surgical interventions. Such alterations fre...
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Research Article
Response to COVID-19 Vaccines in Individuals with Chronic Kidney Disease: A Systematic Review and
Meta-analysis Protocol of Randomised Controlled Trials
Issue:
Volume 1, Issue 1, March 2026
Pages:
13-18
Received:
13 June 2025
Accepted:
29 January 2026
Published:
25 February 2026
Abstract: Since SARS-CoV-2 detection, the infection had spread globally resulting in insidious outcomes. The pathogenic mechanism of SARS-CoV-2 indicated that the virus does not only ignite respiratory distress, but can also adversely impact varying organs. Evidence shows patients with chronic kidney disease, particularly those on dialysis or who have received kidney transplant have been disproportionately impacted by SARS-CoV-2. This population group experience significant higher rates of infection, severe disease, hospitalization and mortality compared to the general population. However, long-term response and outcomes in relation to SARS-CoV-2 vaccines in people with chronic kidney disease requires further research. This systematic review and meta-analysis protocol, aims to compare the safety and efficacy of COVID-19 vaccines in patients with chronic kidney disease. We will include randomized controlled trials that assess and evaluates the safety and efficacy as outcomes of COVID-19 vaccines in chronic kidney disease patients. Medline, Embase, Web of Science, CINAHL, LILACS, SCOPUS, Cochrane Library, ClinicalTrials.gov will be searched from January 2020 to December 2025 for eligible studies. Three reviewers will independently screen, identify and select research studies that meet eligibility criteria, assess methodological quality and extract information. A meta-analysis will be performed, if possible and the grading of recommendations, assessment, development and evaluations summary of findings will be presented.
Abstract: Since SARS-CoV-2 detection, the infection had spread globally resulting in insidious outcomes. The pathogenic mechanism of SARS-CoV-2 indicated that the virus does not only ignite respiratory distress, but can also adversely impact varying organs. Evidence shows patients with chronic kidney disease, particularly those on dialysis or who have receiv...
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Case Report
Medical Management of Acromegaly in a Middle-aged Woman with Pituitary Macroadenoma and Metabolic Comorbidities: A Case Report
Abdelrahman Shehata*,
Ayesha Aijaz,
Ibrahim Ibrar,
Abia Gouher,
Muhammad Kamil Shahbaz,
Mahir Jallo
Issue:
Volume 1, Issue 1, March 2026
Pages:
19-23
Received:
13 July 2025
Accepted:
3 March 2026
Published:
19 March 2026
DOI:
10.11648/j.sdmed.20260101.14
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Views:
Abstract: A 62-year-old Iraqi woman exhibited progressive enlargement of her hands, feet, and facial features over several years, accompanied by poorly controlled type 2 diabetes mellitus, hypertension, and dyslipidemia—metabolic disorders that had become increasingly challenging to manage despite conventional treatment. These gradual physical changes, which are often very small in middle-aged and older people, eventually made doctors think that the person might have acromegaly. Biochemical testing confirmed the diagnosis by showing consistently high levels of growth hormone, no suppression on oral glucose tolerance testing, and insulin-like growth factor-1 concentrations that were much higher than normal for someone of the same age and sex. A macroadenoma measuring 14 × 12 × 9 mm was found on a pituitary magnetic resonance imaging scan. There was no suprasellar extension, optic chiasm compression, or visual field problems on formal testing. After a thorough discussion of treatment options, the patient opted against transsphenoidal surgery, citing personal preference and apprehensions about surgical risks, and instead chose to initiate primary medical treatment. She began taking Sandostatin LAR (octreotide), a long-acting somatostatin receptor ligand, at a low dose that was gradually increased over the next few months based on how well she tolerated it and how her biochemical response changed. Regular follow-up lab tests showed that insulin-like growth factor-1 levels were steadily dropping toward the normal range. This showed that the excess growth hormone was being successfully suppressed. A follow-up MRI about a year into treatment showed a good response, with the adenoma getting smaller and cystic degeneration appearing in the tumor, which is what you would expect from somatostatin analog–mediated regression. This hormonal enhancement was accompanied by improved management of her metabolic comorbidities, including enhanced glycemic control, lowered blood pressure, and optimized lipid profiles, highlighting the close association between acromegaly and cardiometabolic complications. This case underscores the necessity of early recognition of acromegaly in patients primarily exhibiting metabolic disturbances and subtle physical manifestations, particularly when surgical intervention is not feasible. It also shows how effective somatostatin analogs can be as a powerful nonsurgical treatment that can help with biochemical control, tumor reduction, and overall metabolic health. In these cases, successful management depends on a personalized, multidisciplinary framework that includes regular endocrinological evaluations, hormonal monitoring, and periodic imaging. This is done to get the best disease control, reduce long-term complications, and improve quality of life.
Abstract: A 62-year-old Iraqi woman exhibited progressive enlargement of her hands, feet, and facial features over several years, accompanied by poorly controlled type 2 diabetes mellitus, hypertension, and dyslipidemia—metabolic disorders that had become increasingly challenging to manage despite conventional treatment. These gradual physical changes, which...
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Research Article
Time to Achieve Target MUAC and Its Predictors Among Children with Severe Acute Malnutrition Under Outpatient Therapeutic Programs, Hossana, Ethiopia
Elias Geneti*
,
Wondimu Laemebo,
Tesfu Zewdu,
Sisay Shewasinad,
Hilina Ketema
Issue:
Volume 1, Issue 1, March 2026
Pages:
24-37
Received:
25 February 2026
Accepted:
6 March 2026
Published:
19 March 2026
DOI:
10.11648/j.sdmed.20260101.15
Downloads:
Views:
Abstract: Severe acute malnutrition (SAM) is the most severe and visible form of undernutrition and remains a major cause of morbidity and mortality in developing countries, particularly in Sub-Saharan Africa. Despite its public health significance, limited studies especially multicenter studies have been conducted in Ethiopia, including the present study area. Therefore, this study aimed to assess the time to achieve target mid-upper arm circumference (MUAC) and its predictors among children with severe acute malnutrition treated in the outpatient therapeutic feeding program (OTP) in Hossana Town, Central Ethiopia. A retrospective follow-up study was conducted among 631 children with SAM enrolled in OTP using systematic random sampling. Kaplan–Meier survival analysis was used to estimate the time to achieve target MUAC, and Cox proportional hazards regression analysis was employed to identify independent predictors. Variables with a p-value <0.25 in the bivariable analysis were included in the multivariable Cox regression model, and statistical significance was declared at p-value <0.05. A total of 631 children were included in the study. The incidence rate of achieving target MUAC was 17.7 per 1000 child-days of observation. Overall, 94.9% of children achieved the target MUAC, while 5.31% were censored (2.16% lost to follow-up and 3.15% referred). The median time to achieve target MUAC was 60 days (IQR: 54–65). Factors significantly associated with time to achieve target MUAC included the presence of cough (AHR = 0.39; 95% CI: 0.30–0.51), inappropriate consumption of ready-to-use therapeutic food (RUTF) (AHR = 0.21; 95% CI: 0.17–0.26), and HIV/AIDS infection (AHR = 0.42; 95% CI: 0.22–0.77). In conclusion, the time to achieve target MUAC was significantly influenced by cough, HIV/AIDS infection, and inappropriate RUTF consumption. Therefore, providing special attention and appropriate management for children with these conditions is essential to improve recovery outcomes and reduce the duration of treatment in OTP programs.
Abstract: Severe acute malnutrition (SAM) is the most severe and visible form of undernutrition and remains a major cause of morbidity and mortality in developing countries, particularly in Sub-Saharan Africa. Despite its public health significance, limited studies especially multicenter studies have been conducted in Ethiopia, including the present study ar...
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