Rare Atypical Presentation of Ogilvie Syndrome in a Hispanic Man

Background: Ogilvie syndrome (OS) also known as acute pseudo-obstruction of the colon is a bowel motility disorder characterized by features of intestinal obstruction in the absence of an anatomical or mechanical cause. Typical presentation is with abdominal distension but atypical and more rare presenting features have also been reported including respiratory distress. Thus, we present the first case of Ogilvie syndrome presenting with respiratory distress in a Hispanic man. Case Presentation: A 71-year-old gentleman with a history of diabetes mellitus, functional quadriplegia and other comorbidities was brought to the ED via EMS on account of altered metal status and constipation for about three days. Pertinent findings from the examination showed a chronically ill looking gentleman with a GCS of 8/15, respiratory rate of 34, pulse oximeter saturating at 86% on ambient air, and the usage of accessory muscles. Abdominal examination showed a mildly distended abdomen with tympanitic percussion notes and hypoactive bowel sounds in all the quadrants. Digital rectal examination revealed soft non bloody loose brown stools. Three was global muscle wasting and reduced muscle strength. Blood gas showed a pH of 7.12, pCO2- 117.4 and pO2- 74 suggestive of severe hypoxic and hypercapnic respiratory acidosis. Plain KUB X-ray and CT scan showed significant colonic distension with no fecal or anatomic obstruction. Patient was intubated for airway protection and abdominal distension was managed conservatively with discontinuation of enteral feeding, nasogastric tube decompression, potassium and magnesium replacement. Management can be escalated in patients who failed to respond to conservative measures or in those with complications like intestinal ischemia and perforation. in patients with colonic diameter \u3e 12 cm who failed 48 to 72 hours (about 3 days) of conservative therapy, pharmacologic therapy with neostigmine can be used. Conclusion: Our patient responded to conservative measures including withholding of enteral feeding, nasogastric tube decompression, potassium and magnesium replacement. Management can be escalated in patients who failed to respond to conservative measures or in those with complications like intestinal ischemia and perforation. In patients with colonic diameter \u3e 12 cm who failed 48 to 72 hours (about 3 days) of conservative therapy, pharmacologic therapy with neostigmine can be used

The role of women’s empowerment and male engagement in pregnancy healthcare seeking behaviors in western Kenya

We sought to understand whether women’s empowerment and male partner engagement were associated with use of antenatal care (ANC). Women presenting for ANC in Nyanza province of Kenya between June 2015 and May 2016, were approached for participation. A total of 137 pregnant women and 96 male partners completed baseline assessments. Women’s empowerment was measured using the modified Sexual Relationship Power Scale. ANC use measures included timing of the first ANC visit and number of visits. Male engagement was based on whether a husband reported accompanying his wife to one or more antenatal visits during the pregnancy. Multiple linear and logistic regression analyses were used to identify factors independently related to use and timing of ANC. Women with higher mean empowerment scores were likely to have more than one ANC visit in the index pregnancy [Adjusted Odds Ratio (AOR) = 2.8, 95% Confidence Interval (CI): 1.1–7.3], but empowerment was not associated with early ANC use. Women who were more empowered were less likely to have a husband who reported attending an ANC visit with his wife (AOR = 0.1, 95% CI: 0.03–0.8). Women’s empowerment is important and may be related to ANC use and engagement of male partners in complex ways