Case Report
Management of Referred Case of Obesity Hypoventilation Syndrome with Obstructive Sleep Apnea of Morbidly Obese Patient: A Case Report
Issue:
Volume 11, Issue 3, June 2025
Pages:
28-32
Received:
10 January 2025
Accepted:
5 February 2025
Published:
2 September 2025
DOI:
10.11648/j.ijcems.20251103.11
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Abstract: Obesity hypoventilation syndrome (OHS) is a serious condition characterized by obesity (BMI ≥ 30 kg/m2), daytime hypercapnia (PaCO2 ≥ 45 mmHg), and sleep-disordered breathing, without other identifiable causes of reduced alveolar ventilation, such as lung or neuromuscular disorders. The World Health Organization (WHO) defines morbid obesity as a BMI ≥ 35 kg/m2, which significantly increases the risk of obstructive sleep apnea (OSA) and poses challenges in airway management. This case report discusses the successful management of a morbidly obese patient (BMI = 51.3 kg/m2) suffering from hypoventilation and sleep apnea. Initially, the patient received continuous oxygen therapy via nasal prongs, but as symptoms worsened—marked by poor sleep quality and a significant drop in oxygen saturation at night—non-invasive ventilation (NIV) and high-flow nasal cannula (HFNC) were introduced. Proper positioning was also maintained to optimize breathing and prevent further deterioration. Despite the increased risk of prolonged ICU stays and extended mechanical ventilation in morbidly obese patients, this case demonstrates that a multimodal conservative approach can lead to successful outcomes within a short period. It highlights the effectiveness of non-surgical interventions in managing OHS and OSA while emphasizing the importance of early referral to specialized healthcare centers for timely and effective treatment, ultimately improving patient outcomes.
Abstract: Obesity hypoventilation syndrome (OHS) is a serious condition characterized by obesity (BMI ≥ 30 kg/m2), daytime hypercapnia (PaCO2 ≥ 45 mmHg), and sleep-disordered breathing, without other identifiable causes of reduced alveolar ventilation, such as lung or neuromuscular disorders. The World Health Organization (WHO) defines morbid obesity as a BM...
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Research Article
Prevalence and Associated Factors of Severe Perineal Tear at Mekelle Public Hospitals, Tigray, Northern Ethiopia: A Seven Years Review
Issue:
Volume 11, Issue 3, June 2025
Pages:
33-41
Received:
3 August 2025
Accepted:
13 August 2025
Published:
8 September 2025
DOI:
10.11648/j.ijcems.20251103.12
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Abstract: Background: Obstetric anal sphincter injuries (OASIS) from perineal trauma during vaginal delivery are a significant cause of maternal morbidity, especially in low-resource settings. Despite skilled care in hospitals, such injuries still occur. This study investigates the prevalence and associated risk factors of third- and fourth-degree perineal tears at Mekelle Public Hospitals, Tigray, Northern Ethiopia, from July 2016 to June 2023. Methodology: A retrospective unmatched case-control study was conducted at Ayder Comprehensive Specialized Hospital and Mekelle General Hospital. All mothers with documented third- or fourth-degree perineal tears during vaginal delivery were included as cases, with three controls selected per case. Data from delivery logbooks and patient charts were extracted using a structured tool. Data were analyzed with EpiData Management version 4.6 and SPSS version 23, employing bivariate and multivariate logistic regression. Statistical significance was determined with a p-value of <0.05, and associations were measured using odds ratios. Results: A total of 361 women (88 cases, 273 controls) were included. The seven-year prevalence of severe perineal tears was 0.157% (1.57 per 1,000 vaginal deliveries). Significant risk factors included rural residence (AOR: 5.3, 95% CI: 2.1-13.3), primiparity (AOR: 4.7, 95% CI: 2.2-9.8), gestational age ≥ 40 weeks (AOR: 5.1, 95% CI: 2.5-10.3), birth weight ≥ 3.5 kg (AOR: 2.2, 95% CI: 1.1-4.5), and instrumental delivery (AOR: 5.1, 95% CI: 1.2-15.9). Mediolateral episiotomy was protective (AOR: 0.57, 95% CI: 0.3-0.9). Conclusion: Severe perineal tears are associated with identifiable maternal and delivery-related factors. Improved clinical vigilance, timely episiotomy, and skilled delivery practices are essential. Improved documentation and risk assessment strategies are recommended.
Abstract: Background: Obstetric anal sphincter injuries (OASIS) from perineal trauma during vaginal delivery are a significant cause of maternal morbidity, especially in low-resource settings. Despite skilled care in hospitals, such injuries still occur. This study investigates the prevalence and associated risk factors of third- and fourth-degree perineal t...
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,
Bishaka Adhikari
