Science Publishing Group: Science Journal of Clinical Medicine: Table of Contents
<i> Science Journal of Clinical Medicine (SJCM) </i> aims to publish high quality scientific research in the field of clinical medicine, with the goal of promoting and disseminating medical science knowledge to improve global health. Articles on clinical, laboratory and social research in medicine and other related fields that are of interest to the medical and health care profession are eligible for consideration. AJRS welcomes the following tier 1 article types:original research, case reports, reviews, methodologies and other paper types.
http://www.sciencepublishinggroup.com/j/sjcm Science Publishing Group: Science Journal of Clinical Medicine: Table of Contents
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Science Journal of Clinical Medicine
Science Journal of Clinical Medicine
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Recombinant Insulin in Type 2 Diabetes Treatment: Where Are We Now?
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Several insulin formulations are currently available for clinical use, including human regular and protaminated insulins, rapid- and long- acting analogs and premixed combinations, which can be used in different regimens. However, there is no consensus on which are the insulin formulation and the insulin regimen of choice, especially in type 2 diabetes. Overall, insulin analogs are preferred for their better pharmacological properties with a minor hypoglycaemic risk, whereas their superiority in reducing HbA1c levels is still debated. Despite the impressive steps undertaken so far, insulin therapy is still too complex and burdensome, and even with an intensified regimen, only a modest percentage of subjects reaches HbA1c goals. New insulin formulations and devices are currently awaited to better fulfill the still unmet needs of insulin therapy.
Several insulin formulations are currently available for clinical use, including human regular and protaminated insulins, rapid- and long- acting analogs and premixed combinations, which can be used in different regimens. However, there is no consensus on which are the insulin formulation and the insulin regimen of choice, especially in type 2 diabetes. Overall, insulin analogs are preferred for their better pharmacological properties with a minor hypoglycaemic risk, whereas their superiority in reducing HbA1c levels is still debated. Despite the impressive steps undertaken so far, insulin therapy is still too complex and burdensome, and even with an intensified regimen, only a modest percentage of subjects reaches HbA1c goals. New insulin formulations and devices are currently awaited to better fulfill the still unmet needs of insulin therapy.
Recombinant Insulin in Type 2 Diabetes Treatment: Where Are We Now?
doi:10.11648/j.sjcm.20120101.12
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Giuseppina T. Russo
Provvidenza Villari
Elisabetta L Romeo
Annalisa Giandalia
Domenico Cucinotta
Recombinant Insulin in Type 2 Diabetes Treatment: Where Are We Now?
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© Science Publishing Group
Laparoscopic Intraperitoneal Onlay Repair of Abdominal Incisional and Ventral Hernias wth Polyvinylidene Fluoride-Coated Polypropylene Mesh; A Retrospective Study with Short to Medium Term Results
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Laparoscopic repair of incisional and ventral hernias has increased in popularity due to reduced pain, shorter length of stay and earlier return to work. Dynamesh Intraperitoneal onlay mesh (IPOM), a composite of polyvinylidene fluoride (PVDF) coated polypropylene (PP) was designed to utilize the properties of both materials. This retrospective study reports a single surgeon experience with laparoscopic IPOM using Dynamesh , to ascertain any short to medium term complications. Forty consecutive patients underwent intraperitoneal onlay mesh repair with Dynamesh in a District General hospital (DGH) over a 33 month period. Data was collected retrospectively from medical notes, clinical assessment and telephone interviews. Short term complications include development of seromas post operatively in three patients which were successfully drained. One patient was readmitted with small bowel obstruction that was successfully managed conservatively. Medium term results showed two further seromas. Our recurrence rate is 13% after a mean follow up of 15 months. On submission of this manuscript, none of the patients have had to undergo surgical re-intervention for Dynamesh related complications. We have not noticed any significant short to medium term complications with Dynamesh in our experience. The debate about the best composite mesh continues; only a randomised control trial between the different meshes, with long term follow up can determine the true incidence of complications.
Laparoscopic repair of incisional and ventral hernias has increased in popularity due to reduced pain, shorter length of stay and earlier return to work. Dynamesh Intraperitoneal onlay mesh (IPOM), a composite of polyvinylidene fluoride (PVDF) coated polypropylene (PP) was designed to utilize the properties of both materials. This retrospective study reports a single surgeon experience with laparoscopic IPOM using Dynamesh , to ascertain any short to medium term complications. Forty consecutive patients underwent intraperitoneal onlay mesh repair with Dynamesh in a District General hospital (DGH) over a 33 month period. Data was collected retrospectively from medical notes, clinical assessment and telephone interviews. Short term complications include development of seromas post operatively in three patients which were successfully drained. One patient was readmitted with small bowel obstruction that was successfully managed conservatively. Medium term results showed two further seromas. Our recurrence rate is 13% after a mean follow up of 15 months. On submission of this manuscript, none of the patients have had to undergo surgical re-intervention for Dynamesh related complications. We have not noticed any significant short to medium term complications with Dynamesh in our experience. The debate about the best composite mesh continues; only a randomised control trial between the different meshes, with long term follow up can determine the true incidence of complications.
Laparoscopic Intraperitoneal Onlay Repair of Abdominal Incisional and Ventral Hernias wth Polyvinylidene Fluoride-Coated Polypropylene Mesh; A Retrospective Study with Short to Medium Term Results
doi:10.11648/j.sjcm.20120101.13
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
D. G. Roberts
S. Anwar.
Laparoscopic Intraperitoneal Onlay Repair of Abdominal Incisional and Ventral Hernias wth Polyvinylidene Fluoride-Coated Polypropylene Mesh; A Retrospective Study with Short to Medium Term Results
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© Science Publishing Group
Rheumatology Rapid Access and Treatment Service – Improving Patient Care Holistically
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Objective: Various rheumatological conditions can present with different degrees of severity at any point in their course. It is extremely important for such patients to be monitored regularly and to feel reassured that they are able to access the specialist services for flare ups and concerns. The aim of this project was to evaluate the outcome of the Rapid Access and Treatment Service for Rheumatology patients in our institution, over a period of 1 month. Method: We studied the patient records for all patients who were seen in the Rapid Access and Treatment Service in the Rheumatology Department, in the month of January. The referral process and the management offered at the clinic were reviewed. Re-attendances were also recorded. Results: 51 patients were seen over 18 days in the month of January. 11 New patients with 40 follow up/ known rheumatological diagnosis patients were reviewed. 1 patient needed admission into the hospital, while 8 needed IM Depo injections. 3 needed IV Methyl prednisolone infusions and the remaining needed either their steroid dose reviewing or other procedures. Conclusion: The efficacy of this service was proven with patient satisfaction and reduction in hospital admission rates. This system works very well in our Department and establishing such a system throughout the NHS, might enhance patient care, reduce worsening of flare ups, thus reducing hospital admissions and allow patients to experience a personalised specialty service. Key messages: 1. Reduced hospital admission rates due to prompt treatment of acute rheumatological problems. 2. Improved patient satisfaction and reduction in worsening of flare ups. 3. Improved doctor – patient relationship with effective holistic care.
Objective: Various rheumatological conditions can present with different degrees of severity at any point in their course. It is extremely important for such patients to be monitored regularly and to feel reassured that they are able to access the specialist services for flare ups and concerns. The aim of this project was to evaluate the outcome of the Rapid Access and Treatment Service for Rheumatology patients in our institution, over a period of 1 month. Method: We studied the patient records for all patients who were seen in the Rapid Access and Treatment Service in the Rheumatology Department, in the month of January. The referral process and the management offered at the clinic were reviewed. Re-attendances were also recorded. Results: 51 patients were seen over 18 days in the month of January. 11 New patients with 40 follow up/ known rheumatological diagnosis patients were reviewed. 1 patient needed admission into the hospital, while 8 needed IM Depo injections. 3 needed IV Methyl prednisolone infusions and the remaining needed either their steroid dose reviewing or other procedures. Conclusion: The efficacy of this service was proven with patient satisfaction and reduction in hospital admission rates. This system works very well in our Department and establishing such a system throughout the NHS, might enhance patient care, reduce worsening of flare ups, thus reducing hospital admissions and allow patients to experience a personalised specialty service. Key messages: 1. Reduced hospital admission rates due to prompt treatment of acute rheumatological problems. 2. Improved patient satisfaction and reduction in worsening of flare ups. 3. Improved doctor – patient relationship with effective holistic care.
Rheumatology Rapid Access and Treatment Service – Improving Patient Care Holistically
doi:10.11648/j.sjcm.20120101.11
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Deepa Iyer
Richard Hull
Rheumatology Rapid Access and Treatment Service – Improving Patient Care Holistically
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© Science Publishing Group
Assessment of Voluntary Counseling and Testing (VCT) Service Quality in Terms of Client Satisfaction; a Comparative Study between Public and Private Health Institutions in Addis Ababa, Ethiopia.
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Background: Although Quality of the service is key principle for effectiveness of the program, very little work has been done to assess the quality of Voluntary Counseling and Testing (VCT) services in most countries including Ethiopian. Objectives: To assess quality of VCT services in terms of client satisfaction in both private and public VCT sites. Methods: cross-sectional comparative health institution based study was employed in public and private VCT sites in Addis Ababa from January 1 to February 30, 2009. By modifying the UNAIDS VCT Quality Evaluation Tools and quality assurance and quality improvement guide developed by Family Health International (FHI), data were collected using interviewer administered questionnaires for both qualitative and quantitative methods. Results: A total of 160 clients, of which 80 from private and 80 from public as well as 20 counselors of which seven from private and 13 from public sites were included in the study. Clients from public sites were more satisfied than private sites with the VCT service they took; 90% versus 76%. Motivation of seeking the service, estimated time spent waiting the test result and waiting to see the counselor, service fee, the presence of comfortable and private counseling room, service given individually, issue of confidentiality, discussion with counselors on different risks and meaning of the test result had significant difference in public and private institutions. Educational status of grade 9-12 in private sites OR=.22(.05-.92), p=.038, time spent on waiting the test result within 30-60 minutes in public sites OR=8.4(1.5-41.9), p=.024, information on HIV/AIDS and Sexual transmitted Infections (STIs) given to protect themselves and others in private sites OR=62.3(17.7-123), p=.025, counselor comfortable on taking sensitive issue in private sites (OR= 54.5(2.3-90.1), p=.014 ) were found to be significantly associated with client satisfaction. All, but one, counselor took training in formal institutions, all counselors from public and only some in private were given fulltime counseling, no regular supportive supervision by governmental officials or partners, all had not taken any refreshment training. Conclusions and recommendations: generally, rate of client satisfaction was low in private VCT sites so that effort should be made to maintain the quality. In addition, regular and supportive supervision by regional health bureau and its partners were minimal so that strong and coordinated supervision in both sites need to be done.
Background: Although Quality of the service is key principle for effectiveness of the program, very little work has been done to assess the quality of Voluntary Counseling and Testing (VCT) services in most countries including Ethiopian. Objectives: To assess quality of VCT services in terms of client satisfaction in both private and public VCT sites. Methods: cross-sectional comparative health institution based study was employed in public and private VCT sites in Addis Ababa from January 1 to February 30, 2009. By modifying the UNAIDS VCT Quality Evaluation Tools and quality assurance and quality improvement guide developed by Family Health International (FHI), data were collected using interviewer administered questionnaires for both qualitative and quantitative methods. Results: A total of 160 clients, of which 80 from private and 80 from public as well as 20 counselors of which seven from private and 13 from public sites were included in the study. Clients from public sites were more satisfied than private sites with the VCT service they took; 90% versus 76%. Motivation of seeking the service, estimated time spent waiting the test result and waiting to see the counselor, service fee, the presence of comfortable and private counseling room, service given individually, issue of confidentiality, discussion with counselors on different risks and meaning of the test result had significant difference in public and private institutions. Educational status of grade 9-12 in private sites OR=.22(.05-.92), p=.038, time spent on waiting the test result within 30-60 minutes in public sites OR=8.4(1.5-41.9), p=.024, information on HIV/AIDS and Sexual transmitted Infections (STIs) given to protect themselves and others in private sites OR=62.3(17.7-123), p=.025, counselor comfortable on taking sensitive issue in private sites (OR= 54.5(2.3-90.1), p=.014 ) were found to be significantly associated with client satisfaction. All, but one, counselor took training in formal institutions, all counselors from public and only some in private were given fulltime counseling, no regular supportive supervision by governmental officials or partners, all had not taken any refreshment training. Conclusions and recommendations: generally, rate of client satisfaction was low in private VCT sites so that effort should be made to maintain the quality. In addition, regular and supportive supervision by regional health bureau and its partners were minimal so that strong and coordinated supervision in both sites need to be done.
Assessment of Voluntary Counseling and Testing (VCT) Service Quality in Terms of Client Satisfaction; a Comparative Study between Public and Private Health Institutions in Addis Ababa, Ethiopia.
doi:10.11648/j.sjcm.20130201.11
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Fasika Dinku
Gashaw Andargie
Assessment of Voluntary Counseling and Testing (VCT) Service Quality in Terms of Client Satisfaction; a Comparative Study between Public and Private Health Institutions in Addis Ababa, Ethiopia.
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© Science Publishing Group
Phenotypic and Molecular Characterization of Candida Species in Urine Samples from Renal Failure Patients
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The prevalence of Candida infections of the urinary tract (candiduria)has increased significantly over the past few years due to various predisposing factors especially in hospitalized patients. The predisposing factors frequently asso-ciated with candiduria are urinary tract instrumentation, prior antibiotic use, prolonged hospital stay, extremes of age, di-abetes mellitus, female sex and use of immunosuppressive therapy. The purpose of this study was to apply different diag-nostic techniques for characterization of Candida species in urine samples from renal failure patients using urinary cathe-ters. Results showed that 20 % of renal failure patients were suffering from candiduria. Females were more affected than males (64% versus 36% of culture positive cases). Diabetes mellitus and catheterization were the obvious risk factors. Dif-ferent Candida isolates showed variations in their phenotypic (macroscopic and microscopic) characteristics when cultured on CHROMagar Candida, corn meal agar and bovine serum. Candida albicans was the most common species being isolated from 54% of positive cases. C.krusei (Teleomorph: Pichia kudriavzevii), C. glabrata and C.tropicalis were respectively identified in 24%, 16% and 6% of samples. Positive germ tube test (in serum) and production of chlamydospores (on corn meal agar) were only confined to C. albicans. Sequencing of rRNA gene (18S covering ITS1 and ITS2) confirmed the identification of the four Candida species. In vitro antifungal sensitivity test (disc diffusion method) revealed that all Candida strains were inhibited by Amphotericin-B and Nystatin. Other compounds as Clotrimazole, Itraconazole, Ketoconazole, Tioconazole, Fluconazole and Sertaconazole were effective against 50% - 67% of Candida strains. All isolates of C. glabrata were resistant to Clotrimazole and Sertaconazole.It is highly recommended to follow standard hygienic precautions to avoid cross contamination by Candida during hemodialysis. Complications following candiduria can be avoided by early diagnosis and proper treatment with effective antifungal agents.
The prevalence of Candida infections of the urinary tract (candiduria)has increased significantly over the past few years due to various predisposing factors especially in hospitalized patients. The predisposing factors frequently asso-ciated with candiduria are urinary tract instrumentation, prior antibiotic use, prolonged hospital stay, extremes of age, di-abetes mellitus, female sex and use of immunosuppressive therapy. The purpose of this study was to apply different diag-nostic techniques for characterization of Candida species in urine samples from renal failure patients using urinary cathe-ters. Results showed that 20 % of renal failure patients were suffering from candiduria. Females were more affected than males (64% versus 36% of culture positive cases). Diabetes mellitus and catheterization were the obvious risk factors. Dif-ferent Candida isolates showed variations in their phenotypic (macroscopic and microscopic) characteristics when cultured on CHROMagar Candida, corn meal agar and bovine serum. Candida albicans was the most common species being isolated from 54% of positive cases. C.krusei (Teleomorph: Pichia kudriavzevii), C. glabrata and C.tropicalis were respectively identified in 24%, 16% and 6% of samples. Positive germ tube test (in serum) and production of chlamydospores (on corn meal agar) were only confined to C. albicans. Sequencing of rRNA gene (18S covering ITS1 and ITS2) confirmed the identification of the four Candida species. In vitro antifungal sensitivity test (disc diffusion method) revealed that all Candida strains were inhibited by Amphotericin-B and Nystatin. Other compounds as Clotrimazole, Itraconazole, Ketoconazole, Tioconazole, Fluconazole and Sertaconazole were effective against 50% - 67% of Candida strains. All isolates of C. glabrata were resistant to Clotrimazole and Sertaconazole.It is highly recommended to follow standard hygienic precautions to avoid cross contamination by Candida during hemodialysis. Complications following candiduria can be avoided by early diagnosis and proper treatment with effective antifungal agents.
Phenotypic and Molecular Characterization of Candida Species in Urine Samples from Renal Failure Patients
doi:10.11648/j.sjcm.20130201.13
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Mohammed S. Alhussaini
Noha F. El-Tahtawi
AhmadM. Moharram
Phenotypic and Molecular Characterization of Candida Species in Urine Samples from Renal Failure Patients
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© Science Publishing Group
The Association between Gender and Tooth Loss in A Small Rural Population of South Africa
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130201.12
Periodontal disease, which attacks the gums and supporting structures of the tooth, is one of the major causes of tooth loss in adults. Few studies on general well-being have compared the differences in oral health between men and women with studies from Europe and USA reporting that there are more edentulous women than men.Among the many factors contributing to tooth loss are poverty, availability and accessibility to dental and other health care as well as cultural traditions. This study examined a population living in a high fluoride area near Cape Town. This isolated community has until recently been unexposed to the diets and habits of the western world and have inter-married for decades. The results of this study indicated that although women had better oral hygiene habits than men, tooth loss was associated with age rather than gender.
Periodontal disease, which attacks the gums and supporting structures of the tooth, is one of the major causes of tooth loss in adults. Few studies on general well-being have compared the differences in oral health between men and women with studies from Europe and USA reporting that there are more edentulous women than men.Among the many factors contributing to tooth loss are poverty, availability and accessibility to dental and other health care as well as cultural traditions. This study examined a population living in a high fluoride area near Cape Town. This isolated community has until recently been unexposed to the diets and habits of the western world and have inter-married for decades. The results of this study indicated that although women had better oral hygiene habits than men, tooth loss was associated with age rather than gender.
The Association between Gender and Tooth Loss in A Small Rural Population of South Africa
doi:10.11648/j.sjcm.20130201.12
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Charlene W. J. Africa
Jairam Reddy
The Association between Gender and Tooth Loss in A Small Rural Population of South Africa
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© Science Publishing Group
Folates and Prevention of Neural-Tube Diseases
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Neural tube defects (NTDs) are congenital malformations of the brain and spinal cord caused by failure of the neural tube to close between 21 and 28 days following conception. Each year almost 400.000 infants are born with NTDs all over the world. Although many advances have been made in the spina bifida’s treatment and have led to an increased life expectancy and an improved life quality, no treatment exists that will completely eliminate the serious disability or premature mortality associated with it. For such a reason, reducing the risk of NTDs is an important goal. It is widely ac-cepted that adequate maternal consumption of folic acid before pregnancy and during the early weeks of gestation can reduce the danger of having a child with a neural tube defect (NTD). As a result, public health authorities worldwide have recommended consuming 400 μg folic acid per day during the periconceptional period in order to decrease the risk of first occurrence NTDs . This recommended dose is based mainly on the amount of folic acid associated with a reduction in NTDs in the majority of epidemiological studies. Literature data asserts that folic acid can prevent about 70% of NTD conceptions while folic acid-containing multivitamin can prevent about 90%; the diagnostic efficacy of ultrasound is nearly 100% in anencephalic fetuses and about 80% in fetuses with different manifestations of spina bifida. A bibliographical research regarding folate and NTD prevention, between 1988 and 2012, was done. The words used for Literature research were: Folic Acid, Spina bifida, Neural Tube Defects, Malformations. Search engines employed were: Medline, Pubmed, PopLine and the most relevant reports on the topic.
Neural tube defects (NTDs) are congenital malformations of the brain and spinal cord caused by failure of the neural tube to close between 21 and 28 days following conception. Each year almost 400.000 infants are born with NTDs all over the world. Although many advances have been made in the spina bifida’s treatment and have led to an increased life expectancy and an improved life quality, no treatment exists that will completely eliminate the serious disability or premature mortality associated with it. For such a reason, reducing the risk of NTDs is an important goal. It is widely ac-cepted that adequate maternal consumption of folic acid before pregnancy and during the early weeks of gestation can reduce the danger of having a child with a neural tube defect (NTD). As a result, public health authorities worldwide have recommended consuming 400 μg folic acid per day during the periconceptional period in order to decrease the risk of first occurrence NTDs . This recommended dose is based mainly on the amount of folic acid associated with a reduction in NTDs in the majority of epidemiological studies. Literature data asserts that folic acid can prevent about 70% of NTD conceptions while folic acid-containing multivitamin can prevent about 90%; the diagnostic efficacy of ultrasound is nearly 100% in anencephalic fetuses and about 80% in fetuses with different manifestations of spina bifida. A bibliographical research regarding folate and NTD prevention, between 1988 and 2012, was done. The words used for Literature research were: Folic Acid, Spina bifida, Neural Tube Defects, Malformations. Search engines employed were: Medline, Pubmed, PopLine and the most relevant reports on the topic.
Folates and Prevention of Neural-Tube Diseases
doi:10.11648/j.sjcm.20130202.13
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Leanza V.
Stracquadanio M.
Ciotta L.
Pafumi C.
Giannone T. T.
Giunta M. R.
Leanza G.
Mayada Chammas
Fawzi Chammas
Zarbo G.
Folates and Prevention of Neural-Tube Diseases
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© Science Publishing Group
Assessment of Knowledge and Utilization of the Partograph among Health Professionals in Amhara Region, Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130202.11
Labor and delivery are unpredictable events, which if not monitored properly can result in a disabled or a fatal state. The World Health Organization (WHO) promotes the use of the partograph to monitor and improve the management of labor and to support decision-making regarding interventions. However, little is known about the status of knowledge and utilization of the partograph in Amhara region, Ethiopia. Therefore, this study aimed to assess the level of knowledge of the partograph and its utilization. A facility based cross-sectional study was conducted from September 1 to 30, 2012 among 292 health professionals working in public health institutions of the region, using a structured interviewer administered ques-tionnaires. The collected data were analyzed using SPSS version 16. Binary logistic regression analysis was used to identify factors associated with knowledge of the partograph and obstetric care. Utilization status of the partograph was assessed from 160 purposively selected delivery charts using structured checklists. More than half (53.4%) of the study participants had good knowledge of the partograph. Females were 2 times more likely to have good knowledge of the partograph than males (AOR=2.0, 95% CI= (1.2, 3.6). Similarly, those who had previous obstetric training were 2 time more likely to have good knowledge of the partograph than otherwise (AOR=2.1, 95% CI= (1.3, 3.7). However, participants’ level of knowledge of components ofthe partograph was very poor. While only 26.6% of participants were able to mention 50%or more of com-ponentsof the partograph; females, midwives, and those having prior obstetric training were found to have better knowledge of components of the partograph than their counter parts (AOR=3.3, 95% CI (1.9, 5.6), (AOR=4.9, 95% CI (2.4, 9.9)and (AOR=2.0, 95% CI (1.1, 3.6)) respectively. In this study, the level of knowledge of obstetric care was found to be poor. Although it wasrevealed that majority of the participants had favorable attitude towards the use of partograph, only 29% of the paragraph papers reviewed was properly filled to monitor the progress of labor. Despite significant number of study participants reported that the partograph is useful to monitor laborand make timely decision, their level of knowledge of the partograph and its components was generally poor. Presence of prior training, participants’ sex and profession were the variables that had influenced the level of knowledge of the partograph and obstetric care. Favorable attitude by itself was inadequate to ensure use of the partograph. Periodic on-job training regarding to obstetric care and on the partograph should be provided to all obstetric care providersparticularly to males and nurses by profession in the region. Regular supportive supervision is also needed to motivate staffs to utilize the partograph and help them become dedicated to record and document their findings.
Labor and delivery are unpredictable events, which if not monitored properly can result in a disabled or a fatal state. The World Health Organization (WHO) promotes the use of the partograph to monitor and improve the management of labor and to support decision-making regarding interventions. However, little is known about the status of knowledge and utilization of the partograph in Amhara region, Ethiopia. Therefore, this study aimed to assess the level of knowledge of the partograph and its utilization. A facility based cross-sectional study was conducted from September 1 to 30, 2012 among 292 health professionals working in public health institutions of the region, using a structured interviewer administered ques-tionnaires. The collected data were analyzed using SPSS version 16. Binary logistic regression analysis was used to identify factors associated with knowledge of the partograph and obstetric care. Utilization status of the partograph was assessed from 160 purposively selected delivery charts using structured checklists. More than half (53.4%) of the study participants had good knowledge of the partograph. Females were 2 times more likely to have good knowledge of the partograph than males (AOR=2.0, 95% CI= (1.2, 3.6). Similarly, those who had previous obstetric training were 2 time more likely to have good knowledge of the partograph than otherwise (AOR=2.1, 95% CI= (1.3, 3.7). However, participants’ level of knowledge of components ofthe partograph was very poor. While only 26.6% of participants were able to mention 50%or more of com-ponentsof the partograph; females, midwives, and those having prior obstetric training were found to have better knowledge of components of the partograph than their counter parts (AOR=3.3, 95% CI (1.9, 5.6), (AOR=4.9, 95% CI (2.4, 9.9)and (AOR=2.0, 95% CI (1.1, 3.6)) respectively. In this study, the level of knowledge of obstetric care was found to be poor. Although it wasrevealed that majority of the participants had favorable attitude towards the use of partograph, only 29% of the paragraph papers reviewed was properly filled to monitor the progress of labor. Despite significant number of study participants reported that the partograph is useful to monitor laborand make timely decision, their level of knowledge of the partograph and its components was generally poor. Presence of prior training, participants’ sex and profession were the variables that had influenced the level of knowledge of the partograph and obstetric care. Favorable attitude by itself was inadequate to ensure use of the partograph. Periodic on-job training regarding to obstetric care and on the partograph should be provided to all obstetric care providersparticularly to males and nurses by profession in the region. Regular supportive supervision is also needed to motivate staffs to utilize the partograph and help them become dedicated to record and document their findings.
Assessment of Knowledge and Utilization of the Partograph among Health Professionals in Amhara Region, Ethiopia
doi:10.11648/j.sjcm.20130202.11
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Fantu Abebe
Dereje Birhanu
Worku Awoke
Tadesse Ejigu
Assessment of Knowledge and Utilization of the Partograph among Health Professionals in Amhara Region, Ethiopia
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© Science Publishing Group
Epidemiology and Clinical Study of Pediatric Psoriasis on Black Skin in Dakar, Senegal
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130202.12
Introduction: In subsaharian African countries there are so few data concerning the psoriasis of the child. Our objective was to determine the epidemiological, clinical and therapeutic aspects of the pediatric psoriasis in a dermatology unit, at Dakar in Senegal. Patients and methods: This was an 8 years (2004-2011) retrospective study conducted at the Dermatological clinic of HALD. All patients under 16 years old with psoriasis were included. Results: We report 40 cases of psoriasis of the child. The sex ratio was 1.05 and the average age of 6 years. The atopic status was found in 4 cases as follows: 3 cases of asthma and 1 case of atopic dermatitis. The average time of consultation was 5 months. The way the patients consulted was: 28 cases consulted a general practitioner, 6 cases seen by a paramedic and 5 patients consulted a traditional healer. The pruritus was present in 14 patients. The psoriasis vulgaris was the predominant form with 20 cases. The other forms were: 12 cases of guttate psoriasis, 6 cases of psoriasis universalis, 1 case in pustular and 1 case erythro-dermic. The topical glucocorticoids were prescribed in all the patients. The recurrence was found in 5 cases and 8 patients were lost of follow up. Conclusion: Psoriasis is a rare and benign condition in children with predominance of simple forms such as psoriasis vulgaris.
Introduction: In subsaharian African countries there are so few data concerning the psoriasis of the child. Our objective was to determine the epidemiological, clinical and therapeutic aspects of the pediatric psoriasis in a dermatology unit, at Dakar in Senegal. Patients and methods: This was an 8 years (2004-2011) retrospective study conducted at the Dermatological clinic of HALD. All patients under 16 years old with psoriasis were included. Results: We report 40 cases of psoriasis of the child. The sex ratio was 1.05 and the average age of 6 years. The atopic status was found in 4 cases as follows: 3 cases of asthma and 1 case of atopic dermatitis. The average time of consultation was 5 months. The way the patients consulted was: 28 cases consulted a general practitioner, 6 cases seen by a paramedic and 5 patients consulted a traditional healer. The pruritus was present in 14 patients. The psoriasis vulgaris was the predominant form with 20 cases. The other forms were: 12 cases of guttate psoriasis, 6 cases of psoriasis universalis, 1 case in pustular and 1 case erythro-dermic. The topical glucocorticoids were prescribed in all the patients. The recurrence was found in 5 cases and 8 patients were lost of follow up. Conclusion: Psoriasis is a rare and benign condition in children with predominance of simple forms such as psoriasis vulgaris.
Epidemiology and Clinical Study of Pediatric Psoriasis on Black Skin in Dakar, Senegal
doi:10.11648/j.sjcm.20130202.12
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Ndiaye Maodo
Dioussé Pauline
Diallo Moussa
Diop Assane
Diatta Boubacar Ahy
Niang Suzanne Oumou
Diallo Salimatou
Seck Ndeye Bougoul
Diadie Saer
Ndiaye Mame Téné
Ly Fatimata
Dieng Mame Thierno
Kane Assane
Epidemiology and Clinical Study of Pediatric Psoriasis on Black Skin in Dakar, Senegal
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2014-01-01
10.11648/j.sjcm.20130202.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130202.12
© Science Publishing Group
Quality Audit on Venous Blood Sample Processing in Laboratories of Governmental Hospitals in Gamo Gofa Zone, South Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130202.14
Back ground: Pre-analytical activities persist to pose significant amount of uncertainties in clinical laboratories causing adverse impacts on patient health and the entire healthcare system. Venous blood sample (VBS) processing that has many error prone activities is one of the pre-analytical procedures performed in the laboratory. The objective of our survey was to identify, in Ethiopian Hospital laboratory set-up, the major activities in the processing of VBS in which undesirable practices that may result in errors are executed. Methods: We have conducted institution based cross-sectional survey sup-plemented with non-participatory type observational study from February 2012 to September 2012 in laboratories of three governmental hospitals of Gamo Gofa zone, Southern Ethiopia. Pre-tested questionnaire and check list were used for data collection. Analysis of the data was performed using Medcalc® version 12.1.4 software. Results: A total of 19 laboratory professionals working in the three governmental hospitals were included in this survey. The activities possessing highest proportions of undesirable practices were related to establishment and adherence to serum/plasma/whole blood rejection criteria, measures taken when produced serum/plasma is too small for analysis, speed and duration of centrifugation. Low proportion of undesirable practices were found in activities related to capping test tubes before centrifugation, maximum allowed time before analysis of unpreserved serum/plasma/whole blood samples and balancing during centrifugation. None of the socio-demographic and background information of participants we assessed was associated with undesirability of VBS processing activities. Conclusion: From this study, we concluded that the VBS processing in the laboratories involved many undesirable practices that might lead to erroneous results. We identified that the gearing problem to the undesirable practices was absence of laboratory documents regarding VBS processing activities. Therefore, establishment and strict adherence to laboratory documents for every activity in VBS processing by every laboratory personnel would avoid many of the unde-sirable practices.
Back ground: Pre-analytical activities persist to pose significant amount of uncertainties in clinical laboratories causing adverse impacts on patient health and the entire healthcare system. Venous blood sample (VBS) processing that has many error prone activities is one of the pre-analytical procedures performed in the laboratory. The objective of our survey was to identify, in Ethiopian Hospital laboratory set-up, the major activities in the processing of VBS in which undesirable practices that may result in errors are executed. Methods: We have conducted institution based cross-sectional survey sup-plemented with non-participatory type observational study from February 2012 to September 2012 in laboratories of three governmental hospitals of Gamo Gofa zone, Southern Ethiopia. Pre-tested questionnaire and check list were used for data collection. Analysis of the data was performed using Medcalc® version 12.1.4 software. Results: A total of 19 laboratory professionals working in the three governmental hospitals were included in this survey. The activities possessing highest proportions of undesirable practices were related to establishment and adherence to serum/plasma/whole blood rejection criteria, measures taken when produced serum/plasma is too small for analysis, speed and duration of centrifugation. Low proportion of undesirable practices were found in activities related to capping test tubes before centrifugation, maximum allowed time before analysis of unpreserved serum/plasma/whole blood samples and balancing during centrifugation. None of the socio-demographic and background information of participants we assessed was associated with undesirability of VBS processing activities. Conclusion: From this study, we concluded that the VBS processing in the laboratories involved many undesirable practices that might lead to erroneous results. We identified that the gearing problem to the undesirable practices was absence of laboratory documents regarding VBS processing activities. Therefore, establishment and strict adherence to laboratory documents for every activity in VBS processing by every laboratory personnel would avoid many of the unde-sirable practices.
Quality Audit on Venous Blood Sample Processing in Laboratories of Governmental Hospitals in Gamo Gofa Zone, South Ethiopia
doi:10.11648/j.sjcm.20130202.14
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Mulugeta Melkie
Abel Girma
Tsegaye Tsalla
Quality Audit on Venous Blood Sample Processing in Laboratories of Governmental Hospitals in Gamo Gofa Zone, South Ethiopia
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57
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2014-01-01
2014-01-01
10.11648/j.sjcm.20130202.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130202.14
© Science Publishing Group
The Immunogenetic Analysis of Acne Vulgaris
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130202.15
Polymorphisms that occur in the CYP1A1, CYP17 and TNF-α genes affects hyperkeratinzation process, se-bum production and inflammation in acne vulgaris. Polymorphisms of CYP1A1, CYP17 and TNF-α genes can be identified by using PCR and sequencing techniques. The aim of this study is to demonstrate the role of polymorphisms of CYP1A1, CYP17, and TNF-α genes and the interaction polimorphisms of CYP1A1, CYP17 and TNF-α genes to severe acne vulgaris. This study was conducted as an observational study with case-control method, in 64 patients with severe acne, and as controls 73 patients with mild acne and healthy people. Criteria based on Combined Acne Severity Classification. Biospesimen blood 1 ml taken from vena mediana cubiti then performed PCR and sequencing to determine the sequence of nucleotides in DNA fragments. The conclution from the study shows that polymorphisms of CYP1A1, CYP17, TNF-α genes and the interaction polimorphisms of CYP1A1, CYP 17 and TNF-α genes is not a risk factor for severe acne vulgaris, but polymorphism of CYP1A1 gene is a risk factor for acne vulgaris.
Polymorphisms that occur in the CYP1A1, CYP17 and TNF-α genes affects hyperkeratinzation process, se-bum production and inflammation in acne vulgaris. Polymorphisms of CYP1A1, CYP17 and TNF-α genes can be identified by using PCR and sequencing techniques. The aim of this study is to demonstrate the role of polymorphisms of CYP1A1, CYP17, and TNF-α genes and the interaction polimorphisms of CYP1A1, CYP17 and TNF-α genes to severe acne vulgaris. This study was conducted as an observational study with case-control method, in 64 patients with severe acne, and as controls 73 patients with mild acne and healthy people. Criteria based on Combined Acne Severity Classification. Biospesimen blood 1 ml taken from vena mediana cubiti then performed PCR and sequencing to determine the sequence of nucleotides in DNA fragments. The conclution from the study shows that polymorphisms of CYP1A1, CYP17, TNF-α genes and the interaction polimorphisms of CYP1A1, CYP 17 and TNF-α genes is not a risk factor for severe acne vulgaris, but polymorphism of CYP1A1 gene is a risk factor for acne vulgaris.
The Immunogenetic Analysis of Acne Vulgaris
doi:10.11648/j.sjcm.20130202.15
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Anis Irawan Anwar
Indropo Agusni
Muh. Nasrum Massi
Irawan Yusuf
The Immunogenetic Analysis of Acne Vulgaris
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2014-01-01
10.11648/j.sjcm.20130202.15
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130202.15
© Science Publishing Group
Sirenomelia within a One-Year Period at Fallujah General Hospital: Two Case Reports
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.11
Sirenomelia also called as Mermaid Syndrome, is a rare congenital malformation of uncertain aetiology. It is characterised by fusion of the lower limbs and commonly associated with severe urogenital and gastrointestinal malformation. It should be suspected in antenatal period in cases presenting with severe oligohydramnios and intra-uterine growth retardation. This is a report of 2 cases of Sirenomelia in Fallujah general hospital within a period of about 1 yr., with an incidence of about 10.3 / 100.000 total births which was about 2 to 3 times the registered overall incidence.
Sirenomelia also called as Mermaid Syndrome, is a rare congenital malformation of uncertain aetiology. It is characterised by fusion of the lower limbs and commonly associated with severe urogenital and gastrointestinal malformation. It should be suspected in antenatal period in cases presenting with severe oligohydramnios and intra-uterine growth retardation. This is a report of 2 cases of Sirenomelia in Fallujah general hospital within a period of about 1 yr., with an incidence of about 10.3 / 100.000 total births which was about 2 to 3 times the registered overall incidence.
Sirenomelia within a One-Year Period at Fallujah General Hospital: Two Case Reports
doi:10.11648/j.sjcm.20130203.11
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Samira Alaani
Michael Musanzikwa
Abdulqadir Abdulkareem Murie
Sirenomelia within a One-Year Period at Fallujah General Hospital: Two Case Reports
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2014-01-01
2014-01-01
10.11648/j.sjcm.20130203.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.11
© Science Publishing Group
Urban-Rural Differentials in Using Antimicrobials at Home among Under-5 Children with Diarrhea
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.14
Due to self-limiting course of disease, use of antimicrobials in childhood diarrhea should be limited; however, irrational use is widely reported and is considered as a potential challenge for controlling its rational use. Thus, the present study aimed to describe urban-rural differentials with regard to socio-demographic characteristics, clinical features, and etiologic distribution in antimicrobial use and identify predictors of its use at home before coming to the hospital. From the database (January, 2010 to December, 2012) of Diarrheal Disease Surveillance System (DDSS) of urban Dhaka Hospital and rural Matlab Hospital of icddr,b, we extracted relevant information of 4,245 under-5 children from Dhaka Hospital and 2,161 children from Matlab Hospital. In multivariate analysis, children from urban area were 1.53 times, children aged under 2 years were 1.31 times, better socio-economic status (monthly income >100 US\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\$) were 1.34 times, distance to health facility >5 miles from home 1.63 times, use of oral rehydration solution at home 2.95 times, duration of diarrhea >24 hours 4.25 times, frequency of stool >10 times/24 hrs. 1.47 times, abdominal pain 1.30 times and rotavirus infection were 1.54 times more likely to use antimicrobials at home before coming to the hospital (all p<0.05). On the other hand, maternal illiteracy (OR-0.74), cough (0.83) and Vibrio cholerae infection (0.70) were less likely to influence antimicrobials use at home in study children (all p<0.05). Socio-economic characteristics, clinical features, and etiologic agents of under-5 children determine use of antimicrobials at home before presenting to health facility.
Due to self-limiting course of disease, use of antimicrobials in childhood diarrhea should be limited; however, irrational use is widely reported and is considered as a potential challenge for controlling its rational use. Thus, the present study aimed to describe urban-rural differentials with regard to socio-demographic characteristics, clinical features, and etiologic distribution in antimicrobial use and identify predictors of its use at home before coming to the hospital. From the database (January, 2010 to December, 2012) of Diarrheal Disease Surveillance System (DDSS) of urban Dhaka Hospital and rural Matlab Hospital of icddr,b, we extracted relevant information of 4,245 under-5 children from Dhaka Hospital and 2,161 children from Matlab Hospital. In multivariate analysis, children from urban area were 1.53 times, children aged under 2 years were 1.31 times, better socio-economic status (monthly income >100 US\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\$) were 1.34 times, distance to health facility >5 miles from home 1.63 times, use of oral rehydration solution at home 2.95 times, duration of diarrhea >24 hours 4.25 times, frequency of stool >10 times/24 hrs. 1.47 times, abdominal pain 1.30 times and rotavirus infection were 1.54 times more likely to use antimicrobials at home before coming to the hospital (all p<0.05). On the other hand, maternal illiteracy (OR-0.74), cough (0.83) and Vibrio cholerae infection (0.70) were less likely to influence antimicrobials use at home in study children (all p<0.05). Socio-economic characteristics, clinical features, and etiologic agents of under-5 children determine use of antimicrobials at home before presenting to health facility.
Urban-Rural Differentials in Using Antimicrobials at Home among Under-5 Children with Diarrhea
doi:10.11648/j.sjcm.20130203.14
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Shahnawaz Ahmed
Fahmida Dil Farzana
Farzana Ferdous
Mohammod Jobayer Chisti
Mohammad Abdul Malek
Abu Syed Golam Faruque
Sumon Kumar Das
Urban-Rural Differentials in Using Antimicrobials at Home among Under-5 Children with Diarrhea
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86
86
2014-01-01
2014-01-01
10.11648/j.sjcm.20130203.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.14
© Science Publishing Group
Diagnosis of Congenital Cytomegalovirus Infection In High Risk Neonates
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.12
Objectives: This study aimed to compare polymerase chain reaction (PCR) and IgM detection using enzyme linked immune-sorbent assay (ELISA) in diagnosis of congenital cytomegalovirus (CMV) infection. Methods: This study was conducted from May 2011 to December 2012. Urine and blood samples were collected from 94 neonates with suspected congenital CMV infection. Serum and part of urine samples were stored at -20°C freezer, until the serologic and PCR tests were achieved. A 94 fresh urine samples were processed for cell culture. Nineteen (20.2%) out of 94 urine samples were proven positive for CMV infection by viral culture. For comparing PCR and IgM ELISA we used tissue culture technique as a reference, the 19 positive samples on culture (CMV group) and 20 negative samples (control group) were included in the comparison. Some characteristics of CMV and control groups were compared including sex, age, birth weight, gestational age < 37 and small for gestational age. Clinical and laboratory abnormalities were also compared in both groups. Results: This study showed that the sensitivity and specificity of PCR in relation to viral culture were 100% and 100% respectively, there was excellent agreement between both tests (Kappa coefficient was 1 and P=0.000). On the other hand, the sensitivity of IgM CMV ELISA in relation to viral culture was 63.2% and the specificity was 85%. There was good agreement between both tests (Kappa coefficient was 0.48 and P=0.002). By comparing CMV and control groups, there were high statistically significant differences between both groups as regard the birth weight, gestational age < 37 and small for gestational age items (P= 0.00, 0.03 and 0.01 respectively). There were statistically insignificant differences as regarding the clinical and laboratory abnormalities detected for neonates of both groups. In this study jaundice (63%) and hepato-splenomegaly (42%) were the most common clinical signs in both groups. Conclusion: PCR is more sensitive and specific technique for detection of congenital CMV infection than CMV IgM ELISA. Being more cost effective, less cumbersome and less time consuming in relation to viral culture, PCR may be used in detection of congenital CMV infection.
Objectives: This study aimed to compare polymerase chain reaction (PCR) and IgM detection using enzyme linked immune-sorbent assay (ELISA) in diagnosis of congenital cytomegalovirus (CMV) infection. Methods: This study was conducted from May 2011 to December 2012. Urine and blood samples were collected from 94 neonates with suspected congenital CMV infection. Serum and part of urine samples were stored at -20°C freezer, until the serologic and PCR tests were achieved. A 94 fresh urine samples were processed for cell culture. Nineteen (20.2%) out of 94 urine samples were proven positive for CMV infection by viral culture. For comparing PCR and IgM ELISA we used tissue culture technique as a reference, the 19 positive samples on culture (CMV group) and 20 negative samples (control group) were included in the comparison. Some characteristics of CMV and control groups were compared including sex, age, birth weight, gestational age < 37 and small for gestational age. Clinical and laboratory abnormalities were also compared in both groups. Results: This study showed that the sensitivity and specificity of PCR in relation to viral culture were 100% and 100% respectively, there was excellent agreement between both tests (Kappa coefficient was 1 and P=0.000). On the other hand, the sensitivity of IgM CMV ELISA in relation to viral culture was 63.2% and the specificity was 85%. There was good agreement between both tests (Kappa coefficient was 0.48 and P=0.002). By comparing CMV and control groups, there were high statistically significant differences between both groups as regard the birth weight, gestational age < 37 and small for gestational age items (P= 0.00, 0.03 and 0.01 respectively). There were statistically insignificant differences as regarding the clinical and laboratory abnormalities detected for neonates of both groups. In this study jaundice (63%) and hepato-splenomegaly (42%) were the most common clinical signs in both groups. Conclusion: PCR is more sensitive and specific technique for detection of congenital CMV infection than CMV IgM ELISA. Being more cost effective, less cumbersome and less time consuming in relation to viral culture, PCR may be used in detection of congenital CMV infection.
Diagnosis of Congenital Cytomegalovirus Infection In High Risk Neonates
doi:10.11648/j.sjcm.20130203.12
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Ehab Abd Elmoniem Albanna
Randa Saddek Abd El-latif
Hend Alsayed Sharaf
Maha Kamal Gohar
Basem Mohamed Ibrahim
Diagnosis of Congenital Cytomegalovirus Infection In High Risk Neonates
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2014-01-01
10.11648/j.sjcm.20130203.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.12
© Science Publishing Group
Sputum Expectoration as a Useful non-Invasive Alternative to Bronchoalveolar Lavage for Collecting Human Alveolar Macrophages in Tuberculosis Research
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.16
As tuberculosis (TB) still claims millions of lives in the world, more research should be directed toward understanding this disease and finding a more effective solution. In vivo human alveolar macrophages are an important focus in TB research since the causative agent, Mycobacterium tuberculosis, can be harbored within these cells in an inactive form for a long time before reactivation. To date, TB researchers collect alveolar macrophage samples using a special clinical procedure known as bronchoalveolar lavage (BAL) in which a bronchoscope is inserted into the lung and the cell samples are collected after being washed out with fluid. BAL is an invasive procedure and its use for a clinical study would often meet with practical constraints and the patient’s psychological resistance. These concerns led us to seek a non-invasive approach. In the present study, we collected alveolar macrophage samples from patients with active tuberculosis using a simple sputum expectoration procedure and used the samples to assess the gene expression activities of these immune cells. In this work, we made contributions in two aspects. This study is the first to demonstrate that sputum expectoration is a useful non-invasive alternative for collecting alveolar macrophages whose gene activities would serve to monitor the disease activity. In addition, we analyzed the gene expression of alveolar macrophages in the in vivo samples obtained from TB patients, in contrast to related work where gene expression was profiled on alveolar macrophages collected from non-TB patients and then infected with Mycobacterium tuberculosis in vitro.
As tuberculosis (TB) still claims millions of lives in the world, more research should be directed toward understanding this disease and finding a more effective solution. In vivo human alveolar macrophages are an important focus in TB research since the causative agent, Mycobacterium tuberculosis, can be harbored within these cells in an inactive form for a long time before reactivation. To date, TB researchers collect alveolar macrophage samples using a special clinical procedure known as bronchoalveolar lavage (BAL) in which a bronchoscope is inserted into the lung and the cell samples are collected after being washed out with fluid. BAL is an invasive procedure and its use for a clinical study would often meet with practical constraints and the patient’s psychological resistance. These concerns led us to seek a non-invasive approach. In the present study, we collected alveolar macrophage samples from patients with active tuberculosis using a simple sputum expectoration procedure and used the samples to assess the gene expression activities of these immune cells. In this work, we made contributions in two aspects. This study is the first to demonstrate that sputum expectoration is a useful non-invasive alternative for collecting alveolar macrophages whose gene activities would serve to monitor the disease activity. In addition, we analyzed the gene expression of alveolar macrophages in the in vivo samples obtained from TB patients, in contrast to related work where gene expression was profiled on alveolar macrophages collected from non-TB patients and then infected with Mycobacterium tuberculosis in vitro.
Sputum Expectoration as a Useful non-Invasive Alternative to Bronchoalveolar Lavage for Collecting Human Alveolar Macrophages in Tuberculosis Research
doi:10.11648/j.sjcm.20130203.16
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Li M. Fu
Charles D. Sohaskey
Brenda Jones
Sputum Expectoration as a Useful non-Invasive Alternative to Bronchoalveolar Lavage for Collecting Human Alveolar Macrophages in Tuberculosis Research
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2014-01-01
2014-01-01
10.11648/j.sjcm.20130203.16
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.16
© Science Publishing Group
Burn Shock and Multiple Organ Failure Syndromes
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.15
Critical condition, developing in patients with burns during the burn shock more often produce the development of nonspecific reactions in the body, manifested as the system or the organ insufficiency and are determined by the term «syndrome of poly organ insufficiency» (SPOI). The course and treatment of 189 patients with burn shock have been analyzed. With the purpose of investigation all patients with burn shock were subdivided into 2 groups: The first (control) group included 79 patients (23 children, 56 adults) and was treated according to traditional antishock infusion-transfusion therapy without inotropic therapy. The second (basic) group included 110 patients (33 children, 77 adults) with burn shock and underwent a complex, antishock infusion-transfusion therapy with employment of inotropic and organoprotective therapy depending on dysfunction of vitals and systems. All patients with burn shock underwent general clinical examinations of: cardiovascular and respiratory systems, functions of the lever, kidneys and gastrointestinal tract for revealing of polyorgan insufficiency (POI). The victims of burns - material prove high spread POI in patients with burns, that requires complex, purposeful conservative (local and general) and surgical treatment for its reduction and prevention of unfavorable results.
Critical condition, developing in patients with burns during the burn shock more often produce the development of nonspecific reactions in the body, manifested as the system or the organ insufficiency and are determined by the term «syndrome of poly organ insufficiency» (SPOI). The course and treatment of 189 patients with burn shock have been analyzed. With the purpose of investigation all patients with burn shock were subdivided into 2 groups: The first (control) group included 79 patients (23 children, 56 adults) and was treated according to traditional antishock infusion-transfusion therapy without inotropic therapy. The second (basic) group included 110 patients (33 children, 77 adults) with burn shock and underwent a complex, antishock infusion-transfusion therapy with employment of inotropic and organoprotective therapy depending on dysfunction of vitals and systems. All patients with burn shock underwent general clinical examinations of: cardiovascular and respiratory systems, functions of the lever, kidneys and gastrointestinal tract for revealing of polyorgan insufficiency (POI). The victims of burns - material prove high spread POI in patients with burns, that requires complex, purposeful conservative (local and general) and surgical treatment for its reduction and prevention of unfavorable results.
Burn Shock and Multiple Organ Failure Syndromes
doi:10.11648/j.sjcm.20130203.15
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Erkin A. Hakimov
Babur M. Shakirov
Bohodir H. Karabaev
Komil R. Tagaev
Burn Shock and Multiple Organ Failure Syndromes
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2014-01-01
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.15
© Science Publishing Group
Antimicrobial Activity of the Aqueous Extract of Mint Plant
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.19
In the present study, an antimicrobial activity of the Aqueous extract of Mentha species was assessed using both well diffusion and microdilution method in multi-well micro-titer plates. Mint extract investigated for its antibacterial activity against seven selected pathogenic bacteria: Bacillus fastidiosus, Staphylococcus aureus, Proteus mirabilis, Proteus vulgaris, Salmonella choleraesuis, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Serratia odorifera. Menth extract at different concentrations (1:1, 1:5, 1:10, and 1:20) was active against all tested bacteria except for S.aureus, and the highest inhibitory effect was observed against S. mutans using the well diffusion method. Antibacterial activity of Aqueous extracts of selected commonly used Mint were screened against multi drug resistant bacteria ,which concludes that their extracts can be used against multi drug resistance bacteria capable of causing both nosocomial and community acquired infections.
In the present study, an antimicrobial activity of the Aqueous extract of Mentha species was assessed using both well diffusion and microdilution method in multi-well micro-titer plates. Mint extract investigated for its antibacterial activity against seven selected pathogenic bacteria: Bacillus fastidiosus, Staphylococcus aureus, Proteus mirabilis, Proteus vulgaris, Salmonella choleraesuis, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Serratia odorifera. Menth extract at different concentrations (1:1, 1:5, 1:10, and 1:20) was active against all tested bacteria except for S.aureus, and the highest inhibitory effect was observed against S. mutans using the well diffusion method. Antibacterial activity of Aqueous extracts of selected commonly used Mint were screened against multi drug resistant bacteria ,which concludes that their extracts can be used against multi drug resistance bacteria capable of causing both nosocomial and community acquired infections.
Antimicrobial Activity of the Aqueous Extract of Mint Plant
doi:10.11648/j.sjcm.20130203.19
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Basheer A. Al-Sum
Abdullah A. Al-Arfaj
Antimicrobial Activity of the Aqueous Extract of Mint Plant
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2014-01-01
10.11648/j.sjcm.20130203.19
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.19
© Science Publishing Group
Comparative Effect of Natural Commodities and Commercial Medicines Against Oral Thrush Causing Fungal Organism of Candida Albicans
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.13
The aim of the study was to explore the comparative analysis antifungal efficiency of six natural commodities and four commercial medicines against the oral thrush causing organism of Candida albicans. From the present result along with the six natural commodities, Mayaca showed maximum inhibitory activity against C. albicans followed by garlic, gooseberry, wine, coconut oil and pomegranate. While, the significant antifungal activity noted in Mayaca ehtanolic extract against C. albicans at 50 and 100µl concentration (P<0.05), and other natural substances such as garlic and gooseberry antifungal activity also expressed significantly. In the GC-MS analysis ten bioactive compounds were identified in the ehtanolic extract. Besides the identified bioactive peak phytochemical compounds named as 3,4-Dimethyl-2-3-methyl with its Ret. time 19.050 followed by second and third peak compounds are Diethylpthalate and Bis-3,4 methylene Dioxy accompanied with them responsible RT was 21.004 and 28.666 respectively. The overall results clearly denoted ethanol extract of Mayaca act as significant antifungal C. albicans agent mainly it was possessed specific antimicrobial secondary metabolic compounds present than other five natural commodities and four commercial products. Hence, the present study focused that the Mayaca extract act as a potential antifungal agent for oral thrush causing fungi of C. albicans.
The aim of the study was to explore the comparative analysis antifungal efficiency of six natural commodities and four commercial medicines against the oral thrush causing organism of Candida albicans. From the present result along with the six natural commodities, Mayaca showed maximum inhibitory activity against C. albicans followed by garlic, gooseberry, wine, coconut oil and pomegranate. While, the significant antifungal activity noted in Mayaca ehtanolic extract against C. albicans at 50 and 100µl concentration (P<0.05), and other natural substances such as garlic and gooseberry antifungal activity also expressed significantly. In the GC-MS analysis ten bioactive compounds were identified in the ehtanolic extract. Besides the identified bioactive peak phytochemical compounds named as 3,4-Dimethyl-2-3-methyl with its Ret. time 19.050 followed by second and third peak compounds are Diethylpthalate and Bis-3,4 methylene Dioxy accompanied with them responsible RT was 21.004 and 28.666 respectively. The overall results clearly denoted ethanol extract of Mayaca act as significant antifungal C. albicans agent mainly it was possessed specific antimicrobial secondary metabolic compounds present than other five natural commodities and four commercial products. Hence, the present study focused that the Mayaca extract act as a potential antifungal agent for oral thrush causing fungi of C. albicans.
Comparative Effect of Natural Commodities and Commercial Medicines Against Oral Thrush Causing Fungal Organism of Candida Albicans
doi:10.11648/j.sjcm.20130203.13
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Reena, T
Rohitha Prem
Deepthi, M. S
R. Beni Ramachanran
S. Sujatha
Comparative Effect of Natural Commodities and Commercial Medicines Against Oral Thrush Causing Fungal Organism of Candida Albicans
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2014-01-01
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.13
© Science Publishing Group
Risk Factors For Hepatitis B Virus Infection Among Adult Nigerians With Clinical Features Of Liver Diseases In A Resource-Constrained Environment Of A Primary Care Clinic In Eastern Nigeria
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.17
Background: Hepatitis B virus (HBV) infection is an important contributor to the burden of liver diseases in adult Nigerians and constitutes a threat to socio-economic development in the sub-region. Screening for its risk factors in patients with clinical features of liver diseases is an important primary care challenge that is often neglected. Aim: To determine the risk factors for HBV infection in adult Nigerians with clinical features of liver diseases in a resource-constrained environment of a primary care clinic in Eastern Nigeria. Materials and Methods: A cross sectional study was carried out on 140 adult Nigerians with clinical features of liver diseases at the primary care clinic of a tertiary hospital in Nigeria. Clinical features of liver diseases were based on the presence of some constitutional, hepatic and extra-hepatic features. Hepatitis B surface antigen (HBsAg) was assayed using immunochromatographic method. A pre-tested, structured interviewer-administered questionnaire was used to obtain socio-demographic variables and histories of HBV-related risk factors. Results: The HBV sero-prevalence was 50.7%. The age group 40 – 60 years (P=0.048) and artisans (P=0.019) were significantly infected. The behavioural risk factors significantly associated with HBV infection were histories of unprotected sexual exposures (P=0.001), blood transfusion (P=0.022) and non-hepatitis B vaccination (P=0.030). The most significant predictor of HBV infection was history of unprotected sexual exposures (OR=5.04, P=0.003). Conclusion: Risk factors of HBV infection exist in adult Nigerian patients with clinical features of liver diseases and HBV infection was significantly associated with age, occupation, unprotected sexual exposures, blood transfusion and non-hepatitis B vaccination.
Background: Hepatitis B virus (HBV) infection is an important contributor to the burden of liver diseases in adult Nigerians and constitutes a threat to socio-economic development in the sub-region. Screening for its risk factors in patients with clinical features of liver diseases is an important primary care challenge that is often neglected. Aim: To determine the risk factors for HBV infection in adult Nigerians with clinical features of liver diseases in a resource-constrained environment of a primary care clinic in Eastern Nigeria. Materials and Methods: A cross sectional study was carried out on 140 adult Nigerians with clinical features of liver diseases at the primary care clinic of a tertiary hospital in Nigeria. Clinical features of liver diseases were based on the presence of some constitutional, hepatic and extra-hepatic features. Hepatitis B surface antigen (HBsAg) was assayed using immunochromatographic method. A pre-tested, structured interviewer-administered questionnaire was used to obtain socio-demographic variables and histories of HBV-related risk factors. Results: The HBV sero-prevalence was 50.7%. The age group 40 – 60 years (P=0.048) and artisans (P=0.019) were significantly infected. The behavioural risk factors significantly associated with HBV infection were histories of unprotected sexual exposures (P=0.001), blood transfusion (P=0.022) and non-hepatitis B vaccination (P=0.030). The most significant predictor of HBV infection was history of unprotected sexual exposures (OR=5.04, P=0.003). Conclusion: Risk factors of HBV infection exist in adult Nigerian patients with clinical features of liver diseases and HBV infection was significantly associated with age, occupation, unprotected sexual exposures, blood transfusion and non-hepatitis B vaccination.
Risk Factors For Hepatitis B Virus Infection Among Adult Nigerians With Clinical Features Of Liver Diseases In A Resource-Constrained Environment Of A Primary Care Clinic In Eastern Nigeria
doi:10.11648/j.sjcm.20130203.17
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Gabriel Uche Pascal Iloh
Abali Chuku
Agwu Nkwa Amadi
Nnadozie Paul Obiegbu
Risk Factors For Hepatitis B Virus Infection Among Adult Nigerians With Clinical Features Of Liver Diseases In A Resource-Constrained Environment Of A Primary Care Clinic In Eastern Nigeria
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2014-01-01
2014-01-01
10.11648/j.sjcm.20130203.17
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.17
© Science Publishing Group
Osteoid Osteoma of Base of Coracoid process, a Rare Location. A Case Report and Brief Review of Literature
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.18
Osteoid Osteoma is a little uncommon bony lesion. It rarely affects the scapula. Only a few cases are found in the literature. Even rarer is its occurrence at base of coracoids process. Osteoid osteoma of the base of coracoid process is a rare location. They may present simply as diffuse shoulder pain. Careful evaluation of the patient is important to diagnose this rare lesion. Clinical history is valuable, as well as the radiological investigations. Surgical treatment is definitive and rewarding. We are presenting a case of osteoid osteoma involving the base of coracoid process in a 12 year boy which was diagnosed clinico-radiologically and treated surgically by de-roofing and curettage of the lesion. The boy got complete relief of pre-operative symptoms.
Osteoid Osteoma is a little uncommon bony lesion. It rarely affects the scapula. Only a few cases are found in the literature. Even rarer is its occurrence at base of coracoids process. Osteoid osteoma of the base of coracoid process is a rare location. They may present simply as diffuse shoulder pain. Careful evaluation of the patient is important to diagnose this rare lesion. Clinical history is valuable, as well as the radiological investigations. Surgical treatment is definitive and rewarding. We are presenting a case of osteoid osteoma involving the base of coracoid process in a 12 year boy which was diagnosed clinico-radiologically and treated surgically by de-roofing and curettage of the lesion. The boy got complete relief of pre-operative symptoms.
Osteoid Osteoma of Base of Coracoid process, a Rare Location. A Case Report and Brief Review of Literature
doi:10.11648/j.sjcm.20130203.18
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Paragjyoti Gogoi
Kiran Makwana
Anshuman Dutta
Aditi Das
Osteoid Osteoma of Base of Coracoid process, a Rare Location. A Case Report and Brief Review of Literature
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2014-01-01
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.18
© Science Publishing Group
Alzheimer’s Disease and Type 2 Diabetes Mellitus: Risk Factors and Effectiveness of Antidiabetic Agents in Treatment of Alzheimer’s Disease
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.20
The aim of this review is to highlight the association between type 2 diabetes mellitus (DM) and cognitive impairment/Alzheimer’s disease (AD) and provide an updated summary of the evidence related to various potentially modifiable risk factors such as hyperinsulinaemia,insulin resistance,hypo-and hyperglycaemia, vascular risk factors like hypertension and obesity, micro and macrovascular complications, depression in AD.Treating modifiable risk factors can reduce the prevalence of AD.In addition we provide the information about potential benefits of antidiabetic agents for slowing of cognitive decline and AD in patients with type2 DM. There were studies demonstrating the novel effects of antidiabetic agents on neuronal functions by increased insulin signaling in an AD brain with a neuroprotective and neurotrophic effect. In this regard insulin, metformin and thiazolidinediones (in particular, rosiglitazone and pioglitazone ) would have potential protective effect for the development of AD.
The aim of this review is to highlight the association between type 2 diabetes mellitus (DM) and cognitive impairment/Alzheimer’s disease (AD) and provide an updated summary of the evidence related to various potentially modifiable risk factors such as hyperinsulinaemia,insulin resistance,hypo-and hyperglycaemia, vascular risk factors like hypertension and obesity, micro and macrovascular complications, depression in AD.Treating modifiable risk factors can reduce the prevalence of AD.In addition we provide the information about potential benefits of antidiabetic agents for slowing of cognitive decline and AD in patients with type2 DM. There were studies demonstrating the novel effects of antidiabetic agents on neuronal functions by increased insulin signaling in an AD brain with a neuroprotective and neurotrophic effect. In this regard insulin, metformin and thiazolidinediones (in particular, rosiglitazone and pioglitazone ) would have potential protective effect for the development of AD.
Alzheimer’s Disease and Type 2 Diabetes Mellitus: Risk Factors and Effectiveness of Antidiabetic Agents in Treatment of Alzheimer’s Disease
doi:10.11648/j.sjcm.20130203.20
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Aye Aye Myint
Kyaw Soe Win
Zaw Aung
Alzheimer’s Disease and Type 2 Diabetes Mellitus: Risk Factors and Effectiveness of Antidiabetic Agents in Treatment of Alzheimer’s Disease
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2014-01-01
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130203.20
© Science Publishing Group
Prediction of Postoperative Lung Function and Chronic Dyspnea in Lung Cancer Patients by Using Quantitative Computed Tomography
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130204.13
Background-Aim: Prediction of postoperative FEV1 and diffusion capacity of the lung for carbon monoxide (DLCO) has a key role in the preoperative evaluation of lung resection candidates with impaired lung function. Additionally, dyspnea is a symptom which significantly affects patients’ quality of life. The aim of our study is to evaluate the role of quantitative Computed Tomography (CT) in predicting postoperative FEV1, DLCO, and chronic dyspnea in lung cancer patients undergoing lung resection. Methods: Thirty lung cancer patients were evaluated. Pulmonary function tests (PFTs) and low-dose chest CT scan were performed preoperatively. Fifteen patients (group A) had normal PFTs and fifteen patients (group B) had impaired lung function. Quantitative evaluation of CT using dual threshold of -910 to -500 Hounsfield Units estimated functional lung volumes. Dyspnea was evaluated using the modified Medical Research Council (mMRC) scale. Patients were reevaluated 3 months after surgery. Results: Predicted values of FEV1 and DLCO correlate significantly with the actual postoperative measurements in both groups. DLCO is the lung function index that demonstrates the highest correlation with postoperative dyspnea (r= -0.755, p<0.001). Predicted volume loss correlates well with the postoperative mMRC (r=0.662, p<0.001). Dyspnea score increases by one mMRC score unit per 21% of functional lung parenchyma resected during surgery. Conclusion: Quantitative CT is a valuable tool in the preoperative evaluation of lung cancer patients since it can simultaneously be used for staging, prediction of postoperative lung function, and prediction of postoperative chronic dyspnea.
Background-Aim: Prediction of postoperative FEV1 and diffusion capacity of the lung for carbon monoxide (DLCO) has a key role in the preoperative evaluation of lung resection candidates with impaired lung function. Additionally, dyspnea is a symptom which significantly affects patients’ quality of life. The aim of our study is to evaluate the role of quantitative Computed Tomography (CT) in predicting postoperative FEV1, DLCO, and chronic dyspnea in lung cancer patients undergoing lung resection. Methods: Thirty lung cancer patients were evaluated. Pulmonary function tests (PFTs) and low-dose chest CT scan were performed preoperatively. Fifteen patients (group A) had normal PFTs and fifteen patients (group B) had impaired lung function. Quantitative evaluation of CT using dual threshold of -910 to -500 Hounsfield Units estimated functional lung volumes. Dyspnea was evaluated using the modified Medical Research Council (mMRC) scale. Patients were reevaluated 3 months after surgery. Results: Predicted values of FEV1 and DLCO correlate significantly with the actual postoperative measurements in both groups. DLCO is the lung function index that demonstrates the highest correlation with postoperative dyspnea (r= -0.755, p<0.001). Predicted volume loss correlates well with the postoperative mMRC (r=0.662, p<0.001). Dyspnea score increases by one mMRC score unit per 21% of functional lung parenchyma resected during surgery. Conclusion: Quantitative CT is a valuable tool in the preoperative evaluation of lung cancer patients since it can simultaneously be used for staging, prediction of postoperative lung function, and prediction of postoperative chronic dyspnea.
Prediction of Postoperative Lung Function and Chronic Dyspnea in Lung Cancer Patients by Using Quantitative Computed Tomography
doi:10.11648/j.sjcm.20130204.13
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
CV Papageorgiou
Dimosthenis Antoniou
Georgios Kaltsakas
Foteini Karakontaki
Panagiotis Misthos
Iris Tsangaridou
Loukas Thanos
NG Koulouris
Prediction of Postoperative Lung Function and Chronic Dyspnea in Lung Cancer Patients by Using Quantitative Computed Tomography
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2014-01-01
10.11648/j.sjcm.20130204.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130204.13
© Science Publishing Group
Pathophysiology Prevention and Management of Chronic Neurogenic Constipation in Adults
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130204.11
Neurogenic constipation occurs most commonly after spinal cord injury, in multiple sclerosis and in Parkinson`s disease. Slow colonic transit time is a major disorder. Patients also develop pelvic floor dysfunction. Spinal cord patients are unable to defecate voluntarily due to the loss of the rectal fullness sensation and they depend on the spinal reflexes. Obstructed defecation in upper motor neuron spinal cord injury and in Parkinson`s disease is a result of inability to relax the pelvic floor muscles, whereas in the lower type of injury it is due to hyporeactivity of the rectum. In multiple sclerosis it is a combination of lesions from different levels of the nervous system. In diagnosis, neurological and proctologic examinations are required followed by colonic transit time, defecography and anorectal manometry. Most of the patients respond positively on medical treatment. However, a small group of them requires surgical treatment in the form of either colostomy or ileostomy.
Neurogenic constipation occurs most commonly after spinal cord injury, in multiple sclerosis and in Parkinson`s disease. Slow colonic transit time is a major disorder. Patients also develop pelvic floor dysfunction. Spinal cord patients are unable to defecate voluntarily due to the loss of the rectal fullness sensation and they depend on the spinal reflexes. Obstructed defecation in upper motor neuron spinal cord injury and in Parkinson`s disease is a result of inability to relax the pelvic floor muscles, whereas in the lower type of injury it is due to hyporeactivity of the rectum. In multiple sclerosis it is a combination of lesions from different levels of the nervous system. In diagnosis, neurological and proctologic examinations are required followed by colonic transit time, defecography and anorectal manometry. Most of the patients respond positively on medical treatment. However, a small group of them requires surgical treatment in the form of either colostomy or ileostomy.
Pathophysiology Prevention and Management of Chronic Neurogenic Constipation in Adults
doi:10.11648/j.sjcm.20130204.11
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Jacek Hermann
Sławomir Michalak
Michał Dopierała
Dariusz Tertoń
Michał Drews
Pathophysiology Prevention and Management of Chronic Neurogenic Constipation in Adults
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2014-01-01
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130204.11
© Science Publishing Group
Management of Idiopathic Dilated Cardiomyopathy with Intramyocardial Stem Cell Transplantation in Children: A Retrospective Study of 7 Patients
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130204.12
This retrospective report presents findings on 7 patients with idiopathic dilated cardiomyopathy who underwent transplantation of autologous bone marrow derived mononuclear cells (BMSC) after failed routine conservative treatment, and were on a waiting list for cardiac transplantation. In two out of seven patients, we performed intramyocardial delivery of BMSC twice, 22 and 24 months respectively after the first transplant. All patients received anti-congestive therapy by diu-retics, ACE inhibitors, carvedilol, digitalis and aspirin. We discuss potential disadvantages of intracoronary injections of autologous bone marrow stem cells. We believe that our BMSC transplantation method as opposed to intravascular input is the method of choice, particularly in children with idiopathic dilated cardiomyopathy because it is safe, gentle and is not associated with risks for coronary circulation.
This retrospective report presents findings on 7 patients with idiopathic dilated cardiomyopathy who underwent transplantation of autologous bone marrow derived mononuclear cells (BMSC) after failed routine conservative treatment, and were on a waiting list for cardiac transplantation. In two out of seven patients, we performed intramyocardial delivery of BMSC twice, 22 and 24 months respectively after the first transplant. All patients received anti-congestive therapy by diu-retics, ACE inhibitors, carvedilol, digitalis and aspirin. We discuss potential disadvantages of intracoronary injections of autologous bone marrow stem cells. We believe that our BMSC transplantation method as opposed to intravascular input is the method of choice, particularly in children with idiopathic dilated cardiomyopathy because it is safe, gentle and is not associated with risks for coronary circulation.
Management of Idiopathic Dilated Cardiomyopathy with Intramyocardial Stem Cell Transplantation in Children: A Retrospective Study of 7 Patients
doi:10.11648/j.sjcm.20130204.12
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Aris Lacis
Inguna Lubaua
Andrejs Erglis
Andis Lacis
Inta Bergmane
Management of Idiopathic Dilated Cardiomyopathy with Intramyocardial Stem Cell Transplantation in Children: A Retrospective Study of 7 Patients
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2014-01-01
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© Science Publishing Group
Report of Bilateral Microtia in 2 Successive Female Siblings in Fallujah General Hospital
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130204.14
Microtia is a congenital anomaly; characterized by a small, abnormally shaped auricle (pinna). It is usually accompanied by a narrow, blocked or absent ear canal. Microtia can occur as the only clinical abnormality or as part of a syndrome. The estimated incidence of microtia is (1 / 5000) to (1/ 20000) of total births and it is more common in males. Microtia can have a genetic or environmental predisposition. Here we reported a family with 2 successive deliveries of female infants within 12 months period, with bilateral microtia in the absence of any of the known risk factors or teratogens, in addition to the absence of previous family history of any kind of birth anomalies.
Microtia is a congenital anomaly; characterized by a small, abnormally shaped auricle (pinna). It is usually accompanied by a narrow, blocked or absent ear canal. Microtia can occur as the only clinical abnormality or as part of a syndrome. The estimated incidence of microtia is (1 / 5000) to (1/ 20000) of total births and it is more common in males. Microtia can have a genetic or environmental predisposition. Here we reported a family with 2 successive deliveries of female infants within 12 months period, with bilateral microtia in the absence of any of the known risk factors or teratogens, in addition to the absence of previous family history of any kind of birth anomalies.
Report of Bilateral Microtia in 2 Successive Female Siblings in Fallujah General Hospital
doi:10.11648/j.sjcm.20130204.14
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Samira Telfah Alaani
Abdulqadir Abdulkareem Alrawi
Report of Bilateral Microtia in 2 Successive Female Siblings in Fallujah General Hospital
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2014-01-01
2014-01-01
10.11648/j.sjcm.20130204.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130204.14
© Science Publishing Group
Monitoring of the Microbial Community of Periodontal Pockets in Patients with Chronic Generalized and Aggressive Periodontitis
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130205.11
The fundamental problem of general medicine and particularly of periodontology, remains the accurate and early diagnostics, which allows to start the casual treatment as soon as possible. The panel test-system, developed earlier, is based on the real-time PCR system for the qualitative and quantitative analysis of the oral microbial communities considering the microorganisms associated with periodontal diseases. The panel allows the simultaneous quantitative determination of these periodontal pathogens with the diagnostic accuracy of not less than 97 %. The study included 78 patients with clinically and radiographically confirmed diagnosis of chronic generalized periodontitis of moderate and severe degrees and patients with aggressive periodontitis.
The fundamental problem of general medicine and particularly of periodontology, remains the accurate and early diagnostics, which allows to start the casual treatment as soon as possible. The panel test-system, developed earlier, is based on the real-time PCR system for the qualitative and quantitative analysis of the oral microbial communities considering the microorganisms associated with periodontal diseases. The panel allows the simultaneous quantitative determination of these periodontal pathogens with the diagnostic accuracy of not less than 97 %. The study included 78 patients with clinically and radiographically confirmed diagnosis of chronic generalized periodontitis of moderate and severe degrees and patients with aggressive periodontitis.
Monitoring of the Microbial Community of Periodontal Pockets in Patients with Chronic Generalized and Aggressive Periodontitis
doi:10.11648/j.sjcm.20130205.11
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Zorina Oxana
Petrukhina Natalia
Berkutova Irina
Monitoring of the Microbial Community of Periodontal Pockets in Patients with Chronic Generalized and Aggressive Periodontitis
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2014-01-01
10.11648/j.sjcm.20130205.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130205.11
© Science Publishing Group
Factors Affecting Utilization of Insecticide Treated Nets among People Living with HIV/Aids in Bahir Dar City, Northwest Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130206.11
Introduction: Malaria and HIV are among the two most important global health problems of this time. All HIV-positive persons (PLHAs) in the household were encouraged to sleep under insecticide treated nets (ITNs) at all times of year. However, the information on utilization and associated factors on these groups have been limited. Objective: the aim of the study was to assess utilization of ITN and associated factors among PLHA, who are members of the three PLHA associations in Bahir City Administration, northwest Ethiopia. Methods: A community based cross-sectional study was conducted from March to May, 2013. A simple random sampling technique was used to select the study participants. Pre-tested and structured questionnaire and observation check list was used to collect the data. Each variable were analyzed by using bi variate logistic regression to know their significance and to assess the separate effects and multi variate analysis was done using backward stepwise logistic regression to control the possible confounding effect for variables with p-value <0.2 in bi variate analysis. Result: Three hundred four304 (76.8%) of PLHA utilized ITNs properly. The main reasons for those who had not have ITN and not utilized ITN were, they did not know where obtained the ITNs 20 (41.7%), ITNs were expensive 16 (33.3%), and no fear of mosquito bite at this time 60(65.2%). Knowledge about malaria risks and ITNs importance (AOR= 2.3; 95% CI 1.23- 4.40), formal education (AOR= 2.39; 95% CI 1.40- 4.08) and better income was significantly associated with ITN utilizations (AOR= 1.83; 95%CI 1.05- 3.20) Conclusion: The PLHA needs special attention on the utilization of ITN. Free provision of ITNs, awareness creation on the utilization of ITN and participate in Income generating activities are supreme important.
Introduction: Malaria and HIV are among the two most important global health problems of this time. All HIV-positive persons (PLHAs) in the household were encouraged to sleep under insecticide treated nets (ITNs) at all times of year. However, the information on utilization and associated factors on these groups have been limited. Objective: the aim of the study was to assess utilization of ITN and associated factors among PLHA, who are members of the three PLHA associations in Bahir City Administration, northwest Ethiopia. Methods: A community based cross-sectional study was conducted from March to May, 2013. A simple random sampling technique was used to select the study participants. Pre-tested and structured questionnaire and observation check list was used to collect the data. Each variable were analyzed by using bi variate logistic regression to know their significance and to assess the separate effects and multi variate analysis was done using backward stepwise logistic regression to control the possible confounding effect for variables with p-value <0.2 in bi variate analysis. Result: Three hundred four304 (76.8%) of PLHA utilized ITNs properly. The main reasons for those who had not have ITN and not utilized ITN were, they did not know where obtained the ITNs 20 (41.7%), ITNs were expensive 16 (33.3%), and no fear of mosquito bite at this time 60(65.2%). Knowledge about malaria risks and ITNs importance (AOR= 2.3; 95% CI 1.23- 4.40), formal education (AOR= 2.39; 95% CI 1.40- 4.08) and better income was significantly associated with ITN utilizations (AOR= 1.83; 95%CI 1.05- 3.20) Conclusion: The PLHA needs special attention on the utilization of ITN. Free provision of ITNs, awareness creation on the utilization of ITN and participate in Income generating activities are supreme important.
Factors Affecting Utilization of Insecticide Treated Nets among People Living with HIV/Aids in Bahir Dar City, Northwest Ethiopia
doi:10.11648/j.sjcm.20130206.11
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Yibeltal Berie
Kasahun Alemu
Alemayehu Belay
Zemichale Gizaw
Factors Affecting Utilization of Insecticide Treated Nets among People Living with HIV/Aids in Bahir Dar City, Northwest Ethiopia
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2014-01-01
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130206.11
© Science Publishing Group
Determinants of Exclusive Breastfeeding Practice among Mothers of Children Age Less Than 6 Month in Bahir Dar City Administration, Northwest Ethiopia; A Community Based Cross-Sectional Survey
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130206.12
Background- Exclusive breastfeeding is the optimal feeding practice to achieve infants’ growth and development. Most mothers breastfeed their children but malnutrition is still prevalent in Ethiopia. Factors affecting exclusive breastfeeding practice are less known in the study area. Therefore the study aimed to assess its determinants among mother of children age less than 6 months in Bahir Dar city administration, Ethiopia. Method: Community based cross sectional survey was conducted from Jan to Feb 2013. In Bahir Dar city administration there were a total 20 (12 Urban & 8 Rural) Kebles, of which 6 (4 Urban & 2 Rural) were selected randomly using lottery method. The registration of mothers who had a child age less than 6 months by the local HEW was used as a sampling frame. Data was collected using interviewer administered questionnaire and was entered and analyzed using SPSS version 16. Logistic regression was used to identify determinants. P value <0.05 was considered statistically significant. Results: A total of 159 mothers were interviewed (93.5% response rate). Respondent’s mean age was 27.2±4.6 years, 2/3rd of respondents were housewives by occupation, and more than 90% of participants were urban residents and were married. Prevalence of exclusive breastfeeding was 49.1%. Mother education level (AOR=2.99), child sex (AOR=2.22), Parity (AOR=2.46), family size (AOR=2.92), and time of postnatal care (AOR=3.44) were independent predictors of exclusive breastfeeding practice in the study area. Conclusion & recommendation: Practice of exclusive breastfeeding was below the WHO recommendation and the target of the fifth Ethiopian Health Sector Development program. Mother education, child sex, parity, family size, and time of postnatal care were the independent predictors of exclusive breast feeding practice. The city administration should work on promoting exclusive breastfeeding practice giving special emphasis to educated mothers. The government should also consider revising the legislation of the two month postpartum maternity leave.
Background- Exclusive breastfeeding is the optimal feeding practice to achieve infants’ growth and development. Most mothers breastfeed their children but malnutrition is still prevalent in Ethiopia. Factors affecting exclusive breastfeeding practice are less known in the study area. Therefore the study aimed to assess its determinants among mother of children age less than 6 months in Bahir Dar city administration, Ethiopia. Method: Community based cross sectional survey was conducted from Jan to Feb 2013. In Bahir Dar city administration there were a total 20 (12 Urban & 8 Rural) Kebles, of which 6 (4 Urban & 2 Rural) were selected randomly using lottery method. The registration of mothers who had a child age less than 6 months by the local HEW was used as a sampling frame. Data was collected using interviewer administered questionnaire and was entered and analyzed using SPSS version 16. Logistic regression was used to identify determinants. P value <0.05 was considered statistically significant. Results: A total of 159 mothers were interviewed (93.5% response rate). Respondent’s mean age was 27.2±4.6 years, 2/3rd of respondents were housewives by occupation, and more than 90% of participants were urban residents and were married. Prevalence of exclusive breastfeeding was 49.1%. Mother education level (AOR=2.99), child sex (AOR=2.22), Parity (AOR=2.46), family size (AOR=2.92), and time of postnatal care (AOR=3.44) were independent predictors of exclusive breastfeeding practice in the study area. Conclusion & recommendation: Practice of exclusive breastfeeding was below the WHO recommendation and the target of the fifth Ethiopian Health Sector Development program. Mother education, child sex, parity, family size, and time of postnatal care were the independent predictors of exclusive breast feeding practice. The city administration should work on promoting exclusive breastfeeding practice giving special emphasis to educated mothers. The government should also consider revising the legislation of the two month postpartum maternity leave.
Determinants of Exclusive Breastfeeding Practice among Mothers of Children Age Less Than 6 Month in Bahir Dar City Administration, Northwest Ethiopia; A Community Based Cross-Sectional Survey
doi:10.11648/j.sjcm.20130206.12
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Abay Sefene
Dereje Birhanu
Worku Awoke
Tesfaye Taye
Determinants of Exclusive Breastfeeding Practice among Mothers of Children Age Less Than 6 Month in Bahir Dar City Administration, Northwest Ethiopia; A Community Based Cross-Sectional Survey
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159
2014-01-01
2014-01-01
10.11648/j.sjcm.20130206.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130206.12
© Science Publishing Group
Alterations in Postmodernity: Setting up Bulimia Nervosa
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130206.13
In Bulimia nervosa, a complex syndrome of clinical symptoms is formed. The patient who will mostly attempt to keep her syndrome hidden is subjected to diverse alterations that can be observed in her, her family and society. Somatic alterations in Bulimia nervosa patients are depicted, family idiosyncrasies in families with a bulimic member are highlighted. The research project on Bulimia nervosa 2007-2010 at the University of Heidelberg is outlined, leading to a pondering of psychodynamic symptom formation. Aspects of oedipality are shown in a case vignette of an 18-year-old female bulimic patient experiencing and restaging guilt and seduction issues. Some leads at mass society´s influence on the way symptom formations appear today are to broaden the perspective by means of I. Hassan´s cultural characteristics of modernity and postmodernity. After a close look at alterations in clinics of bulimic patients that shows how the cultural paradigm of postmodernity is reflected in the patient, Bulimia nervosa, often as a low profile phenomenon in daily gynaecologic and primary care practice, is declared requiring apt intervening in clinical treatment, and conceptualizing of human developmental processes in new ways. Psychosomatic Medicine will benefit from cross-referencing on psyche, body, and society, in order to understand psychosomatic condition even better than before.
In Bulimia nervosa, a complex syndrome of clinical symptoms is formed. The patient who will mostly attempt to keep her syndrome hidden is subjected to diverse alterations that can be observed in her, her family and society. Somatic alterations in Bulimia nervosa patients are depicted, family idiosyncrasies in families with a bulimic member are highlighted. The research project on Bulimia nervosa 2007-2010 at the University of Heidelberg is outlined, leading to a pondering of psychodynamic symptom formation. Aspects of oedipality are shown in a case vignette of an 18-year-old female bulimic patient experiencing and restaging guilt and seduction issues. Some leads at mass society´s influence on the way symptom formations appear today are to broaden the perspective by means of I. Hassan´s cultural characteristics of modernity and postmodernity. After a close look at alterations in clinics of bulimic patients that shows how the cultural paradigm of postmodernity is reflected in the patient, Bulimia nervosa, often as a low profile phenomenon in daily gynaecologic and primary care practice, is declared requiring apt intervening in clinical treatment, and conceptualizing of human developmental processes in new ways. Psychosomatic Medicine will benefit from cross-referencing on psyche, body, and society, in order to understand psychosomatic condition even better than before.
Alterations in Postmodernity: Setting up Bulimia Nervosa
doi:10.11648/j.sjcm.20130206.13
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Goetz Egloff
Alterations in Postmodernity: Setting up Bulimia Nervosa
2
6
165
165
2014-01-01
2014-01-01
10.11648/j.sjcm.20130206.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130206.13
© Science Publishing Group
Comparison of SWL and RIRS in Lower Calyceal Stones
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130206.14
Background: The efficacy of extracorporeal shock wave lithotripsy(SWL) in kidney stones in the lower calices was compared using retrograde intrarenal surgery(RIRS). Methodology And Materials: Between January 2008 and May 2011, 64 patients (40 male and 24 female) undergoing SWL and 60 patients (38 male 22 female) undergoing flexible URS were analyzed retrospectively, and success rates were compared. Using the Storz Medical Modulith SLK, patients underwent the SWL process prior to the induction of anesthesia. On the other hand, the 8 f Storz flex X2 flexible URS was used for URS after general anesthesia and RIRS. During the RIRS process, stones were crushed using the 0.2 mm diameter holmium: YAG laser probe, and stone fragments larger than 2 mm were extracted. In some cases, double J or ureteral catheters were placed in the ureter. Results: In the 64 patients undergoing SWL with lower caliceal stones, the following ranges were noted: stone diameter: 6-35 mm (mean 15.9 mm), age: 16-72 years (mean , sessions required: 1-4 sessions (mean: 1.6), the number of shots: 1000-7650 (mean: 4124.6), fire intensity: 25-75 (mean: 60). Ten percent of patients required analgesia, and the success rate of the procedure was 87.5%. Hematuria occurred in 65% of patients as a minor complication and in 2%,streinstrasse occurred as a major complication. Inpatients undergoing RIRS, the following ranges were noted: stones size: 7-30 mm in diameter (average 15.2 mm), age: 21-60 years (mean 39.75),duration of operation: 30-85 minutes(mean: 48.8 minutes), respectively. An access sheath was used in all 32 patients. Balloon dilation was performed in 8 patients with distal ureteral stenosis, and a double J catheter was placed in 2 patients because of stenosis in the upper ureter and four weeks later, the stones were treated with fURS. Patients were discharged on an average of 1.2 days (1-3 days). A ureteral laceration was noted in 30% of patients while 75% of patients had hematuria. Partial ureteral avulsion occurred in one patient with an overall success rate of 96.4%. Conclusions: During the treatment of lower caliceal stones, the success and complication rate of RIRS is higher than SWL.
Background: The efficacy of extracorporeal shock wave lithotripsy(SWL) in kidney stones in the lower calices was compared using retrograde intrarenal surgery(RIRS). Methodology And Materials: Between January 2008 and May 2011, 64 patients (40 male and 24 female) undergoing SWL and 60 patients (38 male 22 female) undergoing flexible URS were analyzed retrospectively, and success rates were compared. Using the Storz Medical Modulith SLK, patients underwent the SWL process prior to the induction of anesthesia. On the other hand, the 8 f Storz flex X2 flexible URS was used for URS after general anesthesia and RIRS. During the RIRS process, stones were crushed using the 0.2 mm diameter holmium: YAG laser probe, and stone fragments larger than 2 mm were extracted. In some cases, double J or ureteral catheters were placed in the ureter. Results: In the 64 patients undergoing SWL with lower caliceal stones, the following ranges were noted: stone diameter: 6-35 mm (mean 15.9 mm), age: 16-72 years (mean , sessions required: 1-4 sessions (mean: 1.6), the number of shots: 1000-7650 (mean: 4124.6), fire intensity: 25-75 (mean: 60). Ten percent of patients required analgesia, and the success rate of the procedure was 87.5%. Hematuria occurred in 65% of patients as a minor complication and in 2%,streinstrasse occurred as a major complication. Inpatients undergoing RIRS, the following ranges were noted: stones size: 7-30 mm in diameter (average 15.2 mm), age: 21-60 years (mean 39.75),duration of operation: 30-85 minutes(mean: 48.8 minutes), respectively. An access sheath was used in all 32 patients. Balloon dilation was performed in 8 patients with distal ureteral stenosis, and a double J catheter was placed in 2 patients because of stenosis in the upper ureter and four weeks later, the stones were treated with fURS. Patients were discharged on an average of 1.2 days (1-3 days). A ureteral laceration was noted in 30% of patients while 75% of patients had hematuria. Partial ureteral avulsion occurred in one patient with an overall success rate of 96.4%. Conclusions: During the treatment of lower caliceal stones, the success and complication rate of RIRS is higher than SWL.
Comparison of SWL and RIRS in Lower Calyceal Stones
doi:10.11648/j.sjcm.20130206.14
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Basri Cakiroglu
Tuncay Tas
Seyit Erkan Eyyupoglu
Aydin Ismet Hazar
M. Bahadir Can Balci
Suleyman Hilmi Aksoy
Bekir Sami Uyanik
Comparison of SWL and RIRS in Lower Calyceal Stones
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170
170
2014-01-01
2014-01-01
10.11648/j.sjcm.20130206.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130206.14
© Science Publishing Group
The Efficacy of Diffusion Weighted Imaging and Apparent Diffusion Coefficient Mapping for Meniscal Tears in the Knee
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130206.15
Objective : The aim of this study was to analyse the efficacy of Diffusion Weighted MR Imaging (DWI) and Apparent Diffusion Coefficient (ADC) mapping in the diagnosis of meniscal tears in the knee. Conclusion : DWI and ADC mapping technique are fast and easily applicable with routine MRI sequences and these new MRI techniques (for the knee) depicts very important information for menisci and cartilages of the knee.
Objective : The aim of this study was to analyse the efficacy of Diffusion Weighted MR Imaging (DWI) and Apparent Diffusion Coefficient (ADC) mapping in the diagnosis of meniscal tears in the knee. Conclusion : DWI and ADC mapping technique are fast and easily applicable with routine MRI sequences and these new MRI techniques (for the knee) depicts very important information for menisci and cartilages of the knee.
The Efficacy of Diffusion Weighted Imaging and Apparent Diffusion Coefficient Mapping for Meniscal Tears in the Knee
doi:10.11648/j.sjcm.20130206.15
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Volkan Kızılgöz
Hasan Aydın
Baki Hekimoğlu
The Efficacy of Diffusion Weighted Imaging and Apparent Diffusion Coefficient Mapping for Meniscal Tears in the Knee
2
6
175
175
2014-01-01
2014-01-01
10.11648/j.sjcm.20130206.15
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130206.15
© Science Publishing Group
Response to Conventional Nutritional Treatment of Severely Malnourished Hospitalized Children in the Context of HIV Infection at Yekatit 12 Hospital, Addis Ababa, Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130206.16
Background: The aim of this study was to describe the response to nutritional treatment of severely malnourished hospitalized children in relation to HIV infection Methods: The study was conducted in the paediatric wards of Yekatit 12 hospital, which is situated in Addis Ababa, Ethiopia serving as a referral hospital for clinics, health centers and hospitals situated in and out of Addis Ababa. It also serves as a teaching hospital for AAU Medical students and Residents. We studied 300 severely malnourished children (presence of oedema, weight for age < 60% on HC and/ or weight-for-height <70%). At admission, HIV serology was confirmed by ELISA, for children >18 months of age, and PCR (DBS) was performed for those <18 months and CD4+ cells were measured for those who turned out to be positive. Complete blood count (CBC), including differential counts, was determined using a Coulter counter and/or manually. The study is a prospective observational analytic cohort study. Result: Of the 300 children, 75 were HIV Positive (cases) and the remaining 225 were controls (1:3 ratio). There was no significant difference by sex, age group, site of residency, family in come, family educational status, medical illness, hematologic profiles, immune category and presence or absence of edema in the treatment out come of HIV infected children compared to uninfected once. Among HIV infected forty three (43/75) failed to respond to the nutritional intervention when compared to those who are not infected (225/38) (Adjusted OR = 6.61, 95%CI = 0.053, 0.423). Conclusion: HIV infection is a major challenge in addressing nutritional intervention for those children who are severely malnourished admitted in Yekatit 12 hospital. An intervention to alleviate the challenge in managing the problem has to be designed based on further interventional studies.
Background: The aim of this study was to describe the response to nutritional treatment of severely malnourished hospitalized children in relation to HIV infection Methods: The study was conducted in the paediatric wards of Yekatit 12 hospital, which is situated in Addis Ababa, Ethiopia serving as a referral hospital for clinics, health centers and hospitals situated in and out of Addis Ababa. It also serves as a teaching hospital for AAU Medical students and Residents. We studied 300 severely malnourished children (presence of oedema, weight for age < 60% on HC and/ or weight-for-height <70%). At admission, HIV serology was confirmed by ELISA, for children >18 months of age, and PCR (DBS) was performed for those <18 months and CD4+ cells were measured for those who turned out to be positive. Complete blood count (CBC), including differential counts, was determined using a Coulter counter and/or manually. The study is a prospective observational analytic cohort study. Result: Of the 300 children, 75 were HIV Positive (cases) and the remaining 225 were controls (1:3 ratio). There was no significant difference by sex, age group, site of residency, family in come, family educational status, medical illness, hematologic profiles, immune category and presence or absence of edema in the treatment out come of HIV infected children compared to uninfected once. Among HIV infected forty three (43/75) failed to respond to the nutritional intervention when compared to those who are not infected (225/38) (Adjusted OR = 6.61, 95%CI = 0.053, 0.423). Conclusion: HIV infection is a major challenge in addressing nutritional intervention for those children who are severely malnourished admitted in Yekatit 12 hospital. An intervention to alleviate the challenge in managing the problem has to be designed based on further interventional studies.
Response to Conventional Nutritional Treatment of Severely Malnourished Hospitalized Children in the Context of HIV Infection at Yekatit 12 Hospital, Addis Ababa, Ethiopia
doi:10.11648/j.sjcm.20130206.16
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Tesfaye Taye Gelaw
Amha Mekasha Wondemagegn
Response to Conventional Nutritional Treatment of Severely Malnourished Hospitalized Children in the Context of HIV Infection at Yekatit 12 Hospital, Addis Ababa, Ethiopia
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182
182
2014-01-01
2014-01-01
10.11648/j.sjcm.20130206.16
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20130206.16
© Science Publishing Group
Atypical Case of the Postpartum Posterior Reversible Encephalopathy Associated with Acute Pulmonary Edema
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140301.11
The Posterior Reversible Encephalopathy Syndrome (PRES) is a clinical and radiological entity involving varying degrees of neurological symptoms to neurological abnormalities in parietal-occipital white matter. We report a case of reversible encephalopathy of late posterior postpartum encephalopathy as an association with acute pulmonary edema, in a young woman without any significant medical history. The physiopathology, diagnosis and treatment were discussed.
The Posterior Reversible Encephalopathy Syndrome (PRES) is a clinical and radiological entity involving varying degrees of neurological symptoms to neurological abnormalities in parietal-occipital white matter. We report a case of reversible encephalopathy of late posterior postpartum encephalopathy as an association with acute pulmonary edema, in a young woman without any significant medical history. The physiopathology, diagnosis and treatment were discussed.
Atypical Case of the Postpartum Posterior Reversible Encephalopathy Associated with Acute Pulmonary Edema
doi:10.11648/j.sjcm.20140301.11
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Hicham Bakkali
Salahedine Massou
Elhassani Mehdi
Abdellah Babahabib
Khalil Aboulaala
Hicham Balkhi
Jaouad Kouach
Atypical Case of the Postpartum Posterior Reversible Encephalopathy Associated with Acute Pulmonary Edema
3
1
3
3
2014-01-01
2014-01-01
10.11648/j.sjcm.20140301.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140301.11
© Science Publishing Group
Poor Compliance to Inhaler Therapy in Bronchial Asthma Patients –A Prospective Study in General Population
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140301.12
Background: Considering the prevalence and associated burden of disease due to bronchial asthma, it is mandatory to obtain an optimal control of the disease and to improve outcomes for these patients. Asthma control and treatment compliance are widely investigated issues around the world. But it has been observed that there is very poor adherence to the inhalational therapy which leads to the sub-optimal control of the disease. Objectives of the study: To investigate the adherence for anti-asthma inhalational medications in adults with bronchial asthma. Methodology: A prospective study was done in a total of 400 bronchial asthma patients over a period of 2 years. Once included in the study, the patients were followed up for a total of 12 weeks for calculation of non-adherence to the aerosol therapy. Results: A total of 400 patients of bronchial asthma who were started on inhalational therapy were included in the study. At the end of 12 weeks, it was observed that, only 154 patients (38.5%) had regular compliance and 246 patients (61.5%) were non-compliant to aerosol therapy as prescribed for bronchial asthma. Factors that were associated with poor compliance were: lower educational level status, poor socio-economic status, cumbersome regimens, dislike of medication and distant pharmacies. Non-Drug factors that reduced the compliance were: fears about side effects, anger about condition or its treatment, forgetfulness or complacency and patient’s ill attitudes toward health. Conclusion: Noncompliance in asthma management is a fact of life and no single compliance-improving strategy probably will be as effective as a good physician–patient relationship. Optimal self-management allowing for optimization of asthma control by adjustment of medications may be conducted by either self-adjustment with the aid of a written action plan or by regular medical review.
Background: Considering the prevalence and associated burden of disease due to bronchial asthma, it is mandatory to obtain an optimal control of the disease and to improve outcomes for these patients. Asthma control and treatment compliance are widely investigated issues around the world. But it has been observed that there is very poor adherence to the inhalational therapy which leads to the sub-optimal control of the disease. Objectives of the study: To investigate the adherence for anti-asthma inhalational medications in adults with bronchial asthma. Methodology: A prospective study was done in a total of 400 bronchial asthma patients over a period of 2 years. Once included in the study, the patients were followed up for a total of 12 weeks for calculation of non-adherence to the aerosol therapy. Results: A total of 400 patients of bronchial asthma who were started on inhalational therapy were included in the study. At the end of 12 weeks, it was observed that, only 154 patients (38.5%) had regular compliance and 246 patients (61.5%) were non-compliant to aerosol therapy as prescribed for bronchial asthma. Factors that were associated with poor compliance were: lower educational level status, poor socio-economic status, cumbersome regimens, dislike of medication and distant pharmacies. Non-Drug factors that reduced the compliance were: fears about side effects, anger about condition or its treatment, forgetfulness or complacency and patient’s ill attitudes toward health. Conclusion: Noncompliance in asthma management is a fact of life and no single compliance-improving strategy probably will be as effective as a good physician–patient relationship. Optimal self-management allowing for optimization of asthma control by adjustment of medications may be conducted by either self-adjustment with the aid of a written action plan or by regular medical review.
Poor Compliance to Inhaler Therapy in Bronchial Asthma Patients –A Prospective Study in General Population
doi:10.11648/j.sjcm.20140301.12
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Gajanan Gaude
Jyothi Hattiholi
Alisha Chaudhury
Poor Compliance to Inhaler Therapy in Bronchial Asthma Patients –A Prospective Study in General Population
3
1
9
9
2014-01-01
2014-01-01
10.11648/j.sjcm.20140301.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140301.12
© Science Publishing Group
Assessment of Radiation Exposure of Head and Neck during Panoramic Radiography in Different Age Groups
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140301.13
Background and aim: Panoramic imaging is one of the most commonly used imaging techniques in dentistry. Being able to accurately assess the radiation dose patients receive during procedures is a crucial step in the management of dose. The main objective of this study was to evaluate the head and neck skin absorbed dose during panoramic radiography in different age groups with panoramic machine of Oral and Maxillofacial Radiology section of Babol school of dentistry. Materials and methods: 273 thermoluminescent dosemeters (TLDs) (100 LiF: Mg, Ti , harshaw, USA) were used.90 samples were selected from the patients who referred to the Oral and Maxillofacial Radiology section of Babol school of dentistry for panoramic radiography. .Samples divided in 3 age_ group: 4_ 10 years, 10_40 years and above 40 years . TLDs were calibrated in dosimetry laboratory, National Radiation Protection Department. Thermoluminescent signal was read out with a Harshaw 4500 (Harshaw, Bicron USA) reader. Mean and standard deviation was determined by SPSS10 software and ANOVA statistic analysis. Results: Mean ± SD of skin absorbed dose of head and neck for 90 patients was 0.47± 0.09mGy. Conclusions: Since Diagnostic Reference level (DRL) of panoramic imaging is unknown in Iran, there is no possibility to compare the current results with DRL. However, This study conclude that decrease of radiation dose seems to be achievable with lower exposure condition with the panoramic unit.
Background and aim: Panoramic imaging is one of the most commonly used imaging techniques in dentistry. Being able to accurately assess the radiation dose patients receive during procedures is a crucial step in the management of dose. The main objective of this study was to evaluate the head and neck skin absorbed dose during panoramic radiography in different age groups with panoramic machine of Oral and Maxillofacial Radiology section of Babol school of dentistry. Materials and methods: 273 thermoluminescent dosemeters (TLDs) (100 LiF: Mg, Ti , harshaw, USA) were used.90 samples were selected from the patients who referred to the Oral and Maxillofacial Radiology section of Babol school of dentistry for panoramic radiography. .Samples divided in 3 age_ group: 4_ 10 years, 10_40 years and above 40 years . TLDs were calibrated in dosimetry laboratory, National Radiation Protection Department. Thermoluminescent signal was read out with a Harshaw 4500 (Harshaw, Bicron USA) reader. Mean and standard deviation was determined by SPSS10 software and ANOVA statistic analysis. Results: Mean ± SD of skin absorbed dose of head and neck for 90 patients was 0.47± 0.09mGy. Conclusions: Since Diagnostic Reference level (DRL) of panoramic imaging is unknown in Iran, there is no possibility to compare the current results with DRL. However, This study conclude that decrease of radiation dose seems to be achievable with lower exposure condition with the panoramic unit.
Assessment of Radiation Exposure of Head and Neck during Panoramic Radiography in Different Age Groups
doi:10.11648/j.sjcm.20140301.13
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Ehsan Moudi
Sina Haghanifar
Hoora Hadian
Ali Shabestani Monfared
Gholamreza Deilam
Nika Bahemmat
Assessment of Radiation Exposure of Head and Neck during Panoramic Radiography in Different Age Groups
3
1
14
14
2014-01-01
2014-01-01
10.11648/j.sjcm.20140301.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140301.13
© Science Publishing Group
Case Report – Hemangioma of the Urinary Bladder
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140301.14
Hemangioma of the urinary bladder is a rare and benign tumor which may be present at any age. Among all kinds of bladder tumors, hemangioma of the bladder constitutes just 0.6 % of them. It consists of numerous proliferative capillaries united with thin-walled, expanded blood-filled vessels that are covered by flat endothelial cells. Here, we present a case of a 60 years old man referred to our hospital with macroscopic hematuria and we discuss hemangioma of the bladder that is the diagnosis we determined after the cystoscopic examination.
Hemangioma of the urinary bladder is a rare and benign tumor which may be present at any age. Among all kinds of bladder tumors, hemangioma of the bladder constitutes just 0.6 % of them. It consists of numerous proliferative capillaries united with thin-walled, expanded blood-filled vessels that are covered by flat endothelial cells. Here, we present a case of a 60 years old man referred to our hospital with macroscopic hematuria and we discuss hemangioma of the bladder that is the diagnosis we determined after the cystoscopic examination.
Case Report – Hemangioma of the Urinary Bladder
doi:10.11648/j.sjcm.20140301.14
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Seyma Ozkanli
Burcin Girgin
Duygu Kosemetin
Ebru Zemheri
Case Report – Hemangioma of the Urinary Bladder
3
1
16
16
2014-01-01
2014-01-01
10.11648/j.sjcm.20140301.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140301.14
© Science Publishing Group
Abdominal Pregnancy: Case Report
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140302.11
The Abdominal pregnancy is defined as the establishment and development of the egg, fertilized partially or entirely in the abdominal cavity, in a primary or generally secondary way. This is a rare event in the evolution of pregnancy since it accounts for only 1% of the ectopic ovular locations. The goal is to present its pathophysiological and clinical aspects, the complications and the principles taken into account in order to think of evoking this experience so as not to discover it during a very serious complication or per operating. We reported a case of evolutionary abdominal pregnancy diagnosed to 18 SA in 22 years old patient without particular pathological antecedents. The echography and the nuclear magnetic resonance (NMR) confirmed the diagnosis. The processing was surgical and the post operative consequences were simple.
The Abdominal pregnancy is defined as the establishment and development of the egg, fertilized partially or entirely in the abdominal cavity, in a primary or generally secondary way. This is a rare event in the evolution of pregnancy since it accounts for only 1% of the ectopic ovular locations. The goal is to present its pathophysiological and clinical aspects, the complications and the principles taken into account in order to think of evoking this experience so as not to discover it during a very serious complication or per operating. We reported a case of evolutionary abdominal pregnancy diagnosed to 18 SA in 22 years old patient without particular pathological antecedents. The echography and the nuclear magnetic resonance (NMR) confirmed the diagnosis. The processing was surgical and the post operative consequences were simple.
Abdominal Pregnancy: Case Report
doi:10.11648/j.sjcm.20140302.11
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Mouna Achenani
Jaouad Kouach
Souad Mezzane
Abdellah Babahabib
Rhali Driss Moussaoui
Mohamed Dehayni
Hicham Bakkali
Abdominal Pregnancy: Case Report
3
2
20
20
2014-01-01
2014-01-01
10.11648/j.sjcm.20140302.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140302.11
© Science Publishing Group
Age and Gender Relation in Ureterial Tumors Detected with Transurethral Resection
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140302.12
Bladder tumors are biologically and chemically hazardous tumors that still remains as high morbidity and mortality rates even though the improvements of diagnosis and treatment in clinical field. Ureteral tumors constitutes about 90% of all bladder tumors and their biological behaviour vary from benign lesions to agressive cancers. In our study 66 diagnosed bladder biopsy and transureteral resection material were analysed retrospectively through the database of pathology department of Iskenderun State Hospital between january 2011 and November 2013.When only the bladder tumor cases were examined, 26 (59.65%) male and 3 (10.35%) female patients were detected. The age average of these tumor cases was 63.86±14.84 and ages were varied from 28-84. The 29 patients of tumor cases were consisted of 1 (1.52%) carcinoma in situ, 2 methastathic cancers, 1 papilloma, 2 low malignity potential papillary neoplasia, 14 low grade papillary carcinoma and 9 high grade papillary carcinoma. We observed that urothelial papilloma and low malignant potential papillary carcinoma has low rates and the percentage of low grade papillary carcinoma has high rates according to smilar studies. Unlikely the other studies, we found that the high grade papillary ureteral carcinoma can seen in further ages than low grade papillary ureteral carcinoma.In the light of our study, we recommend to keep in mind that malignant tumors of ureterium can be seen in all age groups and gender.
Bladder tumors are biologically and chemically hazardous tumors that still remains as high morbidity and mortality rates even though the improvements of diagnosis and treatment in clinical field. Ureteral tumors constitutes about 90% of all bladder tumors and their biological behaviour vary from benign lesions to agressive cancers. In our study 66 diagnosed bladder biopsy and transureteral resection material were analysed retrospectively through the database of pathology department of Iskenderun State Hospital between january 2011 and November 2013.When only the bladder tumor cases were examined, 26 (59.65%) male and 3 (10.35%) female patients were detected. The age average of these tumor cases was 63.86±14.84 and ages were varied from 28-84. The 29 patients of tumor cases were consisted of 1 (1.52%) carcinoma in situ, 2 methastathic cancers, 1 papilloma, 2 low malignity potential papillary neoplasia, 14 low grade papillary carcinoma and 9 high grade papillary carcinoma. We observed that urothelial papilloma and low malignant potential papillary carcinoma has low rates and the percentage of low grade papillary carcinoma has high rates according to smilar studies. Unlikely the other studies, we found that the high grade papillary ureteral carcinoma can seen in further ages than low grade papillary ureteral carcinoma.In the light of our study, we recommend to keep in mind that malignant tumors of ureterium can be seen in all age groups and gender.
Age and Gender Relation in Ureterial Tumors Detected with Transurethral Resection
doi:10.11648/j.sjcm.20140302.12
Science Journal of Clinical Medicine
2014-01-01
© Science Publishing Group
Serdar Yanık
Ozan Turgut
Ahmet Ay
Burak Sivaslıoglu
Ali Aydın
Aybala Ağaç Ay
Isin Gençay
Selcuk Misirligil
Age and Gender Relation in Ureterial Tumors Detected with Transurethral Resection
3
2
23
23
2014-01-01
2014-01-01
10.11648/j.sjcm.20140302.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140302.12
© Science Publishing Group
Retrospective Assessment of Patients over 15 Years of Age Presenting to Emergency Department with a Suicide Attempt
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140302.13
Aims: In this study we aimed to assess sociodemographic characteristics of cases over 15 years of age who admitted to emergency department (ED) after a suicide attempt and determine the risk factors for suicide. Methods: This study was conducted retrospectively between 01.01.2013 – 31.12.2013 at the Emergency Department of Keçiören Training and Research Hospital. Age, sex, marital status, educational status, suicide cause and method, interventions applied in emergency department, history of suicide attempts, history of psychiayric diseases, time of suicide attempt, and admission time to emergency department were examined. Categorical variables were analysed using Chi-Square test. A p value less than 0.05 was considered statistically significant. Results: This study included data of 561 patients. The patients were most commonly 15 to 24 years old (46.3%) and 419 (74.7%) of them were female. Three hundred (53.5%) patients were single, 271 (48.3%) were primary school graduate, and 111 (%19.8) were active workers. The most common suicide cause was familial problems (49.9%). The most common suicide method was consuming medications in large amount (92.5%) and the most common intervention applied in emergency department was gastric lavage (26.6%). Twenty-seven (4.8%) patients had a history of suicide attempts, 371 (66.1%) patients had a previously diagnosed psychiatric illness. The highest number of attempts occurred in July (11.1%) and majority of them occurred between 18:00 and 24:00. The mean time from suicide attempt to ED admission was 2.5 hours. Conclusion: Although it is probably not possible to completely eliminate all suicide attempts, it is well possible to decrease the number of suicide attempts by reducing the number of possible risk factors for suicide
Aims: In this study we aimed to assess sociodemographic characteristics of cases over 15 years of age who admitted to emergency department (ED) after a suicide attempt and determine the risk factors for suicide. Methods: This study was conducted retrospectively between 01.01.2013 – 31.12.2013 at the Emergency Department of Keçiören Training and Research Hospital. Age, sex, marital status, educational status, suicide cause and method, interventions applied in emergency department, history of suicide attempts, history of psychiayric diseases, time of suicide attempt, and admission time to emergency department were examined. Categorical variables were analysed using Chi-Square test. A p value less than 0.05 was considered statistically significant. Results: This study included data of 561 patients. The patients were most commonly 15 to 24 years old (46.3%) and 419 (74.7%) of them were female. Three hundred (53.5%) patients were single, 271 (48.3%) were primary school graduate, and 111 (%19.8) were active workers. The most common suicide cause was familial problems (49.9%). The most common suicide method was consuming medications in large amount (92.5%) and the most common intervention applied in emergency department was gastric lavage (26.6%). Twenty-seven (4.8%) patients had a history of suicide attempts, 371 (66.1%) patients had a previously diagnosed psychiatric illness. The highest number of attempts occurred in July (11.1%) and majority of them occurred between 18:00 and 24:00. The mean time from suicide attempt to ED admission was 2.5 hours. Conclusion: Although it is probably not possible to completely eliminate all suicide attempts, it is well possible to decrease the number of suicide attempts by reducing the number of possible risk factors for suicide
Retrospective Assessment of Patients over 15 Years of Age Presenting to Emergency Department with a Suicide Attempt
doi:10.11648/j.sjcm.20140302.13
Science Journal of Clinical Medicine
2014-04-11
© Science Publishing Group
Bahattin Işık
Muhittin Serkan Yilmaz
Cihat Yel
Cemil Kavalci
Gulsum Kavalci
Yunsur Cevik
Burak Demirci
Miray Özlem
Bedriye Muge Sonmez
Retrospective Assessment of Patients over 15 Years of Age Presenting to Emergency Department with a Suicide Attempt
3
2
28
28
2014-04-11
2014-04-11
10.11648/j.sjcm.20140302.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140302.13
© Science Publishing Group
Otorhinolaryngologie Alterations in Patients with Gastro-Esophageal Reflux Diseases
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140302.14
Introduction: The gastroesophageal reflux disease (GERD) is defined as a chronic affection resulting from the reflux of part of the gastric content (and sometimes, gastroduodenal) to the esophagus and/or adjacent organs (pharynx, larynx, bronchia), causing a variable spectrum of esophageal and/or extra-esophageal signs and symptoms associated or not to tissue lesions. Object: To determine the prevalence of ORL’ disorders in patients with gastro-esophageal reflux disease (GERD). Nowadays the number of patients with such complaints increases, which could be a result of higher acidity, inappropriate eating and lifestyle. Material and Methods: We carried out a retrospective study by approaching records of 54 patients attended in a period of 18 months. For all patients were made: standard ORL’ examination; examinations of gastro-digestive tract: upper endoscopy (Patients with erosive esophagitis were classified according to the criteria of Los Angeles), X- Ray of esophagus and stomach; Ph test; The results were evaluated in the SPSS program, version 10.0, and we carried out frequencies evaluation, central tendency and standard deviation measurements and association test (chi-square). Results: Patients with typical symptoms of gastroesophageal reflux disease accounted for 48 (88%) .Twenty seven had changes consistent with class A (50%), class B with 17 (31.5%) and 10 with classes C + D (18.5%). The presence of laryngeal changes were more prevalent in more severe esophagitis (grades C and D Los Angeles) when compared to milder forms (classes A and B), a statistically significant difference (p<0.05). Conclusion: As a first level of gastro-digestive tract, the oral cavity can attack with hirer PH of stomach’ contents. Following these circumstances they are possible changes and lesions in the mucosa of oral cavity and the pharynx wall, the tongue root and teeth. The laryngeal disorders are frequent findings in patients with GERD, more frequent the greater the degree of esophageal injury.
Introduction: The gastroesophageal reflux disease (GERD) is defined as a chronic affection resulting from the reflux of part of the gastric content (and sometimes, gastroduodenal) to the esophagus and/or adjacent organs (pharynx, larynx, bronchia), causing a variable spectrum of esophageal and/or extra-esophageal signs and symptoms associated or not to tissue lesions. Object: To determine the prevalence of ORL’ disorders in patients with gastro-esophageal reflux disease (GERD). Nowadays the number of patients with such complaints increases, which could be a result of higher acidity, inappropriate eating and lifestyle. Material and Methods: We carried out a retrospective study by approaching records of 54 patients attended in a period of 18 months. For all patients were made: standard ORL’ examination; examinations of gastro-digestive tract: upper endoscopy (Patients with erosive esophagitis were classified according to the criteria of Los Angeles), X- Ray of esophagus and stomach; Ph test; The results were evaluated in the SPSS program, version 10.0, and we carried out frequencies evaluation, central tendency and standard deviation measurements and association test (chi-square). Results: Patients with typical symptoms of gastroesophageal reflux disease accounted for 48 (88%) .Twenty seven had changes consistent with class A (50%), class B with 17 (31.5%) and 10 with classes C + D (18.5%). The presence of laryngeal changes were more prevalent in more severe esophagitis (grades C and D Los Angeles) when compared to milder forms (classes A and B), a statistically significant difference (p<0.05). Conclusion: As a first level of gastro-digestive tract, the oral cavity can attack with hirer PH of stomach’ contents. Following these circumstances they are possible changes and lesions in the mucosa of oral cavity and the pharynx wall, the tongue root and teeth. The laryngeal disorders are frequent findings in patients with GERD, more frequent the greater the degree of esophageal injury.
Otorhinolaryngologie Alterations in Patients with Gastro-Esophageal Reflux Diseases
doi:10.11648/j.sjcm.20140302.14
Science Journal of Clinical Medicine
2014-04-30
© Science Publishing Group
Mariana Penkova Radicheva
Otorhinolaryngologie Alterations in Patients with Gastro-Esophageal Reflux Diseases
3
2
32
32
2014-04-30
2014-04-30
10.11648/j.sjcm.20140302.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140302.14
© Science Publishing Group
Aetiology of Bacterial Pathogens from Adult Patients with Community-Acquired Pneumonia in Arba Minch Hospital, South Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140303.11
Background: Community-acquired pneumonia (CAP) is major causes of morbidity and mortality. The etiology of CAP varies by geographic region; knowing the etiology might help for the management of the case in case of emergency and to guide treatment. So, in resource limited countries it is wise to identify the most common pathogens of CAP. The objective of this study was to determine bacterial etiology of CAP among adult patients visiting Arba Minch Hospital. Methods: A cross sectional study was conducted in Arba Minch Hospital, Southern Ethiopia from March 01 to June 01, 2013. Data was collected from adult patients with CAP visiting Arba Minch Hospital using face to face interviews, observation using checklist and laboratory examinations. Sputum specimens were collected and microbiological investigations were performed using standard procedures. Data was processed and analyzed with SPSS version16.0 and Excel 2007. Results: Out of 170 cases, only 68 (40%) were culture positive. One pathogen was demonstrated in 63 (92.6%) patients and 6 (7.4%) had mixed infection. The common isolates of single bacterial pathogens from sputum specimens were S. pneumoniae 20 (11.8%), S. aureus 15 (8.8%), P. aeruginosa 10 (5.8%), K. pneumoniae 8 (4.7%), E. coli 4 (2.4%), H. influenzae 4 (2.4%), P. mirabilis 1 (0.6%), and P. vulgaris 1 (0.6%). The commonest mixed bacterial isolate was K. pneumoniae and P. aeruginosa 2(1.2%). Conclusion: In this study, common bacteria isolated were S. pneumoniae, S. aureus and gram negative bacteria. Significant numbers of Gram negative bacteria were isolated which may indicate a shift of infection trend to Gram negative bacteria. Hence, periodic monitoring of etiologic agents with their drug resistant pattern is essential for better management of CAP and treatment strategies.
Background: Community-acquired pneumonia (CAP) is major causes of morbidity and mortality. The etiology of CAP varies by geographic region; knowing the etiology might help for the management of the case in case of emergency and to guide treatment. So, in resource limited countries it is wise to identify the most common pathogens of CAP. The objective of this study was to determine bacterial etiology of CAP among adult patients visiting Arba Minch Hospital. Methods: A cross sectional study was conducted in Arba Minch Hospital, Southern Ethiopia from March 01 to June 01, 2013. Data was collected from adult patients with CAP visiting Arba Minch Hospital using face to face interviews, observation using checklist and laboratory examinations. Sputum specimens were collected and microbiological investigations were performed using standard procedures. Data was processed and analyzed with SPSS version16.0 and Excel 2007. Results: Out of 170 cases, only 68 (40%) were culture positive. One pathogen was demonstrated in 63 (92.6%) patients and 6 (7.4%) had mixed infection. The common isolates of single bacterial pathogens from sputum specimens were S. pneumoniae 20 (11.8%), S. aureus 15 (8.8%), P. aeruginosa 10 (5.8%), K. pneumoniae 8 (4.7%), E. coli 4 (2.4%), H. influenzae 4 (2.4%), P. mirabilis 1 (0.6%), and P. vulgaris 1 (0.6%). The commonest mixed bacterial isolate was K. pneumoniae and P. aeruginosa 2(1.2%). Conclusion: In this study, common bacteria isolated were S. pneumoniae, S. aureus and gram negative bacteria. Significant numbers of Gram negative bacteria were isolated which may indicate a shift of infection trend to Gram negative bacteria. Hence, periodic monitoring of etiologic agents with their drug resistant pattern is essential for better management of CAP and treatment strategies.
Aetiology of Bacterial Pathogens from Adult Patients with Community-Acquired Pneumonia in Arba Minch Hospital, South Ethiopia
doi:10.11648/j.sjcm.20140303.11
Science Journal of Clinical Medicine
2014-05-28
© Science Publishing Group
Belayneh Regasa
Aetiology of Bacterial Pathogens from Adult Patients with Community-Acquired Pneumonia in Arba Minch Hospital, South Ethiopia
3
3
36
36
2014-05-28
2014-05-28
10.11648/j.sjcm.20140303.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140303.11
© Science Publishing Group
Antibiotic Utilization in a Dental Teaching Hospital in Yogyakarta, Indonesia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140303.12
Background: Various antibiotics are prescribed by dental practitioners to treat odontogenic infections. However, there has been no comprehensive study of antibiotics use in a dental teaching hospital in a developing country using World Health Organization (WHO) dose measurement units. Objective: This study was designed to evaluate the use of antibiotics among dental outpatients at a dental teaching hospital in Yogyakarta, Indonesia. Methods: A cross-sectional study of outpatients’ medical records was carried out in order to identify oral antibiotics administered during January-December 2011. Prescriptions that included antibiotics (N=2024) were separated from total prescriptions collected from medical records. The source and type of antibiotics prescribed and the diagnoses were recorded. Anatomical Therapeutic Chemical classification and Defined Daily Dosage (DDD) measurement units were assigned, and the information was compiled, coded, analyzed in accordance with WHO guidelines. Results: Thirteen different antibiotics were prescribed and all were administered to patients. Antibiotics were frequently prescribed contrary to generally accepted criteria and there was wide variation in prescribing. The most commonly prescribed antibiotic was amoxicillin (78.8%), followed by clindamycin (9.0%) and metronidazole (5.0%). The dental diagnosis most frequently reported was pulp gangrene (26.7%), followed by pulp necrosis (8.8%) and impaction-related problems (6.4%). There was a marked increase in total antibiotics use expressed in defined daily dose (DDD) per 1000 patient visit per month during September to November, which might have been associated with seasonal change or availability of student health insurance at the start of the academic year. Conclusion: Our findings show a high level of inappropriate antibiotics usage at a dental teaching hospital in Indonesia, and indicate that there is a need for educational initiatives and guidelines to promote best practice and appropriate use of antibiotics in this hospital.
Background: Various antibiotics are prescribed by dental practitioners to treat odontogenic infections. However, there has been no comprehensive study of antibiotics use in a dental teaching hospital in a developing country using World Health Organization (WHO) dose measurement units. Objective: This study was designed to evaluate the use of antibiotics among dental outpatients at a dental teaching hospital in Yogyakarta, Indonesia. Methods: A cross-sectional study of outpatients’ medical records was carried out in order to identify oral antibiotics administered during January-December 2011. Prescriptions that included antibiotics (N=2024) were separated from total prescriptions collected from medical records. The source and type of antibiotics prescribed and the diagnoses were recorded. Anatomical Therapeutic Chemical classification and Defined Daily Dosage (DDD) measurement units were assigned, and the information was compiled, coded, analyzed in accordance with WHO guidelines. Results: Thirteen different antibiotics were prescribed and all were administered to patients. Antibiotics were frequently prescribed contrary to generally accepted criteria and there was wide variation in prescribing. The most commonly prescribed antibiotic was amoxicillin (78.8%), followed by clindamycin (9.0%) and metronidazole (5.0%). The dental diagnosis most frequently reported was pulp gangrene (26.7%), followed by pulp necrosis (8.8%) and impaction-related problems (6.4%). There was a marked increase in total antibiotics use expressed in defined daily dose (DDD) per 1000 patient visit per month during September to November, which might have been associated with seasonal change or availability of student health insurance at the start of the academic year. Conclusion: Our findings show a high level of inappropriate antibiotics usage at a dental teaching hospital in Indonesia, and indicate that there is a need for educational initiatives and guidelines to promote best practice and appropriate use of antibiotics in this hospital.
Antibiotic Utilization in a Dental Teaching Hospital in Yogyakarta, Indonesia
doi:10.11648/j.sjcm.20140303.12
Science Journal of Clinical Medicine
2014-05-30
© Science Publishing Group
Mayu Winnie Rachmawati
Naoko YOSHIDA
Hirohito TSUBOI
Kazuko KIMURA
Antibiotic Utilization in a Dental Teaching Hospital in Yogyakarta, Indonesia
3
3
42
42
2014-05-30
2014-05-30
10.11648/j.sjcm.20140303.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140303.12
© Science Publishing Group
Cystoid Macular Edema in Complicated Cataract Surgery: A Case Report
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140303.13
One of the major risk factors for conversion from Phacoemulsification (Phaco) to Extracapsular Cataract Extraction (ECCE) is the Posterior capsule rupture. The capsule rupture or any cause leads to Vitreous Loss (VL) will develop tractional inflammation to the retina and Cystoid Macular Edema (CME) will occur. A 65 years old Chinese man had a history of left eye phaco converted to ECCE, anterior vitrectomy and Anterior Chamber Intra Ocular Lens (ACIOL) implant was done due to complication by inferior zonulolysis and VL. After 10 months he complained of dropped Best Corrected Visual Acuity (BCVA) in the operated eye and he was diagnosed to have CME. The diagnosis was done using Optical Coherence Tomography (OCT).Incomplete Posterior Vitreous Detachment (PVD) increases the risk of CME development, and this may make it necessary to start treatment before cataract surgery to reduce the incidence or improve the prognosis of the condition. In this case, PVD was diagnosed in the right eye suggesting that it will be at higher risk to develop CME in case of cataract surgery when it is complicated by VL and starting CME treatment before the surgery will be highly recommended.
One of the major risk factors for conversion from Phacoemulsification (Phaco) to Extracapsular Cataract Extraction (ECCE) is the Posterior capsule rupture. The capsule rupture or any cause leads to Vitreous Loss (VL) will develop tractional inflammation to the retina and Cystoid Macular Edema (CME) will occur. A 65 years old Chinese man had a history of left eye phaco converted to ECCE, anterior vitrectomy and Anterior Chamber Intra Ocular Lens (ACIOL) implant was done due to complication by inferior zonulolysis and VL. After 10 months he complained of dropped Best Corrected Visual Acuity (BCVA) in the operated eye and he was diagnosed to have CME. The diagnosis was done using Optical Coherence Tomography (OCT).Incomplete Posterior Vitreous Detachment (PVD) increases the risk of CME development, and this may make it necessary to start treatment before cataract surgery to reduce the incidence or improve the prognosis of the condition. In this case, PVD was diagnosed in the right eye suggesting that it will be at higher risk to develop CME in case of cataract surgery when it is complicated by VL and starting CME treatment before the surgery will be highly recommended.
Cystoid Macular Edema in Complicated Cataract Surgery: A Case Report
doi:10.11648/j.sjcm.20140303.13
Science Journal of Clinical Medicine
2014-06-05
© Science Publishing Group
Hatem Barhoom
Sharanjeet -Kaur
Sabri Kamarudin
Cystoid Macular Edema in Complicated Cataract Surgery: A Case Report
3
3
45
45
2014-06-05
2014-06-05
10.11648/j.sjcm.20140303.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140303.13
© Science Publishing Group
Retrospective Assessment of Irrational use of Antibiotics to Children Attending in Mekelle General Hospital
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140303.14
Background: In the last decades, there has been an escalating consumption of antibiotics with the number of antibiotic prescriptions increasing worldwide. Since children are more vulnerable to infectious disease than adults, more antibiotics are prescribed for them. Inappropriate use of antibiotics has resulted in a major increase in the development of multi-drug resistant pathogens with great implication in terms of morbidity, mortality and costs. The objective of this study was to determine the irrational use of antibiotics prescribed for children under the age of 15 years in Mekelle general hospital. Methods: A retrospective cross sectional study was conducted. Four hundred three children’s prescriptions and corresponding cards which were recorded by the year 2012 were selected by systematic random sampling proportionally from each month in the year. Results: Of all antibiotic prescriptions reviewed, the numbers of outpatient antibiotic prescriptions were 222 (55.1%) while inpatient prescriptions were 181 (44.9%).The predefined antibiotics indicators like percentage of antibiotics prescribed, frequency of route of administration, antibiotics prescribed from Standard treatment guideline, proportion of antibiotics, cost of antibiotics per antibiotics days, incidence and antibiotics utilization ratio were determined and 141(35.1%) were treated with different antibiotics irrationally. Conclusion: The finding of this study indicated that antibiotics were prescribed irrationally. Prescriptions containing one or more antibiotics constituted 73.68% of all prescriptions and around 5.9% of encounters were treated without any diagnosis. T he study has revealed that third generation cephalosporin (ceftriaxone) has been highly prescribed in the study hospital.
Background: In the last decades, there has been an escalating consumption of antibiotics with the number of antibiotic prescriptions increasing worldwide. Since children are more vulnerable to infectious disease than adults, more antibiotics are prescribed for them. Inappropriate use of antibiotics has resulted in a major increase in the development of multi-drug resistant pathogens with great implication in terms of morbidity, mortality and costs. The objective of this study was to determine the irrational use of antibiotics prescribed for children under the age of 15 years in Mekelle general hospital. Methods: A retrospective cross sectional study was conducted. Four hundred three children’s prescriptions and corresponding cards which were recorded by the year 2012 were selected by systematic random sampling proportionally from each month in the year. Results: Of all antibiotic prescriptions reviewed, the numbers of outpatient antibiotic prescriptions were 222 (55.1%) while inpatient prescriptions were 181 (44.9%).The predefined antibiotics indicators like percentage of antibiotics prescribed, frequency of route of administration, antibiotics prescribed from Standard treatment guideline, proportion of antibiotics, cost of antibiotics per antibiotics days, incidence and antibiotics utilization ratio were determined and 141(35.1%) were treated with different antibiotics irrationally. Conclusion: The finding of this study indicated that antibiotics were prescribed irrationally. Prescriptions containing one or more antibiotics constituted 73.68% of all prescriptions and around 5.9% of encounters were treated without any diagnosis. T he study has revealed that third generation cephalosporin (ceftriaxone) has been highly prescribed in the study hospital.
Retrospective Assessment of Irrational use of Antibiotics to Children Attending in Mekelle General Hospital
doi:10.11648/j.sjcm.20140303.14
Science Journal of Clinical Medicine
2014-06-12
© Science Publishing Group
Girum Sebsibie
Teklemariam Gultie
Retrospective Assessment of Irrational use of Antibiotics to Children Attending in Mekelle General Hospital
3
3
51
51
2014-06-12
2014-06-12
10.11648/j.sjcm.20140303.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140303.14
© Science Publishing Group
Ear, Nose and Throat Changes Observed during three Trimester of Pregnancy
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140303.15
Aim: To evaulate frequencies and distribution of ear, nose, throat symptoms during pregnancy. Materials and Methods: The study population consisted of 40 pregnant women and 40 non-pregnant women who applied clinics of Otorhinolarıngology and Obstetrics. Pregnant women were evaluated each trimester and after birth. Results:Results in pregnant group were as follows: Sensation of blockage in ears(15% in first trimester , 25% in second trimester, 30% in third trimester and 17.5% after birth), hearing loss(2.5% , only 1 patient in third trimester), facial paralysis(2.5% , only 1 patient in third trimester), stuffiness(7.5% in first trimester , 15% in second trimester, 20% in third trimester and 5% after birth), olfactive sensitivity (5% in first trimester , 30% in second trimester, 33% in third trimester and 10% after birth), gum bleeding(25% in first trimester , 30% in second trimester, 33% in third trimester and 5% after birth),epulis(2.5% , only 1 patient in second trimester), change in taste(37.5% in first trimester , 20% in second trimester, 17.5% in third trimester and 2.5% after birth), hoarseness(12.5% in first trimester , 17.5% in second trimester, 22.5% in third trimester and 5% after birth), dysphagia(20% in first trimester , 40% in second trimester, 45% in third trimester and 2.5% after birth), regurgitation(25% in first trimester , 37.5% in second trimester, 50% in third trimester and 2.5% after birth), facial pigmentation(10% in first trimester , 11.25% in second trimester, 30% in third trimester and 30% after birth). İn control group, symptoms were sensation of blockage in ears(12.5%), stuffiness(5%), olfactive sensitivity (5%), gum bleeding(5%), change in taste(2.5%), hoarseness(5%), dysphagia(2.5%), regurgitation(7.5%), facial pigmentation (7.5%). There were no hearing loss , facial paralysis and epulis in control group. Conclusion: Pregnancy changes ear, nose, throat symptoms and these symptoms may differ according to trimesters. While incidince of symptoms increased as pregnancy progresses, incidince of symptoms decreased after birth.
Aim: To evaulate frequencies and distribution of ear, nose, throat symptoms during pregnancy. Materials and Methods: The study population consisted of 40 pregnant women and 40 non-pregnant women who applied clinics of Otorhinolarıngology and Obstetrics. Pregnant women were evaluated each trimester and after birth. Results:Results in pregnant group were as follows: Sensation of blockage in ears(15% in first trimester , 25% in second trimester, 30% in third trimester and 17.5% after birth), hearing loss(2.5% , only 1 patient in third trimester), facial paralysis(2.5% , only 1 patient in third trimester), stuffiness(7.5% in first trimester , 15% in second trimester, 20% in third trimester and 5% after birth), olfactive sensitivity (5% in first trimester , 30% in second trimester, 33% in third trimester and 10% after birth), gum bleeding(25% in first trimester , 30% in second trimester, 33% in third trimester and 5% after birth),epulis(2.5% , only 1 patient in second trimester), change in taste(37.5% in first trimester , 20% in second trimester, 17.5% in third trimester and 2.5% after birth), hoarseness(12.5% in first trimester , 17.5% in second trimester, 22.5% in third trimester and 5% after birth), dysphagia(20% in first trimester , 40% in second trimester, 45% in third trimester and 2.5% after birth), regurgitation(25% in first trimester , 37.5% in second trimester, 50% in third trimester and 2.5% after birth), facial pigmentation(10% in first trimester , 11.25% in second trimester, 30% in third trimester and 30% after birth). İn control group, symptoms were sensation of blockage in ears(12.5%), stuffiness(5%), olfactive sensitivity (5%), gum bleeding(5%), change in taste(2.5%), hoarseness(5%), dysphagia(2.5%), regurgitation(7.5%), facial pigmentation (7.5%). There were no hearing loss , facial paralysis and epulis in control group. Conclusion: Pregnancy changes ear, nose, throat symptoms and these symptoms may differ according to trimesters. While incidince of symptoms increased as pregnancy progresses, incidince of symptoms decreased after birth.
Ear, Nose and Throat Changes Observed during three Trimester of Pregnancy
doi:10.11648/j.sjcm.20140303.15
Science Journal of Clinical Medicine
2014-06-24
© Science Publishing Group
Ayşe Neslin Akkoca
Gül Soylu Özler
Raziye Keskin Kurt
Oya Soylu Karapınar
Zeynep Tuba Özdemir
Serdar Yanık
Ear, Nose and Throat Changes Observed during three Trimester of Pregnancy
3
3
56
56
2014-06-24
2014-06-24
10.11648/j.sjcm.20140303.15
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140303.15
© Science Publishing Group
Clinicopathological Evaluation and Outcome of Mycosis Fungoides
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140304.12
Although mycosis fungoides is the most common cutaneous T-cell lymphoma, its etiopathogenesis has not been clarified definitively and there is no standard and curative treatment method. Medical records of 57 patients diagnosed with mycosis fungoides by clinical and histopathological findings were retrospectively reviewed in our clinic. Complete blood count, erythrocyte sedimentation rate, peripheral blood smear, biochemical findings, chest radiographs, and computerized tomography of all patients were reviewed; patients were staged using TNM system. The clinical presentation was classical patch/plaque form in 44patients and other forms in 13. According to TNM staging, 9patients were stage 1a, 38 were stage 1b, 5 were 2a, and 2 were stage 3, and 2 were stage 4a. The pathological findings were basal alignment of lymphocytes, reticular fibroplasia, atypical lymphocytes, and epidermotropism. Remission was achieved by topical imiquimod in 2patients, phototherapy in 30, and phototherapy and systemic treatment in 8. Remission rate with narrow band UV B was 72%, and that of psoralen UV A was 85.71%. Ten patients in remission had recurrence. Age, sex, duration of disease, and clinical presentation had no effect on remission or recurrence of mycosis fungoides. Reticular fibroplasia is a supporting histopathological finding in mycosis fungoides, together with basal alignment of lymphocytes, atypical lymphocytes and epidermotropism. Topical imiquimod treatment for local lesions and phototherapy for widespread lesions are effective, and psoralen UVA treatment seems to be more efficient than narrow band UVB.
Although mycosis fungoides is the most common cutaneous T-cell lymphoma, its etiopathogenesis has not been clarified definitively and there is no standard and curative treatment method. Medical records of 57 patients diagnosed with mycosis fungoides by clinical and histopathological findings were retrospectively reviewed in our clinic. Complete blood count, erythrocyte sedimentation rate, peripheral blood smear, biochemical findings, chest radiographs, and computerized tomography of all patients were reviewed; patients were staged using TNM system. The clinical presentation was classical patch/plaque form in 44patients and other forms in 13. According to TNM staging, 9patients were stage 1a, 38 were stage 1b, 5 were 2a, and 2 were stage 3, and 2 were stage 4a. The pathological findings were basal alignment of lymphocytes, reticular fibroplasia, atypical lymphocytes, and epidermotropism. Remission was achieved by topical imiquimod in 2patients, phototherapy in 30, and phototherapy and systemic treatment in 8. Remission rate with narrow band UV B was 72%, and that of psoralen UV A was 85.71%. Ten patients in remission had recurrence. Age, sex, duration of disease, and clinical presentation had no effect on remission or recurrence of mycosis fungoides. Reticular fibroplasia is a supporting histopathological finding in mycosis fungoides, together with basal alignment of lymphocytes, atypical lymphocytes and epidermotropism. Topical imiquimod treatment for local lesions and phototherapy for widespread lesions are effective, and psoralen UVA treatment seems to be more efficient than narrow band UVB.
Clinicopathological Evaluation and Outcome of Mycosis Fungoides
doi:10.11648/j.sjcm.20140304.12
Science Journal of Clinical Medicine
2014-07-18
© Science Publishing Group
Ilkin Zindanci
Mukaddes Kavala
Ebru Zemheri
Emek Kocaturk
Burce Can
Zafer Turkoglu
Melek Koc
Seyma Ozkanli
Filiz Topaloglu
Clinicopathological Evaluation and Outcome of Mycosis Fungoides
3
4
69
69
2014-07-18
2014-07-18
10.11648/j.sjcm.20140304.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140304.12
© Science Publishing Group
Knowledge of Breast Cancer and Its Early Detection Measures among Female Students, in Mekelle University, Tigray Region, Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140304.11
Background: Breast cancer is the most common of all cancers in women both in the developed and less developed world. Its incidence rate varies from 19.3 per 100,000 women in Eastern Africa to 89.7 per 100,000 women in Western Europe. Globally, it claims the lives of 508, 000 women per year. Since risk reduction strategies cannot eliminate the majority of breast cancers, early detectionremains the cornerstone of breast cancer control. Health education and communication have been found critical to promote breast cancer prevention and screening strategies. However, to our knowledge no previous research was done in the study area and awareness about breast cancer among Ethiopian women is not well documented. This paper, therefore, attempts to assess the level of Knowledge of breast cancer and its early detection measures among female students in Mekelle University, Ethiopia.Method:An institution based descriptive cross-sectional study was conducted from January 2013 to June, 2013 on randomly selected female students.. Multistage sampling technique was employed to select the study participants. A pre-tested structured questionnaire wasused to collect the data. Data analysis was carried out using SPSS. Frequencies,means, and standard deviations were computed.Result: In this study, 760 studentsparticipated making a response rate of 96%. The finding of this study showed that respondents with good knowledge score for risk factors, early detections measures and warning signs of breast cancer was 1.4%, 3.6% and 22.1% respectively. The majority 477 (62.8%) of participants practiced self-breast examination. Of the respondents who practiced breast self-examination, 201 (71.0%) reported that they practiced monthly.Conclusion: The finding of this study revealed that respondents had poor knowledge of risk factors, early detection measures and early warning signs of breast cancer. This implies that the health care system particularly policy makers, health care managers, health care professionals and community based health extension workers are giving limited attention to non-communicable disease like breast cancer despite their public health burden. Moreover, very few of the respondents have practiced self and clinical breast examination. Therefore, the Ministry of health of Ethiopia and other stalk holders should promote provision of information, education and communication targeting women, family, and the general community to increase their awareness about breast cancer and its early detection measure.
Background: Breast cancer is the most common of all cancers in women both in the developed and less developed world. Its incidence rate varies from 19.3 per 100,000 women in Eastern Africa to 89.7 per 100,000 women in Western Europe. Globally, it claims the lives of 508, 000 women per year. Since risk reduction strategies cannot eliminate the majority of breast cancers, early detectionremains the cornerstone of breast cancer control. Health education and communication have been found critical to promote breast cancer prevention and screening strategies. However, to our knowledge no previous research was done in the study area and awareness about breast cancer among Ethiopian women is not well documented. This paper, therefore, attempts to assess the level of Knowledge of breast cancer and its early detection measures among female students in Mekelle University, Ethiopia.Method:An institution based descriptive cross-sectional study was conducted from January 2013 to June, 2013 on randomly selected female students.. Multistage sampling technique was employed to select the study participants. A pre-tested structured questionnaire wasused to collect the data. Data analysis was carried out using SPSS. Frequencies,means, and standard deviations were computed.Result: In this study, 760 studentsparticipated making a response rate of 96%. The finding of this study showed that respondents with good knowledge score for risk factors, early detections measures and warning signs of breast cancer was 1.4%, 3.6% and 22.1% respectively. The majority 477 (62.8%) of participants practiced self-breast examination. Of the respondents who practiced breast self-examination, 201 (71.0%) reported that they practiced monthly.Conclusion: The finding of this study revealed that respondents had poor knowledge of risk factors, early detection measures and early warning signs of breast cancer. This implies that the health care system particularly policy makers, health care managers, health care professionals and community based health extension workers are giving limited attention to non-communicable disease like breast cancer despite their public health burden. Moreover, very few of the respondents have practiced self and clinical breast examination. Therefore, the Ministry of health of Ethiopia and other stalk holders should promote provision of information, education and communication targeting women, family, and the general community to increase their awareness about breast cancer and its early detection measure.
Knowledge of Breast Cancer and Its Early Detection Measures among Female Students, in Mekelle University, Tigray Region, Ethiopia
doi:10.11648/j.sjcm.20140304.11
Science Journal of Clinical Medicine
2014-07-10
© Science Publishing Group
Tesfay Hailu
Hailemariam Berhe
Desta Hailu
Haftu Berhe
Knowledge of Breast Cancer and Its Early Detection Measures among Female Students, in Mekelle University, Tigray Region, Ethiopia
3
4
64
64
2014-07-10
2014-07-10
10.11648/j.sjcm.20140304.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140304.11
© Science Publishing Group
Immunohistochemical Expression of Endothelial Cell Markers in Case of Dieulafoy Lesion: Is There Is a Differences
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140304.13
Dieulafoy's lesion (DL) is a rare of cases of acute upper GIT bleeding. We investigate the immunohistochemical expression of several endothelial markers in a patient with Dieulafoy’s lesion of the stomach, by comparing the results with data on the expression of these markers in other types of gastric pathology. The histological examination of the patient with Dieulafoy’s lesion showed small erosive defect covered with fibrin, under which there were several highly deformed and dilated blood vessels with different diameters. We found that the expression of EC markers CD31, CD34, vWF and VEGF in gastric blood vessels of DL is heterogeneous and there is some differences compared with endothelial markers expression in other gastric pathology.
Dieulafoy's lesion (DL) is a rare of cases of acute upper GIT bleeding. We investigate the immunohistochemical expression of several endothelial markers in a patient with Dieulafoy’s lesion of the stomach, by comparing the results with data on the expression of these markers in other types of gastric pathology. The histological examination of the patient with Dieulafoy’s lesion showed small erosive defect covered with fibrin, under which there were several highly deformed and dilated blood vessels with different diameters. We found that the expression of EC markers CD31, CD34, vWF and VEGF in gastric blood vessels of DL is heterogeneous and there is some differences compared with endothelial markers expression in other gastric pathology.
Immunohistochemical Expression of Endothelial Cell Markers in Case of Dieulafoy Lesion: Is There Is a Differences
doi:10.11648/j.sjcm.20140304.13
Science Journal of Clinical Medicine
2014-08-08
© Science Publishing Group
Julian Ananiev
Mariana Penkova
Kiril Slaveykov
Georgi Tchernev
Immunohistochemical Expression of Endothelial Cell Markers in Case of Dieulafoy Lesion: Is There Is a Differences
3
4
74
74
2014-08-08
2014-08-08
10.11648/j.sjcm.20140304.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140304.13
© Science Publishing Group
Paralytic Toxin Profiles of Xanthid Crab Atergatis Floridus Collected on Reefs of Ishigaki Island, Okinawa Prefecture, Japan and Camotes Island, Cebu Province, Philippines
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140305.11
Attempts were made to assess the toxicity and to analyze paralytic toxin profiles of xanthid crab Atergatis floridus collected on two reefs on the left- and the right-side, tentatively designated as site A and B, separated by the passage at the outside of Kabira Bay in Ishigaki Island, Okinawa Prefecture, Japan in comparison with those of the same crabs from Camotes Island off the eastern coast of Cebu Island, Cebu Province, Philippines. They were dissected into 4 parts; carapace, viscera, appendage and muscle of appendage. Muscle of appendage was highly toxic, and the maximum toxicity of 4,641±972MU/g as paralytic shellfish poison (PSP) was recorded in the specimens from the right-side reef (site B). Toxicity assays showed that all of them were toxic irrespective of the crab-collecting years, locations, and tissues, and in addition to these, there seemed to be marked narrow regionality and individual variation of toxicity and toxin profiles. Toxicity of Ishigaki specimens was seemed to be higher than that of Camotes specimens. Toxin profiles of the viscera of A.floridus were examined by high performance liquid chromatography-fluorescent detection (HPLC-FLD) analysis. In the viscera of A.floridus from site A in June, 2007, relative abundances (mole %) of carbamoyl-N-hydroxyneosaxitoxin (hyneoSTX), neosaxitoxin (neoSTX), and saxitoxin (STX) were high (98%), and only 2% of gonyautoxin 2(GTX2) were contained in addition to similar amounts (3%) of decarbamoylsaxitoxin (dcSTX). Its viscera from site B in the same month possessed GTX2 (36%) and STX group (63 %) predominantly, and only 1% of GTX1 was contained in addition to similar amount (2%) of STX. Their viscera possessed STX group as the major components (89%) along with the GTX4 (11%) as the minor. On the other hand, PSP compositions of the viscera of Camotes specimen resembled to that of the viscera from the specimens on site A in Kabira Bay with higher GTX4 but lower hyneoSTX. A solitary outstanding difference of toxin profiles in both crabs was the occurrence of tetrodotoxin (TTX) in the Camotes specimen due to the results of HPLC-FLD and gas chromatography-mass spectrometry (GC-MS) analysis.
Attempts were made to assess the toxicity and to analyze paralytic toxin profiles of xanthid crab Atergatis floridus collected on two reefs on the left- and the right-side, tentatively designated as site A and B, separated by the passage at the outside of Kabira Bay in Ishigaki Island, Okinawa Prefecture, Japan in comparison with those of the same crabs from Camotes Island off the eastern coast of Cebu Island, Cebu Province, Philippines. They were dissected into 4 parts; carapace, viscera, appendage and muscle of appendage. Muscle of appendage was highly toxic, and the maximum toxicity of 4,641±972MU/g as paralytic shellfish poison (PSP) was recorded in the specimens from the right-side reef (site B). Toxicity assays showed that all of them were toxic irrespective of the crab-collecting years, locations, and tissues, and in addition to these, there seemed to be marked narrow regionality and individual variation of toxicity and toxin profiles. Toxicity of Ishigaki specimens was seemed to be higher than that of Camotes specimens. Toxin profiles of the viscera of A.floridus were examined by high performance liquid chromatography-fluorescent detection (HPLC-FLD) analysis. In the viscera of A.floridus from site A in June, 2007, relative abundances (mole %) of carbamoyl-N-hydroxyneosaxitoxin (hyneoSTX), neosaxitoxin (neoSTX), and saxitoxin (STX) were high (98%), and only 2% of gonyautoxin 2(GTX2) were contained in addition to similar amounts (3%) of decarbamoylsaxitoxin (dcSTX). Its viscera from site B in the same month possessed GTX2 (36%) and STX group (63 %) predominantly, and only 1% of GTX1 was contained in addition to similar amount (2%) of STX. Their viscera possessed STX group as the major components (89%) along with the GTX4 (11%) as the minor. On the other hand, PSP compositions of the viscera of Camotes specimen resembled to that of the viscera from the specimens on site A in Kabira Bay with higher GTX4 but lower hyneoSTX. A solitary outstanding difference of toxin profiles in both crabs was the occurrence of tetrodotoxin (TTX) in the Camotes specimen due to the results of HPLC-FLD and gas chromatography-mass spectrometry (GC-MS) analysis.
Paralytic Toxin Profiles of Xanthid Crab Atergatis Floridus Collected on Reefs of Ishigaki Island, Okinawa Prefecture, Japan and Camotes Island, Cebu Province, Philippines
doi:10.11648/j.sjcm.20140305.11
Science Journal of Clinical Medicine
2014-09-10
© Science Publishing Group
Manabu Asakawa
Shintaro Tsuruda
Yasuyuki Ishimoto
Michitaka Shimomura
Kazuo Kishimoto
Yasuo Shida
Mercy Barte-Quilantang
Gloria Gomez-Delan
Paralytic Toxin Profiles of Xanthid Crab Atergatis Floridus Collected on Reefs of Ishigaki Island, Okinawa Prefecture, Japan and Camotes Island, Cebu Province, Philippines
3
5
81
81
2014-09-10
2014-09-10
10.11648/j.sjcm.20140305.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140305.11
© Science Publishing Group
Determination of Sample Size for Two Stage Sequential Designs in Bioequivalence Studies under 2x2 Crossover Design
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140305.12
Sequential design is an adaptive design that allows for pre-mature termination of a trial due to efficacy or futility based on the interim analyses. The concept of sequential statistical methods was originally motivated by the need to obtain clinical benefits under certain economic constraints. That is for a trial for a positive results, early stopping ensures that a new drug product can exploited sooner, while negative results indicated, early stopping avoids wastage of resources. In short, the right drug at the right time for the right patient. Furthermore, the possible implication of two stage sequential design/ sample size re-estimation is to adjust the sample size based on the observed variance estimated from the first stage. The purpose of this work was to determine the minimum number of sample size required to proceed the second stage of sequential design, and the simulation is done through R ve. 3.0.3 Statistical software package. In general, from our simulation study, we can understand that, for highly variable drugs (CV ≥30), the appropriate GMR value is between (0.95, 1.05), which is also appropriate for low variable drugs to achieve the minimum sample size required to conduct any clinical trials.
Sequential design is an adaptive design that allows for pre-mature termination of a trial due to efficacy or futility based on the interim analyses. The concept of sequential statistical methods was originally motivated by the need to obtain clinical benefits under certain economic constraints. That is for a trial for a positive results, early stopping ensures that a new drug product can exploited sooner, while negative results indicated, early stopping avoids wastage of resources. In short, the right drug at the right time for the right patient. Furthermore, the possible implication of two stage sequential design/ sample size re-estimation is to adjust the sample size based on the observed variance estimated from the first stage. The purpose of this work was to determine the minimum number of sample size required to proceed the second stage of sequential design, and the simulation is done through R ve. 3.0.3 Statistical software package. In general, from our simulation study, we can understand that, for highly variable drugs (CV ≥30), the appropriate GMR value is between (0.95, 1.05), which is also appropriate for low variable drugs to achieve the minimum sample size required to conduct any clinical trials.
Determination of Sample Size for Two Stage Sequential Designs in Bioequivalence Studies under 2x2 Crossover Design
doi:10.11648/j.sjcm.20140305.12
Science Journal of Clinical Medicine
2014-09-27
© Science Publishing Group
Haile Mekonnen Fenta
Determination of Sample Size for Two Stage Sequential Designs in Bioequivalence Studies under 2x2 Crossover Design
3
5
90
90
2014-09-27
2014-09-27
10.11648/j.sjcm.20140305.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140305.12
© Science Publishing Group
Effect of Glycemic Control on Plasma Oxidized Low Density Lipoprotein Levels in Diabetics
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140305.13
Objective: Increased low-density lipoprotein (LDL) glycation in diabetics could facilitate LDL oxidation, which is proatherogenic. I studied plasma oxidized LDL (OxLDL) levels in diabetics and non-diabetics, their relation to glycemic control, and their circadian variations. Methods: OxLDL in diabetics (n=32) and in non-diabetics without coronary artery diseases (n=20) were compared. OxLDL in diabetics (n=24) was measured on Days 2, 3, 4, 8 and the last day of hospitalization. Circadian variation in OxLDL in diabetics (n=18) was also examined. Glycemic control was implemented during hospitalization. Patients: The diabetics were divided into two groups; moderately-controlled (MC) group (HbA1c < 9.0% at admission, n = 15) and poorly-controlled (PC) group (HbA1c ≧ 9.0% at admission, n = 9). Results: In the MC group, OxLDL decreased by 20.8% after glycemic control (p = 0.0139), but not in the PC group. OxLDL is correlated with LDL on Days 3, 4, 8 (r = 0.837, 0.864, 0.801, respectively), TG on Day 8(r = 0.932), and Lp(a) at discharge (r = 0.871). In the PC group, OxLDL was 15.8% higher on the average in the daytime than at night (p = 0.0024). Conclusion: Plasma OxLDL is decreased by glycemic control, particularly in moderately glycemic controlled patients. OxLDL has a circadian variation, particularly in poorly glycemic controlled patients. Long-term glycemic control could reduce the progression of atherosclerosis, by reducing OxLDL levels.
Objective: Increased low-density lipoprotein (LDL) glycation in diabetics could facilitate LDL oxidation, which is proatherogenic. I studied plasma oxidized LDL (OxLDL) levels in diabetics and non-diabetics, their relation to glycemic control, and their circadian variations. Methods: OxLDL in diabetics (n=32) and in non-diabetics without coronary artery diseases (n=20) were compared. OxLDL in diabetics (n=24) was measured on Days 2, 3, 4, 8 and the last day of hospitalization. Circadian variation in OxLDL in diabetics (n=18) was also examined. Glycemic control was implemented during hospitalization. Patients: The diabetics were divided into two groups; moderately-controlled (MC) group (HbA1c < 9.0% at admission, n = 15) and poorly-controlled (PC) group (HbA1c ≧ 9.0% at admission, n = 9). Results: In the MC group, OxLDL decreased by 20.8% after glycemic control (p = 0.0139), but not in the PC group. OxLDL is correlated with LDL on Days 3, 4, 8 (r = 0.837, 0.864, 0.801, respectively), TG on Day 8(r = 0.932), and Lp(a) at discharge (r = 0.871). In the PC group, OxLDL was 15.8% higher on the average in the daytime than at night (p = 0.0024). Conclusion: Plasma OxLDL is decreased by glycemic control, particularly in moderately glycemic controlled patients. OxLDL has a circadian variation, particularly in poorly glycemic controlled patients. Long-term glycemic control could reduce the progression of atherosclerosis, by reducing OxLDL levels.
Effect of Glycemic Control on Plasma Oxidized Low Density Lipoprotein Levels in Diabetics
doi:10.11648/j.sjcm.20140305.13
Science Journal of Clinical Medicine
2014-10-09
© Science Publishing Group
Koichi Ono
Effect of Glycemic Control on Plasma Oxidized Low Density Lipoprotein Levels in Diabetics
3
5
97
97
2014-10-09
2014-10-09
10.11648/j.sjcm.20140305.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140305.13
© Science Publishing Group
Acute Respiratory Distress Syndrome in Renal Transplant Patients with Pneumonia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140305.14
Objective: To establish the frequency of Acute Respiratory Distress Syndrome in kidney transplant patients with pneumonia and to define the risk factors associated with its development. Material and Methods: 81 kidney transplant patients hospitalized with pneumonia for the period of three years were studied. All the recipients were observed for the development of Acute Respiratory Distress Syndrome. Different noninvasive and invasive diagnostic tests were used. Results: 15 of the patients with pneumonia developed ARDS. The factors associated with increased risk for the development of Acute Respiratory Distress Syndrome included pneumonia in 1-6 month after transplantation, increased level of C – reactive protein, Cytomegalovirus-infection, bilateral lung infiltrates and failure of initial antibiotic therapy. Conclusions: The risk factors can be used to identify patients with pneumonia at increased risk for development of Acute Respiratory Distress Syndrome. Strict monitoring of high-risk patients can reduce the morbidity and mortality after renal transplantation.
Objective: To establish the frequency of Acute Respiratory Distress Syndrome in kidney transplant patients with pneumonia and to define the risk factors associated with its development. Material and Methods: 81 kidney transplant patients hospitalized with pneumonia for the period of three years were studied. All the recipients were observed for the development of Acute Respiratory Distress Syndrome. Different noninvasive and invasive diagnostic tests were used. Results: 15 of the patients with pneumonia developed ARDS. The factors associated with increased risk for the development of Acute Respiratory Distress Syndrome included pneumonia in 1-6 month after transplantation, increased level of C – reactive protein, Cytomegalovirus-infection, bilateral lung infiltrates and failure of initial antibiotic therapy. Conclusions: The risk factors can be used to identify patients with pneumonia at increased risk for development of Acute Respiratory Distress Syndrome. Strict monitoring of high-risk patients can reduce the morbidity and mortality after renal transplantation.
Acute Respiratory Distress Syndrome in Renal Transplant Patients with Pneumonia
doi:10.11648/j.sjcm.20140305.14
Science Journal of Clinical Medicine
2014-10-15
© Science Publishing Group
Ventsislava Pencheva
Daniela Petrova
Diyan Genov
Ognian Georgiev
Acute Respiratory Distress Syndrome in Renal Transplant Patients with Pneumonia
3
5
103
103
2014-10-15
2014-10-15
10.11648/j.sjcm.20140305.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140305.14
© Science Publishing Group
Quadriplegia Due to Potassium Depletion: A Case Report
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140306.11
Hypokalemia is a very frequent metabolic disorder seen in emergency medicine, paralysis related to depletion hypokalemia is rare. We present the case of a 22 years old male patient who presented with flaccid quadriplegia after vomiting. After potassium supplementation the patient completely recovered. We will explain through this case the pathogenesis of this paralysis and different pitfalls that must be avoided.
Hypokalemia is a very frequent metabolic disorder seen in emergency medicine, paralysis related to depletion hypokalemia is rare. We present the case of a 22 years old male patient who presented with flaccid quadriplegia after vomiting. After potassium supplementation the patient completely recovered. We will explain through this case the pathogenesis of this paralysis and different pitfalls that must be avoided.
Quadriplegia Due to Potassium Depletion: A Case Report
doi:10.11648/j.sjcm.20140306.11
Science Journal of Clinical Medicine
2014-10-22
© Science Publishing Group
Rachid Sirbou
Ahmed Belkouch
Lahcen Belyamani
Quadriplegia Due to Potassium Depletion: A Case Report
3
6
105
105
2014-10-22
2014-10-22
10.11648/j.sjcm.20140306.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140306.11
© Science Publishing Group
Psoriasis at Ayder Referral Hospital among Patients Attending Dermatology Clinic, Mekelle, North Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140306.12
Background: Psoriasis is a chronic recurrent inflammatory skin condition.The prevalence of psoriasis varies in different population from 0.1% to 11%. It can classify in to type one (< 40 yrs) and type two (>=40 yrs). And also classified into four major categories; chronic plaque psoriasis, guttate psoriasis, pustular psoriasis and erthroderma. The objective of this study was to assess magnitude and factors associated with psoriasis. Methods: A cross-sectional study design and convenient sampling technique was implemented at Ayder referral hospital dermatologic unit until sample size (422) was fulfilled. Data was entered and analyzed by SPSS version 16.0. Descriptive statistics and logistic regression analysis was done. . The magnitude of psoriasis was 5.4% where majorities (81%) of psoriasis cases were chronic plaque. Multiple site involvement (42.9%) (arms, trunk and leg) were the main characteristics. Marital status (widowed/divorced) (AOR= 7.75, 95%CI (1.58, 37.98)) and complaining joint pain (AOR=7.66, 95%CI (2.24, 26.17)) were significantly associated with psoriasis. Conclusion: The magnitude of psoriasis in ARH was relatively higher. Having history of joint pain and being divorced/ widowed were significantly associated with occurrence of psoriasis. Therefore, early diagnosis and treatment of joint pain, minimizing social stressor conditions such as divorce and providing emotional and psychological support were recommended.
Background: Psoriasis is a chronic recurrent inflammatory skin condition.The prevalence of psoriasis varies in different population from 0.1% to 11%. It can classify in to type one (< 40 yrs) and type two (>=40 yrs). And also classified into four major categories; chronic plaque psoriasis, guttate psoriasis, pustular psoriasis and erthroderma. The objective of this study was to assess magnitude and factors associated with psoriasis. Methods: A cross-sectional study design and convenient sampling technique was implemented at Ayder referral hospital dermatologic unit until sample size (422) was fulfilled. Data was entered and analyzed by SPSS version 16.0. Descriptive statistics and logistic regression analysis was done. . The magnitude of psoriasis was 5.4% where majorities (81%) of psoriasis cases were chronic plaque. Multiple site involvement (42.9%) (arms, trunk and leg) were the main characteristics. Marital status (widowed/divorced) (AOR= 7.75, 95%CI (1.58, 37.98)) and complaining joint pain (AOR=7.66, 95%CI (2.24, 26.17)) were significantly associated with psoriasis. Conclusion: The magnitude of psoriasis in ARH was relatively higher. Having history of joint pain and being divorced/ widowed were significantly associated with occurrence of psoriasis. Therefore, early diagnosis and treatment of joint pain, minimizing social stressor conditions such as divorce and providing emotional and psychological support were recommended.
Psoriasis at Ayder Referral Hospital among Patients Attending Dermatology Clinic, Mekelle, North Ethiopia
doi:10.11648/j.sjcm.20140306.12
Science Journal of Clinical Medicine
2014-10-24
© Science Publishing Group
Sintayehu Worku Aynalem
Workalemahu Alemu
Alemayehu Bayray
Tilahun Belete Mossie
Psoriasis at Ayder Referral Hospital among Patients Attending Dermatology Clinic, Mekelle, North Ethiopia
3
6
110
110
2014-10-24
2014-10-24
10.11648/j.sjcm.20140306.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140306.12
© Science Publishing Group
The Current Status of Cutaneous Leishmaniasis and the Pattern of Lesions in Ochollo Primary School Students, Ochollo, Southwestern Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140306.13
Background: Leishmaniasis is a vector borne disease caused by the obligate intracellular protozoan leishmania. Objective:To assess the prevalence of cutaneous leishmaniasis and pattern of lesions in Dega Ochollo primary school students, Ochollo, Southwestern Ethiopia. Methods: A cross-sectional study was carried out among 523 school children aging between 6 to 25 years. The students were physically examined for the presence of scar and active lesions. Skin slit and blood were collected from students with suspected active lesions of cutaneous leishmaniasis. Scraps were cultured in Nicolle-Novy-MacNeal(NNN) medium and serological tests were performed using direct agglutination test (DAT). Results: The overall prevalence of tegumentary leishmaniasis including both scar and active lesions among the 523 students which underwent physical examination was 65.8 %. Besides, the study revealed that 64.8% of the participants had current and/or past lesion of cutaneous leishmaniasis. The prevalence of Mucocutaneous leishmaniasis and recidivan was 0.2% and 0.8%, respectively. Three hundred and thirteen (59.8%) students were with scar and 21(4.01%) were with active lesions whereas 8(1.5%) of the cases had both scar and active lesions. Majority (49.71%) of the participants belonging to the age group 11-15 years old were the most affected group (p-value<0.05). The average number of scars and lesions per patient was calculated to be 1.5 and 1.7, respectively. Majority (64.17%) of the cases had single scars while 22.74%, 7.48%, and 5.61% of them had double, triple, and four and above, respectively. The scars were more localized above the neck (82.16%) where the highest (54.56%) proportion of the scars was distributed on check. Of the 29 participants who had active lesions, 4(13.8%) of them were found to be culture positive and one patient was also positive for DAT out of these culture positive patients. One smear positive sample was also found among the samples which were positive for NNN medium. Conclusions: cutaneous leishmaniasis is prevalent in the area causing disfigurement and resulting social stigmatization. This calls for the implementation of prevention and control measures including treatment of infected individuals.
Background: Leishmaniasis is a vector borne disease caused by the obligate intracellular protozoan leishmania. Objective:To assess the prevalence of cutaneous leishmaniasis and pattern of lesions in Dega Ochollo primary school students, Ochollo, Southwestern Ethiopia. Methods: A cross-sectional study was carried out among 523 school children aging between 6 to 25 years. The students were physically examined for the presence of scar and active lesions. Skin slit and blood were collected from students with suspected active lesions of cutaneous leishmaniasis. Scraps were cultured in Nicolle-Novy-MacNeal(NNN) medium and serological tests were performed using direct agglutination test (DAT). Results: The overall prevalence of tegumentary leishmaniasis including both scar and active lesions among the 523 students which underwent physical examination was 65.8 %. Besides, the study revealed that 64.8% of the participants had current and/or past lesion of cutaneous leishmaniasis. The prevalence of Mucocutaneous leishmaniasis and recidivan was 0.2% and 0.8%, respectively. Three hundred and thirteen (59.8%) students were with scar and 21(4.01%) were with active lesions whereas 8(1.5%) of the cases had both scar and active lesions. Majority (49.71%) of the participants belonging to the age group 11-15 years old were the most affected group (p-value<0.05). The average number of scars and lesions per patient was calculated to be 1.5 and 1.7, respectively. Majority (64.17%) of the cases had single scars while 22.74%, 7.48%, and 5.61% of them had double, triple, and four and above, respectively. The scars were more localized above the neck (82.16%) where the highest (54.56%) proportion of the scars was distributed on check. Of the 29 participants who had active lesions, 4(13.8%) of them were found to be culture positive and one patient was also positive for DAT out of these culture positive patients. One smear positive sample was also found among the samples which were positive for NNN medium. Conclusions: cutaneous leishmaniasis is prevalent in the area causing disfigurement and resulting social stigmatization. This calls for the implementation of prevention and control measures including treatment of infected individuals.
The Current Status of Cutaneous Leishmaniasis and the Pattern of Lesions in Ochollo Primary School Students, Ochollo, Southwestern Ethiopia
doi:10.11648/j.sjcm.20140306.13
Science Journal of Clinical Medicine
2014-10-29
© Science Publishing Group
Gessessew Bugssa
Asrat Hailu
Balem Demtsu
The Current Status of Cutaneous Leishmaniasis and the Pattern of Lesions in Ochollo Primary School Students, Ochollo, Southwestern Ethiopia
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2014-10-29
2014-10-29
10.11648/j.sjcm.20140306.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140306.13
© Science Publishing Group
Associations between HBeAg Status, HBV DNA, ALT Level and Liver Histopathology in Patients with Chronic Hepatitis B
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140306.14
Hepatitis B virus (HBV) infection is still a significant healthcare problem all over the world. Between January 2009 and May 2014, a total of 96 patients with chronic hepatitis B (CHB) were enrolled in study. A total of 96 CHB cases were examined. The mean total liver histological activity indices for grade and stage were 6.01±2.46, and 1.6±0.99 and the mean ALT and AST levels were 32.6 ±21.0 IU/L and 25.6 ±11.2 IU/L, respectively. The mean HBV DNA level was 8.9 x106±3.3106 IU/mL. Forty (41.7%) patients had HBV DNA <20 IU/Ml (undetectable) and 14 (14.6%) patients had HBV DNA levels between 21 and 2000 IU/mL. Of the total 96 patients, 100% were HBsAg positive, 88 (91.7%) were HBeAg negative and 8 (8.3%) were HBeAg positive. A significant correlation was found between the HBeAg serostatus, HBV DNA level and the histological activity index necroinflammatory total scores (P= 0.034 and 0.000). We found no correlation between the fibrosis score and HBeAg status (P= 0.451). However, a statistically significant difference was found between HBV DNA levels and stage of fibrosis (P= 0.048). A significant relationship was found between the HBeAg status, HBV DNA level and ALT and AST levels (P= 0.000, 0.000, 0.032, 0.024). The HBeAg status of CHB patients should not affect the treatment response or need for long-term follow-up visits with repeat ALT and HBV DNA levels. However, chronic hepatitis patients who are negative for HBeAg may need different short-term follow-up.
Hepatitis B virus (HBV) infection is still a significant healthcare problem all over the world. Between January 2009 and May 2014, a total of 96 patients with chronic hepatitis B (CHB) were enrolled in study. A total of 96 CHB cases were examined. The mean total liver histological activity indices for grade and stage were 6.01±2.46, and 1.6±0.99 and the mean ALT and AST levels were 32.6 ±21.0 IU/L and 25.6 ±11.2 IU/L, respectively. The mean HBV DNA level was 8.9 x106±3.3106 IU/mL. Forty (41.7%) patients had HBV DNA <20 IU/Ml (undetectable) and 14 (14.6%) patients had HBV DNA levels between 21 and 2000 IU/mL. Of the total 96 patients, 100% were HBsAg positive, 88 (91.7%) were HBeAg negative and 8 (8.3%) were HBeAg positive. A significant correlation was found between the HBeAg serostatus, HBV DNA level and the histological activity index necroinflammatory total scores (P= 0.034 and 0.000). We found no correlation between the fibrosis score and HBeAg status (P= 0.451). However, a statistically significant difference was found between HBV DNA levels and stage of fibrosis (P= 0.048). A significant relationship was found between the HBeAg status, HBV DNA level and ALT and AST levels (P= 0.000, 0.000, 0.032, 0.024). The HBeAg status of CHB patients should not affect the treatment response or need for long-term follow-up visits with repeat ALT and HBV DNA levels. However, chronic hepatitis patients who are negative for HBeAg may need different short-term follow-up.
Associations between HBeAg Status, HBV DNA, ALT Level and Liver Histopathology in Patients with Chronic Hepatitis B
doi:10.11648/j.sjcm.20140306.14
Science Journal of Clinical Medicine
2014-11-10
© Science Publishing Group
Ali Koyuncuer
Associations between HBeAg Status, HBV DNA, ALT Level and Liver Histopathology in Patients with Chronic Hepatitis B
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123
123
2014-11-10
2014-11-10
10.11648/j.sjcm.20140306.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140306.14
© Science Publishing Group
Acne at Ayder Referral Hospital among Patients Attending Dermatologic Clinic, Mekelle, Northern Ethiopia, September 2014
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140306.16
Background: Acne is a chronic inflammatory disease of pilosebceous units with a clinical picture which vary significantly from mild comedonal acne to fulminant systemic disease. Acne has a significant impact on appearance, causing psychosocial and emotional distress, and reducing quality of life of the affected patients. Acne distresses patients due to the fact that it mainly affects the face, being easily visible and constantly present in everyday life. So the aim of this study will be minimizing the gap on magnitude and factors associated with acne at Ayder Referral Hospital.Objectives: To assess the magnitude and factors associated with acne among patients attending dermatologic clinic at Ayder referral hospital, Mekelle, Tigray, Northern Ethiopia.Methods: An institutional based cross sectional study design and sequential convenience sampling technique was implemented at Ayder referral hospital dermatologic Unit until sample size (423) is fulfilled. A total sample size (402) of data was entered and analyzed by SPSS version 16.0. Descriptive and logistic regression analysis was done. Data was presented in the form of tables, graphs and numerical measures. Also it was interpreted by using odds ratio, confidence interval of 95% and p-value less than 0.05.Result: The magnitude of acne in ARH, dermatologic OPD was 19.4%. Mean age of patients with acne were 20.6(±4.6)yrs while the mean age at acne start were 17.56(±3.22)yrs. From total of 78 acne patients female accounts 41(52.6%), Urban resident 66(84%) and never married were 65(83.3%). Age (11-20yrs), urban resident, never married individuals, history of acne in the family and cosmetics use were statistically associated with acne on bivariate analysis while family history of acne (AOR7.72(2.99,19.88)CI95%), cosmetics use (AOR4.83(1.66,14.08),CI95%) and never married individuals (AOR2.68(1.04,6.91(CI95%) were significantly associated variables with acne on multivariate analysis.Conclusion and recommendation: The magnitude of acne in ARH was 19.4% and the associated factors were presence of acne in the family and use of cosmetic make-up. People should avoid use of cosmetics make-up without medical advice.
Background: Acne is a chronic inflammatory disease of pilosebceous units with a clinical picture which vary significantly from mild comedonal acne to fulminant systemic disease. Acne has a significant impact on appearance, causing psychosocial and emotional distress, and reducing quality of life of the affected patients. Acne distresses patients due to the fact that it mainly affects the face, being easily visible and constantly present in everyday life. So the aim of this study will be minimizing the gap on magnitude and factors associated with acne at Ayder Referral Hospital.Objectives: To assess the magnitude and factors associated with acne among patients attending dermatologic clinic at Ayder referral hospital, Mekelle, Tigray, Northern Ethiopia.Methods: An institutional based cross sectional study design and sequential convenience sampling technique was implemented at Ayder referral hospital dermatologic Unit until sample size (423) is fulfilled. A total sample size (402) of data was entered and analyzed by SPSS version 16.0. Descriptive and logistic regression analysis was done. Data was presented in the form of tables, graphs and numerical measures. Also it was interpreted by using odds ratio, confidence interval of 95% and p-value less than 0.05.Result: The magnitude of acne in ARH, dermatologic OPD was 19.4%. Mean age of patients with acne were 20.6(±4.6)yrs while the mean age at acne start were 17.56(±3.22)yrs. From total of 78 acne patients female accounts 41(52.6%), Urban resident 66(84%) and never married were 65(83.3%). Age (11-20yrs), urban resident, never married individuals, history of acne in the family and cosmetics use were statistically associated with acne on bivariate analysis while family history of acne (AOR7.72(2.99,19.88)CI95%), cosmetics use (AOR4.83(1.66,14.08),CI95%) and never married individuals (AOR2.68(1.04,6.91(CI95%) were significantly associated variables with acne on multivariate analysis.Conclusion and recommendation: The magnitude of acne in ARH was 19.4% and the associated factors were presence of acne in the family and use of cosmetic make-up. People should avoid use of cosmetics make-up without medical advice.
Acne at Ayder Referral Hospital among Patients Attending Dermatologic Clinic, Mekelle, Northern Ethiopia, September 2014
doi:10.11648/j.sjcm.20140306.16
Science Journal of Clinical Medicine
2014-11-27
© Science Publishing Group
Efa Ambaw Bogino
Mairie Guizaw Kebede
Alemayehu Bayray Kahsay
Acne at Ayder Referral Hospital among Patients Attending Dermatologic Clinic, Mekelle, Northern Ethiopia, September 2014
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134
134
2014-11-27
2014-11-27
10.11648/j.sjcm.20140306.16
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140306.16
© Science Publishing Group
Evaluation of Reproducibility of Prognostic Index and Nomogram in Prognosis, and Therapeutically Approach of Patients with Chronic Lymphocytic Leukaemia-Single Centre Experience
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140306.15
At this time staging and prognostication of Chronic lymphocytic leukemia( CLL) is performed by 2 equivalent clinical staging systems developed 30 to 35 years ago by Binet and Rai Both systems use low-cost, simple components such as blood counts and physical examination to identify 3 major prognostic subgroups. Despite these advantages, the clinical staging systems do not reflect the high unpredictability of CLL, nor do they account for known biological characteristics of CLL cells predicting survival and response to therapy. That was the motivation for Mayo Clinic, and Wierda proposed to combine a set of clinical risk factors, to develop a prognostic index (PI) stratifying patients in three risk groups with different expected median survival, and a nomogram, estimating individual patient survivals. Here we report the results from a study designed to evaluate Wierda`s nomogram and prognostic index on Macedonian CLL population. Material and methods: We analyzed medical data of 300 CLL patients diagnosed and treated at University Clinic of Hematology -Skopje Macedonia from a period of 10 years. We used Wierda`s prognostics index and a nomogram, to see 5- and 10-year survival probability and estimated median survival time. Results: There were 300 CLL patients who had traditional and biological prognostic factors evaluated. According to prognostic index a classification tree was built that identified three subsets of patients. Estimated median survival at low risk subset of patients with prognostic nomogram <80 was 68, 7 months, and 37, 5 months respectively at high risk subsets of patients with prognostic nomogram >80. Projected survival in respectively low, intermediate and high-risk groups was 91, 7%, 80%, 50%, and 81, 5%, 60%, 10% at 5-year and10-year, respectively. Conclusion: We use this model to identify patients at high risk for progression to treatment and we are experiencing a paradigm shift toward personalized medicine. This prognostic model may help patients and clinicians in clinical decision making as well as in clinical research and clinical trial design.
At this time staging and prognostication of Chronic lymphocytic leukemia( CLL) is performed by 2 equivalent clinical staging systems developed 30 to 35 years ago by Binet and Rai Both systems use low-cost, simple components such as blood counts and physical examination to identify 3 major prognostic subgroups. Despite these advantages, the clinical staging systems do not reflect the high unpredictability of CLL, nor do they account for known biological characteristics of CLL cells predicting survival and response to therapy. That was the motivation for Mayo Clinic, and Wierda proposed to combine a set of clinical risk factors, to develop a prognostic index (PI) stratifying patients in three risk groups with different expected median survival, and a nomogram, estimating individual patient survivals. Here we report the results from a study designed to evaluate Wierda`s nomogram and prognostic index on Macedonian CLL population. Material and methods: We analyzed medical data of 300 CLL patients diagnosed and treated at University Clinic of Hematology -Skopje Macedonia from a period of 10 years. We used Wierda`s prognostics index and a nomogram, to see 5- and 10-year survival probability and estimated median survival time. Results: There were 300 CLL patients who had traditional and biological prognostic factors evaluated. According to prognostic index a classification tree was built that identified three subsets of patients. Estimated median survival at low risk subset of patients with prognostic nomogram <80 was 68, 7 months, and 37, 5 months respectively at high risk subsets of patients with prognostic nomogram >80. Projected survival in respectively low, intermediate and high-risk groups was 91, 7%, 80%, 50%, and 81, 5%, 60%, 10% at 5-year and10-year, respectively. Conclusion: We use this model to identify patients at high risk for progression to treatment and we are experiencing a paradigm shift toward personalized medicine. This prognostic model may help patients and clinicians in clinical decision making as well as in clinical research and clinical trial design.
Evaluation of Reproducibility of Prognostic Index and Nomogram in Prognosis, and Therapeutically Approach of Patients with Chronic Lymphocytic Leukaemia-Single Centre Experience
doi:10.11648/j.sjcm.20140306.15
Science Journal of Clinical Medicine
2014-11-27
© Science Publishing Group
Trajkova Sanja
Cevreska Lidija
Ivanovski Martin
Dukovski Dusko
Simjanovska-Popova Marija
Stankovik Svetlana
Panovska-Stavridis Irina
Evaluation of Reproducibility of Prognostic Index and Nomogram in Prognosis, and Therapeutically Approach of Patients with Chronic Lymphocytic Leukaemia-Single Centre Experience
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6
128
128
2014-11-27
2014-11-27
10.11648/j.sjcm.20140306.15
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20140306.15
© Science Publishing Group
Childhood Diarrhea in Central Ethiopia: Determining Factors for Mothers in Seeking Modern Health Treatments
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150401.12
Background: Diarrhea remains one of the principal causes of morbidity and mortality in children in developing countries. A major contributing factor is the treatment provided by the mother. The current study was carried out to assess the behavior of mothers in seeking modern health care and its impact on childhood diarrhea in the Central Ethiopia. Methods: A comparative cross-sectional study was conducted in randomly selected mothers or care providers who had at least one child under five years who had experienced diarrhea within the previous two weeks. Descriptive statistics, bivariate, and multiple regression analyses were performed. P-values less than 0.05 and 95% confidence intervals were used to determine an association between independent and dependent variables. Results: Ninety-five percent (413/434) mothers or care-providers completed the survey. Seventy-seven percent of urban and 54.4% of rural women sought care at a health institution. Mothers who lived in urban areas were four and half times more likely to seek modern treatment than rural dwellers [OR (95%CIs)=4.49(2.07, 9.7)], while mothers with grade 9-12 levels of literacy were nine times more likely to seek modern treatment than illiterate mothers [8.88 (1.15, 68.6)]. Households using latrines and with income greater than 30USD per month were 4.6 and 3.3 times more likely to seek modern treatment than who used open fields and who earned less than 30USD per month, respectively [4.62 (1.84, 11.60) and 3.31(1.45, 7.54)]. Increased fluids were given to only 50.8% urban and 26% rural children with diarrhea. Notably, fluids were stopped in 3.8% and 11.4% of urban and rural children, respectively, while fluid intake was reduced in 6.8% urban and 19.2% rural children. Conclusion: Socioeconomic factors such as the educational status of the women, the distance of health care facilities, and the method of disposing of excreta were significantly associated with the behavior of the mother in seeking modern treatment. An urgent requirement for improved health education and infrastructure for women is needed.
Background: Diarrhea remains one of the principal causes of morbidity and mortality in children in developing countries. A major contributing factor is the treatment provided by the mother. The current study was carried out to assess the behavior of mothers in seeking modern health care and its impact on childhood diarrhea in the Central Ethiopia. Methods: A comparative cross-sectional study was conducted in randomly selected mothers or care providers who had at least one child under five years who had experienced diarrhea within the previous two weeks. Descriptive statistics, bivariate, and multiple regression analyses were performed. P-values less than 0.05 and 95% confidence intervals were used to determine an association between independent and dependent variables. Results: Ninety-five percent (413/434) mothers or care-providers completed the survey. Seventy-seven percent of urban and 54.4% of rural women sought care at a health institution. Mothers who lived in urban areas were four and half times more likely to seek modern treatment than rural dwellers [OR (95%CIs)=4.49(2.07, 9.7)], while mothers with grade 9-12 levels of literacy were nine times more likely to seek modern treatment than illiterate mothers [8.88 (1.15, 68.6)]. Households using latrines and with income greater than 30USD per month were 4.6 and 3.3 times more likely to seek modern treatment than who used open fields and who earned less than 30USD per month, respectively [4.62 (1.84, 11.60) and 3.31(1.45, 7.54)]. Increased fluids were given to only 50.8% urban and 26% rural children with diarrhea. Notably, fluids were stopped in 3.8% and 11.4% of urban and rural children, respectively, while fluid intake was reduced in 6.8% urban and 19.2% rural children. Conclusion: Socioeconomic factors such as the educational status of the women, the distance of health care facilities, and the method of disposing of excreta were significantly associated with the behavior of the mother in seeking modern treatment. An urgent requirement for improved health education and infrastructure for women is needed.
Childhood Diarrhea in Central Ethiopia: Determining Factors for Mothers in Seeking Modern Health Treatments
doi:10.11648/j.sjcm.20150401.12
Science Journal of Clinical Medicine
2015-02-03
© Science Publishing Group
Ephrem Mamo Gebrehiwot
Tezera Moshago Berheto
Alemayehu Worku
Tadele Dana Darebo
Ephrem Lejore Sibamo
Childhood Diarrhea in Central Ethiopia: Determining Factors for Mothers in Seeking Modern Health Treatments
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1
9
9
2015-02-03
2015-02-03
10.11648/j.sjcm.20150401.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150401.12
© Science Publishing Group
Update on Human Bone Hydatid Disease
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150401.13
Hydatid disease is public health problem worldwide causing considerable health and economic loss. The disease may develop in almost any part of the human body. Bone involvement is often asymptomatic and diagnosis is primarily based on radiographic findings. Bone hydatidosis is less frequent than primary hydatidosis of the visceral organs. The localization of hydatid cysts in the bones has been little studied and so there is inadequate information in literature on the subsequent disease evolution from primary hydatidosis. We present a detailed review on hydatidosis of the bony skeleton particularly of patients who normally seek medical attention late. The review underlines the difficulties of diagnosis and treatment of bone hydatid disease and its variants that may be currently under-/mis-diagnosed in disease endemic areas. We hope to stimulate a high index of suspicion among clinicians to facilitate early diagnosis and to consider the disease(s) as a differential diagnosis in cases of multiple abnormal activities in bones especially among middle aged and elderly people in endemic areas. Bone hydatid disease treatment and management is delicate, expensive and risky and in most cases reccur at some point. We therefore advocate for improved active methods of disease prevention in endemic areas.
Hydatid disease is public health problem worldwide causing considerable health and economic loss. The disease may develop in almost any part of the human body. Bone involvement is often asymptomatic and diagnosis is primarily based on radiographic findings. Bone hydatidosis is less frequent than primary hydatidosis of the visceral organs. The localization of hydatid cysts in the bones has been little studied and so there is inadequate information in literature on the subsequent disease evolution from primary hydatidosis. We present a detailed review on hydatidosis of the bony skeleton particularly of patients who normally seek medical attention late. The review underlines the difficulties of diagnosis and treatment of bone hydatid disease and its variants that may be currently under-/mis-diagnosed in disease endemic areas. We hope to stimulate a high index of suspicion among clinicians to facilitate early diagnosis and to consider the disease(s) as a differential diagnosis in cases of multiple abnormal activities in bones especially among middle aged and elderly people in endemic areas. Bone hydatid disease treatment and management is delicate, expensive and risky and in most cases reccur at some point. We therefore advocate for improved active methods of disease prevention in endemic areas.
Update on Human Bone Hydatid Disease
doi:10.11648/j.sjcm.20150401.13
Science Journal of Clinical Medicine
2015-02-11
© Science Publishing Group
Mulambalah Chrispinus Siteti
Siteti Darwin Injete
Update on Human Bone Hydatid Disease
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1
17
17
2015-02-11
2015-02-11
10.11648/j.sjcm.20150401.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150401.13
© Science Publishing Group
Health Promotion Practice and Its Associated Factors among Pregnant Mothers Attending ANC Services in Public Health Institution of Mekelle City, Tigray, Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150401.14
Introduction: Health promotion involves supporting personal and social development through providing information health education, and life skill straining, thereby increasing option for people to exercise more over control their own health and their environment, and to make choice conducive in health. A number of potentially modifiable risk factors are known to be associated with poor pregnancy out comes. However, to our knowledge no previous tangible research was done in the study area about health promotion. Thus, this paper, attempts to assess health promotion practice and its associated factors among pregnant women attending ANC services in public health institutions of Mekelle City. Methods: An institutional based cross-sectional survey was conducted among 278 pregnant mothers at Mekelle city from December to June/ 2014. Simple random sampling technique with Probabilities proportional to size allocation technique was used. Data were analyzed by SPSS window version 20.0 soft ware package and presented using frequencies, percentages, crude odds Ratio, 95% Confidence Intervals and multiple logistic-regressions to adjust for possible confounding variables. Finally, the result of the study was presented using texts, figures and tables. Results: Out of 278 pregnant mothers who were participated in this study, 268 of them responded to the questionnaire making a response rate of 96.4%. The mean age of the participants was 25.87 (± 5.717) years, while the age range was 15 - 44. This research showed 79.9% of the respondents were found to have good Health promotion practices during their pregnancy. The major factors for health promotion practice during pregnancy were income, parity and unintended pregnancy. Women whose unintended pregnancies were 0.79 less likely to practice health promotion than women whose intended pregnancy (AOR= 0.21[0.07 – 0.56]). This finding strongly suggests that the government provide the issue of women education and empowerment more seriously to increase health promotion activity as a way of reducing maternal mortality in the country. And moreover antenatal care clinics should give due emphasis to provide the vital information and education to all pregnant women about health promotional activity.
Introduction: Health promotion involves supporting personal and social development through providing information health education, and life skill straining, thereby increasing option for people to exercise more over control their own health and their environment, and to make choice conducive in health. A number of potentially modifiable risk factors are known to be associated with poor pregnancy out comes. However, to our knowledge no previous tangible research was done in the study area about health promotion. Thus, this paper, attempts to assess health promotion practice and its associated factors among pregnant women attending ANC services in public health institutions of Mekelle City. Methods: An institutional based cross-sectional survey was conducted among 278 pregnant mothers at Mekelle city from December to June/ 2014. Simple random sampling technique with Probabilities proportional to size allocation technique was used. Data were analyzed by SPSS window version 20.0 soft ware package and presented using frequencies, percentages, crude odds Ratio, 95% Confidence Intervals and multiple logistic-regressions to adjust for possible confounding variables. Finally, the result of the study was presented using texts, figures and tables. Results: Out of 278 pregnant mothers who were participated in this study, 268 of them responded to the questionnaire making a response rate of 96.4%. The mean age of the participants was 25.87 (± 5.717) years, while the age range was 15 - 44. This research showed 79.9% of the respondents were found to have good Health promotion practices during their pregnancy. The major factors for health promotion practice during pregnancy were income, parity and unintended pregnancy. Women whose unintended pregnancies were 0.79 less likely to practice health promotion than women whose intended pregnancy (AOR= 0.21[0.07 – 0.56]). This finding strongly suggests that the government provide the issue of women education and empowerment more seriously to increase health promotion activity as a way of reducing maternal mortality in the country. And moreover antenatal care clinics should give due emphasis to provide the vital information and education to all pregnant women about health promotional activity.
Health Promotion Practice and Its Associated Factors among Pregnant Mothers Attending ANC Services in Public Health Institution of Mekelle City, Tigray, Ethiopia
doi:10.11648/j.sjcm.20150401.14
Science Journal of Clinical Medicine
2015-02-13
© Science Publishing Group
Kidsti Tesfay
Haftom Gebrehiwot
Gebreziher Bruh
Atsede Fantahun
Health Promotion Practice and Its Associated Factors among Pregnant Mothers Attending ANC Services in Public Health Institution of Mekelle City, Tigray, Ethiopia
4
1
25
25
2015-02-13
2015-02-13
10.11648/j.sjcm.20150401.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150401.14
© Science Publishing Group
A Fast Computational Formula for Kappa Coefficient
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150401.11
Kappa coefficient is very important in clinical research when there is a requirement of inter-agreement among physicians who measure clinical data. It is too complicated to calculate traditional Kappa formula in huge data because of many arithmetic operations for determining probability of observed agreement and probability of chance agreement. Therefore, this research proposes a fast computational formula for Kappa coefficient based on comments about probability of observed agreement and probability of chance agreement. These comments lead to the method to save time cost when calculating Kappa coefficient and to reduce the number of arithmetic operations at least. Finally, such fast formula is applied into the gestational data measured in real world so as to evaluate its strong point.
Kappa coefficient is very important in clinical research when there is a requirement of inter-agreement among physicians who measure clinical data. It is too complicated to calculate traditional Kappa formula in huge data because of many arithmetic operations for determining probability of observed agreement and probability of chance agreement. Therefore, this research proposes a fast computational formula for Kappa coefficient based on comments about probability of observed agreement and probability of chance agreement. These comments lead to the method to save time cost when calculating Kappa coefficient and to reduce the number of arithmetic operations at least. Finally, such fast formula is applied into the gestational data measured in real world so as to evaluate its strong point.
A Fast Computational Formula for Kappa Coefficient
doi:10.11648/j.sjcm.20150401.11
Science Journal of Clinical Medicine
2015-01-12
© Science Publishing Group
Loc Nguyen
Hang Ho
A Fast Computational Formula for Kappa Coefficient
4
1
3
3
2015-01-12
2015-01-12
10.11648/j.sjcm.20150401.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150401.11
© Science Publishing Group
A Novel Intervention to Increase Male Involvement in Prevention of Parent to Child HIV Transmission
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150402.14
Background: Prevention of Parent To Child Transmission (PPTCT) of HIV is a major intervention to stop the spread of HIV. Rates of <2% are possible with early combination antiretroviral therapy. Tearfund African PPTCT Alliance (TAPA) supports a network of African partners in PPTCT through a church-based community outreach. To promote quality, TAPA conducts periodic programme audits to strengthen male partner involvement in PPTCT. Methods: The present audit was conducted among 11 TAPA partners in August 2011 to determine factors responsible for poor Prevention of Mother To Child Transmission (PMTCT) of HIV or PPTCT uptake in areas where churches and faith-based organizations work. Participants were all expectant mothers, male sexual partners and infants registered at these clinics. Each record was evaluated for evidence of HIV testing, results, treatment and prophylaxis against mother to child HIV transmission. Information on infant feeding patterns were also gathered. Intervention: In 2009, TAPA partners identified the need for a training toolkit to stimulate greater male partner involvement in PPTCT through antenatal clinics (ANCs) in church-based sites. The toolkit entitled “Guardians of our Children Health (GOOCH)” identified men as guardians of the health of their families and was designed to build the knowledge and skills of both parents to reduce HIV transmission to their infant. GOOCH has been successfully piloted by two organizations in Jos, Nigeria since 2008—Faith Alive Foundation (FAF) and ECWA AIDS Ministry (TEAM), as well as 14 other organizations across Africa. Lessons Learned: Male involvement in PPTCT through GOOCH increases rates of HIV testing among pregnant women (sometimes up to five times); motivates male partner involvement in PPTCT; and raises PPTCT awareness in communities. Records on men are not always kept at ANC clinics. Often there is a lack of follow up. National policies for ARV intervention are often inconsistent and change too quickly. Infant feeding patterns are mixed and not all programmes were able to obtain reliable data to assess this area of preventing transmission of HIV. Next Steps: Advocacy for improvements and scaling up of PPTCT especially with Nigeria being the lowest in Africa. Scale up GOOCH in communities where it was most effective and introduce it to communities where it is likely to have the greatest impact. Also, adopt the concept of Integrated Supportive Supervision trainings with integration of Maternal Child Health (MCH) into all levels of health care system.
Background: Prevention of Parent To Child Transmission (PPTCT) of HIV is a major intervention to stop the spread of HIV. Rates of <2% are possible with early combination antiretroviral therapy. Tearfund African PPTCT Alliance (TAPA) supports a network of African partners in PPTCT through a church-based community outreach. To promote quality, TAPA conducts periodic programme audits to strengthen male partner involvement in PPTCT. Methods: The present audit was conducted among 11 TAPA partners in August 2011 to determine factors responsible for poor Prevention of Mother To Child Transmission (PMTCT) of HIV or PPTCT uptake in areas where churches and faith-based organizations work. Participants were all expectant mothers, male sexual partners and infants registered at these clinics. Each record was evaluated for evidence of HIV testing, results, treatment and prophylaxis against mother to child HIV transmission. Information on infant feeding patterns were also gathered. Intervention: In 2009, TAPA partners identified the need for a training toolkit to stimulate greater male partner involvement in PPTCT through antenatal clinics (ANCs) in church-based sites. The toolkit entitled “Guardians of our Children Health (GOOCH)” identified men as guardians of the health of their families and was designed to build the knowledge and skills of both parents to reduce HIV transmission to their infant. GOOCH has been successfully piloted by two organizations in Jos, Nigeria since 2008—Faith Alive Foundation (FAF) and ECWA AIDS Ministry (TEAM), as well as 14 other organizations across Africa. Lessons Learned: Male involvement in PPTCT through GOOCH increases rates of HIV testing among pregnant women (sometimes up to five times); motivates male partner involvement in PPTCT; and raises PPTCT awareness in communities. Records on men are not always kept at ANC clinics. Often there is a lack of follow up. National policies for ARV intervention are often inconsistent and change too quickly. Infant feeding patterns are mixed and not all programmes were able to obtain reliable data to assess this area of preventing transmission of HIV. Next Steps: Advocacy for improvements and scaling up of PPTCT especially with Nigeria being the lowest in Africa. Scale up GOOCH in communities where it was most effective and introduce it to communities where it is likely to have the greatest impact. Also, adopt the concept of Integrated Supportive Supervision trainings with integration of Maternal Child Health (MCH) into all levels of health care system.
A Novel Intervention to Increase Male Involvement in Prevention of Parent to Child HIV Transmission
doi:10.11648/j.sjcm.20150402.14
Science Journal of Clinical Medicine
2015-03-19
© Science Publishing Group
Isichei Christian
Courtney Snelling Jennifer
Onwuezobe Caroline
Oyebode Tinuade
Mercy Isichei
Njab Jean
Adeyanju Segun
Johnson Rotimi
A Novel Intervention to Increase Male Involvement in Prevention of Parent to Child HIV Transmission
4
2
51
51
2015-03-19
2015-03-19
10.11648/j.sjcm.20150402.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150402.14
© Science Publishing Group
Acute Pericarditis and Viral Infection
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150402.12
Introduction: Hantaviruses is a disease of fever character caused by the virus, RNA from simple tape, of the Bunyaviridae family. Hantaviruses may occur in two clinical types: 1) hemorrhagic fever with renal syndrome in Europe and Asia; 2) cardiopulmonary syndrome by hantaviruses only in Americas. Acute pericarditis is a clinical syndrome with the following characteristics: chest pain, pericardium friction and evolutive alterations of repolarization in the electrocardiogram. The most common etiology is idiopathic and viral. Case report: A man, 38 years old, living at the rural area, with myalgia, arthralgia, fever, loss of appetite, diarrhea, dry cough, chronic headache and retroorbital pain for 5 days. He was diagnosed with classical dengue, so, he received medical treatment with oral hydratation and symptomatical. He went to the Emergency Unit Care - Ribeirão Preto in the 6th day of symptoms, because of the worsening in his clinical condition, with the diagnosis hypothesis of Syndrome of Dengue Shock. Though, serology for dengue was negative. With this result and for the fact that the patient lived in a rural area a survey about the presence of Hantaviruses was made. As the result for the serology had positive for Hantaviruses. With the diagnosis for Cardiopulmonary Syndrome and Pericarditis for Hantaviruses it was made a clinical support to maintain the vital functions, with emphasis in oxygenation and observing the respiratory functions. The patient had satisfactory evolution in the clinical condition. Discussion: Ribeirão Preto is an endemic area for Dengue. Dengue is a fever disease that in its initial phase, has common symptoms with other diseases, like Hantaviruses. This case refers to a patient with clinic and laboratorial exams compatible with Dengue. Though, with the worsening of his symptoms, and the Hypothesis of Shock Syndrome Dengue, treatment began according to the preconizing protocol and the Electrocardiogram identified alterations of repolarization, and the echocardiography was indicated, where the pericardial effusion was evident. Pericarditis was not mentioned as a complication of cardiopulmonary syndrome by hantaviruses. Conclusion: In this report we introduced the case of a patient initially medicated for Dengue and after had Hantaviruses confirmed. EKG helped in the identification and the severity of the illness and the sorological exams defined the infection. Only the clinical board and the epidemiology can't be used for the diagnosis of Dengue. Serology survey is getting more important for these pathologies not being sub notifcated and not treated correctly and conveniently.
Introduction: Hantaviruses is a disease of fever character caused by the virus, RNA from simple tape, of the Bunyaviridae family. Hantaviruses may occur in two clinical types: 1) hemorrhagic fever with renal syndrome in Europe and Asia; 2) cardiopulmonary syndrome by hantaviruses only in Americas. Acute pericarditis is a clinical syndrome with the following characteristics: chest pain, pericardium friction and evolutive alterations of repolarization in the electrocardiogram. The most common etiology is idiopathic and viral. Case report: A man, 38 years old, living at the rural area, with myalgia, arthralgia, fever, loss of appetite, diarrhea, dry cough, chronic headache and retroorbital pain for 5 days. He was diagnosed with classical dengue, so, he received medical treatment with oral hydratation and symptomatical. He went to the Emergency Unit Care - Ribeirão Preto in the 6th day of symptoms, because of the worsening in his clinical condition, with the diagnosis hypothesis of Syndrome of Dengue Shock. Though, serology for dengue was negative. With this result and for the fact that the patient lived in a rural area a survey about the presence of Hantaviruses was made. As the result for the serology had positive for Hantaviruses. With the diagnosis for Cardiopulmonary Syndrome and Pericarditis for Hantaviruses it was made a clinical support to maintain the vital functions, with emphasis in oxygenation and observing the respiratory functions. The patient had satisfactory evolution in the clinical condition. Discussion: Ribeirão Preto is an endemic area for Dengue. Dengue is a fever disease that in its initial phase, has common symptoms with other diseases, like Hantaviruses. This case refers to a patient with clinic and laboratorial exams compatible with Dengue. Though, with the worsening of his symptoms, and the Hypothesis of Shock Syndrome Dengue, treatment began according to the preconizing protocol and the Electrocardiogram identified alterations of repolarization, and the echocardiography was indicated, where the pericardial effusion was evident. Pericarditis was not mentioned as a complication of cardiopulmonary syndrome by hantaviruses. Conclusion: In this report we introduced the case of a patient initially medicated for Dengue and after had Hantaviruses confirmed. EKG helped in the identification and the severity of the illness and the sorological exams defined the infection. Only the clinical board and the epidemiology can't be used for the diagnosis of Dengue. Serology survey is getting more important for these pathologies not being sub notifcated and not treated correctly and conveniently.
Acute Pericarditis and Viral Infection
doi:10.11648/j.sjcm.20150402.12
Science Journal of Clinical Medicine
2015-03-08
© Science Publishing Group
Beatriz Cruz Barcelos
Luis Felipe Silveira Santos
Nathalia Antônio Monteiro de Castro
Ana Paula Silveira Menezes
Tufik José Geleilete
Reinaldo Bugarelli Bestetti
Rosemary Aparecida Furlan Daniel
Acute Pericarditis and Viral Infection
4
2
31
31
2015-03-08
2015-03-08
10.11648/j.sjcm.20150402.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150402.12
© Science Publishing Group
Good Outcome in Isolated Basilar Artery Dissection
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150402.11
Isolated basilar artery dissection is a rare vascular pathology with varied clinical presentations and prognoses. We report a case of a 54-year-old woman, presented with subarachnoid hemorrhages (Hunt-Hess grade II). Brain computed tomography demonstrated a perimesencephalic pattern of haemorrhage. Magnetic resonance angiography revealed an isolated basilar artery dissection. Conservative treatment was performed. A complete resolution of the clinical symptoms occurs over a period of 30 days. There was no recurrent haemorrhage. On a follow-up magnetic resonance angiography three months later, a complete resolution of the intramural haematoma in the basilar artery was demonstrated. Some of the cases of basilar artery dissection with perimesencephalic pattern of subarachnoid haemorrhages could have a good prognosis, and could be treated conservatively.
Isolated basilar artery dissection is a rare vascular pathology with varied clinical presentations and prognoses. We report a case of a 54-year-old woman, presented with subarachnoid hemorrhages (Hunt-Hess grade II). Brain computed tomography demonstrated a perimesencephalic pattern of haemorrhage. Magnetic resonance angiography revealed an isolated basilar artery dissection. Conservative treatment was performed. A complete resolution of the clinical symptoms occurs over a period of 30 days. There was no recurrent haemorrhage. On a follow-up magnetic resonance angiography three months later, a complete resolution of the intramural haematoma in the basilar artery was demonstrated. Some of the cases of basilar artery dissection with perimesencephalic pattern of subarachnoid haemorrhages could have a good prognosis, and could be treated conservatively.
Good Outcome in Isolated Basilar Artery Dissection
doi:10.11648/j.sjcm.20150402.11
Science Journal of Clinical Medicine
2015-02-27
© Science Publishing Group
Yordan Spirdonov
Plamen Getsov
Grigorii Nedelkov
Evguenia Vassileva
Marko Klissurski
Marin Daskalov
Good Outcome in Isolated Basilar Artery Dissection
4
2
28
28
2015-02-27
2015-02-27
10.11648/j.sjcm.20150402.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150402.11
© Science Publishing Group
Laboratory Dilutions of Thioridaxine with Potential to Enhance Antibiotic Sensitivity in a Multidrug Resistant Escherichia Coli Uropathogen
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150402.13
This research effort seeks to use doses of thioridaxine to enhance antibiotic sensitivity in a MDR Escherichia coli strain. Five axenic (pure) strains of Escherichia coli coded EC1 to EC5 were obtained from five infected midstream urine samples among several other urine samples inoculated on sterile Cystine Lactose Electrolyte Deficient (CLED) agar with appropriate labeling in the Microbiology and Biotechnology Laboratory of Western Delta University, Oghara, Nigeria and stocked on sterile Nutrient agar slants at 4oC in a refrigerator. Slant cultures were sub-cultured aseptically on fresh sterile CLED agar plates and incubated aerobically at 37oC for 24hrs to confirm Escherichia coli strains. Gram staining, indole production, methyl red test, voges praskaeur and citrate utilization tests were done on the resulting colonies to further confirm the strains as E.coli. Antibiotic susceptibility test was done by agar disc diffusion method on all confirmed strains on sterile Mueller- Hinton agar plates before and after treatment with laboratory dilutions of thioridaxine. Only E.coli strain 2 (EC2) was multidrug resistant as it resisted 4(44.4%) of the antibiotics used which were cefuroxime, nalidixic acid, augmentin and tetracycline. Other strains resisted 1-2 antibiotics. The highest (15.6±20.6mm) and least (2.0±8.1mm) zones of inhibition by all five strains were recorded for ofloxacin and cefuroxime respectively. Whereas all five uropathogen strains resisted augmentin, they were sensitive to ciprofloxacin, ofloxacin (both being fluoroquinolones), gentamicin, chloramphenicol and nitrofurantoin. After treatment with 2000-2240ug/ml laboratory dilutions of thioridaxine, ≤50.0% loss of resistance was recorded for 2040ug/ml, 2160ug/ml and 2240ug/ml dilutions. Thioridaxine dilution of 2040ug/ml induced 250% and 90% resistance losses of EC2 to ciprofloxacin and nitrofurantoin respectively with an overall mean±S.E loss of 68.0±24.4%. Resistance losses of 112.5%, 130.0% and 100.0% to ciprofloxacin, nitrofurantoin and chloramphenicol respectively were recorded after 2160ug/ml treatment and 68.5±16.3% overall loss of resistance. Thioridaxine dilutions of 2240ug/ml induced 55.6±25.0% overall loss of resistance with a corresponding 50.0%, 50.0%, 58.1%, 70.0% and 50.0% resistance losses with gentamicin, ciprofloxacin, ofloxacin, nitrofurantoin and chloramphenicol respectively. Less than 50% resistance losses were recorded for 2000, 2080, 2120 and 2200ug/ml dilutions. Minimum inhibitory concentration of chloramphenicol was lowered by 2080ug/ml, 2160ug/ml and 2240ug/ml dilutions by two-fold (15ug), two-fold (15ug) and four-fold (7.5ug) respectively. The medical/ chemotherapeutic implications of these findings are discussed.
This research effort seeks to use doses of thioridaxine to enhance antibiotic sensitivity in a MDR Escherichia coli strain. Five axenic (pure) strains of Escherichia coli coded EC1 to EC5 were obtained from five infected midstream urine samples among several other urine samples inoculated on sterile Cystine Lactose Electrolyte Deficient (CLED) agar with appropriate labeling in the Microbiology and Biotechnology Laboratory of Western Delta University, Oghara, Nigeria and stocked on sterile Nutrient agar slants at 4oC in a refrigerator. Slant cultures were sub-cultured aseptically on fresh sterile CLED agar plates and incubated aerobically at 37oC for 24hrs to confirm Escherichia coli strains. Gram staining, indole production, methyl red test, voges praskaeur and citrate utilization tests were done on the resulting colonies to further confirm the strains as E.coli. Antibiotic susceptibility test was done by agar disc diffusion method on all confirmed strains on sterile Mueller- Hinton agar plates before and after treatment with laboratory dilutions of thioridaxine. Only E.coli strain 2 (EC2) was multidrug resistant as it resisted 4(44.4%) of the antibiotics used which were cefuroxime, nalidixic acid, augmentin and tetracycline. Other strains resisted 1-2 antibiotics. The highest (15.6±20.6mm) and least (2.0±8.1mm) zones of inhibition by all five strains were recorded for ofloxacin and cefuroxime respectively. Whereas all five uropathogen strains resisted augmentin, they were sensitive to ciprofloxacin, ofloxacin (both being fluoroquinolones), gentamicin, chloramphenicol and nitrofurantoin. After treatment with 2000-2240ug/ml laboratory dilutions of thioridaxine, ≤50.0% loss of resistance was recorded for 2040ug/ml, 2160ug/ml and 2240ug/ml dilutions. Thioridaxine dilution of 2040ug/ml induced 250% and 90% resistance losses of EC2 to ciprofloxacin and nitrofurantoin respectively with an overall mean±S.E loss of 68.0±24.4%. Resistance losses of 112.5%, 130.0% and 100.0% to ciprofloxacin, nitrofurantoin and chloramphenicol respectively were recorded after 2160ug/ml treatment and 68.5±16.3% overall loss of resistance. Thioridaxine dilutions of 2240ug/ml induced 55.6±25.0% overall loss of resistance with a corresponding 50.0%, 50.0%, 58.1%, 70.0% and 50.0% resistance losses with gentamicin, ciprofloxacin, ofloxacin, nitrofurantoin and chloramphenicol respectively. Less than 50% resistance losses were recorded for 2000, 2080, 2120 and 2200ug/ml dilutions. Minimum inhibitory concentration of chloramphenicol was lowered by 2080ug/ml, 2160ug/ml and 2240ug/ml dilutions by two-fold (15ug), two-fold (15ug) and four-fold (7.5ug) respectively. The medical/ chemotherapeutic implications of these findings are discussed.
Laboratory Dilutions of Thioridaxine with Potential to Enhance Antibiotic Sensitivity in a Multidrug Resistant Escherichia Coli Uropathogen
doi:10.11648/j.sjcm.20150402.13
Science Journal of Clinical Medicine
2015-03-09
© Science Publishing Group
Otajevwo F. D.
Iyabor F. O.
Laboratory Dilutions of Thioridaxine with Potential to Enhance Antibiotic Sensitivity in a Multidrug Resistant Escherichia Coli Uropathogen
4
2
40
40
2015-03-09
2015-03-09
10.11648/j.sjcm.20150402.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150402.13
© Science Publishing Group
Utilization of Family Planning Services and Influencing Factors Among Women of Child Bearing Age in Assosa District, Benishangul Gumuz Regional State, West Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150403.11
Background: Nearly all (99%) of maternal death occur in the developing countries. However, family planning (FP) could prevent as many as one in every three maternal deaths by allowing women to delay motherhood, space birth, avoid unintended pregnancies and abortion and stop childbearing when they reached their desired family size. Objective: To assess utilization of family planning services and influencing factors among women in Assosa District. Methods: A community based cross sectional study was conducted from May 17 – 31, 2012 on the selected samples of 536 women who had at least one delivery in the five years prior to the study using simple random sampling technique. Structured questionnaire, FGD and in-depth interview guide were used to collect data. Data were analyzed by using SPSS version 16.0. Binary logistic regression was used to determine the association between dependent and independent variables. Results: Out of the 525 study subjects 339(64.6%) women were currently using any method of contraceptive. Factors influencing utilization of family planning services were attending grade 7 and above [AOR= 2.19, 95% CI: 1.11, 4.33], being knowledgeable on family planning service [AOR= 3.9, 95% CI: 1.36, 8.48], having favorable attitude towards family planning service [AOR= 2.16, 95% CI: 1.45, 3.23] and availability of family planning service [AOR= 4.33, 95% CI: 1.5, 12.46]. Conclusion: This study revealed that family planning services were relatively better; they are still low as compared to national HSDP IV target. Educational status, knowledge on family planning, attitude towards family planning services and availability of family planning services were identified as factors affecting current utilization of family planning service. Providing IEC and house-hold level discussion on the important of family planning service utilization in the district is recommended.
Background: Nearly all (99%) of maternal death occur in the developing countries. However, family planning (FP) could prevent as many as one in every three maternal deaths by allowing women to delay motherhood, space birth, avoid unintended pregnancies and abortion and stop childbearing when they reached their desired family size. Objective: To assess utilization of family planning services and influencing factors among women in Assosa District. Methods: A community based cross sectional study was conducted from May 17 – 31, 2012 on the selected samples of 536 women who had at least one delivery in the five years prior to the study using simple random sampling technique. Structured questionnaire, FGD and in-depth interview guide were used to collect data. Data were analyzed by using SPSS version 16.0. Binary logistic regression was used to determine the association between dependent and independent variables. Results: Out of the 525 study subjects 339(64.6%) women were currently using any method of contraceptive. Factors influencing utilization of family planning services were attending grade 7 and above [AOR= 2.19, 95% CI: 1.11, 4.33], being knowledgeable on family planning service [AOR= 3.9, 95% CI: 1.36, 8.48], having favorable attitude towards family planning service [AOR= 2.16, 95% CI: 1.45, 3.23] and availability of family planning service [AOR= 4.33, 95% CI: 1.5, 12.46]. Conclusion: This study revealed that family planning services were relatively better; they are still low as compared to national HSDP IV target. Educational status, knowledge on family planning, attitude towards family planning services and availability of family planning services were identified as factors affecting current utilization of family planning service. Providing IEC and house-hold level discussion on the important of family planning service utilization in the district is recommended.
Utilization of Family Planning Services and Influencing Factors Among Women of Child Bearing Age in Assosa District, Benishangul Gumuz Regional State, West Ethiopia
doi:10.11648/j.sjcm.20150403.11
Science Journal of Clinical Medicine
2015-05-15
© Science Publishing Group
Muluwas Amentie
Muluemebet Abera
Misra Abdulahi
Utilization of Family Planning Services and Influencing Factors Among Women of Child Bearing Age in Assosa District, Benishangul Gumuz Regional State, West Ethiopia
4
3
59
59
2015-05-15
2015-05-15
10.11648/j.sjcm.20150403.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150403.11
© Science Publishing Group
Comparison between Four Types of Long Term Tube Feeding Regarding Nutritional Effects, Complications and Outcomes
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150403.12
Objective: to compare four types of long term tube feeding regarding nutritional effects, tube-related complications and outcome. Methods: retrospective study. Results: Mean BMI at time of tube insertion is 23.3, two years later 20.3 (P= 0.0312). Patients have follow up with HHC their mean BMI at base line is 23.5, after two years 21.53 (p =0.547). No difference regarding albumin, urea, sodium, potassium, hemoglobin over 6, 12, 24 months either patient has followed up with HHC or not. High creatinine level in 12 months with jejunostomy tube (p= 0.0270). There are no major complications among the patients. No minor complications within 48 h of tube insertion in 42.18%, No complications after 48 h of tube insertion in 36.05%.The mortality rate is 56.59%. Old age is associated with a higher mortality (p 0.0018) and survival is better for patients who have HHC follow up (p <0.0001).The commonest cause of death is aspiration pneumonia with septic shock and respiratory failure 37.68 % and PFG has the highest mortality rate. Conclusion: 1) Patients on long-term feeding tubes don’t gain weight. There is an urgent need to improve method of nutritional assessment and to have regular follow up to calculate their calories requirement and adjust their formula accordingly; 2) The nutritional status in four feeding tubes is similar except in12 months there is significant difference in creatinine in jejunostomy tube; 3) Rate of complications is low among our patients with reference to the long period of follow-up. Almost all complications have been mild and could be managed throughout adequately; 4) Tube related infection and leakage reported more in PFG. It could be because it is the commonest tube used among our patients.
Objective: to compare four types of long term tube feeding regarding nutritional effects, tube-related complications and outcome. Methods: retrospective study. Results: Mean BMI at time of tube insertion is 23.3, two years later 20.3 (P= 0.0312). Patients have follow up with HHC their mean BMI at base line is 23.5, after two years 21.53 (p =0.547). No difference regarding albumin, urea, sodium, potassium, hemoglobin over 6, 12, 24 months either patient has followed up with HHC or not. High creatinine level in 12 months with jejunostomy tube (p= 0.0270). There are no major complications among the patients. No minor complications within 48 h of tube insertion in 42.18%, No complications after 48 h of tube insertion in 36.05%.The mortality rate is 56.59%. Old age is associated with a higher mortality (p 0.0018) and survival is better for patients who have HHC follow up (p <0.0001).The commonest cause of death is aspiration pneumonia with septic shock and respiratory failure 37.68 % and PFG has the highest mortality rate. Conclusion: 1) Patients on long-term feeding tubes don’t gain weight. There is an urgent need to improve method of nutritional assessment and to have regular follow up to calculate their calories requirement and adjust their formula accordingly; 2) The nutritional status in four feeding tubes is similar except in12 months there is significant difference in creatinine in jejunostomy tube; 3) Rate of complications is low among our patients with reference to the long period of follow-up. Almost all complications have been mild and could be managed throughout adequately; 4) Tube related infection and leakage reported more in PFG. It could be because it is the commonest tube used among our patients.
Comparison between Four Types of Long Term Tube Feeding Regarding Nutritional Effects, Complications and Outcomes
doi:10.11648/j.sjcm.20150403.12
Science Journal of Clinical Medicine
2015-06-06
© Science Publishing Group
Muneerah Albugami
Yasmin Al Twaijri
Abeer Ibrahim
Habib Bassil
Ulrike Laudon
Mohamed El Karouri
Abdulaziz Al Rashed
Abdelazeim Elamin
Ahmed Sabry
Rania Abdelreheem
Abdulwahab Motieb
Ali Al Araj
Reem Hawary
Sawsan Al Balawi
Comparison between Four Types of Long Term Tube Feeding Regarding Nutritional Effects, Complications and Outcomes
4
3
66
66
2015-06-06
2015-06-06
10.11648/j.sjcm.20150403.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150403.12
© Science Publishing Group
Risky Sexual Behavior and Associated Factors Among High School Youth in Pawe Woreda Benishangul Gumuz Region
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150404.11
Background: Youths’ sexual behaviour affects their physical, psychological and social well-being leading to death. Youth are at high risk of Human Immune Virus (HIV) and Sexual Transmitted Infection (STI) despite high level of knowledge about HIV/STI. Objective: to assess risky sexual behaviour and associated factors among high school youth 15- 24 years. Methods: A cross-sectional study design was employed using a pre-tested self-administered questionnaire and supplemented by focus group discussion which conducted from May 10th to 20th, 2012G.C among high school youth in Pawe Woreda, Northwest Ethiopia. Bivariate and multivariate analyses were employed. A total of 374 youth were selected using simple random sampling method. The data were analyzed using SPSS for windows version 16.0. Descriptive statists, bivariate and multi-variable logistic regression analyses were performed after cleaning the data. Statistical significance was declared at P<0.05. Results: Out of the study subjects; 90 (24.1%) respondents were sexually active. Among the sexually active students: 37(41.1%) reported ever use of condom, 5.5% reported sexual contact with commercial sex workers and 26 (35.1%) reported having more than two sexual partner. Consistent use of condom was reported only by 16(43.2%). Seventy four (82.2%) had risky sexual behavior. Only 24 (26.7%) reported high chance of acquiring Human Immune Virus (HIV) and Sexual Transmitted Infection (STI). Multivariable logistic regression analyses showed that being in 18-24 age group (AOR=3.279 [95% CI: 1.79, 6.008]) and drinking alcohol (AOR = 9.1 [95% CI: 2.517, 32.9]) were associated with risky sexual behaviour. Conclusion: Considerable amount of school youth had started early sexual activity and have developed risky sexual behaviour that might predispose them to different sexual and reproductive health problems. Delaying sexual initiation and reducing risky sexual behaviour among youth can be achieved through well designed sexual education programs at earlier life in school.
Background: Youths’ sexual behaviour affects their physical, psychological and social well-being leading to death. Youth are at high risk of Human Immune Virus (HIV) and Sexual Transmitted Infection (STI) despite high level of knowledge about HIV/STI. Objective: to assess risky sexual behaviour and associated factors among high school youth 15- 24 years. Methods: A cross-sectional study design was employed using a pre-tested self-administered questionnaire and supplemented by focus group discussion which conducted from May 10th to 20th, 2012G.C among high school youth in Pawe Woreda, Northwest Ethiopia. Bivariate and multivariate analyses were employed. A total of 374 youth were selected using simple random sampling method. The data were analyzed using SPSS for windows version 16.0. Descriptive statists, bivariate and multi-variable logistic regression analyses were performed after cleaning the data. Statistical significance was declared at P<0.05. Results: Out of the study subjects; 90 (24.1%) respondents were sexually active. Among the sexually active students: 37(41.1%) reported ever use of condom, 5.5% reported sexual contact with commercial sex workers and 26 (35.1%) reported having more than two sexual partner. Consistent use of condom was reported only by 16(43.2%). Seventy four (82.2%) had risky sexual behavior. Only 24 (26.7%) reported high chance of acquiring Human Immune Virus (HIV) and Sexual Transmitted Infection (STI). Multivariable logistic regression analyses showed that being in 18-24 age group (AOR=3.279 [95% CI: 1.79, 6.008]) and drinking alcohol (AOR = 9.1 [95% CI: 2.517, 32.9]) were associated with risky sexual behaviour. Conclusion: Considerable amount of school youth had started early sexual activity and have developed risky sexual behaviour that might predispose them to different sexual and reproductive health problems. Delaying sexual initiation and reducing risky sexual behaviour among youth can be achieved through well designed sexual education programs at earlier life in school.
Risky Sexual Behavior and Associated Factors Among High School Youth in Pawe Woreda Benishangul Gumuz Region
doi:10.11648/j.sjcm.20150404.11
Science Journal of Clinical Medicine
2015-06-25
© Science Publishing Group
Mulatu Agajie
Tefera Belachew
Tizta Tilahun
Muluwas Amentie
Risky Sexual Behavior and Associated Factors Among High School Youth in Pawe Woreda Benishangul Gumuz Region
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4
75
75
2015-06-25
2015-06-25
10.11648/j.sjcm.20150404.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150404.11
© Science Publishing Group
Prevalence of Hyperuricemia (HU) in Arterial Hypertension
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150404.12
Introduction: Hyperuricemia constitutes a risk for many organs and its prevalence is high ranging from 15-20% up to 35% in developing countries. HU relation to arterial hypertension was pointed out in the end of the XIX century and is recognized as independent cardiovascular risk factor. Thus HU is less studied in our environment which justifies our work to determine prevalence and with HU associated factors among hypertensive patients followed in the Cardiology department in the Mother Child Hospital “Le Luxembourg”. Methodology: It’s was a cross-sectional study in the Mother-Child Hospital “Le Luxembourg” in Bamako. All patients with complete labor tests were included making a sample of 51 hypertensive outpatients seen from July 2010 to January 2011. For any included patient, socio-demographic and biological variables were collected. In the same way a chest radiography, an ECG and an echocardiography were realized. Patients were asked about their knowledge about HU Hyperuricemia was defined as an uricemia > 420 μmol/l for men and 360 μmol/l for women. Microsoft Excel 2007 was used to gather data and SPSS version 12 to perform analyzes. Results: Mean age of the sample was 56,35 years, the sex-ratio Male: Female 0,76. Hyperuricemia, hypercreatininemia and hyperglycemia were found respectively in 66,7,33,3% and 23,5% of the cases. 78,4% of the patients had stated to have heard about hyperuricemia, 27,5% knew their hyperuricemia. The socio-demographic characteristics did not present a statistically significant difference. Conclusion: Hyperuricemia as a cardiovascular risk factor, had to be researched and managed more agressively. The very high proportion of patients with a hyperuricemia requires to detect it among hypertensive patients, to carry out an early treatment and thus to reduce the cardiovascular risk of the patient.
Introduction: Hyperuricemia constitutes a risk for many organs and its prevalence is high ranging from 15-20% up to 35% in developing countries. HU relation to arterial hypertension was pointed out in the end of the XIX century and is recognized as independent cardiovascular risk factor. Thus HU is less studied in our environment which justifies our work to determine prevalence and with HU associated factors among hypertensive patients followed in the Cardiology department in the Mother Child Hospital “Le Luxembourg”. Methodology: It’s was a cross-sectional study in the Mother-Child Hospital “Le Luxembourg” in Bamako. All patients with complete labor tests were included making a sample of 51 hypertensive outpatients seen from July 2010 to January 2011. For any included patient, socio-demographic and biological variables were collected. In the same way a chest radiography, an ECG and an echocardiography were realized. Patients were asked about their knowledge about HU Hyperuricemia was defined as an uricemia > 420 μmol/l for men and 360 μmol/l for women. Microsoft Excel 2007 was used to gather data and SPSS version 12 to perform analyzes. Results: Mean age of the sample was 56,35 years, the sex-ratio Male: Female 0,76. Hyperuricemia, hypercreatininemia and hyperglycemia were found respectively in 66,7,33,3% and 23,5% of the cases. 78,4% of the patients had stated to have heard about hyperuricemia, 27,5% knew their hyperuricemia. The socio-demographic characteristics did not present a statistically significant difference. Conclusion: Hyperuricemia as a cardiovascular risk factor, had to be researched and managed more agressively. The very high proportion of patients with a hyperuricemia requires to detect it among hypertensive patients, to carry out an early treatment and thus to reduce the cardiovascular risk of the patient.
Prevalence of Hyperuricemia (HU) in Arterial Hypertension
doi:10.11648/j.sjcm.20150404.12
Science Journal of Clinical Medicine
2015-07-05
© Science Publishing Group
Bâ Hamidou Oumar
Menta Ichaka
Maiga Asmaou Kéita
Daou Adama
Diall Ilo Bella
Coulibaly Souleymane
Doumbia Coumba Thiam
Daffé Sanoussi
Sidibé Noumou
Sangaré Ibrahima
Millogo Georges Rosario Christian
Touré Mamadou
Sidibé Salimata
Diarra Mamadou Bocary
Prevalence of Hyperuricemia (HU) in Arterial Hypertension
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2015-07-05
2015-07-05
10.11648/j.sjcm.20150404.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150404.12
© Science Publishing Group
Prostate carcinoma: correlation of histopathology with serum prostate specific antigen
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.s.2015040401.11
Prostate Specific Antigen (PSA) is the first line test in screening of prostate cancer. The increase in PSA depends on differentiation of tumour cells. Gleason grading is one of the most powerful predictors of biological behaviour and influential factors used to determine treatment. PSA, when combined with Gleason score and clinical stage, improves the prediction of pathological stage for prostate carcinoma. Aims of this study were to study the histopathological features and Gleason grading in Prostatic Carcinoma and to correlate pretreatment PSA levels with Gleason grade. The study was undertaken in a tertiary care hospital over a period of two years.Fifty one cases of prostatic carcinoma were studied. Grading done by Gleason grading system, was correlated with serum PSA levels. Software statistical package for social sciences (SPSS), version 16 was used. P value < 0.05 was considered significant. Patients were aged predominantly between 60 to 70 yrs. Majority (66.7%) had poorly differentiated adenocarcinoma. 84.3% had high values of PSA (>10ng/ml). 5.9 % had PSA value in normal range (< 4 ng/ml). Though there was a comparative increase in PSA level with increase in Gleason grade, it was not statistically significant (‘p’ value = 0.75). To conclude, a proportion of tumours with Gleason score 8-10 are so poorly differentiated that they produce relatively little PSA. Refinement in estimation and interpretation of PSA values may be considered to improve the sensitivity and specificity of PSA. Gleason grading is a better predictor of biological behaviour of prostate cancer.
Prostate Specific Antigen (PSA) is the first line test in screening of prostate cancer. The increase in PSA depends on differentiation of tumour cells. Gleason grading is one of the most powerful predictors of biological behaviour and influential factors used to determine treatment. PSA, when combined with Gleason score and clinical stage, improves the prediction of pathological stage for prostate carcinoma. Aims of this study were to study the histopathological features and Gleason grading in Prostatic Carcinoma and to correlate pretreatment PSA levels with Gleason grade. The study was undertaken in a tertiary care hospital over a period of two years.Fifty one cases of prostatic carcinoma were studied. Grading done by Gleason grading system, was correlated with serum PSA levels. Software statistical package for social sciences (SPSS), version 16 was used. P value < 0.05 was considered significant. Patients were aged predominantly between 60 to 70 yrs. Majority (66.7%) had poorly differentiated adenocarcinoma. 84.3% had high values of PSA (>10ng/ml). 5.9 % had PSA value in normal range (< 4 ng/ml). Though there was a comparative increase in PSA level with increase in Gleason grade, it was not statistically significant (‘p’ value = 0.75). To conclude, a proportion of tumours with Gleason score 8-10 are so poorly differentiated that they produce relatively little PSA. Refinement in estimation and interpretation of PSA values may be considered to improve the sensitivity and specificity of PSA. Gleason grading is a better predictor of biological behaviour of prostate cancer.
Prostate carcinoma: correlation of histopathology with serum prostate specific antigen
doi:10.11648/j.sjcm.s.2015040401.11
Science Journal of Clinical Medicine
2015-08-03
© Science Publishing Group
Deepika Gurumurthy
Rangaswamy Maggad
Sapna Patel
Prostate carcinoma: correlation of histopathology with serum prostate specific antigen
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4
5
5
2015-08-03
2015-08-03
10.11648/j.sjcm.s.2015040401.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.s.2015040401.11
© Science Publishing Group
Efficacy of Manual Liquid Based Cytology over Conventional Cytology in Oral Squamous Cell Carcinoma
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.s.2015040401.13
Context/Background: Oral cytology has come long way from its primitive Papanicolau days. Liquid Based cytology has shown significant advantages over conventional exfoliative cytology. However, LBC requires expensive automated devices and materials which might not be affordable for many cytopathological laboratories in countries with limited resources. Manual liquid Based Cytology (MLBC) is a technique that enables cells to be suspended in a monolayer and thus improves detection of lesions and improvement of adequacy. Aim: To study and evaluate the diagnostic efficiency and reliability of MLBC in comparison with conventional PAP smear (CPS) of oral squamous cell carcinoma. Materials and Methods: Two smear were prepared from 50 patients, clinically diagnosed with Oral Squamous Cell Carcinoma. Each smear was subjected to MLBC and CPS methods. The slides were evaluated by two pathologists for the staining characterstics of nucleus and cytoplasm. The diagnostic efficiency of each smear was evaluated by comparing the cytological diagnosis of each method with histopathological diagnosis. Results: Increased detection rate with MLBC was 29.41%. Identifying cellular atypia by MLBC was more sensitive (44%) compared to CPS (34%) with similar specificity (100%). The percentage agreement by the two methods was 77.28%. Conclusion: MLBC is an easy, cost effective technique comparable to CPS; however, it warrants further study in its potential application in screening of oral precancer and cancer.
Context/Background: Oral cytology has come long way from its primitive Papanicolau days. Liquid Based cytology has shown significant advantages over conventional exfoliative cytology. However, LBC requires expensive automated devices and materials which might not be affordable for many cytopathological laboratories in countries with limited resources. Manual liquid Based Cytology (MLBC) is a technique that enables cells to be suspended in a monolayer and thus improves detection of lesions and improvement of adequacy. Aim: To study and evaluate the diagnostic efficiency and reliability of MLBC in comparison with conventional PAP smear (CPS) of oral squamous cell carcinoma. Materials and Methods: Two smear were prepared from 50 patients, clinically diagnosed with Oral Squamous Cell Carcinoma. Each smear was subjected to MLBC and CPS methods. The slides were evaluated by two pathologists for the staining characterstics of nucleus and cytoplasm. The diagnostic efficiency of each smear was evaluated by comparing the cytological diagnosis of each method with histopathological diagnosis. Results: Increased detection rate with MLBC was 29.41%. Identifying cellular atypia by MLBC was more sensitive (44%) compared to CPS (34%) with similar specificity (100%). The percentage agreement by the two methods was 77.28%. Conclusion: MLBC is an easy, cost effective technique comparable to CPS; however, it warrants further study in its potential application in screening of oral precancer and cancer.
Efficacy of Manual Liquid Based Cytology over Conventional Cytology in Oral Squamous Cell Carcinoma
doi:10.11648/j.sjcm.s.2015040401.13
Science Journal of Clinical Medicine
2015-08-03
© Science Publishing Group
Sudhir Mishra
Jagadish Hosmani
Nandini Manoli
Ramakant Nayak
Manjunath G. V.
Efficacy of Manual Liquid Based Cytology over Conventional Cytology in Oral Squamous Cell Carcinoma
4
4
15
15
2015-08-03
2015-08-03
10.11648/j.sjcm.s.2015040401.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.s.2015040401.13
© Science Publishing Group
Cytodiagnosis of Dimorphic Fungi with Disseminated Infection in a HIV Positive Patient – A Diagnostic Dilemma
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.s.2015040401.15
Systemic mycosis caused by fungi (or dimorphic fungi) such as Histoplasma, emmonsia, candida & penicillium has emerged as an important opportunistic fungal infection in immunocompromised patient in South- East Asia. Several cases of opportunistic fungal infection has been reported but cytological diagnosis of disseminated (dimorphic) fungal infection has been reported in very few cases. Cytological diagnosis of these infections depending on the morphological characteristics has always been a challenge to practising cytologists. A case of rare disseminated fungal infection reported in a 45 year old seropositive male who is noncompliant on ART presented with ulcer over palate, fever, weight loss, occasional per rectal bleeding. On examination having bilateral cervical lymphadenopathy and hepatomegaly. On investigation- anaemia, high ESR, deranged liver function test, CD4 count 16/cumm, USG showed hepatomegaly, underwent FNAC cervical lymphnodes and guided FNAC of liver, which showed these organisms, but no pathogens were found with classical microbiological procedure. Patient was treated with itraconazole and amphotericine and showed improvement. This case illustrate the utility of FNAC in early diagnosis & management of rare infection & it also highlight the combined role of molecular technique and FNAC as an interdisciplinary approach for management of patient.
Systemic mycosis caused by fungi (or dimorphic fungi) such as Histoplasma, emmonsia, candida & penicillium has emerged as an important opportunistic fungal infection in immunocompromised patient in South- East Asia. Several cases of opportunistic fungal infection has been reported but cytological diagnosis of disseminated (dimorphic) fungal infection has been reported in very few cases. Cytological diagnosis of these infections depending on the morphological characteristics has always been a challenge to practising cytologists. A case of rare disseminated fungal infection reported in a 45 year old seropositive male who is noncompliant on ART presented with ulcer over palate, fever, weight loss, occasional per rectal bleeding. On examination having bilateral cervical lymphadenopathy and hepatomegaly. On investigation- anaemia, high ESR, deranged liver function test, CD4 count 16/cumm, USG showed hepatomegaly, underwent FNAC cervical lymphnodes and guided FNAC of liver, which showed these organisms, but no pathogens were found with classical microbiological procedure. Patient was treated with itraconazole and amphotericine and showed improvement. This case illustrate the utility of FNAC in early diagnosis & management of rare infection & it also highlight the combined role of molecular technique and FNAC as an interdisciplinary approach for management of patient.
Cytodiagnosis of Dimorphic Fungi with Disseminated Infection in a HIV Positive Patient – A Diagnostic Dilemma
doi:10.11648/j.sjcm.s.2015040401.15
Science Journal of Clinical Medicine
2015-08-03
© Science Publishing Group
Chitresh Yadav
Nandini N. M.
Shruti M. K.
Sowmya G. S.
M. R. Shivaprakash
G. V. Manjunath
Cytodiagnosis of Dimorphic Fungi with Disseminated Infection in a HIV Positive Patient – A Diagnostic Dilemma
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4
22
22
2015-08-03
2015-08-03
10.11648/j.sjcm.s.2015040401.15
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.s.2015040401.15
© Science Publishing Group
Evaluation of Breast Neoplastic Lesions by Different Cytology Grading Methods
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.s.2015040401.17
Introduction: With the increase in the awareness of breast cancer among women, cases of lump in the breast has increased in outpatient department. Fine needle aspiration cytology (FNAC) is the easy, quick and cost effective technique of evaluating breast lump. Objective: The present study, evaluated and compared the modified Masood's cytology index (MCI) with various other cytology grading methods and histopathology. Result: Modified MCI has over all concordance rate of 86%, sensitivity of 86%, specificity of 50%, positive predictive value (PPV) of 93% and negative predictive value (NPV) of 30%. Multiple regression analysis revealed an r2 value of 60%, which was significant. The p-value of anisonucleosis, nucleoli and chromatin pattern were 0.001, 0.05 and 0.02 respectively, which was significant (p-value less than 0.05). Conclusion: Modified MCI will help the cytopathologist to accurately delineate both benign and malignant neoplastic breast lesions into respective categories. This in turn will help the treating surgeon to plan the treatment modality of the patients with lump in the breast. The study recommends that modified MCI method to be routinely incorporated for evaluation of all lump in the breast.
Introduction: With the increase in the awareness of breast cancer among women, cases of lump in the breast has increased in outpatient department. Fine needle aspiration cytology (FNAC) is the easy, quick and cost effective technique of evaluating breast lump. Objective: The present study, evaluated and compared the modified Masood's cytology index (MCI) with various other cytology grading methods and histopathology. Result: Modified MCI has over all concordance rate of 86%, sensitivity of 86%, specificity of 50%, positive predictive value (PPV) of 93% and negative predictive value (NPV) of 30%. Multiple regression analysis revealed an r2 value of 60%, which was significant. The p-value of anisonucleosis, nucleoli and chromatin pattern were 0.001, 0.05 and 0.02 respectively, which was significant (p-value less than 0.05). Conclusion: Modified MCI will help the cytopathologist to accurately delineate both benign and malignant neoplastic breast lesions into respective categories. This in turn will help the treating surgeon to plan the treatment modality of the patients with lump in the breast. The study recommends that modified MCI method to be routinely incorporated for evaluation of all lump in the breast.
Evaluation of Breast Neoplastic Lesions by Different Cytology Grading Methods
doi:10.11648/j.sjcm.s.2015040401.17
Science Journal of Clinical Medicine
2015-08-03
© Science Publishing Group
T. S. Rekha
N. M. Nandini
Evaluation of Breast Neoplastic Lesions by Different Cytology Grading Methods
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4
30
30
2015-08-03
2015-08-03
10.11648/j.sjcm.s.2015040401.17
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.s.2015040401.17
© Science Publishing Group
Significance of Endometrial Cells in Cervical Cytology (by Conventional Pap & Manual Liquid Based Cytology) in Abnormal Uterine Bleeding Cases
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.s.2015040401.12
Abnormal uterine bleeding is common gynaecologic complaint. Causes may vary with age, the most worrisome cause is malignancy of endometrium. No widely accepted screening test for endometrial carcinoma exists, but cervical cytology has been found to be of some use in detecting endometrial diseases. Guidelines from the 2001 Bethesda system, in addition to reporting of atypical glandular cells (AGC) and adenocarcinoma, requires the reporting of benign appearing endometrial cells in women aged above 40 years. Smears for cervical cytology are collected from 80 patients in the age group of 20-75 years with complaints of bleeding per vagina. Cyto-histological correlation is attempted in which D&C or hysterectomy specimen is sent. Manual Liquid Based Cytology is strongly advocated as it improves sample quality by removing obscuring factors. Out of 80 abnormal uterine bleeding cases 52 showed endometrial cells (10 atypical glandular cells & 42 benign endometrial cells) & 39 had further diagnostic evaluation of endometrium. The results indicated an association between endometrial cells in cervical cytology with carcinoma in 6 cases(15.4%), 1 case with complex hyperplasia with atypia(0.03%) ,while remaining 84.6% had benign endometrial pathology. Hence we concluded that presence of atypical endometrial cells in all women & benign endometrial cells in post menopausal women(>40yr)has considerable clinical implications & further diagnostic evaluation for endometrial sampling is of utmost importance.
Abnormal uterine bleeding is common gynaecologic complaint. Causes may vary with age, the most worrisome cause is malignancy of endometrium. No widely accepted screening test for endometrial carcinoma exists, but cervical cytology has been found to be of some use in detecting endometrial diseases. Guidelines from the 2001 Bethesda system, in addition to reporting of atypical glandular cells (AGC) and adenocarcinoma, requires the reporting of benign appearing endometrial cells in women aged above 40 years. Smears for cervical cytology are collected from 80 patients in the age group of 20-75 years with complaints of bleeding per vagina. Cyto-histological correlation is attempted in which D&C or hysterectomy specimen is sent. Manual Liquid Based Cytology is strongly advocated as it improves sample quality by removing obscuring factors. Out of 80 abnormal uterine bleeding cases 52 showed endometrial cells (10 atypical glandular cells & 42 benign endometrial cells) & 39 had further diagnostic evaluation of endometrium. The results indicated an association between endometrial cells in cervical cytology with carcinoma in 6 cases(15.4%), 1 case with complex hyperplasia with atypia(0.03%) ,while remaining 84.6% had benign endometrial pathology. Hence we concluded that presence of atypical endometrial cells in all women & benign endometrial cells in post menopausal women(>40yr)has considerable clinical implications & further diagnostic evaluation for endometrial sampling is of utmost importance.
Significance of Endometrial Cells in Cervical Cytology (by Conventional Pap & Manual Liquid Based Cytology) in Abnormal Uterine Bleeding Cases
doi:10.11648/j.sjcm.s.2015040401.12
Science Journal of Clinical Medicine
2015-08-03
© Science Publishing Group
Lopa Mudra kakoti
Nandini N. Manoli
Nandish S. Manoli
Significance of Endometrial Cells in Cervical Cytology (by Conventional Pap & Manual Liquid Based Cytology) in Abnormal Uterine Bleeding Cases
4
4
10
10
2015-08-03
2015-08-03
10.11648/j.sjcm.s.2015040401.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.s.2015040401.12
© Science Publishing Group
Idiopathic Hypereosinophilic Syndrome/Eosinophilic Leukaemia (Case Report): A Challenge to Diagnose
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.s.2015040401.14
Hypereosinophilic syndrome (HES) was first described by Hardy and Anderson in 1968 . HES may result either from eosinophilic differentiation of a clone of neoplastic cells or from reactive eosinophilia. It appears lightly that in many patients idiopathic HES is actually a chronic myeloproliferative disorder. There is vaguely overlapping clinico-pathological picture of HES with (Chronic eosinophilic leukaemia) CEL which often adds to diagnostic confusion. In 2001, the World Health Organization (WHO) proposed a set of criteria that distinguish CEL from HES. An evidence of genetic clonality of eosinophils or an increase in blast cells in blood or bone marrow is mandatory for diagnosis of CEL, while no specific diagnostic tests exists for HES, making it an entity of exclusion. A 36 year old female presented with intermittent fever and dry cough since two months. Clinical examination revealed mild pallor with hepatosplenomegaly. Chest examination showed bilateral basal crepitations. The patient was subjected for hematological, biochemical and radiological assessment. The peripheral smear and bone marrow aspirates revealed presence of eosinophilic precursors with predominance of eosinophiloblasts associated with eosinophilic myelocytes, metamyelocytes, a few myeloblasts and lymphocytes, the features of which are in favour of CEL. CEL, a rare myeloproliferative entity and its presentation with pulmonary manifestations is still rare in India. Hence, we present this rare entity along with review of available literature.
Hypereosinophilic syndrome (HES) was first described by Hardy and Anderson in 1968 . HES may result either from eosinophilic differentiation of a clone of neoplastic cells or from reactive eosinophilia. It appears lightly that in many patients idiopathic HES is actually a chronic myeloproliferative disorder. There is vaguely overlapping clinico-pathological picture of HES with (Chronic eosinophilic leukaemia) CEL which often adds to diagnostic confusion. In 2001, the World Health Organization (WHO) proposed a set of criteria that distinguish CEL from HES. An evidence of genetic clonality of eosinophils or an increase in blast cells in blood or bone marrow is mandatory for diagnosis of CEL, while no specific diagnostic tests exists for HES, making it an entity of exclusion. A 36 year old female presented with intermittent fever and dry cough since two months. Clinical examination revealed mild pallor with hepatosplenomegaly. Chest examination showed bilateral basal crepitations. The patient was subjected for hematological, biochemical and radiological assessment. The peripheral smear and bone marrow aspirates revealed presence of eosinophilic precursors with predominance of eosinophiloblasts associated with eosinophilic myelocytes, metamyelocytes, a few myeloblasts and lymphocytes, the features of which are in favour of CEL. CEL, a rare myeloproliferative entity and its presentation with pulmonary manifestations is still rare in India. Hence, we present this rare entity along with review of available literature.
Idiopathic Hypereosinophilic Syndrome/Eosinophilic Leukaemia (Case Report): A Challenge to Diagnose
doi:10.11648/j.sjcm.s.2015040401.14
Science Journal of Clinical Medicine
2015-08-03
© Science Publishing Group
Sathyavathi Alva
Angshuman Saha
Tahera Syed
T. M. Kariappa
Idiopathic Hypereosinophilic Syndrome/Eosinophilic Leukaemia (Case Report): A Challenge to Diagnose
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4
18
18
2015-08-03
2015-08-03
10.11648/j.sjcm.s.2015040401.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.s.2015040401.14
© Science Publishing Group
FNAC Diagnosis of Soft Tissue Tumour (Proliferative Fascitis and Proliferative Myositis ): A Case Report
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.s.2015040401.16
Nodular fascitis is a benign fibroblastic tumour characterized by rapid growth and most of the time requires its differentiation from other tumorous lesions. Here is a case of 45 year old male who presented with a soft tissue swelling in the popliteal region. On FNAC, a differential diagnosis of proliferative myositis and proliferative fasciitis was given. Histopathological examination gave a diagnosis of nodular fascitis. Hence cytology helps to give a definite diagnosis and aid in the surgical management of soft tissue tumors.
Nodular fascitis is a benign fibroblastic tumour characterized by rapid growth and most of the time requires its differentiation from other tumorous lesions. Here is a case of 45 year old male who presented with a soft tissue swelling in the popliteal region. On FNAC, a differential diagnosis of proliferative myositis and proliferative fasciitis was given. Histopathological examination gave a diagnosis of nodular fascitis. Hence cytology helps to give a definite diagnosis and aid in the surgical management of soft tissue tumors.
FNAC Diagnosis of Soft Tissue Tumour (Proliferative Fascitis and Proliferative Myositis ): A Case Report
doi:10.11648/j.sjcm.s.2015040401.16
Science Journal of Clinical Medicine
2015-08-03
© Science Publishing Group
Sushma K. L.
Nandini N. Manoli
Vasudha Nassa
Jayshree K.
Manjunath G. V.
FNAC Diagnosis of Soft Tissue Tumour (Proliferative Fascitis and Proliferative Myositis ): A Case Report
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2015-08-03
2015-08-03
10.11648/j.sjcm.s.2015040401.16
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.s.2015040401.16
© Science Publishing Group
Metastasis of Adrenocortical Carcinoma to Pericardial Fluid, Cytological Diagnosis (IHC) – A Case Report
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.s.2015040401.18
A 54 years male patient presenting with multiple complaints was found to have large pericardial effusion leading to tamponade. Radiological findings were suggestive of a right adrenal mass. Cytological evaluation of the pericardial fluid revealed features of malignant effusion. Adrenocortical origin of the malignant cells was confirmed by immunostaining with A103 antibody against Melan-A. Hence, identification of primary lesion and confirmation of diagnosis was achieved by cytology with the help of immunohistochemistry performed on the cell block obtained from the drained pericardial fluid.
A 54 years male patient presenting with multiple complaints was found to have large pericardial effusion leading to tamponade. Radiological findings were suggestive of a right adrenal mass. Cytological evaluation of the pericardial fluid revealed features of malignant effusion. Adrenocortical origin of the malignant cells was confirmed by immunostaining with A103 antibody against Melan-A. Hence, identification of primary lesion and confirmation of diagnosis was achieved by cytology with the help of immunohistochemistry performed on the cell block obtained from the drained pericardial fluid.
Metastasis of Adrenocortical Carcinoma to Pericardial Fluid, Cytological Diagnosis (IHC) – A Case Report
doi:10.11648/j.sjcm.s.2015040401.18
Science Journal of Clinical Medicine
2015-08-03
© Science Publishing Group
Vasudha Nassa
Nandini N. M.
Sushma K. L.
Sapna Patel
Manjunath G. V.
Metastasis of Adrenocortical Carcinoma to Pericardial Fluid, Cytological Diagnosis (IHC) – A Case Report
4
4
35
35
2015-08-03
2015-08-03
10.11648/j.sjcm.s.2015040401.18
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.s.2015040401.18
© Science Publishing Group
Early Sexual Initiation and Associated Factors among Debre Markos University Students, North West Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150405.11
Background: Sexual activities during adolescence have been characterized as dynamic and constantly changing, and it has an impact on reproductive life of young peoples, which is related to the increased susceptibility to HIV transmission, unwanted pregnancy and its complications when the sexual activities are unprotected. So, the objective of this study was to identify the prevalence of early sexual initiation and its associated factors among Debre Markos University students, North West Ethiopia, 2014. Methods: Institution based cross sectional study design was conducted among 273 Debre Markos university students. Study participants were selected by stratified sampling technique and self- administrated questionnaire was distributed to collect information. EpiData version 3.1 was used for data entry and SPSS version 16 was used for analysis. To identify factors associated with sexual initiation, bivariate and multivariate logistic regression with 95 % Confidence interval was used. Results: From 260 respondents, 116(44.6%) had sex prior to the data collection period, while 144(55.4%) had never had sexual intercourse. Almost two third (64.7%) of respondents start sexual intercourse during the age range of 16-19 years old. The mean and standard deviation for the age at first sex was 18.28 and 2.04 years respectively. Factors which were significantly associated with early sexual initiation (< 18 years old) were; being female (AOR=5.7, 95%CI=1.16-27.72), lack of discussion on sexual and reproductive health issues (SRH) with their mother (AOR=, 95%CI= 1.23-41.5) and cigarrate smoking (AOR=7, 95%CI=1.06-46.92). Conclusions: Early sexual initiation was high. Factors which were associated with early sexual initiation were being female, lack of discussion on SRH with mother and cigarrate smoking. So, awareness creation for both male and female young peoples through the use of religious leaders, school teachers and parents on sexual and reproductive health issues is important. Young peoples should be encouraged to discuss with their parents on SRH through the use of reproductive health centers and emphasis should also be given for adolescents who use drugs like cigarrate smoking.
Background: Sexual activities during adolescence have been characterized as dynamic and constantly changing, and it has an impact on reproductive life of young peoples, which is related to the increased susceptibility to HIV transmission, unwanted pregnancy and its complications when the sexual activities are unprotected. So, the objective of this study was to identify the prevalence of early sexual initiation and its associated factors among Debre Markos University students, North West Ethiopia, 2014. Methods: Institution based cross sectional study design was conducted among 273 Debre Markos university students. Study participants were selected by stratified sampling technique and self- administrated questionnaire was distributed to collect information. EpiData version 3.1 was used for data entry and SPSS version 16 was used for analysis. To identify factors associated with sexual initiation, bivariate and multivariate logistic regression with 95 % Confidence interval was used. Results: From 260 respondents, 116(44.6%) had sex prior to the data collection period, while 144(55.4%) had never had sexual intercourse. Almost two third (64.7%) of respondents start sexual intercourse during the age range of 16-19 years old. The mean and standard deviation for the age at first sex was 18.28 and 2.04 years respectively. Factors which were significantly associated with early sexual initiation (< 18 years old) were; being female (AOR=5.7, 95%CI=1.16-27.72), lack of discussion on sexual and reproductive health issues (SRH) with their mother (AOR=, 95%CI= 1.23-41.5) and cigarrate smoking (AOR=7, 95%CI=1.06-46.92). Conclusions: Early sexual initiation was high. Factors which were associated with early sexual initiation were being female, lack of discussion on SRH with mother and cigarrate smoking. So, awareness creation for both male and female young peoples through the use of religious leaders, school teachers and parents on sexual and reproductive health issues is important. Young peoples should be encouraged to discuss with their parents on SRH through the use of reproductive health centers and emphasis should also be given for adolescents who use drugs like cigarrate smoking.
Early Sexual Initiation and Associated Factors among Debre Markos University Students, North West Ethiopia
doi:10.11648/j.sjcm.20150405.11
Science Journal of Clinical Medicine
2015-08-01
© Science Publishing Group
Getachew Mullu Kassa
Girmay Tsegay
Nurilign Abebe
Woldie Bogale
Teferi Tadesse
Desalegne Amare
Girma Alem
Early Sexual Initiation and Associated Factors among Debre Markos University Students, North West Ethiopia
4
5
85
85
2015-08-01
2015-08-01
10.11648/j.sjcm.20150405.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150405.11
© Science Publishing Group
Magnitude and Determinants of Self-Referral of Patients at a General Hospital, Western Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150405.12
Background. Self-referrals may cause the primary level health care to be under-utilized and hospitals over used, congested and overburdened, leading to an escalation of health care costs. Large patient load in referral hospitals causes human and physical resources to be stretched to capacity, which results in compromising the quality of care they provide to patients. The aforementioned problem is well observed in the study area but the phenomenon has not been formally studied. Therefore, this study aimed to assess the magnitude and determinants of self-referral of patient to the secondary referral level. Method and materials: A hospital based cross sectional study was conducted from April 16-30, 2014. Four hundred twenty two patients were selected using systematic sampling technique. Data was collected using structured and pre-tested questionnaire. Six data collectors and one supervisor collected the data. Data was analyzed using SPSS for window version 20 computer software. Simple and multiple logistic regressions were used to measure the association of variables at 95 percent confidence interval and p-value of <0.05. Ethical clearance was obtained from the ethics committee of the college of Health sciences, Jimma University, in Ethiopia. Result: A total of 422 patients responded to the interview making the response rate 99.8%. Three hundred forty six (82%) of the participants were self-referred among which 218(63.0%) were females. Three hundred and twenty two (93%) of the self-referred patients bypassed the first rung in the referral ladder despite knowledge of the closer health facility as their first level of care. Those who obtained information on the referral system from health workers were 3.5 times less likely to self refer themselves to the general referral study Hospital. Conclusions: Obtaining laboratory test, availability of drugs at closer health facility, knowing the closer health facility is first referral level and obtaining health education on referral systems from health worker were found to be significantly associated with self-referral to Nekemte General Hospital. Thus it is recommended that the healthcare leaders should strive to ensure better availability of drug supply and laboratory tests at local health centers and health care providers should work hard to make their community aware of the referral system to get efficient and effective service at a closer heath facility.
Background. Self-referrals may cause the primary level health care to be under-utilized and hospitals over used, congested and overburdened, leading to an escalation of health care costs. Large patient load in referral hospitals causes human and physical resources to be stretched to capacity, which results in compromising the quality of care they provide to patients. The aforementioned problem is well observed in the study area but the phenomenon has not been formally studied. Therefore, this study aimed to assess the magnitude and determinants of self-referral of patient to the secondary referral level. Method and materials: A hospital based cross sectional study was conducted from April 16-30, 2014. Four hundred twenty two patients were selected using systematic sampling technique. Data was collected using structured and pre-tested questionnaire. Six data collectors and one supervisor collected the data. Data was analyzed using SPSS for window version 20 computer software. Simple and multiple logistic regressions were used to measure the association of variables at 95 percent confidence interval and p-value of <0.05. Ethical clearance was obtained from the ethics committee of the college of Health sciences, Jimma University, in Ethiopia. Result: A total of 422 patients responded to the interview making the response rate 99.8%. Three hundred forty six (82%) of the participants were self-referred among which 218(63.0%) were females. Three hundred and twenty two (93%) of the self-referred patients bypassed the first rung in the referral ladder despite knowledge of the closer health facility as their first level of care. Those who obtained information on the referral system from health workers were 3.5 times less likely to self refer themselves to the general referral study Hospital. Conclusions: Obtaining laboratory test, availability of drugs at closer health facility, knowing the closer health facility is first referral level and obtaining health education on referral systems from health worker were found to be significantly associated with self-referral to Nekemte General Hospital. Thus it is recommended that the healthcare leaders should strive to ensure better availability of drug supply and laboratory tests at local health centers and health care providers should work hard to make their community aware of the referral system to get efficient and effective service at a closer heath facility.
Magnitude and Determinants of Self-Referral of Patients at a General Hospital, Western Ethiopia
doi:10.11648/j.sjcm.20150405.12
Science Journal of Clinical Medicine
2015-08-20
© Science Publishing Group
Wolkite Olani Abdi
Waju Beyene Salgedo
Gebeyehu Tsega Nebeb
Magnitude and Determinants of Self-Referral of Patients at a General Hospital, Western Ethiopia
4
5
92
92
2015-08-20
2015-08-20
10.11648/j.sjcm.20150405.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150405.12
© Science Publishing Group
Papillary Thyroid Carcinoma During Etanercept Therapy in a Patient with Psoriatic Arthritis
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150405.13
Potential for developing malignancies with Tumor necrosis alpha blockers (Anti-TNFα) in romatologic diseases is an important question in our minds, contrary to the proved efficacy of them. To our knowledge, yet no case report has been established about papillary thyroid carcinoma during etanercept therapy for psoriatic arthritis. Here we reported a patient who was diagnosed as papillary thyroid carcinoma while she was using etanercept for psoriatic arthritis. She had medical history for familial trait of carcinoma. Radioactive iodine therapy was administered after the surgery. We preferred to stop etanercept therapy and there was no increase in clinical and laboratory disease activity.
Potential for developing malignancies with Tumor necrosis alpha blockers (Anti-TNFα) in romatologic diseases is an important question in our minds, contrary to the proved efficacy of them. To our knowledge, yet no case report has been established about papillary thyroid carcinoma during etanercept therapy for psoriatic arthritis. Here we reported a patient who was diagnosed as papillary thyroid carcinoma while she was using etanercept for psoriatic arthritis. She had medical history for familial trait of carcinoma. Radioactive iodine therapy was administered after the surgery. We preferred to stop etanercept therapy and there was no increase in clinical and laboratory disease activity.
Papillary Thyroid Carcinoma During Etanercept Therapy in a Patient with Psoriatic Arthritis
doi:10.11648/j.sjcm.20150405.13
Science Journal of Clinical Medicine
2015-09-02
© Science Publishing Group
Ilker Ilhanli
Necip Guder
Papillary Thyroid Carcinoma During Etanercept Therapy in a Patient with Psoriatic Arthritis
4
5
95
95
2015-09-02
2015-09-02
10.11648/j.sjcm.20150405.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150405.13
© Science Publishing Group
Fibular Hemimelia and Tracheo-Esophageal Fistula in Anewborn in Fallujah General Hospital: A Case Report
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150405.14
Fibular hemimelia is the congenital absence of the fibula and is the most common congenital absence of long bone of the extrimities. It is arare disorder, it may occur as isolated anomaly or as apart of malformation syndrome. The case was reported because it was the 1<sup>st</sup> diagnosed and documented case in our hospital and because of the rare association with tracheoesophageal Fistula. Case report: Bilateral fibular hemimelia was reported in male newborn in Fallujah general hospital. Both fibulae were totally absent& the tibiae showed anterior bowing, both feet showed marked equinovalgus deformity. The bone defect was associated with tracheoesophageal fistula.Conclusion: Our case was considered rare because of it's association with trachea-esophageal fistula, It passed undiagnosed prenataly because there was no antenatal care. Effective plans should be put to raise awareness of the importance and the seriousness of antenatal care and improve facilities of early prenatal detection of congenital anomailies and to follow strict registration system of these anomalies.
Fibular hemimelia is the congenital absence of the fibula and is the most common congenital absence of long bone of the extrimities. It is arare disorder, it may occur as isolated anomaly or as apart of malformation syndrome. The case was reported because it was the 1<sup>st</sup> diagnosed and documented case in our hospital and because of the rare association with tracheoesophageal Fistula. Case report: Bilateral fibular hemimelia was reported in male newborn in Fallujah general hospital. Both fibulae were totally absent& the tibiae showed anterior bowing, both feet showed marked equinovalgus deformity. The bone defect was associated with tracheoesophageal fistula.Conclusion: Our case was considered rare because of it's association with trachea-esophageal fistula, It passed undiagnosed prenataly because there was no antenatal care. Effective plans should be put to raise awareness of the importance and the seriousness of antenatal care and improve facilities of early prenatal detection of congenital anomailies and to follow strict registration system of these anomalies.
Fibular Hemimelia and Tracheo-Esophageal Fistula in Anewborn in Fallujah General Hospital: A Case Report
doi:10.11648/j.sjcm.20150405.14
Science Journal of Clinical Medicine
2015-09-03
© Science Publishing Group
Samira T. Abdulghani Alaani
Abdulqadir Abdulkareem Alrawi
Fibular Hemimelia and Tracheo-Esophageal Fistula in Anewborn in Fallujah General Hospital: A Case Report
4
5
98
98
2015-09-03
2015-09-03
10.11648/j.sjcm.20150405.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150405.14
© Science Publishing Group
Clinical Correlations Between Cesium, Cobalt, Manganese, Rubidium and Rhenium with the Pathogenesis of Rheumatoid Arthritis
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150405.15
Background and Objectives: Rheumatoid arthritis is one of the most common inflammatory diseases. Studies indicated that increased oxidative stress or defective antioxidant status with inflammation contribute to the pathogenesis of disease. This study was emphasized that levels of some trace elements altered due to oxidative stress and inflammatory process which are associated with the pathogenesis of rheumatoid arthritis. This study was aimed to assess the serum levels of cesium, cobalt, manganese, rubidium and rhenium in patients group as compared with the control group and investigate the effect of other confounding factors like rheumatoid factor, age, gender and finally estimate the correlation between studied parameters. It was hypothesized that there were an alteration in levels of parameters due to oxidative stress and inflammatory process which are associated with the etiology and pathogenesis of rheumatoid arthritis. Method: This case control study conducted on 56 Iraqi patients of both genders 30 men and 26 women with the average age (40-57) years and 56 of age –gender matched apparently healthy adults were also enrolled in this study as a control group. The patients were free from any diseases except rheumatoid arthritis and this was confirmed by clinical examination and biochemical and hematological tests. Levels of parameters were estimated using atomic absorption spectrophotometers. Results: There were no significant differences between RF positive and negative groups regarding the studied parameters. There were a significant reduction in cesium and rubidium and a significant elevations in cobalt, manganese and rhenium in patients as compared with the control group. There were no significant differences between rheumatoid factor positive and negative groups regarding focused parameters in men and women groups, except for age factor in women group, there were no significant differences between different age categories in rheumatoid factor positive and negative regarding focused parameters. In addition, there was no significant correlation among studied parameters. Conclusion: Levels of parameters were significantly altered in patients group. These alterations proved the possible association with pathogenesis of rheumatoid arthritis. Therefore, the estimation of these parameters could be a useful complementary non-invasive diagnostic tool to determine trace elements status for treatment and diagnosis of disease. These variations are probably responsive to oxidative stress concomitant with inflammation induced by cytokines and resulted from defensive mechanism of patients. Inflammatory mediators affect on trace elements homeostasis in rheumatoid arthritis.
Background and Objectives: Rheumatoid arthritis is one of the most common inflammatory diseases. Studies indicated that increased oxidative stress or defective antioxidant status with inflammation contribute to the pathogenesis of disease. This study was emphasized that levels of some trace elements altered due to oxidative stress and inflammatory process which are associated with the pathogenesis of rheumatoid arthritis. This study was aimed to assess the serum levels of cesium, cobalt, manganese, rubidium and rhenium in patients group as compared with the control group and investigate the effect of other confounding factors like rheumatoid factor, age, gender and finally estimate the correlation between studied parameters. It was hypothesized that there were an alteration in levels of parameters due to oxidative stress and inflammatory process which are associated with the etiology and pathogenesis of rheumatoid arthritis. Method: This case control study conducted on 56 Iraqi patients of both genders 30 men and 26 women with the average age (40-57) years and 56 of age –gender matched apparently healthy adults were also enrolled in this study as a control group. The patients were free from any diseases except rheumatoid arthritis and this was confirmed by clinical examination and biochemical and hematological tests. Levels of parameters were estimated using atomic absorption spectrophotometers. Results: There were no significant differences between RF positive and negative groups regarding the studied parameters. There were a significant reduction in cesium and rubidium and a significant elevations in cobalt, manganese and rhenium in patients as compared with the control group. There were no significant differences between rheumatoid factor positive and negative groups regarding focused parameters in men and women groups, except for age factor in women group, there were no significant differences between different age categories in rheumatoid factor positive and negative regarding focused parameters. In addition, there was no significant correlation among studied parameters. Conclusion: Levels of parameters were significantly altered in patients group. These alterations proved the possible association with pathogenesis of rheumatoid arthritis. Therefore, the estimation of these parameters could be a useful complementary non-invasive diagnostic tool to determine trace elements status for treatment and diagnosis of disease. These variations are probably responsive to oxidative stress concomitant with inflammation induced by cytokines and resulted from defensive mechanism of patients. Inflammatory mediators affect on trace elements homeostasis in rheumatoid arthritis.
Clinical Correlations Between Cesium, Cobalt, Manganese, Rubidium and Rhenium with the Pathogenesis of Rheumatoid Arthritis
doi:10.11648/j.sjcm.20150405.15
Science Journal of Clinical Medicine
2015-09-06
© Science Publishing Group
Shatha Rouf Moustafa
Clinical Correlations Between Cesium, Cobalt, Manganese, Rubidium and Rhenium with the Pathogenesis of Rheumatoid Arthritis
4
5
108
108
2015-09-06
2015-09-06
10.11648/j.sjcm.20150405.15
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=159&doi=10.11648/j.sjcm.20150405.15
© Science Publishing Group