Advances in General Practice of Medicine <p><a title="Registered Journal" href="" target="_blank" rel="noopener"><img class="journalreviewercredits" src="/journal/public/site/images/jasongong/Logo_ReviewerCredits-journal.jpg" alt="ReviewerCredits" align="right"></a><strong>Advances in General Practice of Medicine (AGPM) (ISSN:2529-8127)</strong> is an open access, continuously published, international, refereed&nbsp; journal to promote comprehensive, coordinated and continuing care for the community members. This journal encourages submissions of original research, review&nbsp;article, clinical case study, clinical trial, commentary, perspective, opinion in the field addressed.</p> <p>Topics of interest include, but are not limited to, the following:<br>• Medical education and training<br>• Medical management and evaluation<br>• Clinical research<br>• Health policy and guideline development<br>• Whole person care<br>• Health economics<br>• International experiences and evolutions<br>• Family doctor service model<br>&nbsp;• Diagnostic and therapeutic<br>• Basic medicine system<br>• Health information technologies</p> SyncSci Publishing Pte. Ltd., Singapore en-US Advances in General Practice of Medicine 2529-8127 <p>Authors contributing to&nbsp;<em>Advances in General Practice of Medicine</em>&nbsp;agree to publish their articles under the&nbsp;<a href="">Creative Commons Attribution-Noncommercial 4.0 International License</a>, allowing third parties to share their work (copy, distribute, transmit) and to adapt it, under the condition that the authors are given credit, that the work is not used for commercial purposes, and that in the event of reuse or distribution, the terms of this license are made clear.</p> Big challenge in health impact of heavy metal: A case study <p>Herbal medicines are potential sources of therapeutic aids for human beings. WHO estimates that 80% of the world’s population depends on herbal products as their primary form of health care. Herbal plants are widely used nowadays because they have few side effects, are readily available, and are cost-effective. Herbal plants are easily contaminated by absorbing heavy metals from soil, air and water. The primary health concerns of heavy metals are Arsenic, Cadmium, Lead and Mercury.&nbsp;&nbsp; Heavy metal causes countless health-related issues, such as kidney and liver damage, skin cancer, etc. So, the estimation of heavy metals is fundamental. Modern techniques estimate heavy metals in herbal plants such as AAS, ICP-MS, ICP-AES and ICP-OES. This review article mainly contains general information about heavy metals, the health impact of heavy metals on the human body, case studies regarding heavy metal toxicity on human health and analytical techniques used to estimate heavy metals.</p> Ritu Tiwari Gaurav Sanjay Mahalpure Copyright (c) 2024 Ritu Tiwari, Gaurav Sanjay Mahalpure 2024-07-16 2024-07-16 5 1 97 101 10.25082/AGPM.2023.01.004 Predictors of in-hospital mortality among patients with status epilepticus in Lubumbashi, Democratic Republic of the Congo: A retrospective study <p><strong>Objective</strong>: Status Epilepticus (SE) is a condition characterized by an epileptic seizure that persists long enough or recurs at sufficiently short intervals to create a fixed and lasting epileptic condition. The objective of this study was to determine the prevalence and to identify predictors of in-hospital death among SE patients in Lubumbashi, Democratic Republic of the Congo (DRC). <br><strong>Methods</strong>: We conducted a retrospective study from January 2020 to December 2022. <br><strong>Results</strong>: Out of 3,006 patients admitted to the neurology department of the University Clinics of Lubumbashi, 97 presented with SE (i.e., a hospital prevalence of 3.23%). The mean age of the patients was 38.38±14.74 years, and men represented 77.3% of the cases. Epileptic patients represented 21.65% of the cases and 66.7% of them were on antiepileptic drugs (AEDs). Seizures were generalized in 72.16% of the patients. Seizures lasted 30 minutes or more in 50.52% of the cases. The most frequent etiologies were strokes, followed by central nervous system (CNS) infections. In-hospital mortality was 24.74% and the predictors of this mortality were CNS infections (adjusted OR = 22.34 [2.69-222.65]; p = 0.0006) and seizures lasting ≥ 30 minutes (adjusted OR = 10.98 [2.89-62.70]; p&lt;0.0001). <br><strong>Conclusion</strong>: SE is a major neurological emergency requiring early and multidisciplinary management to preserve the vital prognosis because, without treatment, SE causes important neurological complications and even death. The present study found a mortality of 24.74% which was associated with seizure duration of more than 30 minutes as well as with infectious etiologies.</p> Marcellin Bugeme Olivier Mukuku Lucien Nawej Ditend Emmanuel Kiyana Muyumba Béatrice Koba Bora Copyright (c) 2024 Marcellin Bugeme, Olivier Mukuku, Lucien Nawej Ditend, Emmanuel Kiyana Muyumba, Béatrice Koba Bora 2024-04-04 2024-04-04 5 1 90 96 10.25082/AGPM.2023.01.003 Prediction of mortality in adult COVID-19 patients using chest CT severity scoring systems: A comparative analysis of different scores <p><strong>Purpose</strong>: To compare the accuracy of mortality prediction of four CT severity scoring systems for COVID-19: CT severity score three levels, CT severity score, Total severity score, and Chest CT score. <br><strong>Methods</strong>: This was a retrospective study of 278 patients hospitalized with COVID-19 confirmed by a positive polymerase chain reaction (PCR) and in whom a CT scan was performed to assess the severity of lung involvement. This assessment was performed using four different scoring systems, including the CT severity score three levels, the CT severity score, the Total severity score, and the Chest CT score. <br><strong>Results</strong>: A total of 278 COVID-19 patients had chest CT scans, of whom 59 (21.22%) died and 219 (78.78%) survived. The ROC curves showed outstanding performance for the four chest CT severity scoring systems: 0.9580 for the CT severity score; 0.9532 for the CT severity score three levels; 0.9474 for the Total severity score; and 0.9327 for the Chest CT score. The comparison of these four ROC curves revealed no statistically significant difference between the four scoring systems (<em>X</em><sup>2</sup> = 3.89; p = 0.2740). <br><strong>Conclusion</strong>: The four chest CT severity scoring systems used predicted mortality in COVID-19 patients with excellent agreement and outstanding performance.</p> Didier Ndyanabo Ndabahweje Olivier Mukuku Charles Kangitsi Kahindo Michel Lelo Tshikwela Gertrude Luyeye Mvila Antoine Molua Aundu Jean Tshibola Mukaya Stanis Okitotsho Wembonyama Zacharie Kibendelwa Tsongo Copyright (c) 2024 Didier Ndyanabo Ndabahweje, Olivier Mukuku, Charles Kangitsi Kahindo, Michel Lelo Tshikwela, Gertrude Luyeye Mvila, Antoine Molua Aundu, Jean Tshibola Mukaya, Stanis Okitotsho Wembonyama, Zacharie Kibendelwa Tsongo 2024-02-22 2024-02-22 5 1 81 89 10.25082/AGPM.2023.01.002 Prevalence and associated factors of uncontrolled hypertension in hypertensive patients in the city of Goma, DRC <p><strong>Background</strong>: The objectives of this study were to determine the proportion of uncontrolled hypertension in hypertensive patients followed up on an outpatient basis and to investigate the factors associated with this poor control. <br><strong>Methods</strong>: This was a cross-sectional analytical study of 167 hypertensive patients followed in eight health facilities in Goma city. Uncontrolled hypertension was defined as systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg. <br><strong>Results</strong>: The proportion of uncontrolled hypertension was 95.2%. In bivariate analysis, no factor was associated with uncontrolled hypertension. <br><strong>Conclusion</strong>: Almost all hypertensive patients in our study were poorly controlled by antihypertensive treatment. These results highlight the need for a cohort study to determine the factors associated with this excessively high prevalence of uncontrolled hypertension in hypertensive patients on antihypertensive drugs, in order to allow targeted actions to try to control hypertension by antihypertensive drugs.</p> Herman Ngadjole Chelo Théophile Kabesha Barhwamire Patricia Lukusa Mishika Zacharie Kibendelwa Tsongo Stanis Okitotsho Wembonyama Copyright (c) 2023 Herman Ngadjole Chelo, Théophile Kabesha Barhwamire, Patricia Lukusa Mishika, Zacharie Kibendelwa Tsongo, Stanis Okitotsho Wembonyama 2023-03-02 2023-03-02 5 1 74 80 10.25082/AGPM.2023.01.001 Gilles de la Tourette syndrome in Central Africa: A case report <p>Gilles de la Tourette syndrome (GTS), also known as Tourette disorder or Tourette syndrome, is a neurodevelopmental disorder that is characterized by the presence of multiple motor and one or more vocal/phonic tics. These tics are generally more common during childhood and reach a maximum severity between 10 and 12 years. Ticks tend to decrease during late adolescence and adulthood in a majority of patients. We report an observation of GTS diagnosed in a 12-year-old child who was taken care of by clonazepam with a good improvement in its symptomatology. This condition has been reported only very rarely in black sub-Saharan Africans and this is probably the first case of GTS reported in Central Africa.</p> Marcellin Bugeme Kegnide Christelle Cadnelle Affognon Jacques Mbaz Musung Franck Shongo Omanjelo Dirk E. Teuwen Sarah Kilumba Numbi Jenny Tshijik Ndua Olivier Mukuku Emmanuel Kiyana Muyumba Copyright (c) 2022 Marcellin Bugeme, Kegnide Christelle Cadnelle Affognon, Jacques Mbaz Musung, Franck Shongo Omanjelo, Dirk E. Teuwen, Sarah Kilumba Numbi, Jenny Tshijik Ndua, Olivier Mukuku, Emmanuel Kiyana Muyumba 2022-12-28 2022-12-28 5 1 71 73 10.25082/AGPM.2022.01.006 Three first cases of Meige syndrome in Central Africa <p>Meige syndrome (MS) is a rare type of focal dystonia characterized by unintentional bilateral activity in facial and mandibular muscles in combination with blepharospasm (spasm in the orbicular muscle). Often unknown cause, MS can be primary (idiopathic) or secondary (to medications or brain degenerative pathologies). Its treatment is based in most cases on botulinum toxin injections, not available in our environment. Nevertheless, clonazepam treatment has allowed us to improve the symptoms of our patients. We report MS in three patients, all with no particular history of consulting for involuntary facial movements. The diagnosis of MS was essentially based on the clinical picture. After treatment with clonazepam, the clinical course in all three patients was marked by the almost complete disappearance of these abnormal movements. In all cases, clinical progress was favorable with an average decline of 12 months; no recidivism was noted.</p> Marcellin Bugeme Yacouba Kaba Franck Shongo Omanjelo Jacques Mbaz Musung Sarah Kilumba Numbi Olivier Mukuku Emmanuel Kiyana Muyumba Dirk E. Teuwen Copyright (c) 2022 Marcellin Bugeme, Yacouba Kaba, Franck Shongo Omanjelo, Jacques Mbaz Musung, Sarah Kilumba Numbi, Olivier Mukuku, Emmanuel Kiyana Muyumba, Dirk E. Teuwen 2022-12-23 2022-12-23 5 1 67 70 10.25082/AGPM.2022.01.005 Etiology of breast development and asymmetry <p>Etiology of breast development and asymmetry is a fascinating research topic physiologically as well as pathophysiology from a certain condition. The shape, contour, and size of the breast are unique to each female. These factors are influenced by genetics, weight, exercise, menstruation cycles, pregnancy, menopause status, and age. An attempt was made to research the breast development at fetal development and transitioning into adulthood and menopause. Additionally, we compare breast development in males to the developments in females. Although breast asymmetry is experienced by all women, it ranges from grossly undetectable to the need for surgical intervention. It is thought that breast asymmetry has intrinsic and extrinsic factors that determine the type and the extent of asymmetry observed. Hormones at play and their effect on breast asymmetry throughout breast development has been charted. Breast asymmetry is most often secondary to benign breast disorders and unassociated with a risk for malignancy. As the perception of one’s body image is an integral part of self-confidence, breast asymmetry has the potential to affect every woman’s quality of life, regardless of the degree of asymmetry. Throughout this effort, our aim was to analyze and understand breast development in males and females, breast changes from the prepubertal to post-menopausal period, benign pathological changes, summarizing the etiologies of breast asymmetry, and their effects on quality of life.&nbsp;</p> Elisabeth N. Adkins Shaina Anderson Trevor McKoy Nakachi Maduka Tarun Goswami Copyright (c) 2022 Elisabeth N. Adkins, Shaina Anderson, Trevor McKoy, Nakachi Maduka, Tarun Goswami 2022-07-14 2022-07-14 5 1 54 66 10.25082/AGPM.2022.01.004 Availability and quality of family planning services in Idjwi Island, DRC <p><strong>Objective</strong>: The objective of this study was to assess the availability and quality of FP services in health facilities (HFs) on Idjwi Island in the eastern Democratic Republic of the Congo (DRC). <br><strong>Methods</strong>: From March 1 to 31, 2022, a descriptive cross-sectional study was conducted in several HFs on Idjwi Island. Identified 31 HFs have been comprehensively included. Data were collected through interviews, literature reviews, and observations, guided by a questionnaire. <br><strong>Results</strong>: Of the 31 HFs included, 29 (93.6%) of them provided FP services on an availability basis, of which 27.6% (8/29) met the criteria for high-quality services. The most widely available methods were male condoms, combined oral contraceptive pills, and progestin-only injectable contraceptives. <br><strong>Conclusion</strong>: The availability of FP services in HFs on Idjwi Island remains high but their quality is low. To improve access to and use of FP, efforts should focus on improving quality in this rural part of the country.</p> Maurice Nyamalyongo Masoda Olivier Mukuku Jean-Claude Atite Bondekwe Jacques Matongo Mutono Charles Wembonyama Mpoy Zacharie Kibendelwa Tsongo Stanis Okitotsho Wembonyama Copyright (c) 2022 Maurice Nyamalyongo Masoda, Olivier Mukuku, Jean-Claude Atite Bondekwe, Jacques Matongo Mutono, Charles Wembonyama Mpoy, Zacharie Kibendelwa Tsongo, Stanis Okitotsho Wembonyama 2022-07-13 2022-07-13 5 1 48 53 10.25082/AGPM.2022.01.003 Gender-specific anterior cruciate ligament – gait forces <p>The purpose of this study was to investigate gender-based differences in gait biomechanics and to evaluate those effects on forces generated on the ACL during walking. Estimation of gender-specific ACL forces in the frontal plane can provide a better understanding of the biomechanical patterns underlying higher female injury risk. The present study used a sample from the Fels Longitudinal Study to test the hypothesis that there are significant gender-differences in frontal plane ACL loading during walking. A cross-sectional sample of 178 participants, including 79 males and 99 females was used to evaluate differences in gait kinetics. Females walked at higher cadence with narrower steps (P &lt; 0.05). No difference was observed in the peak flexion force and knee rotation moment between males and females (P = 0.51 and 0.07), respectively. Peak abduction moment was significantly lower among females than in males (P = 0.05). A regression equation was developed which considers a person’s weight and height in addition to forces which could give better estimate of the forces acting on the ligament. The peak force acting on the ACL during walking reaches as high as 0.44 of BW, regardless of gender.</p> Bharadwaj Cheruvu Amy Neidhard-Doll Tarun Goswami Copyright (c) 2022 Bharadwaj Cheruvu, Amy Neidhard-Doll, Tarun Goswami 2022-05-18 2022-05-18 5 1 42 47 10.25082/AGPM.2022.01.002 Antimicrobial resistance of Salmonella enterica Typhi in the Western and Southern Regions of the Democratic Republic of the Congo: Phenotypic profile and molecular characterization of isolates associated with epidemics of Typhoid Fever <p><strong>Background:</strong> This study has its foundation following the emergence of the phenomenon of antimicrobial resistance of <em>Salmonella enterica enterica</em> Typhi associated with severe complications, such as intestinal perforations with a significant lethality.<br> <strong>Objectives:</strong> Of this antimicrobial resistance, to determine the phenotypic profile, to detect the chromosomal molecular markers (CMMs) such as the class 1 integrons (<em>intl-</em>1) and ESBLs (<em>bla</em><sub>TEM-1</sub>, <em>bla</em><sub>OXA-1 </sub>and <em>bla</em><sub>CTX-M-1</sub>) and to measure the association between the phenotypic profile and CMMs of typhoid isolates in concerned areas.<br> <strong>Methods:&nbsp;</strong> <em>Salmonella</em> Typhi strains of typhoid epidemic areas were confirmed by serotyping tests. The antimicrobial susceptibility testing was conducted by disc diffusion method using the following commercial antimicrobials: Chloramphenicol-C, Ampicillin-AMP, Sulfamethoxazole-RL and Trimethoprim-W (former first-line antimicrobials), Ciprofloxacin-CIP or Cefotaxime-CTX, Ceftriaxone-CRO, Ceftazidime-CAZ (first-line antimicrobials), Tetracycline-TE, Amoxicillin-Potassium clavulanate-AMC, Nalidixic acid-NA, Cefoxitine-FOX, Gentamicin-CN (varied antimicrobials) and FEP-Cefepime (4GC). The phenotypic antimicrobial resistance profile was determined by Kirby-Bauer diffusion method on Mueller-Hinton agar. To perform the molecular characterization, the <em>Salmonella</em> Typhi isolates DNA has been extracted by Sigma Aldrich kit and the CMMs detection was performed by DNA Engine for PCR test. The association between phenotypic profile and CMMs has been measured by Pearson’s chi-square test.<br> <strong>Results:</strong> Out of 320 <em>Salmonella</em> Typhi isolates, 50 were identified conform. The phenotypic profile of antimicrobial resistance was 59.5% in all the Western and Southern regions and 61% in the provinces of Kinshasa City and Bas-Congo to the former antimicrobials of first intention and the mean of CMMs rates were 22.5% and 27.4%, respectively. Those isolates showed a significant resistance profile to AMP, C and RL in those last two provinces.<br> <strong>Conclusion:</strong> The rate of phenotypic multidrug-resistance of <em>Salmonella</em> Typhi isolates was more than 50% with the predominance of CMMs in Kinshasa and Bas-Congo. This study suggests to give up the use of AMP, C and RL in those two provinces. This may also indicate that the antimicrobial resistance surveillance system would be one strategy to manage food borne pathogens.</p> Kumel Kasongo Kumelundu Berthe Nkema Miwanda Ronald Ng'etich Samuel Njoroge Denis Kakongo Kandolo Michel Balaka Ekwalanga Emmanuel Mposhi Malangu Victor Ndibualonji Claude Lubobo Kazadi Philomène Anzwal Lungu Clément Numbi Kashindi Prosper Muenze Kalenga Léon Kafita Cibuabua John Kiiru Samuel Kariuki Jean-Jacques Tamfum Muyembe Christophe Mukena Nyembo Copyright (c) 2022 Kumel Kasongo Kumelundu, Berthe Nkema Miwanda, Ronald Ng'etich, Samuel Njoroge, Denis Kakongo Kandolo, Michel Balaka Ekwalanga, Emmanuel Mposhi Malangu, Victor Ndibualonji, Claude Lubobo Kazadi, Philomène Anzwal Lungu, Clément Numbi Kashindi, Prosper Muenze Kalenga, Léon Kafita Cibuabua, John Kiiru, Samuel Kariuki, Jean-Jacques Tamfum Muyembe, Christophe Mukena Nyembo 2022-04-28 2022-04-28 5 1 28 41 10.25082/AGPM.2022.01.001