Science Publishing Group: Clinical Medicine Research: Table of Contents
<i> Clinical Medicine Research (CMR) </i> is a peer reviewed journal dedicated to the latest advancement of clinical medicine. The goal of this journal is to serve as a resource for dissemination of state-of-the-art research and educational material within the field of clinical medicine. <i> CMR </i> aims to promote rapid communication and dialogue among researchers, scientists, and engineers working in the areas of clinical medicine. It is hoped that this journal will prove to be an important factor in raising the standards of discussion, analyses, and evaluations relating to clinical medicine programs.
http://www.sciencepublishinggroup.com/j/cmr Science Publishing Group: Clinical Medicine Research: Table of Contents
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Clinical Medicine Research
Clinical Medicine Research
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Adequacy of Discharge Summaries Prepared by Junior Medical Residents in a University Hospital
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20120101.11
Discharge summaries are intended to transfer important clinical information from inpatient to outpatient settings and between hospital admissions. Complete, accurate, and timely discharge summaries can communicate important information back to the outpatient (OPD) physician, prevent adverse events and reduce readmission to hospital. However, discharge summaries are not always given the priority it deserves. Too often, discharge summaries contain insufficient or unnecessary information and fail to reach the OPD physician in time for the patient’s follow-up visit. We evaluated dis-charge summaries produced by first-year medical residents (R1) for their completeness and accuracy. Consecutive dis-charge summaries prepared by R1 residents for patients discharged from internal medicine wards were retrospectively eva-luated by two independent reviewers for presence and accuracy of essential items described by the Joint Commission for Hospital Accreditation. One-hundred and thirty-two discharge summaries were assessed for completeness and accuracy. Most items were incompletely reported with a given item missing in 2.3% - 91.7% of all discharge summaries. Inaccuracies of discharge summaries when compared to the patient chart as a reference standard ranged from 8.5% for final diagnosis to 50.9% for anticipated problems and suggested interventions with a mean of 29.6 + 13.3%.Only 18.2% of the discharge summaries were written within 48 hours of patient discharge (p < 0.001). The availability of a finalized (typed and signed) discharge summary at the first post-discharge visit was low (12.1%) and remained poor at 4 weeks (50.8%). Conclusion: Discharge summaries prepared by R1 physicians are grossly inadequate at documenting most of the essential domains described by the Joint Commission for Hospital Accreditation. Our findings will aid in the development of educational interventions for residents.
Discharge summaries are intended to transfer important clinical information from inpatient to outpatient settings and between hospital admissions. Complete, accurate, and timely discharge summaries can communicate important information back to the outpatient (OPD) physician, prevent adverse events and reduce readmission to hospital. However, discharge summaries are not always given the priority it deserves. Too often, discharge summaries contain insufficient or unnecessary information and fail to reach the OPD physician in time for the patient’s follow-up visit. We evaluated dis-charge summaries produced by first-year medical residents (R1) for their completeness and accuracy. Consecutive dis-charge summaries prepared by R1 residents for patients discharged from internal medicine wards were retrospectively eva-luated by two independent reviewers for presence and accuracy of essential items described by the Joint Commission for Hospital Accreditation. One-hundred and thirty-two discharge summaries were assessed for completeness and accuracy. Most items were incompletely reported with a given item missing in 2.3% - 91.7% of all discharge summaries. Inaccuracies of discharge summaries when compared to the patient chart as a reference standard ranged from 8.5% for final diagnosis to 50.9% for anticipated problems and suggested interventions with a mean of 29.6 + 13.3%.Only 18.2% of the discharge summaries were written within 48 hours of patient discharge (p < 0.001). The availability of a finalized (typed and signed) discharge summary at the first post-discharge visit was low (12.1%) and remained poor at 4 weeks (50.8%). Conclusion: Discharge summaries prepared by R1 physicians are grossly inadequate at documenting most of the essential domains described by the Joint Commission for Hospital Accreditation. Our findings will aid in the development of educational interventions for residents.
Adequacy of Discharge Summaries Prepared by Junior Medical Residents in a University Hospital
doi:10.11648/j.cmr.20120101.11
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Ibrahiem Saeed Abdul-Rahman
Adequacy of Discharge Summaries Prepared by Junior Medical Residents in a University Hospital
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© Science Publishing Group
Pressure lowering effect of fixed combination and unfixed- combination of latanoprost and timolol in Asian population
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Introduction: Fixed combination of topical pressure lowering drugs such as latanoprost and timolol (FCLT) has been reported to improve adherence and persistence to medication for chronic disease such as glaucoma. However, its effectiveness has been reported to be less compared to unfixed combination of latanoprost and timolol (UFCLT). Objective: To compare the efficacy of FCLT and UFCLT in Malaysian population. Methods: A non randomized prospective cohort study was conducted from January 2006 to December 2010 involving primary open-angle glaucoma (POAG), ocular hypertension (OHT) and normal-tension glaucoma (NTG) patients who failed to achieve target pressure or demonstrated progression of the disease while on monotherapy treatment with topical timolol XE 0.5% in eye clinic of Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II, Kelantan, Malaysia. A total of 120 glaucoma patients were recruited with 58 were prescribed FCLT and 62 were treated with UFCLT. UFCLT is combination of topical timolol XE 0.5% and latanoprost 0.005%. Intraocular pressure (IOP) was taken at baseline and 3, 6, 9, 12 months post treatment. Results: A total of 95 patients completed the 12 months follow up (47 in FCLT group and 48 in UFCLT). Mean age was 61.0 SD 14.5 years old. Majority of cases were POAG (79%), followed by NTG (12%) and OHT (9%). Mean baseline IOP was 23.9 SD 5.9 mmHg and 19.9 SD 5.6 mmHg in UFCLT and FCLT groups respectively. Mean IOP reduction between baseline and final measurement in UFCLT and FCLT groups were -8.1 mmHg vs.-3.6 mmHg respectively (p<0.001). Based on repeated measures analysis of variance (RM ANOVA) and repeated measures analysis of covariance (RM ANCOVA) model, there was significant difference between UFCLT and FCLT (p =0.002). Conclusions: Both UFCLT and FCLT provide pressure lowering effect in Malaysian population. UFCLT provides significant better pressure lowering effect than FCLT. FCLT provides less inter-visit pressure fluctuation.
Introduction: Fixed combination of topical pressure lowering drugs such as latanoprost and timolol (FCLT) has been reported to improve adherence and persistence to medication for chronic disease such as glaucoma. However, its effectiveness has been reported to be less compared to unfixed combination of latanoprost and timolol (UFCLT). Objective: To compare the efficacy of FCLT and UFCLT in Malaysian population. Methods: A non randomized prospective cohort study was conducted from January 2006 to December 2010 involving primary open-angle glaucoma (POAG), ocular hypertension (OHT) and normal-tension glaucoma (NTG) patients who failed to achieve target pressure or demonstrated progression of the disease while on monotherapy treatment with topical timolol XE 0.5% in eye clinic of Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II, Kelantan, Malaysia. A total of 120 glaucoma patients were recruited with 58 were prescribed FCLT and 62 were treated with UFCLT. UFCLT is combination of topical timolol XE 0.5% and latanoprost 0.005%. Intraocular pressure (IOP) was taken at baseline and 3, 6, 9, 12 months post treatment. Results: A total of 95 patients completed the 12 months follow up (47 in FCLT group and 48 in UFCLT). Mean age was 61.0 SD 14.5 years old. Majority of cases were POAG (79%), followed by NTG (12%) and OHT (9%). Mean baseline IOP was 23.9 SD 5.9 mmHg and 19.9 SD 5.6 mmHg in UFCLT and FCLT groups respectively. Mean IOP reduction between baseline and final measurement in UFCLT and FCLT groups were -8.1 mmHg vs.-3.6 mmHg respectively (p<0.001). Based on repeated measures analysis of variance (RM ANOVA) and repeated measures analysis of covariance (RM ANCOVA) model, there was significant difference between UFCLT and FCLT (p =0.002). Conclusions: Both UFCLT and FCLT provide pressure lowering effect in Malaysian population. UFCLT provides significant better pressure lowering effect than FCLT. FCLT provides less inter-visit pressure fluctuation.
Pressure lowering effect of fixed combination and unfixed- combination of latanoprost and timolol in Asian population
doi:10.11648/j.cmr.20120101.12
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Seyed Ali Asghar Mosavi
Ch’ng Tun Wang
Azhany Yaakub
Nik Azlan Zaid
Liza-Sharmini Ahmad Tajudin
Pressure lowering effect of fixed combination and unfixed- combination of latanoprost and timolol in Asian population
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2014-01-01
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© Science Publishing Group
A Case Report of Asymptomatic Placenta Previa: Diagnosis and Management
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130201.11
Placenta previa is a condition derived to an abnormal implantation of the embryos in the lower uterine segment, a place that predisposes to persistent uterine bleeding because of the development of new vessels and because it is a poorly contractile area of the uterus. Risk factors for placents previa are: maternal age, number of pregnancies, cigarette smoking, multiple pregnancies, previus surgery on the uterus including caesarean section, previous placenta previa. Usually placenta previa becomes symptomatic in the third trimester of pregnancy and it is associated with adverse maternal and neonatal outcomes. The Authors present a case of 38 years old woman whit complete placenta previa who comes to the ER of their hospital complex with plenty of vaginal bleeding; a caesarean section is performed in emergency. There is not doubt that the diagnosis of placenta previa is mainly ultrasound. Clinical and instrumental controls (ultrasound) in these patients will certainly have a frequency different from the other pregnancies and in many cases will require hospitalization. The mode of delivery is in most cases by emergency or elective Caesarean. The Authors based the management of the reported case on the review of the last 20-year International Literature, according to which, in the presence of this type of previa, an Early Term Birth (ETB) at 37 weeks and 0 days is associated with a better maternal and neonatal prognosis if compared to both a Late Preterm Birth (LPTB) at 34-36 weeks or a Term Birth (TB) at 38-39 weeks.
Placenta previa is a condition derived to an abnormal implantation of the embryos in the lower uterine segment, a place that predisposes to persistent uterine bleeding because of the development of new vessels and because it is a poorly contractile area of the uterus. Risk factors for placents previa are: maternal age, number of pregnancies, cigarette smoking, multiple pregnancies, previus surgery on the uterus including caesarean section, previous placenta previa. Usually placenta previa becomes symptomatic in the third trimester of pregnancy and it is associated with adverse maternal and neonatal outcomes. The Authors present a case of 38 years old woman whit complete placenta previa who comes to the ER of their hospital complex with plenty of vaginal bleeding; a caesarean section is performed in emergency. There is not doubt that the diagnosis of placenta previa is mainly ultrasound. Clinical and instrumental controls (ultrasound) in these patients will certainly have a frequency different from the other pregnancies and in many cases will require hospitalization. The mode of delivery is in most cases by emergency or elective Caesarean. The Authors based the management of the reported case on the review of the last 20-year International Literature, according to which, in the presence of this type of previa, an Early Term Birth (ETB) at 37 weeks and 0 days is associated with a better maternal and neonatal prognosis if compared to both a Late Preterm Birth (LPTB) at 34-36 weeks or a Term Birth (TB) at 38-39 weeks.
A Case Report of Asymptomatic Placenta Previa: Diagnosis and Management
doi:10.11648/j.cmr.20130201.11
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Zarbo G.
Pafumi C.
Giannone T. T.
Giunta M. R.
Carbonaro A.
Ciotta L.
Mayada Chammas
Fawzi Chammas
Genovese F.
A Case Report of Asymptomatic Placenta Previa: Diagnosis and Management
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© Science Publishing Group
Exercise Training and Rehabilitation of the Brain in Parkinson’s Disease
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130202.12
Parkinson's disease (PD) is one of the most chronic progressive neurodegenerative diseases that is clinically manifested by of cardinal motor symptoms including, tremor and rigidity. The known cause of PD is the loss of dopaminergic neurons in substantia nigra in the brain. There are motor and non motor features of this disease with heterogenic complaints. The main treatment available for PD is levodopa as dopamine replacement therapy. However, after few years of treatment, PD patients experience levodopa-resistant symptoms. Other neurosurgical procedures for the treatment of PD have become a widely performed. These surgical procedures stimulate the dopaminergic neurons to produce more dopamine, but won’t halt the progression of degeneration of these cells. Over the last years, many studies focused on the effect of physical therapy on PD, most of these studies have investigated the rehabilitation effects on musculoskeletal system, like gait, balance, and strength. Other studies focused on the effect of physiotherapy on non motor feature in PD, like quality of life. However, there is limited information about the beneficial impact of exercise on the brain of PD patients. In this review, we provide a brief review of the literature on exercise effects on the brain of PD. The present review was designed to gain more insight into the mechanism of improvement in PD patients with exercise and to answer in part the question of how exercise training rehabilitates the brain in PD patients.
Parkinson's disease (PD) is one of the most chronic progressive neurodegenerative diseases that is clinically manifested by of cardinal motor symptoms including, tremor and rigidity. The known cause of PD is the loss of dopaminergic neurons in substantia nigra in the brain. There are motor and non motor features of this disease with heterogenic complaints. The main treatment available for PD is levodopa as dopamine replacement therapy. However, after few years of treatment, PD patients experience levodopa-resistant symptoms. Other neurosurgical procedures for the treatment of PD have become a widely performed. These surgical procedures stimulate the dopaminergic neurons to produce more dopamine, but won’t halt the progression of degeneration of these cells. Over the last years, many studies focused on the effect of physical therapy on PD, most of these studies have investigated the rehabilitation effects on musculoskeletal system, like gait, balance, and strength. Other studies focused on the effect of physiotherapy on non motor feature in PD, like quality of life. However, there is limited information about the beneficial impact of exercise on the brain of PD patients. In this review, we provide a brief review of the literature on exercise effects on the brain of PD. The present review was designed to gain more insight into the mechanism of improvement in PD patients with exercise and to answer in part the question of how exercise training rehabilitates the brain in PD patients.
Exercise Training and Rehabilitation of the Brain in Parkinson’s Disease
doi:10.11648/j.cmr.20130202.12
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Muhammed Al-Jarrah
Exercise Training and Rehabilitation of the Brain in Parkinson’s Disease
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© Science Publishing Group
Psycho-Emotional Disorders in Women after Spontaneous Abortion
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Objective: To determine the frequency of women with spontaneous abortions that present psycho-emotional disorders. Design: Cross-sectional study using a face-to-face questionnaire. Setting: Postpartum area at a tertiary care referral hospital in Leon, Mexico. Participants: 210 postpartum women, divided into 105 women with spontaneous abortion, and 105 with eutocic deliveries (controls). Data collection: Women answered face-to-face the questionnaire Minnesota Multiphase Personality Inventory-2 (MMPI-2), applied one day after the abortion. Findings: the frequency of psycho-emotional disorders in women who presented abortion was (12.7%), which was higher compared with the controls (9.04%), P = 0.002, being significant the hysteria (6.6%), P = 0.021. Key conclusions: There is a higher frequency of psycho-emotional disorders in women who present an abortion, represented for hysteria. Implications for practice: It is recommended to supply psychological support to women who suffer a spontaneous abortion.
Objective: To determine the frequency of women with spontaneous abortions that present psycho-emotional disorders. Design: Cross-sectional study using a face-to-face questionnaire. Setting: Postpartum area at a tertiary care referral hospital in Leon, Mexico. Participants: 210 postpartum women, divided into 105 women with spontaneous abortion, and 105 with eutocic deliveries (controls). Data collection: Women answered face-to-face the questionnaire Minnesota Multiphase Personality Inventory-2 (MMPI-2), applied one day after the abortion. Findings: the frequency of psycho-emotional disorders in women who presented abortion was (12.7%), which was higher compared with the controls (9.04%), P = 0.002, being significant the hysteria (6.6%), P = 0.021. Key conclusions: There is a higher frequency of psycho-emotional disorders in women who present an abortion, represented for hysteria. Implications for practice: It is recommended to supply psychological support to women who suffer a spontaneous abortion.
Psycho-Emotional Disorders in Women after Spontaneous Abortion
doi:10.11648/j.cmr.20130202.11
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Gustavo Romero-Gutiérrez
Nancy Pérez-Durán
Ana Camarillo-Trujillo
Armando Ruiz-Treviño
Psycho-Emotional Disorders in Women after Spontaneous Abortion
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2014-01-01
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© Science Publishing Group
The Efficacy of Intraosseous Blood and Ringer Lactate in a Rabbit Model of Hemorrhagic Hypovolemia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130202.13
Purpose: In this study, flow rates of intraosseously (IO) or intravenously (IV) administered fluids (blood or Ringer lactate) and their effects on vital signs were examined in a rabbit model of hypovolemia. Methods: Underanesthesia, 20 mL of blood was removed from each of the 36 New Zealand-type rabbits. Ten minutes later, each group of nine rabbits received one of four fluids by gravity flow from a height of 100 cm: blood via IO, Ringer Laktat (RL) via IO, blood via IV, or RL via IV. IO fluids were given in the proximal tibia through a 15 g needle placed with an EZ-IO instrument; IV fluids were given through a 22g catheter in the femoral vein. Vital signs were monitored for four hours after the infusion ended. Results: Flow rates were blood IO 2.6 mL/min, RL IO 3.4 mL/min, blood IV 3.2 mL/min, and RL IV 11.8 mL/min. Ten minutes after fluid administration ended, in the RL via IO group, heart rate was significantly slower than preinfusion; in the blood via IO group, body temperature was significantly lower than preinfusion, and in the blood via IO group, StO2 saturation was higher than preinfusion. Postinfusion respiratory rates within groups were not significantly different than preinfusion rates. Vital sign changes between groups were not significantly different. Conclusion: Fluids given by gravity feed through an IO needle were effective in treating hypovolemia in this rabbit model, but the flow of RL and blood were significantly slower through the 15g IO needle than the 22g IV catheter.
Purpose: In this study, flow rates of intraosseously (IO) or intravenously (IV) administered fluids (blood or Ringer lactate) and their effects on vital signs were examined in a rabbit model of hypovolemia. Methods: Underanesthesia, 20 mL of blood was removed from each of the 36 New Zealand-type rabbits. Ten minutes later, each group of nine rabbits received one of four fluids by gravity flow from a height of 100 cm: blood via IO, Ringer Laktat (RL) via IO, blood via IV, or RL via IV. IO fluids were given in the proximal tibia through a 15 g needle placed with an EZ-IO instrument; IV fluids were given through a 22g catheter in the femoral vein. Vital signs were monitored for four hours after the infusion ended. Results: Flow rates were blood IO 2.6 mL/min, RL IO 3.4 mL/min, blood IV 3.2 mL/min, and RL IV 11.8 mL/min. Ten minutes after fluid administration ended, in the RL via IO group, heart rate was significantly slower than preinfusion; in the blood via IO group, body temperature was significantly lower than preinfusion, and in the blood via IO group, StO2 saturation was higher than preinfusion. Postinfusion respiratory rates within groups were not significantly different than preinfusion rates. Vital sign changes between groups were not significantly different. Conclusion: Fluids given by gravity feed through an IO needle were effective in treating hypovolemia in this rabbit model, but the flow of RL and blood were significantly slower through the 15g IO needle than the 22g IV catheter.
The Efficacy of Intraosseous Blood and Ringer Lactate in a Rabbit Model of Hemorrhagic Hypovolemia
doi:10.11648/j.cmr.20130202.13
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Tanzer Korkmaz
S. Hakan Atalgın
H. Ali Kilicgun
Onursal Bugra
Nurettin Kahramansoy
The Efficacy of Intraosseous Blood and Ringer Lactate in a Rabbit Model of Hemorrhagic Hypovolemia
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© Science Publishing Group
Neo-Revascularization as the Potential Treatment for Patient Suffering from Pulmonary Arterial Hypertension (Myth or Reality)
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Pulmonary arterial hypertension (APAH, IPAH) is a devastating, progressive disease with increasingly debilitating symptoms [1,2].Intrapulmonary delivery of autologous stem cells could be beneficial for pathogenetic treatment for patients with severe pulmonary arterial hypertension.Two patients with severe pulmonary artery hypertension received intrapulmonary autologous mesenchymal (mononuclear) stem cell transplantation and stem cell transplantation in pulmonary arteries. Patients were examined by scintigraphy of lungs during the periods 12, 14 and 27 months after stem cell transplantation. We find out that perfusion in all lung segments were improved after 14 and 27 months.
Pulmonary arterial hypertension (APAH, IPAH) is a devastating, progressive disease with increasingly debilitating symptoms [1,2].Intrapulmonary delivery of autologous stem cells could be beneficial for pathogenetic treatment for patients with severe pulmonary arterial hypertension.Two patients with severe pulmonary artery hypertension received intrapulmonary autologous mesenchymal (mononuclear) stem cell transplantation and stem cell transplantation in pulmonary arteries. Patients were examined by scintigraphy of lungs during the periods 12, 14 and 27 months after stem cell transplantation. We find out that perfusion in all lung segments were improved after 14 and 27 months.
Neo-Revascularization as the Potential Treatment for Patient Suffering from Pulmonary Arterial Hypertension (Myth or Reality)
doi:10.11648/j.cmr.20130203.13
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Aris Lacis
Inguna Lubaua
Valts Ozolins
Eriks Jekabsons
Andis Lacis
Mara Ratniece
Andrejs Erglis
Neo-Revascularization as the Potential Treatment for Patient Suffering from Pulmonary Arterial Hypertension (Myth or Reality)
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© Science Publishing Group
Autoimmunity and Non-Accidental Injury in Children
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130203.15
Background: The Shaken Baby Syndrome conceived by Guthkeltch to explain bruises, fractures, retinal and cerebral haemorrhage and encephalopathy in children, called the “triad”, can be explained by an autoimmune reaction to antigens in a genetically susceptible child. Method: Children diagnosed as suffering from Non-accidental injuries were investigated for evidence of immune response reactions following mandated vaccination and childhood illnesses. Results: It was found in all the cases reported here the response to antigenic stimulation damaged the Beta cells in the Pancreas causing Hypoinsulinaemia which inhibited the cellular uptake of Vitamin C resulting in liver dysfunction, failure of carboxylation of the Vitamin K dependent proteins resulting in haemorrhages and fractures associated with the “triad”. Conclusion: Fractures, retinal and subdural haemorrhages and encephalopathy in children – is an autoimmune response to antigenic stimulation in a genetically susceptible individual. Common antigens are the mandated vaccines, viral bacterial and parasitic infections.
Background: The Shaken Baby Syndrome conceived by Guthkeltch to explain bruises, fractures, retinal and cerebral haemorrhage and encephalopathy in children, called the “triad”, can be explained by an autoimmune reaction to antigens in a genetically susceptible child. Method: Children diagnosed as suffering from Non-accidental injuries were investigated for evidence of immune response reactions following mandated vaccination and childhood illnesses. Results: It was found in all the cases reported here the response to antigenic stimulation damaged the Beta cells in the Pancreas causing Hypoinsulinaemia which inhibited the cellular uptake of Vitamin C resulting in liver dysfunction, failure of carboxylation of the Vitamin K dependent proteins resulting in haemorrhages and fractures associated with the “triad”. Conclusion: Fractures, retinal and subdural haemorrhages and encephalopathy in children – is an autoimmune response to antigenic stimulation in a genetically susceptible individual. Common antigens are the mandated vaccines, viral bacterial and parasitic infections.
Autoimmunity and Non-Accidental Injury in Children
doi:10.11648/j.cmr.20130203.15
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Michael D Innis
Autoimmunity and Non-Accidental Injury in Children
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© Science Publishing Group
A Case of Clostridium Perfringens Sepsis in the 29 Week Pregnant Woman with Diagnosed Fetal Omphalosel
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130203.12
Although not common, postpartum and post-abortion infections caused by clostridia can be severe. Clostridial uterine infections start as localized chorioamnionitis as a result of an infection from the fetus and/or placental tissues. The infection may spread to the uterine wall and endometrial tissues, and, in the most severe cases, uterine necrosis accompanied by sepsis ensues. In this paper we report the presence of Clostridium perfringens isolated from blood culture and placental specimen after the termination of a 29 gestational week pregnancy. The woman had a history of having omphaloceled fetus and premature membrane rupture. Fetal omphalocele is a congenital defect of the abdominal wall that allows some of the abdominal organs to protrude through it. In order to find the focus of infection, blood and plasental specimen of the patient were examined. Blood cultures of the patient were evaluated by the BACTEC 9120 system. The identification of the bacteria was performed conventionally and confirmed by the automatized API 20A system. Antibiotic susceptibility testing was performed by E-test according to the recommendations of Clinical Laboratory and Standards Institute (CLSI). Although Clostridium spp is rarely isolated from blood cultures, anaerobically evaluation of blood cultures in the infections of abdominal and genital sites could be life-saving, as in this report.
Although not common, postpartum and post-abortion infections caused by clostridia can be severe. Clostridial uterine infections start as localized chorioamnionitis as a result of an infection from the fetus and/or placental tissues. The infection may spread to the uterine wall and endometrial tissues, and, in the most severe cases, uterine necrosis accompanied by sepsis ensues. In this paper we report the presence of Clostridium perfringens isolated from blood culture and placental specimen after the termination of a 29 gestational week pregnancy. The woman had a history of having omphaloceled fetus and premature membrane rupture. Fetal omphalocele is a congenital defect of the abdominal wall that allows some of the abdominal organs to protrude through it. In order to find the focus of infection, blood and plasental specimen of the patient were examined. Blood cultures of the patient were evaluated by the BACTEC 9120 system. The identification of the bacteria was performed conventionally and confirmed by the automatized API 20A system. Antibiotic susceptibility testing was performed by E-test according to the recommendations of Clinical Laboratory and Standards Institute (CLSI). Although Clostridium spp is rarely isolated from blood cultures, anaerobically evaluation of blood cultures in the infections of abdominal and genital sites could be life-saving, as in this report.
A Case of Clostridium Perfringens Sepsis in the 29 Week Pregnant Woman with Diagnosed Fetal Omphalosel
doi:10.11648/j.cmr.20130203.12
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Nezahat Gurler
Lutfiye Oksuz
Bahar Yuksel
Recep Has
A Case of Clostridium Perfringens Sepsis in the 29 Week Pregnant Woman with Diagnosed Fetal Omphalosel
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© Science Publishing Group
Sepsis due to Vibrio Alginolyticus Isolated from Catheter of Young Patient with Hypercholesterolemy: the First Case from Turkey
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130203.14
Vibrio alginolyticus occasionally causes life-threatening infections in immunocompromised individuals. Bacteremia and necrotising fasciits caused by V.alginolyticus have been reported. We described a case of sepsis due to V. alginolyticus isolated from catheter of 19-year-old patient with hypercholesterolemy. Moreover the cases of invasive V.alginolyticus reported in the literature were reviewed. Blood cultures of the patient were evaluated by the BACTEC 9120 system. The identification of the bacteria was performed conventional methods and confirmed by the automatized ID32GN and VITEK 2 automation systems. Antibiotic susceptibility tests were performed according to recommendations of Clinical Laboratory and Standards Institute (CLSI). The patient recovered due to early diagnosis and appropriate therapy. No identifiable source of this infection could be determined. In conclusion, rapid and correct identification of the bacteria and early administration of appropriate antibiotics is essential for controlling invasive Vibrio infections, such as V.alginolyticus sepsis, especially in immunocompromised hosts. To the best of our knowledge, this is the first report of V.alginolyticus bacteremia in Turkey.
Vibrio alginolyticus occasionally causes life-threatening infections in immunocompromised individuals. Bacteremia and necrotising fasciits caused by V.alginolyticus have been reported. We described a case of sepsis due to V. alginolyticus isolated from catheter of 19-year-old patient with hypercholesterolemy. Moreover the cases of invasive V.alginolyticus reported in the literature were reviewed. Blood cultures of the patient were evaluated by the BACTEC 9120 system. The identification of the bacteria was performed conventional methods and confirmed by the automatized ID32GN and VITEK 2 automation systems. Antibiotic susceptibility tests were performed according to recommendations of Clinical Laboratory and Standards Institute (CLSI). The patient recovered due to early diagnosis and appropriate therapy. No identifiable source of this infection could be determined. In conclusion, rapid and correct identification of the bacteria and early administration of appropriate antibiotics is essential for controlling invasive Vibrio infections, such as V.alginolyticus sepsis, especially in immunocompromised hosts. To the best of our knowledge, this is the first report of V.alginolyticus bacteremia in Turkey.
Sepsis due to Vibrio Alginolyticus Isolated from Catheter of Young Patient with Hypercholesterolemy: the First Case from Turkey
doi:10.11648/j.cmr.20130203.14
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Lutfiye Oksuz
Nezahat Gurler
Sepsis due to Vibrio Alginolyticus Isolated from Catheter of Young Patient with Hypercholesterolemy: the First Case from Turkey
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© Science Publishing Group
Doppler Ultrasound Assessment in Women with Threatened Abortion
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130203.11
Objective: To determine which variables obtained by Doppler ultrasound are associated with the outcome of patients with threatened abortion. Study design: We carried out a cross-sectional study. The patient population included patients with pregnancy less than 20 weeks, who were hospitalized with the diagnosis of threatened abortion. Results: We followed the outcome of 223 patients and found 32 patients (14.3%) who aborted and 191 patients (85.7%) who did not abort. The fetal heart rate for the group who aborted was significantly lower than the group who did not abort (143 ± 2.9 vs. 154 ± 3.6 beats per minute, respectively), p = 0.002; the resistance index of uterine artery was higher (0.79 ± 0.07 vs. 0.76 ± 0.09, respectively), p = 0.018; and the resistance index of trophoblastic flow was higher (0.55 ± 0.04 vs. 0.50 ± 0.06, respectively), p = 0.041. The resistance index of umbilical artery and corpus luteum were not statistically different. Conclusion: Alterations of fetal heart rate, resistance index of uterine artery and trophoblastic flow are associated with adverse outcome in women with threatened abortion.
Objective: To determine which variables obtained by Doppler ultrasound are associated with the outcome of patients with threatened abortion. Study design: We carried out a cross-sectional study. The patient population included patients with pregnancy less than 20 weeks, who were hospitalized with the diagnosis of threatened abortion. Results: We followed the outcome of 223 patients and found 32 patients (14.3%) who aborted and 191 patients (85.7%) who did not abort. The fetal heart rate for the group who aborted was significantly lower than the group who did not abort (143 ± 2.9 vs. 154 ± 3.6 beats per minute, respectively), p = 0.002; the resistance index of uterine artery was higher (0.79 ± 0.07 vs. 0.76 ± 0.09, respectively), p = 0.018; and the resistance index of trophoblastic flow was higher (0.55 ± 0.04 vs. 0.50 ± 0.06, respectively), p = 0.041. The resistance index of umbilical artery and corpus luteum were not statistically different. Conclusion: Alterations of fetal heart rate, resistance index of uterine artery and trophoblastic flow are associated with adverse outcome in women with threatened abortion.
Doppler Ultrasound Assessment in Women with Threatened Abortion
doi:10.11648/j.cmr.20130203.11
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Gustavo Romero-Gutiérrez
Antonio Abraham Huebe-Martínez
Immer Amaral-Navarro
Armando Saúl Ruiz-Treviño
Doppler Ultrasound Assessment in Women with Threatened Abortion
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2014-01-01
10.11648/j.cmr.20130203.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130203.11
© Science Publishing Group
Diabetic Cardiomyopathy - Heart Disease in Diabetes
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.20
Diabetic cardiomyopathy is defined as a finding of systolic and diastolic left ventricular dysfunction, myocardial dilation and left ventricular hypertrophy without the presence of macroangiopathy and hypertension. Causes include metabolic changes, myocardial fibrosis, microangiopathy as well as cardiovascular autonomic neuropathy leading to sympathetic denervation and alteration of myocardial perfusion. It comprises abnormalities in the control of heart rate as well as central and peripheral vascular dynamics. The diagnosis of diabetic cardiomyopathy affects significantly the prognosis in patients with diabetes. Echocardiography and nuclear medicine methods are used for diagnosis.
Diabetic cardiomyopathy is defined as a finding of systolic and diastolic left ventricular dysfunction, myocardial dilation and left ventricular hypertrophy without the presence of macroangiopathy and hypertension. Causes include metabolic changes, myocardial fibrosis, microangiopathy as well as cardiovascular autonomic neuropathy leading to sympathetic denervation and alteration of myocardial perfusion. It comprises abnormalities in the control of heart rate as well as central and peripheral vascular dynamics. The diagnosis of diabetic cardiomyopathy affects significantly the prognosis in patients with diabetes. Echocardiography and nuclear medicine methods are used for diagnosis.
Diabetic Cardiomyopathy - Heart Disease in Diabetes
doi:10.11648/j.cmr.20130204.20
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Alena ADAMIKOVA
Jiri BAKALA
Jana PATEROVA
Martin SLABAK
Stepan SVACINA
Diabetic Cardiomyopathy - Heart Disease in Diabetes
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2014-01-01
10.11648/j.cmr.20130204.20
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.20
© Science Publishing Group
Epithelial Defect Induced Photorefractive Surgery: Comparison of Two Mechanical Epithelial Removal Techniques
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.11
Purpose: To compare the epithelial defect size after epithelial removal by Weck-Cel sponge (Medtronic) spatula and blunt scalpel hockey blade. Method: This prospective study comprised 100 cases of PRK with mean age of 26±5 years (range, 19 to 45) performed at Bina Eye Specialist Hospital from January to march 2012. The size of epithelium removal was the same in all patients and it was 8.5 mm2. Each patienst’s right eyes epithelium was removed by Weck spounge and it was removed by Haki spatula in the left eye. The residual epithelial defect size was measured in both eyes after 4 days from surgery. Result: Of 200 eyes that met the inclusion criteria, the mean preoperative spherical equivalent (SE) refractive error in right eyes was -2.6±1.5 (Range: -1 to -7 D) versus 2.6±1.4 (Range: -1 to -6.5D) in left eyes (P= 0.527 ). The mean epithelial defect size after 4 days in right eyes was 1.5+- 0.77 and it was 1.46 +- 0.77 in the left eyes (P = 0.623). Conclusion: This sudy showed that there is no difference between corneal epithelial defect size in two methods of PRK surgery after corneal epithelial removal .We consider both methods to be comparable in terms of efficacy and believe the choice of one method over the other rests on the surgeon’s decision and experience.
Purpose: To compare the epithelial defect size after epithelial removal by Weck-Cel sponge (Medtronic) spatula and blunt scalpel hockey blade. Method: This prospective study comprised 100 cases of PRK with mean age of 26±5 years (range, 19 to 45) performed at Bina Eye Specialist Hospital from January to march 2012. The size of epithelium removal was the same in all patients and it was 8.5 mm2. Each patienst’s right eyes epithelium was removed by Weck spounge and it was removed by Haki spatula in the left eye. The residual epithelial defect size was measured in both eyes after 4 days from surgery. Result: Of 200 eyes that met the inclusion criteria, the mean preoperative spherical equivalent (SE) refractive error in right eyes was -2.6±1.5 (Range: -1 to -7 D) versus 2.6±1.4 (Range: -1 to -6.5D) in left eyes (P= 0.527 ). The mean epithelial defect size after 4 days in right eyes was 1.5+- 0.77 and it was 1.46 +- 0.77 in the left eyes (P = 0.623). Conclusion: This sudy showed that there is no difference between corneal epithelial defect size in two methods of PRK surgery after corneal epithelial removal .We consider both methods to be comparable in terms of efficacy and believe the choice of one method over the other rests on the surgeon’s decision and experience.
Epithelial Defect Induced Photorefractive Surgery: Comparison of Two Mechanical Epithelial Removal Techniques
doi:10.11648/j.cmr.20130204.11
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Aliagha Alishiri
Mostafa Naderi
Khosro Jadidi
Seyed Aliasghar Mosavi
Epithelial Defect Induced Photorefractive Surgery: Comparison of Two Mechanical Epithelial Removal Techniques
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2014-01-01
2014-01-01
10.11648/j.cmr.20130204.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.11
© Science Publishing Group
Atrial Septal Aneurysm Is Always Linked To Right-Left Shunt and Cardio embolic Risk
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.12
Atrial septal aneurysm when associated to other cardiac abnormalities, such as patent foramen ovale, Chiari network or Eustachian Membrane, is a well-known recognised risk factor for cerebral embolism. Aim of study is to assess if isolated atrial septal aneurysm could be considered statistically related to cryptogenic stroke, considering the strong clinical impact that this association could have on these patients outcome. 579 patients were investigated for a suspected patent foramen ovale using transthoracic echocardiography, in order to evaluate the presence of atrial septal aneurysm and to identify other potential cardiac embolic sources. The patients with atrial septal aneurysm underwent transcranic echodoppler and transoesophageal echocardiography examination with contrast solution during Valsalva manoeuvre.209/579 (36%) patients where we made diagnosis of atrial septal aneurysm. In this cohort of patients transcranic echodoppler showed a patent foramen ovale in 114/209 (54%), whereas transoesophageal echocardiography in 111/209 (53%); 6/114 (5%) pa-tients with a positive transcranic echodoppler had a normal transoesophageal echocardiography examination and 3/95 (3%) with normal transcranic echodoppler had a positive transoesophageal echocardiography. Transcranic echodoppler vs. transoesophageal echocardiography sensibility was 97% and specificity 94%. Only 13/98 (13%) of patients with isolated atrial septal aneurysm and 23/111 (26%) with patent foramen ovale had history of cryptogenic stroke. According to our data, isolated atrial septal aneurysm could not be considered an independent risk factor for cryptogenic stroke.
Atrial septal aneurysm when associated to other cardiac abnormalities, such as patent foramen ovale, Chiari network or Eustachian Membrane, is a well-known recognised risk factor for cerebral embolism. Aim of study is to assess if isolated atrial septal aneurysm could be considered statistically related to cryptogenic stroke, considering the strong clinical impact that this association could have on these patients outcome. 579 patients were investigated for a suspected patent foramen ovale using transthoracic echocardiography, in order to evaluate the presence of atrial septal aneurysm and to identify other potential cardiac embolic sources. The patients with atrial septal aneurysm underwent transcranic echodoppler and transoesophageal echocardiography examination with contrast solution during Valsalva manoeuvre.209/579 (36%) patients where we made diagnosis of atrial septal aneurysm. In this cohort of patients transcranic echodoppler showed a patent foramen ovale in 114/209 (54%), whereas transoesophageal echocardiography in 111/209 (53%); 6/114 (5%) pa-tients with a positive transcranic echodoppler had a normal transoesophageal echocardiography examination and 3/95 (3%) with normal transcranic echodoppler had a positive transoesophageal echocardiography. Transcranic echodoppler vs. transoesophageal echocardiography sensibility was 97% and specificity 94%. Only 13/98 (13%) of patients with isolated atrial septal aneurysm and 23/111 (26%) with patent foramen ovale had history of cryptogenic stroke. According to our data, isolated atrial septal aneurysm could not be considered an independent risk factor for cryptogenic stroke.
Atrial Septal Aneurysm Is Always Linked To Right-Left Shunt and Cardio embolic Risk
doi:10.11648/j.cmr.20130204.12
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Sarah Mangiafico
Ines Paola Monte
Vincenzo Lavanco
Lucio Raffaello Tropea
Antonio Andrea Arcidiacono
Maria Concetta di Pasqua
Letizia Santonoceto
Giovanni Millan
Corrado Tamburino
Atrial Septal Aneurysm Is Always Linked To Right-Left Shunt and Cardio embolic Risk
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2014-01-01
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.12
© Science Publishing Group
Patients´Experiences of Splitting Tablets
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.14
Objectives: To examine what patients do when they have a prescription with a dosage where tablets must be split. Methods: Interviews were performed at 12 pharmacies across Sweden with pharmacy customers who had prescriptions with a dosage meaning that the tablets have to be divided to give the prescribed individual dose. Key findings: Of the 436 pharmacy customers interviewed, 255 (58.5%) reported they divided the tablets without tools and 162 (37.2%) used tools, the most common was a knife. Only few used a tablet splitter. Almost every third patient (31.4%) stated they had problems to divide the tablets. Conclusions: Patients’ difficulties in splitting tablets are common, but seem to be overlooked. Pharmacists should be permitted to adjust dispensing to a strength corresponding to the prescribed dosage level, price policies with flat prices need to be revised to eliminate economic incentives to prescribe dosages with split tablets and a computerised decision support should be developed signalling when there is a suitable strength for the prescribed individual dose.
Objectives: To examine what patients do when they have a prescription with a dosage where tablets must be split. Methods: Interviews were performed at 12 pharmacies across Sweden with pharmacy customers who had prescriptions with a dosage meaning that the tablets have to be divided to give the prescribed individual dose. Key findings: Of the 436 pharmacy customers interviewed, 255 (58.5%) reported they divided the tablets without tools and 162 (37.2%) used tools, the most common was a knife. Only few used a tablet splitter. Almost every third patient (31.4%) stated they had problems to divide the tablets. Conclusions: Patients’ difficulties in splitting tablets are common, but seem to be overlooked. Pharmacists should be permitted to adjust dispensing to a strength corresponding to the prescribed dosage level, price policies with flat prices need to be revised to eliminate economic incentives to prescribe dosages with split tablets and a computerised decision support should be developed signalling when there is a suitable strength for the prescribed individual dose.
Patients´Experiences of Splitting Tablets
doi:10.11648/j.cmr.20130204.14
Clinical Medicine Research
2014-01-01
© Science Publishing Group
B E Anders Ekedahl
Patients´Experiences of Splitting Tablets
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2014-01-01
10.11648/j.cmr.20130204.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.14
© Science Publishing Group
Non-Medicinal Helio-Magnetoprotective Remedies Against the Influence of Solar and Geomagnetic Disturbances on Human Physiological Parameters
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.15
The biotropic influence of ionospheric electrical currents (electrojets) and electromagnetic disturbances in the zone of the auroral oval on the electrical and cardiovascular homeostasis of healthy people was the topic of research. This was an investigation of non-medicinal helio-magnetoprotective remedies. “Helio-magnetoprotective” drinking water, certified and patented in Russia, has been developed for and tested in the circumpolar region (town Dixon) on inhabitants-volunteers with high level of helio-magnetosensitivity. This water after exposure to the repeatedly weakened magnetic field of the Earth ( device TRODR) substantially changes its structure, forming, on data of high effective chromatography, resistant nanocluster formations with marked biocatalytic properties which are enhanced with the use of the special informational holograms. Drinking water is treated using translucent holograms in this device is innovation technology. Helio-magnetoprotective water, according to our data, appears to be able to vary the degree of functional dependence of cardiovascular and other systems of both healthy and sick people on extreme impacts of heliogeophysical factors. Protective effect was assessed by changing in the vector of significant correlations: direct dependencies after drinking water became significantly reversed. Electrocardiographic parameters (R, PQ, QT), electrical conductivity in the cutaneous projections of acupuncture points, heart rate, and the blood pressure of the test subjects were registered three times: in the background conditions, 10 minutes after taking control water, and 10 minutes after receiving the same amount of helio-magnetoprotective water. The intensity of the polar electrojets and cosmic noise was determined by the methods of vertical sounding of the ionosphere and the riometer. The state of the polar magnetosphere was estimated according to the value of the Ak-index. It has been shown that the electrical and hemodynamic parameters of healthy people in the Far North are significantly altered during the periods of increased magnetic-ionospheric activity. Based on additional magnetic testing, the helio-magnetosensitivity of an organism increases during periods of increased level of cosmic noises as registered by riometers. Use of helio-magnetoprotective drinking water reduces the biotropic impacts of cosmophysical factors on human functional systems. The use of helio-magnetoprotective drinking water for prophylactic measures is effective against hello-dependent diseases, crisis states, and their life-threatening hemodynamic consequences for people living near the world’s Polar Regions and an other places.
The biotropic influence of ionospheric electrical currents (electrojets) and electromagnetic disturbances in the zone of the auroral oval on the electrical and cardiovascular homeostasis of healthy people was the topic of research. This was an investigation of non-medicinal helio-magnetoprotective remedies. “Helio-magnetoprotective” drinking water, certified and patented in Russia, has been developed for and tested in the circumpolar region (town Dixon) on inhabitants-volunteers with high level of helio-magnetosensitivity. This water after exposure to the repeatedly weakened magnetic field of the Earth ( device TRODR) substantially changes its structure, forming, on data of high effective chromatography, resistant nanocluster formations with marked biocatalytic properties which are enhanced with the use of the special informational holograms. Drinking water is treated using translucent holograms in this device is innovation technology. Helio-magnetoprotective water, according to our data, appears to be able to vary the degree of functional dependence of cardiovascular and other systems of both healthy and sick people on extreme impacts of heliogeophysical factors. Protective effect was assessed by changing in the vector of significant correlations: direct dependencies after drinking water became significantly reversed. Electrocardiographic parameters (R, PQ, QT), electrical conductivity in the cutaneous projections of acupuncture points, heart rate, and the blood pressure of the test subjects were registered three times: in the background conditions, 10 minutes after taking control water, and 10 minutes after receiving the same amount of helio-magnetoprotective water. The intensity of the polar electrojets and cosmic noise was determined by the methods of vertical sounding of the ionosphere and the riometer. The state of the polar magnetosphere was estimated according to the value of the Ak-index. It has been shown that the electrical and hemodynamic parameters of healthy people in the Far North are significantly altered during the periods of increased magnetic-ionospheric activity. Based on additional magnetic testing, the helio-magnetosensitivity of an organism increases during periods of increased level of cosmic noises as registered by riometers. Use of helio-magnetoprotective drinking water reduces the biotropic impacts of cosmophysical factors on human functional systems. The use of helio-magnetoprotective drinking water for prophylactic measures is effective against hello-dependent diseases, crisis states, and their life-threatening hemodynamic consequences for people living near the world’s Polar Regions and an other places.
Non-Medicinal Helio-Magnetoprotective Remedies Against the Influence of Solar and Geomagnetic Disturbances on Human Physiological Parameters
doi:10.11648/j.cmr.20130204.15
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Alexander Trofimov
Non-Medicinal Helio-Magnetoprotective Remedies Against the Influence of Solar and Geomagnetic Disturbances on Human Physiological Parameters
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2014-01-01
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.15
© Science Publishing Group
Pathological Reacting To Meteorological Changes as a Risk-Factor of Cardio-Vascular Pathology in the North
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.13
Background Cardio-vascular pathology is widespread in the North. It is more severe and hard than in moderate latitudes. There are little data available describing reactions of cardio-vascular system to changes of climatic, meteorological and helio-geophysical factors and their role in the development of the disease. The purpose of our study was to study the role of pathological reacting to climate and meteorological changes in development of cardio-vascular pathology in the North. Methods Clinical and physiological material of 1720 persons including 980 patients with cardio-vascular pathology (arterial hypertension I, II and coronary artery disease, stable angina pectoris) was studied. The complex of clinico-physiological, electrocardiographic and computer-analytical methods, including the original computer program “Screenmed” (registration by RosPatent №970035 from 29.01.1997) was used. The program includes a questionnaire for obtaining information about reacting of an organism to changes of climate, meteorological and helio-geophysical factors. The information of climate-meteorological and helio-geophysical factors was obtained from geophysical stations. Results The study indicates that most of patients with cardio-vascular pathology have high level of pathological meteosensitivity. The patients with arterial hypertension associated with coronary artery disease are most meteosensitive. A degree of pathological reacting to meteorological and geophysical factors determines an increase in complaints, clinical signs of a disease and electrocardiographic changes. Conclusion The study revealed significant association between pathological reacting to meteorological and helio-geophysical changes and the level of cardio-vascular disturbances. It has been found that pathological reacting of human organism to changes of climatic, helio-geophysical, meteorological and other biospheric factors of the environment is an important link in pathogenic mechanism of cardio-vascular pathology in the extreme conditions of the North.
Background Cardio-vascular pathology is widespread in the North. It is more severe and hard than in moderate latitudes. There are little data available describing reactions of cardio-vascular system to changes of climatic, meteorological and helio-geophysical factors and their role in the development of the disease. The purpose of our study was to study the role of pathological reacting to climate and meteorological changes in development of cardio-vascular pathology in the North. Methods Clinical and physiological material of 1720 persons including 980 patients with cardio-vascular pathology (arterial hypertension I, II and coronary artery disease, stable angina pectoris) was studied. The complex of clinico-physiological, electrocardiographic and computer-analytical methods, including the original computer program “Screenmed” (registration by RosPatent №970035 from 29.01.1997) was used. The program includes a questionnaire for obtaining information about reacting of an organism to changes of climate, meteorological and helio-geophysical factors. The information of climate-meteorological and helio-geophysical factors was obtained from geophysical stations. Results The study indicates that most of patients with cardio-vascular pathology have high level of pathological meteosensitivity. The patients with arterial hypertension associated with coronary artery disease are most meteosensitive. A degree of pathological reacting to meteorological and geophysical factors determines an increase in complaints, clinical signs of a disease and electrocardiographic changes. Conclusion The study revealed significant association between pathological reacting to meteorological and helio-geophysical changes and the level of cardio-vascular disturbances. It has been found that pathological reacting of human organism to changes of climatic, helio-geophysical, meteorological and other biospheric factors of the environment is an important link in pathogenic mechanism of cardio-vascular pathology in the extreme conditions of the North.
Pathological Reacting To Meteorological Changes as a Risk-Factor of Cardio-Vascular Pathology in the North
doi:10.11648/j.cmr.20130204.13
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Evgeniya Sevostyanova
Vyacheslav Hasnulin
Pathological Reacting To Meteorological Changes as a Risk-Factor of Cardio-Vascular Pathology in the North
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2014-01-01
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.13
© Science Publishing Group
Pulmonary Hypertension and Multiple Myeloma
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.17
The relationships between pulmonary hypertension multiple myeloma, monoclonal protein and finally drug treatment of plasma cell diseases are complex and not fully elucidated. Pulmonary hypertension has been reported as a rare complication of multiple myeloma (MM), more frequently in patients with POEMS syndrome. More recently pulmonary hypertension has been described during thalidomide treatment for refractory MM. We report a case of severe pulmonary hypertension associated with MM, pleural and cardiac amyloidosis. A revision of literature follows.
The relationships between pulmonary hypertension multiple myeloma, monoclonal protein and finally drug treatment of plasma cell diseases are complex and not fully elucidated. Pulmonary hypertension has been reported as a rare complication of multiple myeloma (MM), more frequently in patients with POEMS syndrome. More recently pulmonary hypertension has been described during thalidomide treatment for refractory MM. We report a case of severe pulmonary hypertension associated with MM, pleural and cardiac amyloidosis. A revision of literature follows.
Pulmonary Hypertension and Multiple Myeloma
doi:10.11648/j.cmr.20130204.17
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Carlo Rostagno
Rostagno Perfetto
Pulmonary Hypertension and Multiple Myeloma
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2014-01-01
10.11648/j.cmr.20130204.17
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.17
© Science Publishing Group
Changes in Vitamin D are Not Associated with Changes in Cardiorespiratory Fitness
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.16
We investigated the relationship between changes in 25-hydroxyvitamin D (25OHD) and changes in aerobic fitness (VO2max)over 6 months in healthy adults (n = 213, mean ± SD age 44.8 ±16.4 yr, range 20-76 yr, 109 women). 25OHD status was defined as deficient (DEF: 25OHD <50 nmol•L-1, n = 16), insufficient (INS: 25OHD > 50 nmol•L-1 but < 75 nmol•L-1, n = 57), and sufficient (SUF: 25OHD >75 nmol•L-1, n = 140). Tertiles for 25OHD change were computed (lowest: < -17.5 nmol•L-1, n = 67; middle: -17.5 to 9.1 nmol•L-1, n = 75; highest: > 9.1 nmol•L-1, n = 71). Baseline 25OHD level (β = -0.003; p = 0.83) and change in 25OHD level (β = 0.01; p = 0.50) were not significant predictors of changes in VO2max. Changes in VO2maxwere similar between 25OHD status groups (p = 0.55; DEF = -1.7 ± 2.1, INS = -0.4 ± 3.2; SUF = -0.3 ± 3.1 ml•kg-1•min-1), and 25OHD change tertiles (p = 0.28; lowest = -0.3 ± 2.7, middle = -0.8 ± 3.5, highest = -0.3 ± 2.9 ml•kg-1•min-1). Changes in vitamin D over a 6-month period were not associated with changes in aerobic fitness. Aerobic fitnessis not impacted by temporal variations in 25OHD.
We investigated the relationship between changes in 25-hydroxyvitamin D (25OHD) and changes in aerobic fitness (VO2max)over 6 months in healthy adults (n = 213, mean ± SD age 44.8 ±16.4 yr, range 20-76 yr, 109 women). 25OHD status was defined as deficient (DEF: 25OHD <50 nmol•L-1, n = 16), insufficient (INS: 25OHD > 50 nmol•L-1 but < 75 nmol•L-1, n = 57), and sufficient (SUF: 25OHD >75 nmol•L-1, n = 140). Tertiles for 25OHD change were computed (lowest: < -17.5 nmol•L-1, n = 67; middle: -17.5 to 9.1 nmol•L-1, n = 75; highest: > 9.1 nmol•L-1, n = 71). Baseline 25OHD level (β = -0.003; p = 0.83) and change in 25OHD level (β = 0.01; p = 0.50) were not significant predictors of changes in VO2max. Changes in VO2maxwere similar between 25OHD status groups (p = 0.55; DEF = -1.7 ± 2.1, INS = -0.4 ± 3.2; SUF = -0.3 ± 3.1 ml•kg-1•min-1), and 25OHD change tertiles (p = 0.28; lowest = -0.3 ± 2.7, middle = -0.8 ± 3.5, highest = -0.3 ± 2.9 ml•kg-1•min-1). Changes in vitamin D over a 6-month period were not associated with changes in aerobic fitness. Aerobic fitnessis not impacted by temporal variations in 25OHD.
Changes in Vitamin D are Not Associated with Changes in Cardiorespiratory Fitness
doi:10.11648/j.cmr.20130204.16
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Sara M. Gregory
Beth A. Parker
Jeffrey A. Capizzi
Adam S. Grimaldi
Priscilla M. Clarkson
Stephanie Moeckel-Cole
Justin Keadle
Stuart Chipkin
Linda S. Pescatello
Kathleen Simpson
C. Michael White
Paul D. Thompson
Changes in Vitamin D are Not Associated with Changes in Cardiorespiratory Fitness
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2014-01-01
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.16
© Science Publishing Group
Magnitude and Correlates of Tuberculosis among HIV Patients at Felege Hiwot Referral Hospital, Bahir Dar City, Northwest Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.18
Background: Tuberculosis and HIV have been closely linked since the emergence of AIDS. The aim of this study is to assess magnitude of Tuberculosis and its associated factors among HIV patients at Felege Hiwot Referral Hospital in Bahir Dar city. Methods: Institutional based Cross-sectional study was conducted in September 2012 in Bahir Dar city. Systematic sampling technique was employed to collect the data; both primary and secondary data were collected by interviewing HIV cases and reviewing their cards. The data were analyzed in bivariate and multivariate analysis using SPSS version 20. Result: The study was conducted among a total of 385 HIV cases. The prevalence of Tuberculosis was 10.1%. This study declared that body mass index (BMI), CD4 count and functional status were significant predictors of tuberculosis (TB). Besides, HIV cases whose BMI less than 18.5 were more than five times more likely to develop TB compared to those with BMI greater than 24.5 (AOR= 5.24, 95%CI:1.01-27.13), individual HIV cases whose CD4 count less than 200 were more than seven times likely to develop Tuberculosis compared to those whose CD4 count greater than 500 (AOR= 7.33, 95%CI:1.57-34.28), besides, the study explored that respondents who were bed redden and ambulatory were more than eight and six times more likely to develop Tuberculosis compared to those respondents who were able to work respectively (AOR=8.61, 95%CI: 1.83-40.40 and AOR=6.22, 95%CI: 1.40-7.65). Conclusion: This study showed that magnitude of TB among HIV cases was 10.1%. HIV patients, whose BMI less than 18.5, CD4 count <200/μL, ambulatory and bedridden patients should be closely supervised by increasing patient round frequency and providing special nutritious food. TB/HIV co-infected patients should get all services in TB clinic. The Hospital should provide fast triaging systems for coughing patients and reducing their waiting time for services.
Background: Tuberculosis and HIV have been closely linked since the emergence of AIDS. The aim of this study is to assess magnitude of Tuberculosis and its associated factors among HIV patients at Felege Hiwot Referral Hospital in Bahir Dar city. Methods: Institutional based Cross-sectional study was conducted in September 2012 in Bahir Dar city. Systematic sampling technique was employed to collect the data; both primary and secondary data were collected by interviewing HIV cases and reviewing their cards. The data were analyzed in bivariate and multivariate analysis using SPSS version 20. Result: The study was conducted among a total of 385 HIV cases. The prevalence of Tuberculosis was 10.1%. This study declared that body mass index (BMI), CD4 count and functional status were significant predictors of tuberculosis (TB). Besides, HIV cases whose BMI less than 18.5 were more than five times more likely to develop TB compared to those with BMI greater than 24.5 (AOR= 5.24, 95%CI:1.01-27.13), individual HIV cases whose CD4 count less than 200 were more than seven times likely to develop Tuberculosis compared to those whose CD4 count greater than 500 (AOR= 7.33, 95%CI:1.57-34.28), besides, the study explored that respondents who were bed redden and ambulatory were more than eight and six times more likely to develop Tuberculosis compared to those respondents who were able to work respectively (AOR=8.61, 95%CI: 1.83-40.40 and AOR=6.22, 95%CI: 1.40-7.65). Conclusion: This study showed that magnitude of TB among HIV cases was 10.1%. HIV patients, whose BMI less than 18.5, CD4 count <200/μL, ambulatory and bedridden patients should be closely supervised by increasing patient round frequency and providing special nutritious food. TB/HIV co-infected patients should get all services in TB clinic. The Hospital should provide fast triaging systems for coughing patients and reducing their waiting time for services.
Magnitude and Correlates of Tuberculosis among HIV Patients at Felege Hiwot Referral Hospital, Bahir Dar City, Northwest Ethiopia
doi:10.11648/j.cmr.20130204.18
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Alemayehu Belay
Zelalem Alamrew
Yibeltal Berie
Bisratewongel Tegegne
Gebeyaw Tiruneh
Amsalu Feleke
Magnitude and Correlates of Tuberculosis among HIV Patients at Felege Hiwot Referral Hospital, Bahir Dar City, Northwest Ethiopia
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83
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2014-01-01
10.11648/j.cmr.20130204.18
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.18
© Science Publishing Group
Case Report: Left Hand Acheiria in 3 Newborns within a Period of 3 Months during the Year 2011 in Fallujah General Hospital
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.19
We present 3 sporadic cases of congenital left hand Acheiria, a rare congenital defect, In one case (male), left hand Acheiria is associated with left radial hemimelia , in the other 2 cases (both are females) ,there is only congenital absence of left hand ( Acheiria) ,with completely normal left forearm & other 3 limbs. The absence of any contributory family or drug history and the normal chromosomal study in the 3 cases lead us to the belief that their occurrence may be linked to environmental contamination. To the best of our knowledge, there is dearth of information on these anomalies in the literatures, & their management remains achallenge.
We present 3 sporadic cases of congenital left hand Acheiria, a rare congenital defect, In one case (male), left hand Acheiria is associated with left radial hemimelia , in the other 2 cases (both are females) ,there is only congenital absence of left hand ( Acheiria) ,with completely normal left forearm & other 3 limbs. The absence of any contributory family or drug history and the normal chromosomal study in the 3 cases lead us to the belief that their occurrence may be linked to environmental contamination. To the best of our knowledge, there is dearth of information on these anomalies in the literatures, & their management remains achallenge.
Case Report: Left Hand Acheiria in 3 Newborns within a Period of 3 Months during the Year 2011 in Fallujah General Hospital
doi:10.11648/j.cmr.20130204.19
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Samira Telfah Alaani
Abdulkadir Abdulkareem Miri'e
Case Report: Left Hand Acheiria in 3 Newborns within a Period of 3 Months during the Year 2011 in Fallujah General Hospital
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2014-01-01
2014-01-01
10.11648/j.cmr.20130204.19
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130204.19
© Science Publishing Group
Assessment of Stoke Patients: Occurrence of Unusually High Number of Haemorrhagic Stroke Casesin Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130205.11
Introduction: Stroke is becoming a leading cause of death and adult disability in the developing world. The global burden of disease study indicates that 80% of stroke deaths occur in low- and middle-income regions. Objective: To assess the clinical characteristics and risk factors among patients presented with stoke in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods and patients: This is a prospective cross sectional survey of all patients with stroke presenting to Tikur Anbessa specialized hospital for consecutive six months (November 2012-April 2013). The data included 114 stroke patients. Data of these patients was collected by an emergency medicine physician through a pre-designed questionnaire. Data was entered and analyzed by a computer software SPSS version 20. Monovariate analysis, bivariate analysis and multivariate analyses to control for confounder variables were done. CI which doesn’t contain 1 is significant. Result: Out of the total patients seen, 63 (55%) were females with females to males ratio of 1.23 to 1.One quarter of patients (25%) were below 34 years of age followed by age greater than 65 and 55-64 years with 21% and 23.6% score respectively. The major risk factors identified were hypertension and Diabetes Mellitus with 69.3 % and 14.9% respectively. Nine (7.8 %) were found to be both hypertensive and diabetic. Atrial fibrillation is the third risk factor associated with stoke with a frequency of 11.4%. More than half of our patients (55.3%) had hemorrhagic stroke. Majority of the patients presented with sever neurological manifestations; hemiplegic deficit by 67 (58.8%), asphyxia by 16% and coma by 15.8 %of patients. Only 46 (40.4%) were on treatment and 7% of patients presented within the first three (golden) hours of onset of their illness; the majority of patients (41.2%) presented after 48 hrs. of onset of their symptoms. Those patients who presented with hemorrhagic stroke were 2.8 times (AOR=2.8, 95% CI: 1.5-7.7) to be presented with hemiplegic deficit as compared to those patients with ischemic stroke. Conclusion and recommendation: Stroke happened more frequently in women than in men and the risks associated with increased age were not evident. The major risk factors identified were high blood pressure and diabetes and atrial fibrillation. Hemorrhagic stroke associated with sever neurological presentations were the most prevalent stroke sub-types. Education of the public on active screening and prompt treatment and sign and symptoms of stroke together with improving the quality of stroke management are very crucial
Introduction: Stroke is becoming a leading cause of death and adult disability in the developing world. The global burden of disease study indicates that 80% of stroke deaths occur in low- and middle-income regions. Objective: To assess the clinical characteristics and risk factors among patients presented with stoke in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods and patients: This is a prospective cross sectional survey of all patients with stroke presenting to Tikur Anbessa specialized hospital for consecutive six months (November 2012-April 2013). The data included 114 stroke patients. Data of these patients was collected by an emergency medicine physician through a pre-designed questionnaire. Data was entered and analyzed by a computer software SPSS version 20. Monovariate analysis, bivariate analysis and multivariate analyses to control for confounder variables were done. CI which doesn’t contain 1 is significant. Result: Out of the total patients seen, 63 (55%) were females with females to males ratio of 1.23 to 1.One quarter of patients (25%) were below 34 years of age followed by age greater than 65 and 55-64 years with 21% and 23.6% score respectively. The major risk factors identified were hypertension and Diabetes Mellitus with 69.3 % and 14.9% respectively. Nine (7.8 %) were found to be both hypertensive and diabetic. Atrial fibrillation is the third risk factor associated with stoke with a frequency of 11.4%. More than half of our patients (55.3%) had hemorrhagic stroke. Majority of the patients presented with sever neurological manifestations; hemiplegic deficit by 67 (58.8%), asphyxia by 16% and coma by 15.8 %of patients. Only 46 (40.4%) were on treatment and 7% of patients presented within the first three (golden) hours of onset of their illness; the majority of patients (41.2%) presented after 48 hrs. of onset of their symptoms. Those patients who presented with hemorrhagic stroke were 2.8 times (AOR=2.8, 95% CI: 1.5-7.7) to be presented with hemiplegic deficit as compared to those patients with ischemic stroke. Conclusion and recommendation: Stroke happened more frequently in women than in men and the risks associated with increased age were not evident. The major risk factors identified were high blood pressure and diabetes and atrial fibrillation. Hemorrhagic stroke associated with sever neurological presentations were the most prevalent stroke sub-types. Education of the public on active screening and prompt treatment and sign and symptoms of stroke together with improving the quality of stroke management are very crucial
Assessment of Stoke Patients: Occurrence of Unusually High Number of Haemorrhagic Stroke Casesin Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
doi:10.11648/j.cmr.20130205.11
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Chalachew Misganaw Alemayehu
Sofia Kebede Birhanesilasie
Assessment of Stoke Patients: Occurrence of Unusually High Number of Haemorrhagic Stroke Casesin Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
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2014-01-01
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130205.11
© Science Publishing Group
Neonatal Intestinal Obstruction Secondary to Mid-Gut Volvulus Complicated by Bowel Gangrene in a Neonate with Ileal Atresia: A Case Report
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130205.12
Mid-gut volvulus in the absence of malrotation of the gut is rare in neonates and rarer in term babies and can be fatal if intervention is delayed. Herein we report a case of a neonate who had billous vomiting, abdominal distension and moderate dehydration. His abdominal radiograph showed gaseous distension of the stomach, ground glass pattern and calcifications. Exploratory laparotomy revealed mid-gut volvulus complicated by atresia and 75 centimeter length of intestinal gangrene involving the distal one-third of the jejunum and ileum. However, no evidence of malrotation of the gut was found. Resection of the gangrenous segment with jejuno-caecal anastomosis was carried out in addition to blood transfusion, antibiotic and fluid therapy. Patient’s condition improved, he passed stools on the 5th postoperative day, and oral sips were commenced.
Mid-gut volvulus in the absence of malrotation of the gut is rare in neonates and rarer in term babies and can be fatal if intervention is delayed. Herein we report a case of a neonate who had billous vomiting, abdominal distension and moderate dehydration. His abdominal radiograph showed gaseous distension of the stomach, ground glass pattern and calcifications. Exploratory laparotomy revealed mid-gut volvulus complicated by atresia and 75 centimeter length of intestinal gangrene involving the distal one-third of the jejunum and ileum. However, no evidence of malrotation of the gut was found. Resection of the gangrenous segment with jejuno-caecal anastomosis was carried out in addition to blood transfusion, antibiotic and fluid therapy. Patient’s condition improved, he passed stools on the 5th postoperative day, and oral sips were commenced.
Neonatal Intestinal Obstruction Secondary to Mid-Gut Volvulus Complicated by Bowel Gangrene in a Neonate with Ileal Atresia: A Case Report
doi:10.11648/j.cmr.20130205.12
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Baba Usman Ahmadu
Yakubu Mava
Joshua Habila Sharah
Abdurrahman Raji Maryam
Paul Dogra
Salihu Akbar
Neonatal Intestinal Obstruction Secondary to Mid-Gut Volvulus Complicated by Bowel Gangrene in a Neonate with Ileal Atresia: A Case Report
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2014-01-01
10.11648/j.cmr.20130205.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130205.12
© Science Publishing Group
Lymphocytic Expression of Fas and FasL Apoptotic Markers in Vitiligo
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130205.13
Background. Lymphocytic dermal infiltrations accompany the melanocytes loss in depigmenting vitiligo skin. These lymphocytes are incriminated during the pathogenesis of the disease. Fas receptor is a death receptor on the surface of cells that leads to programmed cell death (apoptosis) and FasL is its ligand. Fas/FasL system plays a crucial role in modulating apoptosis. Objectives. This study investigates the lymphocytic expression of apoptotic markers Fas/FasL in vitiligo. Methods. The present study was conducted on 45 vitiligo samples obtained from 15 vitiligo patients including 8 females (53.3%) and seven males (46.7%). Biopsies were obtained also from control volunteers. All specimens were routinely stained with Hematoxylin &Eosin and immunohistochemically for Fas & FasL apoptotic markers. Results. Fas & FasL were significantly expressed by infiltrating lymphocytes in vitiligo biopsies compared to control. Lymphocytic expression of Fas & FasL was higher on the edge biopsies than the center. Considerable lymphocytic infiltration and attack of B.M. were associated with higher lymphocytic Fas and FasL expression. During vitiligo activity lymphocytic Fas & FasL expression was also significantly higher. Conclusions. Lymphocytic Fas and FasL are significantly expressed in vitiligo patches which may trigger epidermal apoptosis and loss of melanocytes. At the same time these factors have a role in switching-off of the immune responses and cell mediated cytotoxicity.
Background. Lymphocytic dermal infiltrations accompany the melanocytes loss in depigmenting vitiligo skin. These lymphocytes are incriminated during the pathogenesis of the disease. Fas receptor is a death receptor on the surface of cells that leads to programmed cell death (apoptosis) and FasL is its ligand. Fas/FasL system plays a crucial role in modulating apoptosis. Objectives. This study investigates the lymphocytic expression of apoptotic markers Fas/FasL in vitiligo. Methods. The present study was conducted on 45 vitiligo samples obtained from 15 vitiligo patients including 8 females (53.3%) and seven males (46.7%). Biopsies were obtained also from control volunteers. All specimens were routinely stained with Hematoxylin &Eosin and immunohistochemically for Fas & FasL apoptotic markers. Results. Fas & FasL were significantly expressed by infiltrating lymphocytes in vitiligo biopsies compared to control. Lymphocytic expression of Fas & FasL was higher on the edge biopsies than the center. Considerable lymphocytic infiltration and attack of B.M. were associated with higher lymphocytic Fas and FasL expression. During vitiligo activity lymphocytic Fas & FasL expression was also significantly higher. Conclusions. Lymphocytic Fas and FasL are significantly expressed in vitiligo patches which may trigger epidermal apoptosis and loss of melanocytes. At the same time these factors have a role in switching-off of the immune responses and cell mediated cytotoxicity.
Lymphocytic Expression of Fas and FasL Apoptotic Markers in Vitiligo
doi:10.11648/j.cmr.20130205.13
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Fatma Y. Saleh
Sherif Shoukry Awad
Irene M. Sadek
Lymphocytic Expression of Fas and FasL Apoptotic Markers in Vitiligo
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2014-01-01
10.11648/j.cmr.20130205.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130205.13
© Science Publishing Group
Prevalence and Correlates of Exchanging Sex for Money (Gift), among Private College Students in Bahir Dar City, Northwest Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.13
Background: Transactional sex is the practice of exchanging sex for financial or life style rewords; which has been associated with increased risk of HIV and others STD’s. The aim of this study was to assess the prevalence and correlates of exchanging sex for money (gifts) among college students in Bahir Dar city. Methods: A cross sectional study was conducted in July 2012 among 790 students in eight private colleges in Bahir Dar city using multistage sampling technique. A pre-tested self-administered questionnaire was used. The data were analyzed in bivariate and multivariate logistic regression analysis with SPSS version 16 soft ware package. Results: About 27.8% of sexually active respondents of the study were reported to have exchanged sex for money (gift). Respondents reported unprotected sex were about 2 times more likely to exchange sex compared to those never did unprotected sex (AOR= 1.85, 95%CI: 1.07-8.78).The odds of exchanged sex was higher for students living in rented house with no family compared to those living with family (AOR= 1.78, 95%CI: 1.03 -3.06), and for the students who used khat and shisha compared to those never took these substances (AOR= 1.92, 95%CI: 1.10-3.33 and AOR= 3.14, 95%CI: 1.32-7.44) respectively. Moreover, the students visited night clubs more than two times a week were more than threefold risk of exchanging sex compared to those students never visited night clubs(AOR= 3.87, 95%CI: 1.71- 8.78). Conclusion: This study revealed that 27.8% of sexually active respondents were ever exchanged sex and unprotected sex was associated with it, implying that receiving/paying money (gift) might interfere to negotiate condom use. Besides, several variables were associated with it, therefore, HIV/AIDS prevention programs need to give attention to exchanged sex.
Background: Transactional sex is the practice of exchanging sex for financial or life style rewords; which has been associated with increased risk of HIV and others STD’s. The aim of this study was to assess the prevalence and correlates of exchanging sex for money (gifts) among college students in Bahir Dar city. Methods: A cross sectional study was conducted in July 2012 among 790 students in eight private colleges in Bahir Dar city using multistage sampling technique. A pre-tested self-administered questionnaire was used. The data were analyzed in bivariate and multivariate logistic regression analysis with SPSS version 16 soft ware package. Results: About 27.8% of sexually active respondents of the study were reported to have exchanged sex for money (gift). Respondents reported unprotected sex were about 2 times more likely to exchange sex compared to those never did unprotected sex (AOR= 1.85, 95%CI: 1.07-8.78).The odds of exchanged sex was higher for students living in rented house with no family compared to those living with family (AOR= 1.78, 95%CI: 1.03 -3.06), and for the students who used khat and shisha compared to those never took these substances (AOR= 1.92, 95%CI: 1.10-3.33 and AOR= 3.14, 95%CI: 1.32-7.44) respectively. Moreover, the students visited night clubs more than two times a week were more than threefold risk of exchanging sex compared to those students never visited night clubs(AOR= 3.87, 95%CI: 1.71- 8.78). Conclusion: This study revealed that 27.8% of sexually active respondents were ever exchanged sex and unprotected sex was associated with it, implying that receiving/paying money (gift) might interfere to negotiate condom use. Besides, several variables were associated with it, therefore, HIV/AIDS prevention programs need to give attention to exchanged sex.
Prevalence and Correlates of Exchanging Sex for Money (Gift), among Private College Students in Bahir Dar City, Northwest Ethiopia
doi:10.11648/j.cmr.20130206.13
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Zelalem Alamrew
Worku Awoke
Getachew Fikadie
Bizuayhu Shimekaw
Prevalence and Correlates of Exchanging Sex for Money (Gift), among Private College Students in Bahir Dar City, Northwest Ethiopia
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134
134
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2014-01-01
10.11648/j.cmr.20130206.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.13
© Science Publishing Group
Associated Risk Factors for Postoperative Nosocomial Infections among Patients Admitted at Felege Hiwot Referral Hospital, Bahir Dar, North West Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.15
Background: Nosocomial infections are the most challenging problem in all health care systems. In developing countries many people are dying daily due to inadequate health care services of which postoperative infections constitute a large proportion of this burden. Objective: The aim of this study was to identify risk factors associated for post operative nosocomial infections among operated patients at Felege Hiwot Referral Hospital. Methods: A cross-sectional study was conducted on patients who under gone operations from October 2010 to January 2011. A structured questionnaire was used for collection of data on socio-demographic characteristics and associated risk factors. The clinical diagnosis was made by respective surgeons and gynaecologists. Bacterial culture confirmation was done for all patients who developed clinical signs and symptoms of surgical site (SSI) and/or bloodstream infection (BSI) starting from the second day of admission until the time of discharge using standard bacteriological techniques. Bivariate analysis was made to generate to identify associated risk factors. P.value < 0.05 was considered as stastically significant. Results: A total of 294 patients were included in the study. The rate of postoperative culture confirmed nosocomial infection was 10.9%. The infection rate was higher in females (11.6%) than males (9.4%) (OR=1.27, CI=0.564- 2.863). Patients age of >51 years old were likely to develop post operative nosocomial infection (OR=6.38, CI=1.156-35.14). Patient with underlying diseases (OR=2.725, CI=1.269-5.853) and patients who undergone appendectomy ( OR=3.1, CI=1.1-8.3) were more likely developed post operative nosocomial infections. Operation duration of 91-150 minutes (OR=11.00, CI=1.989-60.83), and postoperative hospital stay of greater than 15 days (OR=82.00, CI=5.738-1.172) were also likely to be risk factor for infection. Conclusion: This study confirmed that advanced age, underlying disease, extended preoperative and postoperative hospital stay, longer duration of surgery and appendectomy were the most likely risk factors for post operative infections. Hence, more attention is required in management of such cases through prior identification of underlying disease, use of effective antibiotics as a prophylaxis and adherence of strict aseptic operating procedures.
Background: Nosocomial infections are the most challenging problem in all health care systems. In developing countries many people are dying daily due to inadequate health care services of which postoperative infections constitute a large proportion of this burden. Objective: The aim of this study was to identify risk factors associated for post operative nosocomial infections among operated patients at Felege Hiwot Referral Hospital. Methods: A cross-sectional study was conducted on patients who under gone operations from October 2010 to January 2011. A structured questionnaire was used for collection of data on socio-demographic characteristics and associated risk factors. The clinical diagnosis was made by respective surgeons and gynaecologists. Bacterial culture confirmation was done for all patients who developed clinical signs and symptoms of surgical site (SSI) and/or bloodstream infection (BSI) starting from the second day of admission until the time of discharge using standard bacteriological techniques. Bivariate analysis was made to generate to identify associated risk factors. P.value < 0.05 was considered as stastically significant. Results: A total of 294 patients were included in the study. The rate of postoperative culture confirmed nosocomial infection was 10.9%. The infection rate was higher in females (11.6%) than males (9.4%) (OR=1.27, CI=0.564- 2.863). Patients age of >51 years old were likely to develop post operative nosocomial infection (OR=6.38, CI=1.156-35.14). Patient with underlying diseases (OR=2.725, CI=1.269-5.853) and patients who undergone appendectomy ( OR=3.1, CI=1.1-8.3) were more likely developed post operative nosocomial infections. Operation duration of 91-150 minutes (OR=11.00, CI=1.989-60.83), and postoperative hospital stay of greater than 15 days (OR=82.00, CI=5.738-1.172) were also likely to be risk factor for infection. Conclusion: This study confirmed that advanced age, underlying disease, extended preoperative and postoperative hospital stay, longer duration of surgery and appendectomy were the most likely risk factors for post operative infections. Hence, more attention is required in management of such cases through prior identification of underlying disease, use of effective antibiotics as a prophylaxis and adherence of strict aseptic operating procedures.
Associated Risk Factors for Postoperative Nosocomial Infections among Patients Admitted at Felege Hiwot Referral Hospital, Bahir Dar, North West Ethiopia
doi:10.11648/j.cmr.20130206.15
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Wondemagegn Mulu
Gebre Kibru
Getenet Beyene
Meku Damtie
Associated Risk Factors for Postoperative Nosocomial Infections among Patients Admitted at Felege Hiwot Referral Hospital, Bahir Dar, North West Ethiopia
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2014-01-01
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.15
© Science Publishing Group
The Correlation of Symptoms Severity and Objective Measures in Patients with Lower Urinary Tract Symptoms
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.14
Purpose: To evaluate the correlation between international prostate symptom score (IPSS) and objective measures of lower urinary tract symptoms to estimate the grade of infravesical obstruction in benign prostatic hyperplasia (BPH). Methods: The data of 152 male patients examined in urology outpatient clinic with lower urinary tract symptoms (LUTS) were retrospectively rewieved between January 2010 and December 2011. Prostate volume, detrusor wall thickness (DWT) and post voiding residue (PVR) were evaluated with suprapubic ultrasound. The patients were distributed in three groups according to IPSS values; 1st, lower IPSS group (n=39), 2nd, moderate IPSS group (n=80) and 3rd, .higher IPSS group (n=33). IPSS, BWT, prostate volume, postvoiding residue (PVR), and maximum urine flow (Qmax) values were compared. Results: The mean age was 52.9 ±9.0 years. There were significant differences between the three groups for total PSA, in terms of prostate volume, DWT, PVR, Qmax, Qave values. There was a significant correlation between IPSS questionnaire results and PVR, Qmax and Qave (P< 0.05). PVR, Qmax and PVR values revealed especially strong positive correlations with symptoms severity or IPSS (Pearson /Spearman’s correlation coefficients were 0.441; p < 0.000 and 0.446; p < 0.000 respectively; Table 3). Conclusions: There are significant correlations between symptoms severity (IPSS) and objective BPH-related parameters, such as age, PSA, prostate volume, DWT, PVR, Qmax, Qave and QoL. The measurements of especially DWT, PVR and Qmax are promising noninvasive tools to predict the grade of LUTS in men and is reflected in IPSS severity.
Purpose: To evaluate the correlation between international prostate symptom score (IPSS) and objective measures of lower urinary tract symptoms to estimate the grade of infravesical obstruction in benign prostatic hyperplasia (BPH). Methods: The data of 152 male patients examined in urology outpatient clinic with lower urinary tract symptoms (LUTS) were retrospectively rewieved between January 2010 and December 2011. Prostate volume, detrusor wall thickness (DWT) and post voiding residue (PVR) were evaluated with suprapubic ultrasound. The patients were distributed in three groups according to IPSS values; 1st, lower IPSS group (n=39), 2nd, moderate IPSS group (n=80) and 3rd, .higher IPSS group (n=33). IPSS, BWT, prostate volume, postvoiding residue (PVR), and maximum urine flow (Qmax) values were compared. Results: The mean age was 52.9 ±9.0 years. There were significant differences between the three groups for total PSA, in terms of prostate volume, DWT, PVR, Qmax, Qave values. There was a significant correlation between IPSS questionnaire results and PVR, Qmax and Qave (P< 0.05). PVR, Qmax and PVR values revealed especially strong positive correlations with symptoms severity or IPSS (Pearson /Spearman’s correlation coefficients were 0.441; p < 0.000 and 0.446; p < 0.000 respectively; Table 3). Conclusions: There are significant correlations between symptoms severity (IPSS) and objective BPH-related parameters, such as age, PSA, prostate volume, DWT, PVR, Qmax, Qave and QoL. The measurements of especially DWT, PVR and Qmax are promising noninvasive tools to predict the grade of LUTS in men and is reflected in IPSS severity.
The Correlation of Symptoms Severity and Objective Measures in Patients with Lower Urinary Tract Symptoms
doi:10.11648/j.cmr.20130206.14
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Basri Cakiroglu
Ramazan Gozukucuk
Orhun Sinanoglu
Suleyman Hilmi Aksoy
Tuncay Tas
Seyit Erkan Eyyupoglu
Bekir Sami Uyanik
The Correlation of Symptoms Severity and Objective Measures in Patients with Lower Urinary Tract Symptoms
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.14
© Science Publishing Group
Well-Differentiated Thyroid Carcinoma Invading the Larynx and Trachea
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.16
Larynx and trachea invasion by thyroid cancer is an uncommon but difficult problem. There is no consensus on indication for the extent of surgery, particularly when there is a requirement for airway reconstruction. In general, the surgeon must decide between a complete ablation of the tumor at the cost of large-mutilation and a less radical dissection that leaves residual tumor to be treated with radiation therapy and additional radio-iodine.
Larynx and trachea invasion by thyroid cancer is an uncommon but difficult problem. There is no consensus on indication for the extent of surgery, particularly when there is a requirement for airway reconstruction. In general, the surgeon must decide between a complete ablation of the tumor at the cost of large-mutilation and a less radical dissection that leaves residual tumor to be treated with radiation therapy and additional radio-iodine.
Well-Differentiated Thyroid Carcinoma Invading the Larynx and Trachea
doi:10.11648/j.cmr.20130206.16
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Melissa Laus
Domenico Crescenzi
Alessandro De Stefano
Adelchi Croce
Well-Differentiated Thyroid Carcinoma Invading the Larynx and Trachea
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2014-01-01
10.11648/j.cmr.20130206.16
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.16
© Science Publishing Group
Autoimmune Tissue Scurvy Misdiagnosed as Child Abuse
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.17
Requests from distressed parents and relatives seeking help after having been falsely accused by doctors of injuring their children are not uncommon. Viraland parasitic infections andvaccinescause an autoimmune disorder, Tissue Scurvy, misdiagnosed as child abuse. This report presents the evidence. Method. Relevant hospital and laboratory reports of three children were examined for evidence of Tissue Scurvy as the cause of the neurological lesions, fractures, bruises and hemorrhages found on them. Results. In all the cases in which appropriate histories and tests were done there was evidence that the doctors either misinterpreted the laboratory evidence or they were unaware of the significance of abnormal tests suggesting Tissue Scurvy as the cause. Conclusion. Some doctors are unaware of the pathophysiological processes of autoimmunity, haemostasis and osteogenesis and are misdiagnosing vaccine induced Tissue Scurvy, absence of Vitamin C within the cell, as Non-accidental Injury.
Requests from distressed parents and relatives seeking help after having been falsely accused by doctors of injuring their children are not uncommon. Viraland parasitic infections andvaccinescause an autoimmune disorder, Tissue Scurvy, misdiagnosed as child abuse. This report presents the evidence. Method. Relevant hospital and laboratory reports of three children were examined for evidence of Tissue Scurvy as the cause of the neurological lesions, fractures, bruises and hemorrhages found on them. Results. In all the cases in which appropriate histories and tests were done there was evidence that the doctors either misinterpreted the laboratory evidence or they were unaware of the significance of abnormal tests suggesting Tissue Scurvy as the cause. Conclusion. Some doctors are unaware of the pathophysiological processes of autoimmunity, haemostasis and osteogenesis and are misdiagnosing vaccine induced Tissue Scurvy, absence of Vitamin C within the cell, as Non-accidental Injury.
Autoimmune Tissue Scurvy Misdiagnosed as Child Abuse
doi:10.11648/j.cmr.20130206.17
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Michael D Innis
Autoimmune Tissue Scurvy Misdiagnosed as Child Abuse
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2014-01-01
10.11648/j.cmr.20130206.17
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.17
© Science Publishing Group
Should We Determine the Significance of “Follicular Lesion of Undetermined Significance’’
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.18
Aim: Thyroid fine-needle aspiration biopsy (TFNAB) is the gold standard methodology for the evaluation of thyroid nodule. Nevertheless, diagnosis of TFNAB specimens is sometimes interpreted as “follicular lesion of undetermined significance”: This indeterminate diagnosis is given upon TFNAB despite the presence of sufficient cellular material available for cytopathological analysis. Furthermore, this indeterminate diagnosis constitutes a grey zone between benign lesion and malignancy. As a result, it becomes difficult to determine the type of surgical intervention that needs to be performed on the patient and the technique that will be used. In this study, we aim to correlate the diagnosis of “follicular lesion of undetermined significance” with clinical and postoperative evaluations. Methods: A total of 147 patients, who were diagnosed as “follicular lesion of undetermined significance” following initial TFNAB, were included in this retrospective study. These patients were evaluated according to whether they underwent a second TFNAB or thyroidectomy pathology following initial diagnosis of “follicular lesion of undetermined significance”. Results: Results were generated by evaluating the reports of the second TFNAB and 15 of 147 patients were followed. Histopathological examination of specimens derived from 132 patients following surgery revealed the following diagnosis: (i) hyperplasia in 67 patients, (ii) nodular lesion belonging to Hashimoto’s thyroiditis in 34 patients, (iii) papillary carcinoma in 28 patients, (iv) follicular carcinoma in two patients, and (v) anaplastic carcinoma in one patient. Conclusion: Based on this retrospective study and on examination of the available literature concerning the treatment options and follow-up of patients initially diagnosed as “follicular lesion of undetermined significance” (FLUS or Atypia of undetermined significance) upon TFNAB, we conclude that it is important to keep in mind the elevated rates of malignancy that potentially develop from these undetermined lesions. is electronic document is a “live” template. The various components of your paper [title, text, heads, etc.] are already defined on the style sheet, as illustrated by the portions given in this document.
Aim: Thyroid fine-needle aspiration biopsy (TFNAB) is the gold standard methodology for the evaluation of thyroid nodule. Nevertheless, diagnosis of TFNAB specimens is sometimes interpreted as “follicular lesion of undetermined significance”: This indeterminate diagnosis is given upon TFNAB despite the presence of sufficient cellular material available for cytopathological analysis. Furthermore, this indeterminate diagnosis constitutes a grey zone between benign lesion and malignancy. As a result, it becomes difficult to determine the type of surgical intervention that needs to be performed on the patient and the technique that will be used. In this study, we aim to correlate the diagnosis of “follicular lesion of undetermined significance” with clinical and postoperative evaluations. Methods: A total of 147 patients, who were diagnosed as “follicular lesion of undetermined significance” following initial TFNAB, were included in this retrospective study. These patients were evaluated according to whether they underwent a second TFNAB or thyroidectomy pathology following initial diagnosis of “follicular lesion of undetermined significance”. Results: Results were generated by evaluating the reports of the second TFNAB and 15 of 147 patients were followed. Histopathological examination of specimens derived from 132 patients following surgery revealed the following diagnosis: (i) hyperplasia in 67 patients, (ii) nodular lesion belonging to Hashimoto’s thyroiditis in 34 patients, (iii) papillary carcinoma in 28 patients, (iv) follicular carcinoma in two patients, and (v) anaplastic carcinoma in one patient. Conclusion: Based on this retrospective study and on examination of the available literature concerning the treatment options and follow-up of patients initially diagnosed as “follicular lesion of undetermined significance” (FLUS or Atypia of undetermined significance) upon TFNAB, we conclude that it is important to keep in mind the elevated rates of malignancy that potentially develop from these undetermined lesions. is electronic document is a “live” template. The various components of your paper [title, text, heads, etc.] are already defined on the style sheet, as illustrated by the portions given in this document.
Should We Determine the Significance of “Follicular Lesion of Undetermined Significance’’
doi:10.11648/j.cmr.20130206.18
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Aybala Agac Ay
Abdullah Çetin
Should We Determine the Significance of “Follicular Lesion of Undetermined Significance’’
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2014-01-01
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.18
© Science Publishing Group
Risk Factors for Frequent Hospital Readmissions for Acute Exacerbations of COPD
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.20
Background: Acute exacerbations of COPD (AECOPD) are known to be associated with increased morbidity and mortality and have a significant socioeconomic impact. The factors that determine frequent hospital readmissions for AECOPD are poorly understood. The aim of this study was to EVALUATE the factors responsible for the repeated admissions for AECOPD. Methodology: We conducted a prospective study of 235 patients with COPD with one or more admissions for acute exacerbations in a tertiary care hospital. Frequency of previous readmissions for AECOPD in the past year, and clinical characteristics, including spirometry were ascertained in the stable state both before discharge and at 6-month post discharge. All the patients were followed up for a period of two years after discharge to evaluate the readmissions for the acute exacerbations. Results: Among 149 COPD patients who were admitted and assessed for AECOPD, there were 278 readmissions for AECOPD over a follow-up period of 24 months. Of these, 27% had one readmission, while rest 78% had two or more readmissions during this period. There was a high prevalence of current or ex-heavy smokers, associated co-morbidity, underweight patients and low prevalence of vaccination and use of domiciliary oxygen therapy among COPD patients. A total of 15.4% mortality was observed in the present study. The multivariate logistic regression analysis for repeated admissions revealed that disease duration >10 years (OR =0.50; 95% CI: 0.27 -0.93), non-use of inhaled corticosteroids (ICS +LABA) (OR = 2.31; 95% CI: 2.26–4.88), lower serum albumin level (<2gm/dl) (OR = 0.48; 95% CI: 0.26–0.88), MRC dyspnea grade > 3 (OR = 1.15; 95% CI: 2.56–4.89), body mass index (BMI) <20 (OR =0.62, 95% CI: 0.31-1.23) and non-use of Tiotropium (OR = 1.21, 95% CI: 0.67-2.19) were independently associated with frequent readmissions for AECOPD. Conclusion: The repeated exacerbations in COPD were common with major burden to the society. The major factors influencing frequency of repeated COPD exacerbations were disease duration, non-prescription of inhaled corticosteroids (ICS +LABA) and Tiotropium, lower serum albumin level (<2gm/dl), lower BMI and MRC dyspnea grade > 3.
Background: Acute exacerbations of COPD (AECOPD) are known to be associated with increased morbidity and mortality and have a significant socioeconomic impact. The factors that determine frequent hospital readmissions for AECOPD are poorly understood. The aim of this study was to EVALUATE the factors responsible for the repeated admissions for AECOPD. Methodology: We conducted a prospective study of 235 patients with COPD with one or more admissions for acute exacerbations in a tertiary care hospital. Frequency of previous readmissions for AECOPD in the past year, and clinical characteristics, including spirometry were ascertained in the stable state both before discharge and at 6-month post discharge. All the patients were followed up for a period of two years after discharge to evaluate the readmissions for the acute exacerbations. Results: Among 149 COPD patients who were admitted and assessed for AECOPD, there were 278 readmissions for AECOPD over a follow-up period of 24 months. Of these, 27% had one readmission, while rest 78% had two or more readmissions during this period. There was a high prevalence of current or ex-heavy smokers, associated co-morbidity, underweight patients and low prevalence of vaccination and use of domiciliary oxygen therapy among COPD patients. A total of 15.4% mortality was observed in the present study. The multivariate logistic regression analysis for repeated admissions revealed that disease duration >10 years (OR =0.50; 95% CI: 0.27 -0.93), non-use of inhaled corticosteroids (ICS +LABA) (OR = 2.31; 95% CI: 2.26–4.88), lower serum albumin level (<2gm/dl) (OR = 0.48; 95% CI: 0.26–0.88), MRC dyspnea grade > 3 (OR = 1.15; 95% CI: 2.56–4.89), body mass index (BMI) <20 (OR =0.62, 95% CI: 0.31-1.23) and non-use of Tiotropium (OR = 1.21, 95% CI: 0.67-2.19) were independently associated with frequent readmissions for AECOPD. Conclusion: The repeated exacerbations in COPD were common with major burden to the society. The major factors influencing frequency of repeated COPD exacerbations were disease duration, non-prescription of inhaled corticosteroids (ICS +LABA) and Tiotropium, lower serum albumin level (<2gm/dl), lower BMI and MRC dyspnea grade > 3.
Risk Factors for Frequent Hospital Readmissions for Acute Exacerbations of COPD
doi:10.11648/j.cmr.20130206.20
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Gaude Gajanan
Hattiholi Jyothi
Chaudhury Alisha
Risk Factors for Frequent Hospital Readmissions for Acute Exacerbations of COPD
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2014-01-01
2014-01-01
10.11648/j.cmr.20130206.20
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.20
© Science Publishing Group
Effects of Fat and Cinnamon Feeding on Adiponectin after Rat Injection with Dexamethasone
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.19
Chronically excessive numbers of glucocorticoids are known to induce insulin resistance, which is possibly involved in impairing the insulin signaling in liver, muscle, and adipose tissues. Excessive levels of cortisol are characterized by the symptoms of abdominal obesity, hypertension, glucose intolerance or diabetes and dyslipidemia ,all of these features are shared by the condition of insulin resistance .Consumption of high levels of dietary fat is thought to be a major factor in the promotion of obesity and insulin resistance [7]. Fatty acid composition in the diet is another mechanism implicated in the development of insulin resistance [6]. Several environmental factors, including high-fat diet, are reported to activate the functioning of the hypothalamus-pituitary-adrenal axis [HPA]. Frequently evoked HPA-axis secretes excessive amount of cortisol [21] and elevated cortisol level is implicated in the development of entire spectrum of the metabolic syndrome, including insulin resistance, visceral obesity and dyslipidemia as well as the kinds of [21]. Cinnamon contains biologically active substances that have demonstrated insulin-mimetic properties. In vitro [3] and in vivo [1, 20] studies have shown that cinnamon enhances glucose uptake by activating insulin receptor kinase activity, autophosphorylation of the insulin receptor, and glycogen synthase activity. Other recent studies have demonstrated the ability of cinnamon to reduce lipid levels in fructose-fed rats, potentially via inhibiting hepatic 3-hydroxy-3-methylglutaryl CoA reductase activity [2]. Adiponectin is the most abundant plasma protein synthesized for the most part in adipose tissue, and it is an insulin-sensitive hormone,playing a central role in glucose and lipid metabolism [7] Furthermore, adiponectin levels are inversely associated with visceral adiposity [15]. Moreover, adiponectin has been reported to exhibit anti-atherosclerotic and anti-inflammatory effects [17,16].
Chronically excessive numbers of glucocorticoids are known to induce insulin resistance, which is possibly involved in impairing the insulin signaling in liver, muscle, and adipose tissues. Excessive levels of cortisol are characterized by the symptoms of abdominal obesity, hypertension, glucose intolerance or diabetes and dyslipidemia ,all of these features are shared by the condition of insulin resistance .Consumption of high levels of dietary fat is thought to be a major factor in the promotion of obesity and insulin resistance [7]. Fatty acid composition in the diet is another mechanism implicated in the development of insulin resistance [6]. Several environmental factors, including high-fat diet, are reported to activate the functioning of the hypothalamus-pituitary-adrenal axis [HPA]. Frequently evoked HPA-axis secretes excessive amount of cortisol [21] and elevated cortisol level is implicated in the development of entire spectrum of the metabolic syndrome, including insulin resistance, visceral obesity and dyslipidemia as well as the kinds of [21]. Cinnamon contains biologically active substances that have demonstrated insulin-mimetic properties. In vitro [3] and in vivo [1, 20] studies have shown that cinnamon enhances glucose uptake by activating insulin receptor kinase activity, autophosphorylation of the insulin receptor, and glycogen synthase activity. Other recent studies have demonstrated the ability of cinnamon to reduce lipid levels in fructose-fed rats, potentially via inhibiting hepatic 3-hydroxy-3-methylglutaryl CoA reductase activity [2]. Adiponectin is the most abundant plasma protein synthesized for the most part in adipose tissue, and it is an insulin-sensitive hormone,playing a central role in glucose and lipid metabolism [7] Furthermore, adiponectin levels are inversely associated with visceral adiposity [15]. Moreover, adiponectin has been reported to exhibit anti-atherosclerotic and anti-inflammatory effects [17,16].
Effects of Fat and Cinnamon Feeding on Adiponectin after Rat Injection with Dexamethasone
doi:10.11648/j.cmr.20130206.19
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Mahmoud Hassan El-Bidawy
Nabil Mohamed Elbahey
Mohamed Mahmoud Shaaban
Effects of Fat and Cinnamon Feeding on Adiponectin after Rat Injection with Dexamethasone
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166
2014-01-01
2014-01-01
10.11648/j.cmr.20130206.19
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.19
© Science Publishing Group
Assessment of the Level and Associated Factors with Knowledge and Practice of Diabetes Mellitus among Diabetic Patients Attending at FelegeHiwot Hospital, Northwest Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.11
Introduction: Diabetes mellitus was perceived as the problem of the developed world but currently developing countries like Ethiopia are suffering chronic diseases of which diabetes is the major one.Objective: The aim of this study wasto assess of the level and associated factors with knowledge and practice of diabetes mellitus among diabetic patients attending at FelegeHiwot hospital. Methods: Institution based cross sectional study was conducted using interviewer administered questionnaire among 410 diabetic patients. Systematic sampling technique was used to select study subjects. Data was entered to EPI info 3.5.1 and then transferred to SPSS for analysis. Descriptive and analytical statistics including bivariate and multivariate analysis were applied. Result: Among 410 respondents, Half (49.8%) of them had good knowledge and one hundred fifty four (36.8%) participants had good practice on diabetes. Lower age was significantly associated with good knowledge and practice. Age group 18-32 yrs, 33-41 yrs and 42-50 yrs were 6.2 times, 3.3 times and 3.1 times respectively more likely to had good knowledge compared to individuals who were at the age of 50 yrsand above. Similarly, age group between 18-32 yrs was 6 times more likely to have good practice. Higher educational status was also associated with good knowledge and practice. Participants in grade 1-8, grade 9-12 and higher education and above were 3.4 times, 4.7 times and 7.2 timesrespectively more likely to had good knowledge compared to those who were unable to read and write.Likewise, those in grade 1-8, grade 9-12 and higher education and above were 3.5, 4.3 and5.4 times respectivelyto have good practice.Increased duration of diabetic therapy was positively associated with good knowledge and practice. Increased level of income was positively associated with good practice.Conclusion: This study demonstrated low level of knowledge and practice among DM patients. Age, educational status and duration of DM therapy were associated with good knowledge and practice of participants. Monthly income was also associated with good practice. Improving knowledge and practice of diabetic patient through active education is advisable. Involvement of both governmental and non-governmental organizations is also crucial to help patients receive maximum benefit from the health care service.
Introduction: Diabetes mellitus was perceived as the problem of the developed world but currently developing countries like Ethiopia are suffering chronic diseases of which diabetes is the major one.Objective: The aim of this study wasto assess of the level and associated factors with knowledge and practice of diabetes mellitus among diabetic patients attending at FelegeHiwot hospital. Methods: Institution based cross sectional study was conducted using interviewer administered questionnaire among 410 diabetic patients. Systematic sampling technique was used to select study subjects. Data was entered to EPI info 3.5.1 and then transferred to SPSS for analysis. Descriptive and analytical statistics including bivariate and multivariate analysis were applied. Result: Among 410 respondents, Half (49.8%) of them had good knowledge and one hundred fifty four (36.8%) participants had good practice on diabetes. Lower age was significantly associated with good knowledge and practice. Age group 18-32 yrs, 33-41 yrs and 42-50 yrs were 6.2 times, 3.3 times and 3.1 times respectively more likely to had good knowledge compared to individuals who were at the age of 50 yrsand above. Similarly, age group between 18-32 yrs was 6 times more likely to have good practice. Higher educational status was also associated with good knowledge and practice. Participants in grade 1-8, grade 9-12 and higher education and above were 3.4 times, 4.7 times and 7.2 timesrespectively more likely to had good knowledge compared to those who were unable to read and write.Likewise, those in grade 1-8, grade 9-12 and higher education and above were 3.5, 4.3 and5.4 times respectivelyto have good practice.Increased duration of diabetic therapy was positively associated with good knowledge and practice. Increased level of income was positively associated with good practice.Conclusion: This study demonstrated low level of knowledge and practice among DM patients. Age, educational status and duration of DM therapy were associated with good knowledge and practice of participants. Monthly income was also associated with good practice. Improving knowledge and practice of diabetic patient through active education is advisable. Involvement of both governmental and non-governmental organizations is also crucial to help patients receive maximum benefit from the health care service.
Assessment of the Level and Associated Factors with Knowledge and Practice of Diabetes Mellitus among Diabetic Patients Attending at FelegeHiwot Hospital, Northwest Ethiopia
doi:10.11648/j.cmr.20130206.11
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Solomon Asnakew Feleke
Chalachew Misganaw Alemayehu
Hawult Taye Adane
Assessment of the Level and Associated Factors with Knowledge and Practice of Diabetes Mellitus among Diabetic Patients Attending at FelegeHiwot Hospital, Northwest Ethiopia
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2014-01-01
10.11648/j.cmr.20130206.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.11
© Science Publishing Group
An Assessment of Hamstring Flexibility of Subjects with Knee Osteoarthritis and Their Age Matched Control
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.12
Most often, attention is focused on management of pains, restricted joint motions and decreased muscle strength in subjects with knee osteoarthritis, with little attention on hamstring flexibility training. The objectives of this study were to assess and compare hamstring flexibility of subjects with knee osteoarthritis with their age matched healthy control. Forty-four subjects with grade III knee osteoarthritis and 58 apparently healthy individuals participated in the study. Hamstring flexibility, pain and knee flexion range of motion of both groups were measured. The data was analyzed using descriptive statistic and parametric inferential statistics [student t-test and Pearson’s product moment correlation]. The result showed that the mean flexibility of apparently healthy individual was significantly higher than that of subjects with knee osteoarthritis [t = 2.84, p<0.001]. Also, there was significant correlation between age, BMI, height and flexibility of the subjects with knee OA [r = -0.453, p = 0.002; r = -0.568 p = 0.034, r = 0.328, p = 0.030] respectively. This study concluded that the mean hamstring flexibility of subjects with knee osteoarthritis was significantly lower than that of apparently healthy individual.
Most often, attention is focused on management of pains, restricted joint motions and decreased muscle strength in subjects with knee osteoarthritis, with little attention on hamstring flexibility training. The objectives of this study were to assess and compare hamstring flexibility of subjects with knee osteoarthritis with their age matched healthy control. Forty-four subjects with grade III knee osteoarthritis and 58 apparently healthy individuals participated in the study. Hamstring flexibility, pain and knee flexion range of motion of both groups were measured. The data was analyzed using descriptive statistic and parametric inferential statistics [student t-test and Pearson’s product moment correlation]. The result showed that the mean flexibility of apparently healthy individual was significantly higher than that of subjects with knee osteoarthritis [t = 2.84, p<0.001]. Also, there was significant correlation between age, BMI, height and flexibility of the subjects with knee OA [r = -0.453, p = 0.002; r = -0.568 p = 0.034, r = 0.328, p = 0.030] respectively. This study concluded that the mean hamstring flexibility of subjects with knee osteoarthritis was significantly lower than that of apparently healthy individual.
An Assessment of Hamstring Flexibility of Subjects with Knee Osteoarthritis and Their Age Matched Control
doi:10.11648/j.cmr.20130206.12
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Ayodele Teslim Onigbinde
Oyebukola Akindoyi
Funmilola Adenike Faremi
Adaobi Okonji
Oniyangi Shuaib
Olaitan Olukunmi Lanre
An Assessment of Hamstring Flexibility of Subjects with Knee Osteoarthritis and Their Age Matched Control
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2014-01-01
10.11648/j.cmr.20130206.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20130206.12
© Science Publishing Group
Priapism due to Glyceryl Trinitrate in Adult Intensive Care Unit: A Case Report
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140301.13
Priapism is a prolonged penile erection without sexual stimulation. Two forms of priapism are recognized: veno-occlusive or low-flow priapism and arterial or high-flow priapism. High-flow (arterial) priapism is usually the result of straddle injury. Treatment of high-flow priapism may be elective Low-flow priapism is usually related to sickle cell disease, haemoglobinopathies, neoplastic syndrome, psychotropic medication, anticoagulant therapy, or idiopathic causes. Low-flow priapism is a case of urologic emergency and priapism must be treated as emergency. A 52-year-old man was admitted to the neurology intensive care unit with the diagnosis of stroke. Glyceryl trinitrate was applied to the patient for the treatment of hypertension. In our case, Low-flow priapisms were completely due to glyceryl trinitrate therapy applied at the insensive care. We report a case of prolonged low-flow priapism induced by Glyceryl trinitrate. In literature, this is the first report of glyceryl trinitrate-associated priapism.
Priapism is a prolonged penile erection without sexual stimulation. Two forms of priapism are recognized: veno-occlusive or low-flow priapism and arterial or high-flow priapism. High-flow (arterial) priapism is usually the result of straddle injury. Treatment of high-flow priapism may be elective Low-flow priapism is usually related to sickle cell disease, haemoglobinopathies, neoplastic syndrome, psychotropic medication, anticoagulant therapy, or idiopathic causes. Low-flow priapism is a case of urologic emergency and priapism must be treated as emergency. A 52-year-old man was admitted to the neurology intensive care unit with the diagnosis of stroke. Glyceryl trinitrate was applied to the patient for the treatment of hypertension. In our case, Low-flow priapisms were completely due to glyceryl trinitrate therapy applied at the insensive care. We report a case of prolonged low-flow priapism induced by Glyceryl trinitrate. In literature, this is the first report of glyceryl trinitrate-associated priapism.
Priapism due to Glyceryl Trinitrate in Adult Intensive Care Unit: A Case Report
doi:10.11648/j.cmr.20140301.13
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Erdogan Aglamis
Cemal Tasdemir
Mehmet Ozgur Yucel
Mehmet Sezai Ogras
Ercan Erdogan
Priapism due to Glyceryl Trinitrate in Adult Intensive Care Unit: A Case Report
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140301.13
© Science Publishing Group
Tissue Scurvy Misdiagnosed as Shaken Baby Syndrome Homicide
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140301.12
“Tissue Scurvy” is an autoimmune disorder in which there is an abundance of Vitamin C in the body(unlike the Seafarer Scurvy of yesteryear) but it is inhibited from entering the tissue cells to perform its functions of maintaining the integrity of the blood vessels and skeletal tissue and partaking in several enzymatic reactions because of the lack of insulin which is essential for the transfer of Vitamin C into the cell. The result is the development of fractures, hemorrhages and other lesions of Scurvy. Here it is shown a child alleged to have been murdered by being shaken to death was found to have hyperglycemia, implying insulin deficiency and concomitant Tissue Scurvy. It is concluded that the diagnosis Shaken Baby Syndrome, and all examples of unexplained fractures, bruises, retinal and subdural hemorrhages with encephalopathy – the so-called “TRIAD” - are in fact an autoimmune disorder following antigenic stimulation in a genetically susceptible child. Vaccines administered within 4 weeks of the onset of symptoms are the most common cause. The Shaken Baby Syndrome is a fabricated diagnosis and has no place in medical jurisprudence.
“Tissue Scurvy” is an autoimmune disorder in which there is an abundance of Vitamin C in the body(unlike the Seafarer Scurvy of yesteryear) but it is inhibited from entering the tissue cells to perform its functions of maintaining the integrity of the blood vessels and skeletal tissue and partaking in several enzymatic reactions because of the lack of insulin which is essential for the transfer of Vitamin C into the cell. The result is the development of fractures, hemorrhages and other lesions of Scurvy. Here it is shown a child alleged to have been murdered by being shaken to death was found to have hyperglycemia, implying insulin deficiency and concomitant Tissue Scurvy. It is concluded that the diagnosis Shaken Baby Syndrome, and all examples of unexplained fractures, bruises, retinal and subdural hemorrhages with encephalopathy – the so-called “TRIAD” - are in fact an autoimmune disorder following antigenic stimulation in a genetically susceptible child. Vaccines administered within 4 weeks of the onset of symptoms are the most common cause. The Shaken Baby Syndrome is a fabricated diagnosis and has no place in medical jurisprudence.
Tissue Scurvy Misdiagnosed as Shaken Baby Syndrome Homicide
doi:10.11648/j.cmr.20140301.12
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Michael D. Innis
Tissue Scurvy Misdiagnosed as Shaken Baby Syndrome Homicide
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2014-01-01
10.11648/j.cmr.20140301.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140301.12
© Science Publishing Group
To Study the Knowledge and Attitude of Postnatal Mothers on Neonatal Jaundice in Motahari Hospital, Iran
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140301.11
Background: Neonatal jaundice (NNJ) is one of the most common disorders worldwide. In time and proper management to reduce serious neurological complications depends on mothers’ knowledge and beliefs about NNJ. Objective: To determine knowledge and attitude on neonatal jaundice of postnatal mothers in Motahari Hospital, Urmia, Iran. Methods: In this descriptive-analytical study, 200 mothers who delivered in Motahari Hospital, Urmia, Iran, were interviewed in the first 3 days of delivery, using a structured questionnaire. Results: The mean knowledge score was 6.65 (SD=3.5) out of 15 and the mean attitude score was 25.9 (SD=4.48) out of 35. The knowledge of mothers on causes, treatment and complications of neonatal jaundice was not adequate. Knowledge and attitude scores were correlated with the past experiences of neonatal jaundice and educational levels. Conclusion: There are still misconceptions on the risk factors, treatments and complications of neonatal jaundice among mothers. Special educational programs are needed to increase the awareness of mothers.
Background: Neonatal jaundice (NNJ) is one of the most common disorders worldwide. In time and proper management to reduce serious neurological complications depends on mothers’ knowledge and beliefs about NNJ. Objective: To determine knowledge and attitude on neonatal jaundice of postnatal mothers in Motahari Hospital, Urmia, Iran. Methods: In this descriptive-analytical study, 200 mothers who delivered in Motahari Hospital, Urmia, Iran, were interviewed in the first 3 days of delivery, using a structured questionnaire. Results: The mean knowledge score was 6.65 (SD=3.5) out of 15 and the mean attitude score was 25.9 (SD=4.48) out of 35. The knowledge of mothers on causes, treatment and complications of neonatal jaundice was not adequate. Knowledge and attitude scores were correlated with the past experiences of neonatal jaundice and educational levels. Conclusion: There are still misconceptions on the risk factors, treatments and complications of neonatal jaundice among mothers. Special educational programs are needed to increase the awareness of mothers.
To Study the Knowledge and Attitude of Postnatal Mothers on Neonatal Jaundice in Motahari Hospital, Iran
doi:10.11648/j.cmr.20140301.11
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Soheila Rabiyeepoor
Shahsanam Gheibi
Saeideh Jafari
To Study the Knowledge and Attitude of Postnatal Mothers on Neonatal Jaundice in Motahari Hospital, Iran
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2014-01-01
10.11648/j.cmr.20140301.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140301.11
© Science Publishing Group
Cervical Lymphadenopathy with Special Reference to Fine Needle Aspiration Cytology Corroborated with Histological Examination: A Cross Sectional Study
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.12
Introduction: Cervical lymphadenoparthy is a common presentation of many diseases, though it is mostly tubercular in origin in developing countries. This cross sectional study was done to corroborate fine needle aspiration cytology (FNAC) findings with histopathological examinations (HPE) in cervical lymphadenopathy. Materials and methods: 120 patients of both sexes attending the FNAC unit of Nilratan Sircar Medical College and Hospital, Kolkata were enrolled in this study. They were evaluated by thorough clinical examination followed by routine investigations, FNAC and histopathological examination (HPE). Results: There was maximum corroboration of FNAC and HPE reports in tubercular lymphadenitis (76 v/s 76) and Hodgkin’s disease (2 v/s 2) followed by metastatic carcinoma (20 v/s 16) and non specific lymphadenitis (14 v/s 5) respectively. Overall correlation was 88.4% (excluding 8 cases where FNAC results were inconclusive due to unsatisfactory smear). The sensitivity, specificity, positive predictive value and negative predictive value of FNAC to diagnose tubercular lymphadenopathies were 86.36%. 100.0%, 100.0% and 72.73% respectively. In case of metastatic CA, these were 100.0%, 96.15%, 80.0% and 100.0% respectively. Conclusion: FNAC is simple, safe, quick, cheap, acceptable yet accurate method of establishing the etiology in cases of cervical lymphadenopathy.
Introduction: Cervical lymphadenoparthy is a common presentation of many diseases, though it is mostly tubercular in origin in developing countries. This cross sectional study was done to corroborate fine needle aspiration cytology (FNAC) findings with histopathological examinations (HPE) in cervical lymphadenopathy. Materials and methods: 120 patients of both sexes attending the FNAC unit of Nilratan Sircar Medical College and Hospital, Kolkata were enrolled in this study. They were evaluated by thorough clinical examination followed by routine investigations, FNAC and histopathological examination (HPE). Results: There was maximum corroboration of FNAC and HPE reports in tubercular lymphadenitis (76 v/s 76) and Hodgkin’s disease (2 v/s 2) followed by metastatic carcinoma (20 v/s 16) and non specific lymphadenitis (14 v/s 5) respectively. Overall correlation was 88.4% (excluding 8 cases where FNAC results were inconclusive due to unsatisfactory smear). The sensitivity, specificity, positive predictive value and negative predictive value of FNAC to diagnose tubercular lymphadenopathies were 86.36%. 100.0%, 100.0% and 72.73% respectively. In case of metastatic CA, these were 100.0%, 96.15%, 80.0% and 100.0% respectively. Conclusion: FNAC is simple, safe, quick, cheap, acceptable yet accurate method of establishing the etiology in cases of cervical lymphadenopathy.
Cervical Lymphadenopathy with Special Reference to Fine Needle Aspiration Cytology Corroborated with Histological Examination: A Cross Sectional Study
doi:10.11648/j.cmr.20140302.12
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Sukdeb Biswas
Kaushik Ghosh
Sisir Chakraborty
Rajdip Hazra
Rabindra Nath Biswas
Susmita Ghosh
Kaushik Das
Niladri Sarkar
Cervical Lymphadenopathy with Special Reference to Fine Needle Aspiration Cytology Corroborated with Histological Examination: A Cross Sectional Study
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2014-01-01
2014-01-01
10.11648/j.cmr.20140302.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.12
© Science Publishing Group
Distribution of Bacterial Species and Evaluation of their Antimicrobial Susceptibility Support a General Approach that Urinary Tract İnfections are Considered Complicated in Men
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.13
Background: Urinary tract infections (UTIs) in men are considered complicated, however few studies support this view. We compared the differences in the causative microorganism and their antimicrobial resistance between male and female patients presenting with an UTI. Methods: We evaluated the all microorganism isolated from the urine samples of patients which were admitted to outpatient clinics of our hospital during 2006 – 2011, which diagnosed with uncomplicated community acquired UTI. Results: Totally 8730 bacterial strains were isolated. Of these strains 5168 (59.2%) were isolated in women, whereas 3562 (40.8%) were isolated in men. Escherichia coli was the most frequently isolated microorganism (64.4%), followed by other enterobacteriaceae (15.1%) and enterococci (17.8%). However, the frequency of E. coli in men was significantly lower than in women, and frequency of other enterobacteriaceae and frequency of enterococci were higher than in women (49.4% versus 74.7%, 21.2% versus 10.8%, 24.7% versus 12.9%, respectively, p=0.001). The distribution of microorganism was evaluated according to age groups, similar results were observed in all age groups. In addition, E. coli, the most common strains for both sex. E. coli strains isolated in men were significantly less sensitive to ampicillin, ampicillin/sulbactam, cefuroxime, ceftriaxone, trimethoprim-sulphamethoxazole, gentamicin, ciprofloxacin, nitrofurantoin and fosfomycin than in women (p<0.05). Conclusion: The distribution of bacterial species isolated from urine culture of UTI is different in men. Even though E. coli is the most common strains in men as in women. In addition E. coli strains isolated in men were more resistant to antibiotics.
Background: Urinary tract infections (UTIs) in men are considered complicated, however few studies support this view. We compared the differences in the causative microorganism and their antimicrobial resistance between male and female patients presenting with an UTI. Methods: We evaluated the all microorganism isolated from the urine samples of patients which were admitted to outpatient clinics of our hospital during 2006 – 2011, which diagnosed with uncomplicated community acquired UTI. Results: Totally 8730 bacterial strains were isolated. Of these strains 5168 (59.2%) were isolated in women, whereas 3562 (40.8%) were isolated in men. Escherichia coli was the most frequently isolated microorganism (64.4%), followed by other enterobacteriaceae (15.1%) and enterococci (17.8%). However, the frequency of E. coli in men was significantly lower than in women, and frequency of other enterobacteriaceae and frequency of enterococci were higher than in women (49.4% versus 74.7%, 21.2% versus 10.8%, 24.7% versus 12.9%, respectively, p=0.001). The distribution of microorganism was evaluated according to age groups, similar results were observed in all age groups. In addition, E. coli, the most common strains for both sex. E. coli strains isolated in men were significantly less sensitive to ampicillin, ampicillin/sulbactam, cefuroxime, ceftriaxone, trimethoprim-sulphamethoxazole, gentamicin, ciprofloxacin, nitrofurantoin and fosfomycin than in women (p<0.05). Conclusion: The distribution of bacterial species isolated from urine culture of UTI is different in men. Even though E. coli is the most common strains in men as in women. In addition E. coli strains isolated in men were more resistant to antibiotics.
Distribution of Bacterial Species and Evaluation of their Antimicrobial Susceptibility Support a General Approach that Urinary Tract İnfections are Considered Complicated in Men
doi:10.11648/j.cmr.20140302.13
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Esat Korgali
Mustafa Gökhan Gözel
Emin Yener Gültekin
Mustafa Zahir Bakici
Semih Ayan
Gökhan Gökçe
Distribution of Bacterial Species and Evaluation of their Antimicrobial Susceptibility Support a General Approach that Urinary Tract İnfections are Considered Complicated in Men
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2014-01-01
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.13
© Science Publishing Group
Anamnestic Findings and Alanine Aminotransferase Predict Accurately Chronic HBs Antigen Carriers among Black Africans in Côte d’Ivoire (West Africa)
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.11
Background: The high burden of viral hepatitis B (HBV) remains a challenge in Côte d’Ivoire where patients are mostly seen in hospital at the end stage of the disease. Aim: This cross sectional study is aimed at assessing the usefulness of anamnestic findings, clinical and biological factors in predicting chronic hepatitis B surface antigen (HBsAg) carriers in clinical practice. Patients and methods: The study was conducted in 230 workers (median age: 39 years, female: 20%) of government press enterprise (GPE) in 2010. Socio-demographic, clinical and biological parameters were collected. Chronic HBsAg carrier was defined as serum HBsAg positivity after 2 assessments within 6 months interval. Diagnostic accuracy of predictive factors was determined by multivariate logistic regression. Results: The prevalence of chronic HBsAg was 12.6% [95%CI: 8.61-17.60]. Chronic HBsAg carriers frequently expressed a history of hepatitis (13.8 vs 2.5%, p=0.003), or jaundice (37.9 vs 14.3, p=0.003), had slightly high level of AST (33 vs 25.5 IU/L, p=.004) and ALT (31.5 vs 22, p=<0.0001) compared to non-carriers. In multivariate analysis, age (OR: 0.93, p=0.03), history of hepatitis (OR=8.18, p=0.005), unsafe injection with boiled syringe (OR: 3.41, p=0.03), and ALT (OR=1.03, p=0.002) were predictive factors of chronic HBsAg carriers. The model yielded an AUROC of 0.793±0.06. With a cut-off <0.125, the model allowed predicting chronic HBsAg carrier with a sensitivity and negative predictive value of 78.6 and 96.1% respectively. Among 28 chronic HBsAg carriers 22(78.6%) were correctly predicted and 6(21.4%) were false negative. With a cut-off >0.5, the model showed a specificity, positive and negative predictive values of 99, 66.7 and 88.9% respectively. The model correctly classified 192(99%) workers as non-chronic HBsAg carriers and 2(1%) were misclassified. Conclusion: This study suggests that age, history of hepatitis, unsafe injection with boiled syringe combined with ALT could be used to predict chronic HBsAg carrier in Côte d’Ivoire and other endemic areas in Africa.
Background: The high burden of viral hepatitis B (HBV) remains a challenge in Côte d’Ivoire where patients are mostly seen in hospital at the end stage of the disease. Aim: This cross sectional study is aimed at assessing the usefulness of anamnestic findings, clinical and biological factors in predicting chronic hepatitis B surface antigen (HBsAg) carriers in clinical practice. Patients and methods: The study was conducted in 230 workers (median age: 39 years, female: 20%) of government press enterprise (GPE) in 2010. Socio-demographic, clinical and biological parameters were collected. Chronic HBsAg carrier was defined as serum HBsAg positivity after 2 assessments within 6 months interval. Diagnostic accuracy of predictive factors was determined by multivariate logistic regression. Results: The prevalence of chronic HBsAg was 12.6% [95%CI: 8.61-17.60]. Chronic HBsAg carriers frequently expressed a history of hepatitis (13.8 vs 2.5%, p=0.003), or jaundice (37.9 vs 14.3, p=0.003), had slightly high level of AST (33 vs 25.5 IU/L, p=.004) and ALT (31.5 vs 22, p=<0.0001) compared to non-carriers. In multivariate analysis, age (OR: 0.93, p=0.03), history of hepatitis (OR=8.18, p=0.005), unsafe injection with boiled syringe (OR: 3.41, p=0.03), and ALT (OR=1.03, p=0.002) were predictive factors of chronic HBsAg carriers. The model yielded an AUROC of 0.793±0.06. With a cut-off <0.125, the model allowed predicting chronic HBsAg carrier with a sensitivity and negative predictive value of 78.6 and 96.1% respectively. Among 28 chronic HBsAg carriers 22(78.6%) were correctly predicted and 6(21.4%) were false negative. With a cut-off >0.5, the model showed a specificity, positive and negative predictive values of 99, 66.7 and 88.9% respectively. The model correctly classified 192(99%) workers as non-chronic HBsAg carriers and 2(1%) were misclassified. Conclusion: This study suggests that age, history of hepatitis, unsafe injection with boiled syringe combined with ALT could be used to predict chronic HBsAg carrier in Côte d’Ivoire and other endemic areas in Africa.
Anamnestic Findings and Alanine Aminotransferase Predict Accurately Chronic HBs Antigen Carriers among Black Africans in Côte d’Ivoire (West Africa)
doi:10.11648/j.cmr.20140302.11
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Alassan K. Mahassadi
Emile Allah-Kouadio
Constant Assi
Fulgence M. Y. Bathaix
Ahmad Coulibaly
Hortense Hovi
Mathieu B. Camara
Thérèse Y. Ndri
Anamnestic Findings and Alanine Aminotransferase Predict Accurately Chronic HBs Antigen Carriers among Black Africans in Côte d’Ivoire (West Africa)
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2014-01-01
10.11648/j.cmr.20140302.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.11
© Science Publishing Group
Use of Stool Culture as a Determinant Parameter of Enteric Fever in Adults Attending Bingham University Teaching Hospital Jos, Nigeria
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.15
Background: Enteric fever caused by salmonella typhi is an endemic disease in the tropics and sub-tropics; and has become a major public health problem in developing countries of the world. Presently, cultures of Stool and blood are the most diagnostic means of confirming salmonellosis in humans. However, the stool and serum sample of an infected patient against the somatic (O) and flagella (H) antigens of the bacteria requires thorough laboratory analysis. This study was biased on the use of stool culture as a confirmatory analysis of typhoid fever indices in the region of research particularly among adolescents (18 yrs and above). Methods: 60 adults attending Bingham University Teaching Hospital with symptoms clinically suspected to be enteric fever were randomly selected. Informed consent of volunteers was obtained in 48 patients and stool specimens collected and were cultured. Stool specimens were processed using isolation method and biochemical characteristics of susceptibility testing of typhoid fever from the individual patient. A significant mean difference of male and female that were affected by enteric fever was determined. Results: Results obtained from a total number of 48 patients (32 male and 16 female) indicated 12 positive stool cultures among which 10 were males and 2 were females (31.25% and 12.5%) respectively. Salmonella was found to be susceptible to Offloxacin, Ciprofloxacin, Ceffraxole and Cefuroxime respectively; thus constituting the choice drugs in the treatment of enteric fever. Conclusion: Result showed that a significant mean difference between the number of affected patients and those not affected (P.v = 0.0521) authenticates stool culture as confirmatory test for enteric fever as against clinical diagnosis. Salmonella enterica showed more resistance to some commonly used drugs. Therefore, sensitivity testing based on prescription is recommended to prevent continuous drug resistance development. Results further showed that men were more affected than women; however, a suggested area to explore in the study of enteric fever infections.
Background: Enteric fever caused by salmonella typhi is an endemic disease in the tropics and sub-tropics; and has become a major public health problem in developing countries of the world. Presently, cultures of Stool and blood are the most diagnostic means of confirming salmonellosis in humans. However, the stool and serum sample of an infected patient against the somatic (O) and flagella (H) antigens of the bacteria requires thorough laboratory analysis. This study was biased on the use of stool culture as a confirmatory analysis of typhoid fever indices in the region of research particularly among adolescents (18 yrs and above). Methods: 60 adults attending Bingham University Teaching Hospital with symptoms clinically suspected to be enteric fever were randomly selected. Informed consent of volunteers was obtained in 48 patients and stool specimens collected and were cultured. Stool specimens were processed using isolation method and biochemical characteristics of susceptibility testing of typhoid fever from the individual patient. A significant mean difference of male and female that were affected by enteric fever was determined. Results: Results obtained from a total number of 48 patients (32 male and 16 female) indicated 12 positive stool cultures among which 10 were males and 2 were females (31.25% and 12.5%) respectively. Salmonella was found to be susceptible to Offloxacin, Ciprofloxacin, Ceffraxole and Cefuroxime respectively; thus constituting the choice drugs in the treatment of enteric fever. Conclusion: Result showed that a significant mean difference between the number of affected patients and those not affected (P.v = 0.0521) authenticates stool culture as confirmatory test for enteric fever as against clinical diagnosis. Salmonella enterica showed more resistance to some commonly used drugs. Therefore, sensitivity testing based on prescription is recommended to prevent continuous drug resistance development. Results further showed that men were more affected than women; however, a suggested area to explore in the study of enteric fever infections.
Use of Stool Culture as a Determinant Parameter of Enteric Fever in Adults Attending Bingham University Teaching Hospital Jos, Nigeria
doi:10.11648/j.cmr.20140302.15
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Ramyil, Mamzhi-crown Seljul
Ogundeko, Timothy Olugbenga
Idyu, Iorkyase Isaiah
Ameh, Joshua Momoh
Use of Stool Culture as a Determinant Parameter of Enteric Fever in Adults Attending Bingham University Teaching Hospital Jos, Nigeria
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2014-01-01
10.11648/j.cmr.20140302.15
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.15
© Science Publishing Group
The Prevalence of Depression and Its Relevance to Clinical and Radiological Characteristics among Older Adults with Knee Osteoarthritis
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.14
In this study we assessed the prevalence of depression and its relevance to pain intensity, functional status (health related disability) and radiographic severity in older adults with knee osteoarthritis (OA).One hundred and thirty-eight elderly (sixty-five years or older) patients with knee OA and 82 age and sex matched healthy controls were included into the study. Beck depression scale was used to assess depressive disorders in all participants. The pain intensity, functional status and radiographic severity in patients were assessed with a Visual Analogue Scale (VAS), the Western Ontario and Mc-Master Universities Osteoarthritis Index (WOMAC), and the Kellgren-Lawrence grading system,respectively. Depression was detected in 49.3% of patients and 12.3% of controls. In patients group whose BDI scores were ≥17, the scores of VAS, WOMAC, and radiographic severity were found to be statistically significantly higher, compared to the group whose BDI scores were <17. A positive correlation was detected between BDI score and VAS, WOMAC and radiological classification scores in patients with knee OA. In linear regression analysis, the most significant determinant for the level of depression was WOMAC score. The present study shows that depression is a commonly encountered comorbidity in older adults with knee OA. The level of depression was correlated with the severity of the disorder, especially in patients whose WOMAC score was high. Therefore, coexisting depression should be taken into account in the assessment and management of older patients with knee OA.
In this study we assessed the prevalence of depression and its relevance to pain intensity, functional status (health related disability) and radiographic severity in older adults with knee osteoarthritis (OA).One hundred and thirty-eight elderly (sixty-five years or older) patients with knee OA and 82 age and sex matched healthy controls were included into the study. Beck depression scale was used to assess depressive disorders in all participants. The pain intensity, functional status and radiographic severity in patients were assessed with a Visual Analogue Scale (VAS), the Western Ontario and Mc-Master Universities Osteoarthritis Index (WOMAC), and the Kellgren-Lawrence grading system,respectively. Depression was detected in 49.3% of patients and 12.3% of controls. In patients group whose BDI scores were ≥17, the scores of VAS, WOMAC, and radiographic severity were found to be statistically significantly higher, compared to the group whose BDI scores were <17. A positive correlation was detected between BDI score and VAS, WOMAC and radiological classification scores in patients with knee OA. In linear regression analysis, the most significant determinant for the level of depression was WOMAC score. The present study shows that depression is a commonly encountered comorbidity in older adults with knee OA. The level of depression was correlated with the severity of the disorder, especially in patients whose WOMAC score was high. Therefore, coexisting depression should be taken into account in the assessment and management of older patients with knee OA.
The Prevalence of Depression and Its Relevance to Clinical and Radiological Characteristics among Older Adults with Knee Osteoarthritis
doi:10.11648/j.cmr.20140302.14
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Sami Küçükşen
Yılmaz Halim
Ali Yavuz Karahan
Sinan Bağçacı
The Prevalence of Depression and Its Relevance to Clinical and Radiological Characteristics among Older Adults with Knee Osteoarthritis
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2014-01-01
2014-01-01
10.11648/j.cmr.20140302.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.14
© Science Publishing Group
The Importance of Neutrophil Lymphocyte Ratio in Patients with Psoriasis
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.17
Objective: The aim of this study is to assess the neutrophil lymphocyte ratio (NLR) as an inflammatory marker in patients with psoriasis and to compare it with healthy subjects and to evaluate the correlation with the severity of the disease. Methods: 104 psoriasis patients and 70 healthy persons were included as the control group. The laboratory results were recorded retrospectively from the patients’ files and controls. NLR was calculated by the division of the neutrophil count to the lymphocyte count in the hemogram test. The dermatologic examinations and psoriatic area severity index (PASI) scoring were performed by the same dermatologist. Results: Leukocyte, neutrophil, NLR levels of the psoriasis patients were significantly elevated compared to those of the control group (p<0.05, p<0.01 and p<0.01 respectively). There were no correlation between NLR and PASI score (p>0.05) in the patient group. Conclusions: NLR, an emerging marker of inflammation, is higher in patients with psoriasis.
Objective: The aim of this study is to assess the neutrophil lymphocyte ratio (NLR) as an inflammatory marker in patients with psoriasis and to compare it with healthy subjects and to evaluate the correlation with the severity of the disease. Methods: 104 psoriasis patients and 70 healthy persons were included as the control group. The laboratory results were recorded retrospectively from the patients’ files and controls. NLR was calculated by the division of the neutrophil count to the lymphocyte count in the hemogram test. The dermatologic examinations and psoriatic area severity index (PASI) scoring were performed by the same dermatologist. Results: Leukocyte, neutrophil, NLR levels of the psoriasis patients were significantly elevated compared to those of the control group (p<0.05, p<0.01 and p<0.01 respectively). There were no correlation between NLR and PASI score (p>0.05) in the patient group. Conclusions: NLR, an emerging marker of inflammation, is higher in patients with psoriasis.
The Importance of Neutrophil Lymphocyte Ratio in Patients with Psoriasis
doi:10.11648/j.cmr.20140302.17
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Arzu Ataseven
Aynur Ugur Bilgin
Gulcan Saylam Kurtipek
Perihan Ozturk
Nursel Dilek
Huseyin Ataseven
The Importance of Neutrophil Lymphocyte Ratio in Patients with Psoriasis
3
2
43
43
2014-01-01
2014-01-01
10.11648/j.cmr.20140302.17
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.17
© Science Publishing Group
Association between Tumor Stage and Grade and Mean Platelet Volume in Patients with Renal Cell Carcinoma
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.16
Purpose: To research association between Mean Platelet Volume (MPV) and tumor stage and grade in non-metastatic renal cell carcinomas in circumstances of hypoxia, thromboembolism, and ischemia, based on MPV increase. Material and methods: Data of 104 non-metastatic patients, in whom nephrectomy was done and whose pathology resulted in renal cell carcinoma, have been evaluated retrospectively. The patients were clinically classified as T1a, T1b, T2a, T2b according to TNM stage and as Fuhrman Grade 1, 2, 3, 4 according to pathology results. Preoperative mean platelet number and MPV values of the patients were compared with their tumor stage and grade. Results: Sixteen (15%) were in T1a, 41 (39%) were in T1b, 39 (38%) were in T2a, and 8 (7%) of the patients were in T2b clinical stage. According to pathology results, 21 (20%) were assessed as Fuhrman grade I, 59 (57%) were grade II, 22 (21%) were grade III, and 2 (2%) of the patients were grade IV. Mean MPV values were 8.50±1.39, 8.51±1.25, 8.65±1.12, and 8.95±0.07 in Grade I, II, III, IV, respectively. A positive correlation was present between mean MPV and grade (r= 0.052, p=0.599). As long as grade increases, mean MPV values were observed to increase. However, no statistically difference was determined between tumor grade and mean MPV and platelet (p values: 0.935 and 0.963, respectively). No statistically significant difference was detected between tumor stage and mean MPV and platelet (p values: 0.996 and 0.397, respectively). Conclusion: A positive correlation was observed to be between mean MPV values and tumor grade. However, no statistically significant difference was determined. It can be supported with the larger series that MPV for renal tumors, that is rapidly and expansively growing tumor, can be an effective biochemical indicator in early diagnosis, staging, and evaluation of response to treatment.
Purpose: To research association between Mean Platelet Volume (MPV) and tumor stage and grade in non-metastatic renal cell carcinomas in circumstances of hypoxia, thromboembolism, and ischemia, based on MPV increase. Material and methods: Data of 104 non-metastatic patients, in whom nephrectomy was done and whose pathology resulted in renal cell carcinoma, have been evaluated retrospectively. The patients were clinically classified as T1a, T1b, T2a, T2b according to TNM stage and as Fuhrman Grade 1, 2, 3, 4 according to pathology results. Preoperative mean platelet number and MPV values of the patients were compared with their tumor stage and grade. Results: Sixteen (15%) were in T1a, 41 (39%) were in T1b, 39 (38%) were in T2a, and 8 (7%) of the patients were in T2b clinical stage. According to pathology results, 21 (20%) were assessed as Fuhrman grade I, 59 (57%) were grade II, 22 (21%) were grade III, and 2 (2%) of the patients were grade IV. Mean MPV values were 8.50±1.39, 8.51±1.25, 8.65±1.12, and 8.95±0.07 in Grade I, II, III, IV, respectively. A positive correlation was present between mean MPV and grade (r= 0.052, p=0.599). As long as grade increases, mean MPV values were observed to increase. However, no statistically difference was determined between tumor grade and mean MPV and platelet (p values: 0.935 and 0.963, respectively). No statistically significant difference was detected between tumor stage and mean MPV and platelet (p values: 0.996 and 0.397, respectively). Conclusion: A positive correlation was observed to be between mean MPV values and tumor grade. However, no statistically significant difference was determined. It can be supported with the larger series that MPV for renal tumors, that is rapidly and expansively growing tumor, can be an effective biochemical indicator in early diagnosis, staging, and evaluation of response to treatment.
Association between Tumor Stage and Grade and Mean Platelet Volume in Patients with Renal Cell Carcinoma
doi:10.11648/j.cmr.20140302.16
Clinical Medicine Research
2014-01-01
© Science Publishing Group
Ibrahim Keles
Cavit Ceylan
Erdogan Aglamis
Hasan Salih Saglam
Mustafa Karalar
Soner Coban
Sait Bicer
Oztug Adsan
Mehmet Ozgur Yucel
Association between Tumor Stage and Grade and Mean Platelet Volume in Patients with Renal Cell Carcinoma
3
2
39
39
2014-01-01
2014-01-01
10.11648/j.cmr.20140302.16
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.16
© Science Publishing Group
Hepatitis C-Virus Infection and Risk of Coronary Heart Diseases
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.18
Background: The world Health Organization has declared hepatitis C a global health problem, with approximately 3 % of the worldﹶs population. HCV infection was associated with a high risk of CHD. Hs-CRP and fibrinogen was considered as markers of coronary artery disease, their elevation correlated with incidence of CAD, However Apo A deficiency predict future risk of CAD. Aim: To study correlation between HCV infections and marker risk factors of coronary heart disease in different stages of liver disease. Patients & Method: Forty three chronic HCV patients were recruited at specialized hepatology clinic in National Hepatology and Tropical Medicine Research Institute (NHTMRI),Cairo; they were classified into 3 groups according to Child – Pugh score (A, B, C), 42 % were Child class A, 28 % Child B and 30 % Child C, age from 20 to 80 years. 15 healthy subjects served as control group. Detection of the following tests occurred for both groups: Liver function tests: ALT, AST, ALP, total protein, albumin, bilirubin, GGT and AFP. Ultra sensitive CRP, fibrinogen, apoprotein A and Lipid profile: Total Cholesterol, triglyceride, HDL-C, LDL-C, and Total Lipid. Results: the data obtained from results show that :liver enzymes AST, ALT, total bilirubin, albumin, total protein and INR levels were significantly different between groups and control (p< 0.05), Alkaline phosphates, GGT and AFP levels were not differing significantly in study groups and control (p> 0.05). Cardiac enzymes; CK and LDH levels were not significantly different between groups and control (p> 0.05). The APO A levels were not differs significantly in study groups and controls (p> 0.05). The fibrinogen andhs-CRP levels in the patients appeared to be significantly higher than those in the healthy controls (p< 0.05). Conclusion: hs-CRP and fibrinogen may be considered as a CHC progression prognostic factor, Evidence indicates that hepatitis C virus (HCV) have a key role in coronary heart disease.
Background: The world Health Organization has declared hepatitis C a global health problem, with approximately 3 % of the worldﹶs population. HCV infection was associated with a high risk of CHD. Hs-CRP and fibrinogen was considered as markers of coronary artery disease, their elevation correlated with incidence of CAD, However Apo A deficiency predict future risk of CAD. Aim: To study correlation between HCV infections and marker risk factors of coronary heart disease in different stages of liver disease. Patients & Method: Forty three chronic HCV patients were recruited at specialized hepatology clinic in National Hepatology and Tropical Medicine Research Institute (NHTMRI),Cairo; they were classified into 3 groups according to Child – Pugh score (A, B, C), 42 % were Child class A, 28 % Child B and 30 % Child C, age from 20 to 80 years. 15 healthy subjects served as control group. Detection of the following tests occurred for both groups: Liver function tests: ALT, AST, ALP, total protein, albumin, bilirubin, GGT and AFP. Ultra sensitive CRP, fibrinogen, apoprotein A and Lipid profile: Total Cholesterol, triglyceride, HDL-C, LDL-C, and Total Lipid. Results: the data obtained from results show that :liver enzymes AST, ALT, total bilirubin, albumin, total protein and INR levels were significantly different between groups and control (p< 0.05), Alkaline phosphates, GGT and AFP levels were not differing significantly in study groups and control (p> 0.05). Cardiac enzymes; CK and LDH levels were not significantly different between groups and control (p> 0.05). The APO A levels were not differs significantly in study groups and controls (p> 0.05). The fibrinogen andhs-CRP levels in the patients appeared to be significantly higher than those in the healthy controls (p< 0.05). Conclusion: hs-CRP and fibrinogen may be considered as a CHC progression prognostic factor, Evidence indicates that hepatitis C virus (HCV) have a key role in coronary heart disease.
Hepatitis C-Virus Infection and Risk of Coronary Heart Diseases
doi:10.11648/j.cmr.20140302.18
Clinical Medicine Research
2014-04-09
© Science Publishing Group
Amin M. Abdel Baki
Nashwa A. Zaky
Hepatitis C-Virus Infection and Risk of Coronary Heart Diseases
3
2
49
49
2014-04-09
2014-04-09
10.11648/j.cmr.20140302.18
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.18
© Science Publishing Group
Equivalence on Efficacy and Safety of Two Formulations of Insulin Glargine (Biosimilar and Reference) in the Treatment of Patients with Type 2 Diabetes Mellitus
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.19
Use of biosimilars has allowed the access to biopharmaceuticals to a more patients in the World. Insulin galrgine is an analogue of human insulin to provide consistent level of plasma insulin over a long duration. The aim of this study was compare the safety and efficacy of insulin glargine biosimilar vs reference in individuals with type 2 diabetes. One hundred two type 2 diabetic individuals (64 female and 38 male) were studied in a single center, randomized, comparative study. The patients received during 12 weeks insulin glargine biocomparable or reference at doses of 0.4 to 0.7 IU/kg/day by subcutaneous via. Glycosylated hemoglobin (Hb1Ac), Fasting blood glucose (FBG), and lipid profile were evaluated during the study. Health-related quality of life was evaluated using the 36-item Short Form questionnaire. Hb1Ac, FBG and lipid profile improved significantly from to start to endpoint in both groups. No significant differences were found between both groups. A total of 80.8 and 77.2% of patients had HbA1c < 7.5% and 66,6% and 69.5% achieved the FBG target, for reference and biosimilar insulin glargine, respectively. No significant reductions in body weight were observed between the start and the end of the study. The adverse event more reported was hypoglycemia. There was no apparent association between the levels of cross-reacting antibodies and Hb1Ac, body weight, insulin dose, or hypoglycemic episodes Improvements in both mental and physical health status were found, but no differences significant were found between the groups. We conclude that insulin galrgine biocomparable was similar since the safety and efficacy point of view with insulin glargine of reference in patients with diabetes mellitus 2
Use of biosimilars has allowed the access to biopharmaceuticals to a more patients in the World. Insulin galrgine is an analogue of human insulin to provide consistent level of plasma insulin over a long duration. The aim of this study was compare the safety and efficacy of insulin glargine biosimilar vs reference in individuals with type 2 diabetes. One hundred two type 2 diabetic individuals (64 female and 38 male) were studied in a single center, randomized, comparative study. The patients received during 12 weeks insulin glargine biocomparable or reference at doses of 0.4 to 0.7 IU/kg/day by subcutaneous via. Glycosylated hemoglobin (Hb1Ac), Fasting blood glucose (FBG), and lipid profile were evaluated during the study. Health-related quality of life was evaluated using the 36-item Short Form questionnaire. Hb1Ac, FBG and lipid profile improved significantly from to start to endpoint in both groups. No significant differences were found between both groups. A total of 80.8 and 77.2% of patients had HbA1c < 7.5% and 66,6% and 69.5% achieved the FBG target, for reference and biosimilar insulin glargine, respectively. No significant reductions in body weight were observed between the start and the end of the study. The adverse event more reported was hypoglycemia. There was no apparent association between the levels of cross-reacting antibodies and Hb1Ac, body weight, insulin dose, or hypoglycemic episodes Improvements in both mental and physical health status were found, but no differences significant were found between the groups. We conclude that insulin galrgine biocomparable was similar since the safety and efficacy point of view with insulin glargine of reference in patients with diabetes mellitus 2
Equivalence on Efficacy and Safety of Two Formulations of Insulin Glargine (Biosimilar and Reference) in the Treatment of Patients with Type 2 Diabetes Mellitus
doi:10.11648/j.cmr.20140302.19
Clinical Medicine Research
2014-04-11
© Science Publishing Group
Hernandez-Bastida, Antonio
Meixueiro-Montes de Oca, Raúl
Equivalence on Efficacy and Safety of Two Formulations of Insulin Glargine (Biosimilar and Reference) in the Treatment of Patients with Type 2 Diabetes Mellitus
3
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55
55
2014-04-11
2014-04-11
10.11648/j.cmr.20140302.19
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140302.19
© Science Publishing Group
Validation of Malay Version of Montreal Cognitive Assessment in Patients with Cognitive Impairment
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140303.11
Background: Montreal Cognitive Assessment (MoCA) has been shown to be a sensitive tool for cognitive assessment. There are high proportion of Malaysian elderly with limited proficiency in English language. Malay language is a more familiar language across the multiracial population of Malaysia. Objective: The aim of this study is to validate the Malay version of Montreal Cognitive Assessment (MMoCA) in cognitive impairment patients. Methods: Elderly aged 60 years and above were recruited by using convenient sampling method from 4 government hospitals. Subjects were categorized into normal control group versus patients group with cognitive impairment (Alzheimer’s Disease (AD) and Mild Cognitive Impairment (MCI)). All subjects completed MMoCA & MMSE – Malay version, followed by a second assessment, which involved Clinical Dementia Rating (CDR), clinical neurological and psychiatry assessment. Results: Total of 66 subjects was enrolled in the study, 44 were normal control, 14 with AD, 8 with MCI. MMoCA is better than MMSE-Malay in differentiating CDR 0 from CDR > 0. With the cut off point of less than 22, MMoCA has the sensitivity of 0.824 and specificity of 0.818 to detect cognitive impairment. Whereas MMSE-Malay only has sensitivity of 0.765 and specificity of 0.636 with the cut off point of less than 27. Conclusion: The MMoCA is a validated and useful cognitive screening instrument in patients with cognitive impairment.
Background: Montreal Cognitive Assessment (MoCA) has been shown to be a sensitive tool for cognitive assessment. There are high proportion of Malaysian elderly with limited proficiency in English language. Malay language is a more familiar language across the multiracial population of Malaysia. Objective: The aim of this study is to validate the Malay version of Montreal Cognitive Assessment (MMoCA) in cognitive impairment patients. Methods: Elderly aged 60 years and above were recruited by using convenient sampling method from 4 government hospitals. Subjects were categorized into normal control group versus patients group with cognitive impairment (Alzheimer’s Disease (AD) and Mild Cognitive Impairment (MCI)). All subjects completed MMoCA & MMSE – Malay version, followed by a second assessment, which involved Clinical Dementia Rating (CDR), clinical neurological and psychiatry assessment. Results: Total of 66 subjects was enrolled in the study, 44 were normal control, 14 with AD, 8 with MCI. MMoCA is better than MMSE-Malay in differentiating CDR 0 from CDR > 0. With the cut off point of less than 22, MMoCA has the sensitivity of 0.824 and specificity of 0.818 to detect cognitive impairment. Whereas MMSE-Malay only has sensitivity of 0.765 and specificity of 0.636 with the cut off point of less than 27. Conclusion: The MMoCA is a validated and useful cognitive screening instrument in patients with cognitive impairment.
Validation of Malay Version of Montreal Cognitive Assessment in Patients with Cognitive Impairment
doi:10.11648/j.cmr.20140303.11
Clinical Medicine Research
2014-04-25
© Science Publishing Group
Wee Kooi Cheah
Hoon Lang Teh
Diana Xiao Han Huang
Alan Swee Hock Ch’ng
Mun Pung Choy
Ewe Eow Teh
Irene Looi
Validation of Malay Version of Montreal Cognitive Assessment in Patients with Cognitive Impairment
3
3
60
60
2014-04-25
2014-04-25
10.11648/j.cmr.20140303.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140303.11
© Science Publishing Group
Neurogenic Bladder Revealing a Pernicious Anemia: One Case Report and Literature Review
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140303.12
Background: Neurogenic or neuropathic bladder is defined as any defective functioning of the bladder caused by impaired innervations. Pernicious anemia is a rare cause of neurogenic bladder and it is often accompanied by other neurological manifestations. The standard treatment is based on parenteral vitamin administration. We report a unique case of pernicious anemia revealed by a neurogenic bladder succefully managed by vitamin B12 administration. Case presentation: A 45-year-old man presented with lower urinary tract symptoms (LUTS) with urine retentions. The patient was an important postvoid residual volume. The uroflowmetry result of the patient was low. Cystoscopy reveals a normal urethra, prostatic fossa, and bladder. Urodynamic testing demonstrated a failure voiding bladder. The diagnostic of pernicious anemia was suspected in laboratory exams which have showed megaloblastic anemia and Serum antibodies to gastric parietal cells, the diagnostic was confirmed by gastric biopsy. The patient was traited by oral administration of vitamin B12. At his 6 months follow-up, clinical symptoms had improved, and there was no significant postvoid residual (PVR). Conclusion: The vesicosphincteriens disorders in pernicious anemia are very little detail in the literature .our case is to our knowledge the first to have urinary voiding dysfunction as the only symptom of pernicious anemia with spectacular improvement after vitamin B12 administration.
Background: Neurogenic or neuropathic bladder is defined as any defective functioning of the bladder caused by impaired innervations. Pernicious anemia is a rare cause of neurogenic bladder and it is often accompanied by other neurological manifestations. The standard treatment is based on parenteral vitamin administration. We report a unique case of pernicious anemia revealed by a neurogenic bladder succefully managed by vitamin B12 administration. Case presentation: A 45-year-old man presented with lower urinary tract symptoms (LUTS) with urine retentions. The patient was an important postvoid residual volume. The uroflowmetry result of the patient was low. Cystoscopy reveals a normal urethra, prostatic fossa, and bladder. Urodynamic testing demonstrated a failure voiding bladder. The diagnostic of pernicious anemia was suspected in laboratory exams which have showed megaloblastic anemia and Serum antibodies to gastric parietal cells, the diagnostic was confirmed by gastric biopsy. The patient was traited by oral administration of vitamin B12. At his 6 months follow-up, clinical symptoms had improved, and there was no significant postvoid residual (PVR). Conclusion: The vesicosphincteriens disorders in pernicious anemia are very little detail in the literature .our case is to our knowledge the first to have urinary voiding dysfunction as the only symptom of pernicious anemia with spectacular improvement after vitamin B12 administration.
Neurogenic Bladder Revealing a Pernicious Anemia: One Case Report and Literature Review
doi:10.11648/j.cmr.20140303.12
Clinical Medicine Research
2014-04-25
© Science Publishing Group
Omar Riyach
Mustapha Ahsaini
Mohammed Fadl Tazi
Jalal Eddine El Ammari
Mohammed Jamal El Fassi
Abdelhak Khallouk
Moulay Hassan Farih
Neurogenic Bladder Revealing a Pernicious Anemia: One Case Report and Literature Review
3
3
64
64
2014-04-25
2014-04-25
10.11648/j.cmr.20140303.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140303.12
© Science Publishing Group
Tissue Scurvy Misdiagnosed as Murder
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140303.13
Background: Mr Darryl Elliot was convicted for the murder of Amelia Bowmar on the evidence of doctors who alleged Amelia was a victim of the Shaken Baby Syndrome because ofthe presence of a subdural haematoma, swelling of the brain with ischaemic changes and haemorrhagic contusions in the cortex of the right and left superior frontal gyri of the brain. The brain and spinal cord showed evidence of old and recent injury which the doctors attributed to “Non-accidental Injury”. Method: To prove that the allegation of murder was false the results of the blood tests were analyzed. Result:It is shown that the child had evidence of abnormal coagulation of blood, liver dysfunction and hypoinsulinaemia following mandated MMR vaccine administered a few days prior to the onset of symptoms. Conclusion:The Laboratory results prove the presence of vaccine induced Tissue Scurvy which would account for all the lesions found on the child.
Background: Mr Darryl Elliot was convicted for the murder of Amelia Bowmar on the evidence of doctors who alleged Amelia was a victim of the Shaken Baby Syndrome because ofthe presence of a subdural haematoma, swelling of the brain with ischaemic changes and haemorrhagic contusions in the cortex of the right and left superior frontal gyri of the brain. The brain and spinal cord showed evidence of old and recent injury which the doctors attributed to “Non-accidental Injury”. Method: To prove that the allegation of murder was false the results of the blood tests were analyzed. Result:It is shown that the child had evidence of abnormal coagulation of blood, liver dysfunction and hypoinsulinaemia following mandated MMR vaccine administered a few days prior to the onset of symptoms. Conclusion:The Laboratory results prove the presence of vaccine induced Tissue Scurvy which would account for all the lesions found on the child.
Tissue Scurvy Misdiagnosed as Murder
doi:10.11648/j.cmr.20140303.13
Clinical Medicine Research
2014-05-13
© Science Publishing Group
Michael D. Innis
Tissue Scurvy Misdiagnosed as Murder
3
3
67
67
2014-05-13
2014-05-13
10.11648/j.cmr.20140303.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140303.13
© Science Publishing Group
Surviving Confusion- Differences in Survival among Older African Americans and Whites Hospitalized with Delirium Diagnoses in the United States
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140303.14
Background: Little is known regarding in-hospital mortality for older African Americans hospitalized with delirium diagnoses. Objectives: To estimate the in-hospital mortality for older African Americans hospitalized with delirium diagnoses based on a national representative sample; differences in this outcome and other determinants of morbidity (i.e. length of stay) between well studied populations (non-Hispanic Whites) and African Americans was also the focus. Design: Retrospective cohort study. Setting: Database of hospital discharges from the 2006 Nationwide Inpatient Sample (NIS), a subset of the Healthcare Cost and Utilization Project (HCUP) from the Agency for Healthcare Research and Quality (AHRQ). Participants: Represented 54,003 hospital discharges for those 65 years old and above, both African Americans and non-Hispanic Whites discharged from US hospitals. Key Outcomes: In-hospital mortality and length of stay. Results: Among delirious patients, African Americans had a longer mean length of stay (LOS) than non-Hispanic Whites (7.8 vs. 7.3 days, p=0.005). A larger percentage of non-Hispanic White patients (7.4%) compared to African American patients (6.6%) died during their stay in the hospital, however this was not statistically significant (p=0.076). Limitations: Suspected under-detection of delirium by providers and the subsequent diminished diagnostic capture by evidence of paid billing claims. Conclusion: The in-hospital mortality rate for non-Hispanic White patients hospitalized with diagnoses of delirium was also significantly less than that found in other studies (7.3 vs. 9%) indicating that detection of delirium and its subsequent diagnostic capture in these claims data may have been very low. The most likely explanation is that determining mortality estimates for an already under-diagnosed syndrome based on claims diagnostic data may be suboptimal. Alternatively, these results may indicate that delirium is profoundly under-diagnosed in elderly hospitalized African Americans as compared to their non-Hispanic White counterparts.
Background: Little is known regarding in-hospital mortality for older African Americans hospitalized with delirium diagnoses. Objectives: To estimate the in-hospital mortality for older African Americans hospitalized with delirium diagnoses based on a national representative sample; differences in this outcome and other determinants of morbidity (i.e. length of stay) between well studied populations (non-Hispanic Whites) and African Americans was also the focus. Design: Retrospective cohort study. Setting: Database of hospital discharges from the 2006 Nationwide Inpatient Sample (NIS), a subset of the Healthcare Cost and Utilization Project (HCUP) from the Agency for Healthcare Research and Quality (AHRQ). Participants: Represented 54,003 hospital discharges for those 65 years old and above, both African Americans and non-Hispanic Whites discharged from US hospitals. Key Outcomes: In-hospital mortality and length of stay. Results: Among delirious patients, African Americans had a longer mean length of stay (LOS) than non-Hispanic Whites (7.8 vs. 7.3 days, p=0.005). A larger percentage of non-Hispanic White patients (7.4%) compared to African American patients (6.6%) died during their stay in the hospital, however this was not statistically significant (p=0.076). Limitations: Suspected under-detection of delirium by providers and the subsequent diminished diagnostic capture by evidence of paid billing claims. Conclusion: The in-hospital mortality rate for non-Hispanic White patients hospitalized with diagnoses of delirium was also significantly less than that found in other studies (7.3 vs. 9%) indicating that detection of delirium and its subsequent diagnostic capture in these claims data may have been very low. The most likely explanation is that determining mortality estimates for an already under-diagnosed syndrome based on claims diagnostic data may be suboptimal. Alternatively, these results may indicate that delirium is profoundly under-diagnosed in elderly hospitalized African Americans as compared to their non-Hispanic White counterparts.
Surviving Confusion- Differences in Survival among Older African Americans and Whites Hospitalized with Delirium Diagnoses in the United States
doi:10.11648/j.cmr.20140303.14
Clinical Medicine Research
2014-06-05
© Science Publishing Group
Stephanie Lynn Garrett
Peter T. Baltrus
Patrick A. Griffith
George Staben Rust
Surviving Confusion- Differences in Survival among Older African Americans and Whites Hospitalized with Delirium Diagnoses in the United States
3
3
73
73
2014-06-05
2014-06-05
10.11648/j.cmr.20140303.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140303.14
© Science Publishing Group
Heat Distribution at Joints of Subjects with Musculoskeletal and Neuromuscular Dysfunctions
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140303.15
Body temperature is being speculated to be accurate for diagnosis and also monitor chronicity of diseases. Most studies on skin temperature are obsolete and were mostly done in Europe, and racial differences have been noted to have profound effect on human health. The primary objective of this study was to compare the temperatures on the affected and unaffected sides of selected patients with neuromuscular and musculoskeletal dysfunctions. Sixty-nine patients with neuromuscular and musculoskeletal disorders participated in the study. Temperatures were taken at both the pathologic and non-pathologic joints. Data obtained were analysed using descriptive and inferential statistics of paired t-test at 0.05 alpha levels. The results showed no significant difference between axillary, elbow, wrist, knee and ankle joints temperature of the pathologic and non-pathologic upper extremities of subjects with neurological conditions A mean skin temperature difference of 0.29 °C was observed between neuromuscular and musculoskeletal dysfunctions. However, within subjects with musculoskeletal dysfunctions; the skin temperature at the pathologic knee joint was significantly higher than that of the non-pathologic knee joint (t = 2.43, p = 0.02). We concluded that, for patients with neuromuscular dysfunctions; there was a minor but an insignificant decrease in skin temperature of pathologic joints compared to that of non-pathologic joints. The mean skin temperature at the pathologic knee joint of patients with musculoskeletal dysfunctions was significantly higher than that of the non-pathologic knee joint.
Body temperature is being speculated to be accurate for diagnosis and also monitor chronicity of diseases. Most studies on skin temperature are obsolete and were mostly done in Europe, and racial differences have been noted to have profound effect on human health. The primary objective of this study was to compare the temperatures on the affected and unaffected sides of selected patients with neuromuscular and musculoskeletal dysfunctions. Sixty-nine patients with neuromuscular and musculoskeletal disorders participated in the study. Temperatures were taken at both the pathologic and non-pathologic joints. Data obtained were analysed using descriptive and inferential statistics of paired t-test at 0.05 alpha levels. The results showed no significant difference between axillary, elbow, wrist, knee and ankle joints temperature of the pathologic and non-pathologic upper extremities of subjects with neurological conditions A mean skin temperature difference of 0.29 °C was observed between neuromuscular and musculoskeletal dysfunctions. However, within subjects with musculoskeletal dysfunctions; the skin temperature at the pathologic knee joint was significantly higher than that of the non-pathologic knee joint (t = 2.43, p = 0.02). We concluded that, for patients with neuromuscular dysfunctions; there was a minor but an insignificant decrease in skin temperature of pathologic joints compared to that of non-pathologic joints. The mean skin temperature at the pathologic knee joint of patients with musculoskeletal dysfunctions was significantly higher than that of the non-pathologic knee joint.
Heat Distribution at Joints of Subjects with Musculoskeletal and Neuromuscular Dysfunctions
doi:10.11648/j.cmr.20140303.15
Clinical Medicine Research
2014-06-16
© Science Publishing Group
Onigbinde Ayodele Teslim
Fadare Oluseye Emmanuel
Akindoyin Olubukola
Tarimo Nesto
Heat Distribution at Joints of Subjects with Musculoskeletal and Neuromuscular Dysfunctions
3
3
79
79
2014-06-16
2014-06-16
10.11648/j.cmr.20140303.15
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140303.15
© Science Publishing Group
Cytokeratin 8 Was Over-Expressed in Cells Harboring in Vitro-Transcribed Full Length Hepatitis C Virus 1b RNA, but Down-Expressed in HCV Patients’ Serum
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140303.16
Objectives: Previous proteome analysis conducted by our group has demonstrated that cytokeratin 8 was overexpressed in HuH-7 cells harboring in vitro transcribed HCV 1b full length RNA (HuH-7-HCV). Present study was aim to verify the results of proteomics, and obtain the clinical data of CK8 expresson levels in HCV patients. Methods: The expression level of CK 8 in HuH-7-HCV cells was examined by Real time PCR and Western blotting. The concentration of CK8 in HCV patients’ serum was measured by enzyme-linked immunosorbent assay (ELISA). Results: The results showed expression level of CK8 transcript in HuH-7-HCV cells was 2.3 fold higher than that in HuH-7 mock cells (P<0.01). The protein expression of CK8 in HuH-7-HCV cells was approximately 3 fold higher than that in HuH-7 mock cells (P<0.01). However, results of ELISA demonstrated the serum CK8 concentration was significantly reduced in chronic HCV patients compared to normal healthy controls (P<0.01). And there was a negative linear correlation between serum CK8 concentration and HCV RNA titer (r=-0.380, P<0.01). Conclusion: Our present study supports the hypothesis that in response to HCV infection, expression of CK8 was increased, which may contribute to the essential cytoprotection provided by CK8 in the liver. Altered CK8 expression pattern could be an important event in the pathogenesis of HCV infection. CK8 have potential use as surrogate markers of liver injury.
Objectives: Previous proteome analysis conducted by our group has demonstrated that cytokeratin 8 was overexpressed in HuH-7 cells harboring in vitro transcribed HCV 1b full length RNA (HuH-7-HCV). Present study was aim to verify the results of proteomics, and obtain the clinical data of CK8 expresson levels in HCV patients. Methods: The expression level of CK 8 in HuH-7-HCV cells was examined by Real time PCR and Western blotting. The concentration of CK8 in HCV patients’ serum was measured by enzyme-linked immunosorbent assay (ELISA). Results: The results showed expression level of CK8 transcript in HuH-7-HCV cells was 2.3 fold higher than that in HuH-7 mock cells (P<0.01). The protein expression of CK8 in HuH-7-HCV cells was approximately 3 fold higher than that in HuH-7 mock cells (P<0.01). However, results of ELISA demonstrated the serum CK8 concentration was significantly reduced in chronic HCV patients compared to normal healthy controls (P<0.01). And there was a negative linear correlation between serum CK8 concentration and HCV RNA titer (r=-0.380, P<0.01). Conclusion: Our present study supports the hypothesis that in response to HCV infection, expression of CK8 was increased, which may contribute to the essential cytoprotection provided by CK8 in the liver. Altered CK8 expression pattern could be an important event in the pathogenesis of HCV infection. CK8 have potential use as surrogate markers of liver injury.
Cytokeratin 8 Was Over-Expressed in Cells Harboring in Vitro-Transcribed Full Length Hepatitis C Virus 1b RNA, but Down-Expressed in HCV Patients’ Serum
doi:10.11648/j.cmr.20140303.16
Clinical Medicine Research
2014-06-23
© Science Publishing Group
Meng Xun
Haifeng Wang
Burong Li
Hongyan He
Qian He
Yonglie Chu
Cytokeratin 8 Was Over-Expressed in Cells Harboring in Vitro-Transcribed Full Length Hepatitis C Virus 1b RNA, but Down-Expressed in HCV Patients’ Serum
3
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86
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2014-06-23
2014-06-23
10.11648/j.cmr.20140303.16
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140303.16
© Science Publishing Group
Importance of Histopathology in Diagnosis of Unilateral Nasal Polyps
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140304.11
Nasal polyps are one of the most frequent clinical entities encountered by otolaryngologists. However, nasal polyps should be regarded as “signs” and not “diagnosis”, unless subject to histopathology-especially when the case is of unilateral nasal polyps, as histopathological evaluation is mandatory to reach a confirmed diagnosis. This study was thus aimed to establish the importance of histopathology in diagnosis of unilateral nasal polyps (as many otolaryngologists still do not agree with the need to do so). A prospective study done in the Dept of Otolaryngology, Dhaka Medical College Hospital, Dhaka, Bangladesh from January’2012 to June’2013 on 69 patients clinically diagnosed as unilateral nasal polyps and surgically treated with subsequent histopathological evaluation. It was found that histopathology was very important and conclusive in the diagnosis of nasal polyps.
Nasal polyps are one of the most frequent clinical entities encountered by otolaryngologists. However, nasal polyps should be regarded as “signs” and not “diagnosis”, unless subject to histopathology-especially when the case is of unilateral nasal polyps, as histopathological evaluation is mandatory to reach a confirmed diagnosis. This study was thus aimed to establish the importance of histopathology in diagnosis of unilateral nasal polyps (as many otolaryngologists still do not agree with the need to do so). A prospective study done in the Dept of Otolaryngology, Dhaka Medical College Hospital, Dhaka, Bangladesh from January’2012 to June’2013 on 69 patients clinically diagnosed as unilateral nasal polyps and surgically treated with subsequent histopathological evaluation. It was found that histopathology was very important and conclusive in the diagnosis of nasal polyps.
Importance of Histopathology in Diagnosis of Unilateral Nasal Polyps
doi:10.11648/j.cmr.20140304.11
Clinical Medicine Research
2014-06-27
© Science Publishing Group
Rameez Shah
Md. Shahriar Islam
Md. Rafiqul Islam
Anika Arfin
Importance of Histopathology in Diagnosis of Unilateral Nasal Polyps
3
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89
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2014-06-27
2014-06-27
10.11648/j.cmr.20140304.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140304.11
© Science Publishing Group
Carcinosarcoma of the Ovary: A Case Report
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140304.12
The carcinosarcoma is a mixed tumour composed of epithelial and mesenchymatous malignant tissus. It can occur on the level of all the female genital tract, most frequently the uterus. The ovarian localization is rare. The purpose of our work is to discuss the problems of differential diagnosis raised by this rare entity. We report the case of a 60 years old patient, who consulted for an abdominal mass of 20 cm. Tomodensitometry of the abdomen and the pelvic had objectified the right ovarian origin. The patient was treated by total colpohysterectomy with bilateral annexectomy. Through this case with review of the literature we shall discuss the histogenetic assumptions of this entity which are the object of controversies as well as the prognosis and therapeutic implications.
The carcinosarcoma is a mixed tumour composed of epithelial and mesenchymatous malignant tissus. It can occur on the level of all the female genital tract, most frequently the uterus. The ovarian localization is rare. The purpose of our work is to discuss the problems of differential diagnosis raised by this rare entity. We report the case of a 60 years old patient, who consulted for an abdominal mass of 20 cm. Tomodensitometry of the abdomen and the pelvic had objectified the right ovarian origin. The patient was treated by total colpohysterectomy with bilateral annexectomy. Through this case with review of the literature we shall discuss the histogenetic assumptions of this entity which are the object of controversies as well as the prognosis and therapeutic implications.
Carcinosarcoma of the Ovary: A Case Report
doi:10.11648/j.cmr.20140304.12
Clinical Medicine Research
2014-07-14
© Science Publishing Group
Abdellah Babahabib
Mohamed Elmarjany
Hicham Bakkali
Mehdi Elhassani
Jaouad Kouach
Rhali Driss Moussaoui
Mohamed Dehayni
Carcinosarcoma of the Ovary: A Case Report
3
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93
93
2014-07-14
2014-07-14
10.11648/j.cmr.20140304.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140304.12
© Science Publishing Group
Tissue Scurvy and the Triad
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140304.13
The Triad, characterized by bilateral retinal haemorrhages, diffuse cerebral haemorrhage and hypoxic ischaemic encephalopathy is conventionally thought to result from trauma caused by violently shaking a child by a parent or carer. The shaking is said to cause a to and fro movement of the brain in the skull leading to injury to the neurons, disruption of the cerebral veins and trauma to the retinal vessels. Vigorous shaking of a child has never been observed and an alternative explanation for these changes was sought. Here it is shown that Tissue Scurvy, an autoimmune disorder which has specific and consistent biochemical features of Hyperglycaemia and Liver Dysfunction as shown by abnormal Liver Function Tests, is the cause of the lesions. A child diagnosed as being the victim of the Shaken Baby Syndrome was tested for evidence of Tissue Scurvy and both Hyperglycaemia and Abnormal Liver Function were demonstrated. It is concluded that these results provide conclusive evidence that the Shaken Baby Syndrome is a form of Tissue Scurvy in which encephalopathy is caused by damage to neurons in the cervical spinal column causing hypoxia, which leads to ischaemic encephalopathy and the other features of the triad.
The Triad, characterized by bilateral retinal haemorrhages, diffuse cerebral haemorrhage and hypoxic ischaemic encephalopathy is conventionally thought to result from trauma caused by violently shaking a child by a parent or carer. The shaking is said to cause a to and fro movement of the brain in the skull leading to injury to the neurons, disruption of the cerebral veins and trauma to the retinal vessels. Vigorous shaking of a child has never been observed and an alternative explanation for these changes was sought. Here it is shown that Tissue Scurvy, an autoimmune disorder which has specific and consistent biochemical features of Hyperglycaemia and Liver Dysfunction as shown by abnormal Liver Function Tests, is the cause of the lesions. A child diagnosed as being the victim of the Shaken Baby Syndrome was tested for evidence of Tissue Scurvy and both Hyperglycaemia and Abnormal Liver Function were demonstrated. It is concluded that these results provide conclusive evidence that the Shaken Baby Syndrome is a form of Tissue Scurvy in which encephalopathy is caused by damage to neurons in the cervical spinal column causing hypoxia, which leads to ischaemic encephalopathy and the other features of the triad.
Tissue Scurvy and the Triad
doi:10.11648/j.cmr.20140304.13
Clinical Medicine Research
2014-07-24
© Science Publishing Group
Michael D. Innis
Tissue Scurvy and the Triad
3
4
95
95
2014-07-24
2014-07-24
10.11648/j.cmr.20140304.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140304.13
© Science Publishing Group
Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140304.14
Aims: to evaluate the correlation between endoscopic disease activity, and fecal calprotectin, transforming growth factor-B1, Clinical Activity Index, C- reactive protein, and blood leucocytes. Methods: Ninety two patients with ulcerative colitis were enrolled and scored according to the endoscopic part of the Rachmilewitz Index. Patients and controls provided fecal and blood samples for measuring calprotectin, TGF-B1, CRP, and leucocytes. Results: The values in ulcerative colitis patients (n = 92) compared to controls (n = 20): calprotectin: 728.9 ± 388.4 versus 22.9 ± 12.9 µg / g, TGF-B1: 350.1 ± 214.7 versus 4.3 ± 2.01 pg /Ml, CRP: 36.9 ± 20.3 versus 3.5 ± 1.9m g/L, blood leucocytes: 13.8 ± 4.5 versus 7.3 ± 1.8 g/ L (all P< 0.001). Endoscopic disease activity correlated significantly with calprotectin (Spearman’s rank correlation coefficient r = 0.545), TGF-B1 (r = 0.531), Clinical Activity Index (r = 0. 520), CRP (r = 0.481), and blood leucocytes (r = 436). Calprotectin and TGF-B1 levels were significantly lower in ulcerative colitis patients with inactive disease ( endoscopic score 0 -3, calprotectin 60.5 ± 47.8 µg / g, TGF-B1 39.9 ± 35.4 pg/Ml , P < 0.001), compared to patients with mild ( score 4 – 6, calprotectin 460.2 ±240 µg/g, TGF-B1 172.4 ± 88.2 pg/ Ml, P < 0.001 ), moderate ( score 7 – 9, calprotectin 797.9 ± 239.2 µg/g, TGF-B1 352.6 ± 89.9 pg/Ml, P < 0.001 ), and high disease ( score 10 – 12 , calprotectin 969.2 ±268.9 µg/g, TGF-B1 486.8 ± 211.2 Pg/ Ml, P < 0.001). The overall accuracy for detection of histopathological active disease was 96.7 % for fecal calprotectin, 94.5 % for TGF-B1, 90 % for Endoscopic Activity Index, 87 % for Clinical Activity Index, and 65 % for both blood leucocytes and CRP. Conclusion: Both fecal calprotectin and TGF-B1 correlated significantly with endoscopic disease activity, clinical activity index, CRP, and blood leucocytes. Furthermore, both calprotectin and TGF-B1 were suitable markers that can differentiate endoscopically and histopathologically inactive from active disease, thus, these two biomarkers may be used for monitoring ulcerative colitis activity.
Aims: to evaluate the correlation between endoscopic disease activity, and fecal calprotectin, transforming growth factor-B1, Clinical Activity Index, C- reactive protein, and blood leucocytes. Methods: Ninety two patients with ulcerative colitis were enrolled and scored according to the endoscopic part of the Rachmilewitz Index. Patients and controls provided fecal and blood samples for measuring calprotectin, TGF-B1, CRP, and leucocytes. Results: The values in ulcerative colitis patients (n = 92) compared to controls (n = 20): calprotectin: 728.9 ± 388.4 versus 22.9 ± 12.9 µg / g, TGF-B1: 350.1 ± 214.7 versus 4.3 ± 2.01 pg /Ml, CRP: 36.9 ± 20.3 versus 3.5 ± 1.9m g/L, blood leucocytes: 13.8 ± 4.5 versus 7.3 ± 1.8 g/ L (all P< 0.001). Endoscopic disease activity correlated significantly with calprotectin (Spearman’s rank correlation coefficient r = 0.545), TGF-B1 (r = 0.531), Clinical Activity Index (r = 0. 520), CRP (r = 0.481), and blood leucocytes (r = 436). Calprotectin and TGF-B1 levels were significantly lower in ulcerative colitis patients with inactive disease ( endoscopic score 0 -3, calprotectin 60.5 ± 47.8 µg / g, TGF-B1 39.9 ± 35.4 pg/Ml , P < 0.001), compared to patients with mild ( score 4 – 6, calprotectin 460.2 ±240 µg/g, TGF-B1 172.4 ± 88.2 pg/ Ml, P < 0.001 ), moderate ( score 7 – 9, calprotectin 797.9 ± 239.2 µg/g, TGF-B1 352.6 ± 89.9 pg/Ml, P < 0.001 ), and high disease ( score 10 – 12 , calprotectin 969.2 ±268.9 µg/g, TGF-B1 486.8 ± 211.2 Pg/ Ml, P < 0.001). The overall accuracy for detection of histopathological active disease was 96.7 % for fecal calprotectin, 94.5 % for TGF-B1, 90 % for Endoscopic Activity Index, 87 % for Clinical Activity Index, and 65 % for both blood leucocytes and CRP. Conclusion: Both fecal calprotectin and TGF-B1 correlated significantly with endoscopic disease activity, clinical activity index, CRP, and blood leucocytes. Furthermore, both calprotectin and TGF-B1 were suitable markers that can differentiate endoscopically and histopathologically inactive from active disease, thus, these two biomarkers may be used for monitoring ulcerative colitis activity.
Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis
doi:10.11648/j.cmr.20140304.14
Clinical Medicine Research
2014-07-26
© Science Publishing Group
Arafat A. Kassem
Amir A. Fikry
Doaa Shahin
Hosam Aldeen Salah Shabana
Sadek Mostafa
Fecal Calprotectin and Transforming Growth Factor-b1 in the Evaluation of Disease Activity in Patients with Ulcerative Colitis
3
4
104
104
2014-07-26
2014-07-26
10.11648/j.cmr.20140304.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140304.14
© Science Publishing Group
Mothers Beliefs and Obstacles as Limitations in Promoting Exclusive Breastfeeding among Working Class Mothers Attending Infant Welfare Clinic at University of Nigeria Teaching Hospital (UNTH), Enugu State
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140304.15
Objective: The research was designed to ascertain information on the mothers’ beliefs and obstacles as limitations in promoting exclusive breastfeeding among the working class mothers aimed to: (1) to determine the rate of promotion of the awareness on the benefits of exclusive breastfeeding, (2) to determine the obstacles or barriers to the practice of exclusive breastfeeding, (3) to determine the percentage level of working class who practice exclusive breastfeeding, (4) to assess the nutritional knowledge and beliefs of working class mothers about exclusive breastfeeding and (5) to find out the level to which the practice of exclusive breast feeding influences the working class. Methodology: This survey study was carried out on 60 respondents which compromised of registered working class mothers attending the Infant Welfare Clinic at the Institute of Child Health, UNTH, Enugu. Structured and validated questionnaire were used to obtain information from the subjects on their socio-economic background, baby’s information, promotion of exclusive breastfeeding and obstacles to exclusive breastfeeding. Data obtained from the subjects were analyzed using SPSS version 16 to determine their frequency and percentages. Result: Result showed that 91.7% of the mothers had knowledge of exclusive breastfeeding which they individually came across at different times in their lives. A small number of the mothers 38.3% practiced exclusive breastfeeding which was found to be influenced by their level of education, antenatal clinic attendance and personal conviction. 35% of them initiated breastfeeding within 30 minutes of delivery. It was observed that majority of the mothers, 80% of them do not express their breast milk. Apparently 85% of the mothers are agreed to the numerous benefits of exclusive breastfeeding. 81.7% of the mothers are of the opinion that the presence and availability of hygienic crèche in their offices will reduce the obstacles to exclusive breast feeding. The main obstacle to exclusive breastfeeding identified was absence and unavailability of hygienic crèche in office environments, followed by breast and nipple problems, perceived milk insufficiency, pressure from family and sometimes the effect of drugs taken while breastfeeding. Conclusion: Educational programme on exclusive and optimal breastfeeding should be strengthened and mothers enlightened on its importance. Therefore more behavioural changes and communication should be made to promote, protect and support exclusive breast feeding.
Objective: The research was designed to ascertain information on the mothers’ beliefs and obstacles as limitations in promoting exclusive breastfeeding among the working class mothers aimed to: (1) to determine the rate of promotion of the awareness on the benefits of exclusive breastfeeding, (2) to determine the obstacles or barriers to the practice of exclusive breastfeeding, (3) to determine the percentage level of working class who practice exclusive breastfeeding, (4) to assess the nutritional knowledge and beliefs of working class mothers about exclusive breastfeeding and (5) to find out the level to which the practice of exclusive breast feeding influences the working class. Methodology: This survey study was carried out on 60 respondents which compromised of registered working class mothers attending the Infant Welfare Clinic at the Institute of Child Health, UNTH, Enugu. Structured and validated questionnaire were used to obtain information from the subjects on their socio-economic background, baby’s information, promotion of exclusive breastfeeding and obstacles to exclusive breastfeeding. Data obtained from the subjects were analyzed using SPSS version 16 to determine their frequency and percentages. Result: Result showed that 91.7% of the mothers had knowledge of exclusive breastfeeding which they individually came across at different times in their lives. A small number of the mothers 38.3% practiced exclusive breastfeeding which was found to be influenced by their level of education, antenatal clinic attendance and personal conviction. 35% of them initiated breastfeeding within 30 minutes of delivery. It was observed that majority of the mothers, 80% of them do not express their breast milk. Apparently 85% of the mothers are agreed to the numerous benefits of exclusive breastfeeding. 81.7% of the mothers are of the opinion that the presence and availability of hygienic crèche in their offices will reduce the obstacles to exclusive breast feeding. The main obstacle to exclusive breastfeeding identified was absence and unavailability of hygienic crèche in office environments, followed by breast and nipple problems, perceived milk insufficiency, pressure from family and sometimes the effect of drugs taken while breastfeeding. Conclusion: Educational programme on exclusive and optimal breastfeeding should be strengthened and mothers enlightened on its importance. Therefore more behavioural changes and communication should be made to promote, protect and support exclusive breast feeding.
Mothers Beliefs and Obstacles as Limitations in Promoting Exclusive Breastfeeding among Working Class Mothers Attending Infant Welfare Clinic at University of Nigeria Teaching Hospital (UNTH), Enugu State
doi:10.11648/j.cmr.20140304.15
Clinical Medicine Research
2014-08-05
© Science Publishing Group
Okwy-Nweke C. P.
Anyanwu J. O.
Maduforo A. N.
Mothers Beliefs and Obstacles as Limitations in Promoting Exclusive Breastfeeding among Working Class Mothers Attending Infant Welfare Clinic at University of Nigeria Teaching Hospital (UNTH), Enugu State
3
4
111
111
2014-08-05
2014-08-05
10.11648/j.cmr.20140304.15
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140304.15
© Science Publishing Group
Patients with Low Back Pain in Malawi: Their Attitudes and Beliefs on Their Low Back Pain
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140304.16
Low back pain (LBP) is a musculoskeletal disorder, affecting humans from adolescent to adult age. It is a health and socio-economic problem worldwide. The cause and contributing factors to LBP are multifactorial resulting in different approaches for its management. The attitudes and beliefs of patient with LBP, play an important role in the whole process of pain management. Negative attitudes and beliefs may lead to fear -avoidance behaviour, resulting into pain chronicity and disability. Thus, this study aimed to identify the attitudes and beliefs among patients with LBP, attending physiotherapy treatment in Malawi. Queen Elizabeth and Kamuzu Central hospitals were selected as study settings. A quantitative cross-sectional survey was done, using a self-administered questionnaire, employing a convenience sampling method. Twelve statements about attitudes and beliefs on LBP were adopted from the Back Beliefs Questionnaire (BBQ) and from the Survey of Pain Attitudes (SOPA). The SPSS (version 19.0) was used for data capturing and analysis. Descriptive and inferential statistics were used to summarize data. The Chi-square test was used to determine any association between variables and the Alpha level of significance was set at 0.05. All ethical issues were sought and adhered to throughout the study period. The results showed that out of 205 participants, with mean age of 47.74 years, (SD=13.29), female constituted 53.2% of the sample. More than half (67%) of all participants portrayed negative attitudes and beliefs about their LBP. We concluded that, majority of patients with LBP in Malawi hold negative attitudes and beliefs about their pain. Therefore, patient health education is needed to change these attitudes and beliefs if recovery and treatment goal are to be achieved.
Low back pain (LBP) is a musculoskeletal disorder, affecting humans from adolescent to adult age. It is a health and socio-economic problem worldwide. The cause and contributing factors to LBP are multifactorial resulting in different approaches for its management. The attitudes and beliefs of patient with LBP, play an important role in the whole process of pain management. Negative attitudes and beliefs may lead to fear -avoidance behaviour, resulting into pain chronicity and disability. Thus, this study aimed to identify the attitudes and beliefs among patients with LBP, attending physiotherapy treatment in Malawi. Queen Elizabeth and Kamuzu Central hospitals were selected as study settings. A quantitative cross-sectional survey was done, using a self-administered questionnaire, employing a convenience sampling method. Twelve statements about attitudes and beliefs on LBP were adopted from the Back Beliefs Questionnaire (BBQ) and from the Survey of Pain Attitudes (SOPA). The SPSS (version 19.0) was used for data capturing and analysis. Descriptive and inferential statistics were used to summarize data. The Chi-square test was used to determine any association between variables and the Alpha level of significance was set at 0.05. All ethical issues were sought and adhered to throughout the study period. The results showed that out of 205 participants, with mean age of 47.74 years, (SD=13.29), female constituted 53.2% of the sample. More than half (67%) of all participants portrayed negative attitudes and beliefs about their LBP. We concluded that, majority of patients with LBP in Malawi hold negative attitudes and beliefs about their pain. Therefore, patient health education is needed to change these attitudes and beliefs if recovery and treatment goal are to be achieved.
Patients with Low Back Pain in Malawi: Their Attitudes and Beliefs on Their Low Back Pain
doi:10.11648/j.cmr.20140304.16
Clinical Medicine Research
2014-08-12
© Science Publishing Group
Tarimo Nesto
Ina Diener
Patients with Low Back Pain in Malawi: Their Attitudes and Beliefs on Their Low Back Pain
3
4
118
118
2014-08-12
2014-08-12
10.11648/j.cmr.20140304.16
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140304.16
© Science Publishing Group
Time to Increase WHO Clinical Stage of People Living with HIV in Public Health Facilities of Arba Minch Town, South Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.11
Background: Highly Active Antiretroviral Therapy improves time to death and recurrence of any opportunistic infections in peoples living with HIV. But little is known about its effect on time to increase WHO clinical stage. Thus, this study was aimed at assessing time to increase WHO clinical stage and associated factors. Method: Retrospective cohort study was used and the required sample size was 464. Study participants were selected randomly from the list of adult people living with HIV attending the public health facilities for ART. Univariate analysis was used to describe patients’ baseline and follow up characteristics. Kaplan-Meier survival and log rank test were used to estimate survival and compare survival curves respectively. Cox proportional-hazard regression model was used to calculate hazard rate and to determine independent predictors of time to increase WHO clinical stage. Result: A total of 464 patients (232 in each cohort) contribute for 898.12 person years of follow up. The overall incidence rate of increased WHO clinical stage was 16.6 per 100 person years of follow up and the incidence of increased WHO clinical stage was 38.5 per 100 person year and 3.8 per 100 person year of follow up in ART and HAART cohorts respectively. Being on Highly Active Antiretroviral Therapy and taking prophylaxis at baseline were the identified predictors’ that prevent increment of WHO clinical stage. In contrary being widowed and single marital status, substance use, rural residence and being in age category 45 years and above were independent predictors for increment of WHO clinical stage. Conclusion: Increment of WHO clinical stage was higher in pre ART cohorts. Special consideration should be given for those who are widowed, substance users and aged 45 years and above.
Background: Highly Active Antiretroviral Therapy improves time to death and recurrence of any opportunistic infections in peoples living with HIV. But little is known about its effect on time to increase WHO clinical stage. Thus, this study was aimed at assessing time to increase WHO clinical stage and associated factors. Method: Retrospective cohort study was used and the required sample size was 464. Study participants were selected randomly from the list of adult people living with HIV attending the public health facilities for ART. Univariate analysis was used to describe patients’ baseline and follow up characteristics. Kaplan-Meier survival and log rank test were used to estimate survival and compare survival curves respectively. Cox proportional-hazard regression model was used to calculate hazard rate and to determine independent predictors of time to increase WHO clinical stage. Result: A total of 464 patients (232 in each cohort) contribute for 898.12 person years of follow up. The overall incidence rate of increased WHO clinical stage was 16.6 per 100 person years of follow up and the incidence of increased WHO clinical stage was 38.5 per 100 person year and 3.8 per 100 person year of follow up in ART and HAART cohorts respectively. Being on Highly Active Antiretroviral Therapy and taking prophylaxis at baseline were the identified predictors’ that prevent increment of WHO clinical stage. In contrary being widowed and single marital status, substance use, rural residence and being in age category 45 years and above were independent predictors for increment of WHO clinical stage. Conclusion: Increment of WHO clinical stage was higher in pre ART cohorts. Special consideration should be given for those who are widowed, substance users and aged 45 years and above.
Time to Increase WHO Clinical Stage of People Living with HIV in Public Health Facilities of Arba Minch Town, South Ethiopia
doi:10.11648/j.cmr.20140305.11
Clinical Medicine Research
2014-08-17
© Science Publishing Group
Direslgne Misker Abyu
Eskezyiaw Agidew Getahun
Marelgn Tilahun Malaju
Habtamu Mellie Bizuayehu
Time to Increase WHO Clinical Stage of People Living with HIV in Public Health Facilities of Arba Minch Town, South Ethiopia
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124
2014-08-17
2014-08-17
10.11648/j.cmr.20140305.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.11
© Science Publishing Group
Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.12
Background: There are no randomized trials described outcomes of multivessel percutaneous coronary interventions (PCI) (in primary and staged revascularization) with second generation drug eluting stents (DES) in patients with ST-elevation myocardial infarction (STEMI). We are presenting preliminary results of randomized trial (NCT01781715). Methods: Six-month outcomes of 89 consecutive patients with STEMI and multivessel coronary artery disease (CAD) (SYNTAX 18.6±7.9 points) undergoing primary PCI with zotarolimus-eluting stents (Resolute Integrity; Medtronic) were studied. We used two strategies of multivessel stenting: in primary PCI (MS primary, n=46) (the IRA was opened followed by dilatation of other significantly narrowed arteries during the same procedure) and multivessel stenting in staged revascularisation (MS staged, n=43) (the IRA only was treated during the primary intervention while the complete revascularization was planned in a second procedure (8.5±4.2 days)) in our prospective randomized study. Results: During follow-up of 6 months there was no cardiac death in overall group. We observed 1 (2.3%) non-cardiac death in MS staged group vs 0 in MS primary (p=0.9), 0 non-fatal myocardial infarction (MI) in MS staged group vs 3 (6.5%) in MS primary (p=0.3) due to definite stent thromboses (ST) (2.5% on the number of stents). There was no target vessel revascularization (TVR) in MS staged group, but it was performed in 2 cases (4.3%) in MS primary group (p=0.5). Major adverse cardiac event (MACE) (cardiac death, MI, TVR) was diagnosed in 2.3% and 6.5% in MS staged and MS primary group (p=0.7). Conclusions: second generation DES in STEMI patients with multivessel CAD are satisfactory safely and effectively as part of the strategy of multivessel stenting in primary PCI and multivessel staged PCI (8.5±4.2 days). Multivessel stenting in primary PCI was associated with higher risk of stent thrombosis (ST) compared with multivessel staged PCI in six month follow-up period.
Background: There are no randomized trials described outcomes of multivessel percutaneous coronary interventions (PCI) (in primary and staged revascularization) with second generation drug eluting stents (DES) in patients with ST-elevation myocardial infarction (STEMI). We are presenting preliminary results of randomized trial (NCT01781715). Methods: Six-month outcomes of 89 consecutive patients with STEMI and multivessel coronary artery disease (CAD) (SYNTAX 18.6±7.9 points) undergoing primary PCI with zotarolimus-eluting stents (Resolute Integrity; Medtronic) were studied. We used two strategies of multivessel stenting: in primary PCI (MS primary, n=46) (the IRA was opened followed by dilatation of other significantly narrowed arteries during the same procedure) and multivessel stenting in staged revascularisation (MS staged, n=43) (the IRA only was treated during the primary intervention while the complete revascularization was planned in a second procedure (8.5±4.2 days)) in our prospective randomized study. Results: During follow-up of 6 months there was no cardiac death in overall group. We observed 1 (2.3%) non-cardiac death in MS staged group vs 0 in MS primary (p=0.9), 0 non-fatal myocardial infarction (MI) in MS staged group vs 3 (6.5%) in MS primary (p=0.3) due to definite stent thromboses (ST) (2.5% on the number of stents). There was no target vessel revascularization (TVR) in MS staged group, but it was performed in 2 cases (4.3%) in MS primary group (p=0.5). Major adverse cardiac event (MACE) (cardiac death, MI, TVR) was diagnosed in 2.3% and 6.5% in MS staged and MS primary group (p=0.7). Conclusions: second generation DES in STEMI patients with multivessel CAD are satisfactory safely and effectively as part of the strategy of multivessel stenting in primary PCI and multivessel staged PCI (8.5±4.2 days). Multivessel stenting in primary PCI was associated with higher risk of stent thrombosis (ST) compared with multivessel staged PCI in six month follow-up period.
Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents
doi:10.11648/j.cmr.20140305.12
Clinical Medicine Research
2014-08-29
© Science Publishing Group
Roman S. Tarasov
Vladimir I. Ganyukov
Alexey V. Protopopov
Olga L. Barbarash
Leonid S. Barbarash
Six Month Results of Randomized Clinical trial: Multivessel Stenting in Primary Percutaneous Coronary Intervention and Staged Revascularization for ST-Elevation Myocardial Infarction Patients with Second Generation Drug Eluting Stents
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2014-08-29
2014-08-29
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.12
© Science Publishing Group
Curative Effect of Botulinum Toxin-A Injection in Myopia Treatment: Two Case Reports
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.13
Purpose: To study the curative effect of botulinum toxin-A injection in myopia treatment and whether this method can promote the vision of the patients with myopia. Methods: The left visual acuity of a 37 years old woman was improved from 0.5 to 0.8 after cosmetic injection in July 2011. Another 9 years old girl with pseudomyopia was treated by bilateral ciliary injection in September 2012, and the doses were 2.5IU respectively. Results: The woman was true myopia, and her left visual acuity was lasting at 0.8 for 5 months. The left visual acuity of the girl was enhanced from 0.6 to 0.8, and the right was improved from 0.7 to 1.0. And the improvement is for more than 18 months. Conclusions: BTX-A injection can relax the ciliary muscle tension and promote the myopic vision, especially in pseudomyopia patients.
Purpose: To study the curative effect of botulinum toxin-A injection in myopia treatment and whether this method can promote the vision of the patients with myopia. Methods: The left visual acuity of a 37 years old woman was improved from 0.5 to 0.8 after cosmetic injection in July 2011. Another 9 years old girl with pseudomyopia was treated by bilateral ciliary injection in September 2012, and the doses were 2.5IU respectively. Results: The woman was true myopia, and her left visual acuity was lasting at 0.8 for 5 months. The left visual acuity of the girl was enhanced from 0.6 to 0.8, and the right was improved from 0.7 to 1.0. And the improvement is for more than 18 months. Conclusions: BTX-A injection can relax the ciliary muscle tension and promote the myopic vision, especially in pseudomyopia patients.
Curative Effect of Botulinum Toxin-A Injection in Myopia Treatment: Two Case Reports
doi:10.11648/j.cmr.20140305.13
Clinical Medicine Research
2014-09-02
© Science Publishing Group
Jianjun Liu
Shurong Ji
Curative Effect of Botulinum Toxin-A Injection in Myopia Treatment: Two Case Reports
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2014-09-02
2014-09-02
10.11648/j.cmr.20140305.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.13
© Science Publishing Group
Anesthetic Considerations of Conn Syndrome: A Case Presentation and Mini-Review the Anesthesiologist and Conn Syndrome
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.14
Conn syndrome is characterized by increased secretion of aldosterone. Hyperaldosteronism induces sodium and water retention, hypertension, decreased potassium blood level, muscle weakness, and fatigue. The diagnosis is usually confirmed by decreased renin level, increased aldosteron level, hypokalemia, and imagining tools. Perioperative care consists on blood pressure and hypervolemia control, spironolactone administration, and preoperative potassium correction. We present a case scheduled for left adrenalectomy for Conn syndrome, 5 years after the right adrenalectomy was performed. The surgery and postoperative period were uneventful and the patient was discharged in 6-th postoperative day referring to the endocrinologist. A good cooperation between the anesthesiologist, endocrinologist, and surgeon is strongly recommended.
Conn syndrome is characterized by increased secretion of aldosterone. Hyperaldosteronism induces sodium and water retention, hypertension, decreased potassium blood level, muscle weakness, and fatigue. The diagnosis is usually confirmed by decreased renin level, increased aldosteron level, hypokalemia, and imagining tools. Perioperative care consists on blood pressure and hypervolemia control, spironolactone administration, and preoperative potassium correction. We present a case scheduled for left adrenalectomy for Conn syndrome, 5 years after the right adrenalectomy was performed. The surgery and postoperative period were uneventful and the patient was discharged in 6-th postoperative day referring to the endocrinologist. A good cooperation between the anesthesiologist, endocrinologist, and surgeon is strongly recommended.
Anesthetic Considerations of Conn Syndrome: A Case Presentation and Mini-Review the Anesthesiologist and Conn Syndrome
doi:10.11648/j.cmr.20140305.14
Clinical Medicine Research
2014-09-05
© Science Publishing Group
Arber Jano
Rudin Domi
Leart Berdica
Hektor Sula
Ilir Ohri
Anesthetic Considerations of Conn Syndrome: A Case Presentation and Mini-Review the Anesthesiologist and Conn Syndrome
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2014-09-05
2014-09-05
10.11648/j.cmr.20140305.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.14
© Science Publishing Group
Comparison of the Therapeutic Effects of Two Recombinant Erythropoietin Beta, Biosimilar and Reference Formulations in Patients with Chronic Kidney Disease under Hemodialysis
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.15
Anemia is common in patients with chronic kidney diseases under hemodialysis and it’s managed with recombinant erythropoietin formulation. The objective of the study is to compare the safety and efficacy of two recombinant erythropoietin formulations in patients undergoing hemodialysis with chronic kidney diseases. In this randomized, controlled, prospective, parallel open study 70 patients were treated for 24 weeks with either reference β recombinant erythropoietin (100 IU/kg) or biosimilar β recombinant erythropoietin (100 IU/kg). The primary efficacy endpoint was the hemoglobin and hematocrit levels from baseline to 24 week of treatment. The secondary endpoints were safety, weekly doses of both erythropoietins required to maintain hemoglobin levels and immunogenicity. There was no significant difference between the two preparations in terms of hemoglobin and hematocrit levels achieved. The weekly doses of both erythropoietins required to maintain hemoglobin levels were the same in both groups. The frequency of adverse events was similar in the two groups of treatment. Two patients of the reference erythropoietin group developed anti-erythropoietin antibodies. The biosimilar erythropoietin was comparable since the safety and efficacy point of view with the innovator erythropoietin in hemodialysis patients based on hemoglobin changes. The biosimilar erythropoietin when administered subcutaneously will be equally efficacious and may be interchangeable as therapy.
Anemia is common in patients with chronic kidney diseases under hemodialysis and it’s managed with recombinant erythropoietin formulation. The objective of the study is to compare the safety and efficacy of two recombinant erythropoietin formulations in patients undergoing hemodialysis with chronic kidney diseases. In this randomized, controlled, prospective, parallel open study 70 patients were treated for 24 weeks with either reference β recombinant erythropoietin (100 IU/kg) or biosimilar β recombinant erythropoietin (100 IU/kg). The primary efficacy endpoint was the hemoglobin and hematocrit levels from baseline to 24 week of treatment. The secondary endpoints were safety, weekly doses of both erythropoietins required to maintain hemoglobin levels and immunogenicity. There was no significant difference between the two preparations in terms of hemoglobin and hematocrit levels achieved. The weekly doses of both erythropoietins required to maintain hemoglobin levels were the same in both groups. The frequency of adverse events was similar in the two groups of treatment. Two patients of the reference erythropoietin group developed anti-erythropoietin antibodies. The biosimilar erythropoietin was comparable since the safety and efficacy point of view with the innovator erythropoietin in hemodialysis patients based on hemoglobin changes. The biosimilar erythropoietin when administered subcutaneously will be equally efficacious and may be interchangeable as therapy.
Comparison of the Therapeutic Effects of Two Recombinant Erythropoietin Beta, Biosimilar and Reference Formulations in Patients with Chronic Kidney Disease under Hemodialysis
doi:10.11648/j.cmr.20140305.15
Clinical Medicine Research
2014-09-11
© Science Publishing Group
Maria del Carmen Popoca-Martínez
Julio Flores-Garnica
Odette Díaz-Avendaño
Emmanuel Canales-Vázquez
Raúl Meixueiro-Montes De Oca
Comparison of the Therapeutic Effects of Two Recombinant Erythropoietin Beta, Biosimilar and Reference Formulations in Patients with Chronic Kidney Disease under Hemodialysis
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2014-09-11
2014-09-11
10.11648/j.cmr.20140305.15
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.15
© Science Publishing Group
A Novel Streptomycin and Spectinomycin Resistance Gene Cassette Occurence in E. cloacae isolated from Zhenjiang
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.16
The aadA genes, encoding resistance to streptomycin and spectinomycin, have been found as gene cassettes in different gram-negative and gram-positive bacterial species. The present report has revealed that the sequence of a new gene, aadA5, combining with the trimethoprim resistance gene dfr17 occured in a class 1integron. The integron was identified in a nosocomial pathogen Enterobacter cloacae isolates, which indicated that integrons are specialized genetic elements that were capable of capturing, integrating and mobilizing gene-cassette by site-specific recombination and integron was a dangerous factor to lead to bacterial resistance.
The aadA genes, encoding resistance to streptomycin and spectinomycin, have been found as gene cassettes in different gram-negative and gram-positive bacterial species. The present report has revealed that the sequence of a new gene, aadA5, combining with the trimethoprim resistance gene dfr17 occured in a class 1integron. The integron was identified in a nosocomial pathogen Enterobacter cloacae isolates, which indicated that integrons are specialized genetic elements that were capable of capturing, integrating and mobilizing gene-cassette by site-specific recombination and integron was a dangerous factor to lead to bacterial resistance.
A Novel Streptomycin and Spectinomycin Resistance Gene Cassette Occurence in E. cloacae isolated from Zhenjiang
doi:10.11648/j.cmr.20140305.16
Clinical Medicine Research
2014-09-20
© Science Publishing Group
Hongxia Wu
A Novel Streptomycin and Spectinomycin Resistance Gene Cassette Occurence in E. cloacae isolated from Zhenjiang
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2014-09-20
2014-09-20
10.11648/j.cmr.20140305.16
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.16
© Science Publishing Group
Effects of Capsaicin on Coagulation: Will this be the New Blood Thinner
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.17
Background: The effect of capsaicin (the active ingredient in Capsicum frutescensLinn. [Solanaceae] on coagulationwas reported in several studies. Current research is being directed at elucidating if capsaicin has any effect on coagulation. Objectives: To investigate if either the ethyl acetate extract of Capsicum frutescensLinn. [Solanaceae] (CFE) or capsaicin (FlukaBiotechnika-CPF) on coagulation. Methodss: The effects of ethyl acetate extract of Capsicum frutescensLinn. [Solanaceae] (CFE) and capsaicin (FlukaBiotechnika-CPF) was examined on rat hind paw Ten animals in each of three treatment groups received 2.5, 5.0, 10 mg/kg (i.p.) capsaicin respectively. Data obtained were pooled and analysed using repeated ANOVA, in a general linear model with the CPSS software. Results: Compared to the control group, the mean INR was statistically significant (P<0.05). Conclusion: Taken together, the use of capsaicin at therapeutic doses (2.5-10.0 mg/kg) may reduce thromboembolism without any clinically relevant alteration in platelets.
Background: The effect of capsaicin (the active ingredient in Capsicum frutescensLinn. [Solanaceae] on coagulationwas reported in several studies. Current research is being directed at elucidating if capsaicin has any effect on coagulation. Objectives: To investigate if either the ethyl acetate extract of Capsicum frutescensLinn. [Solanaceae] (CFE) or capsaicin (FlukaBiotechnika-CPF) on coagulation. Methodss: The effects of ethyl acetate extract of Capsicum frutescensLinn. [Solanaceae] (CFE) and capsaicin (FlukaBiotechnika-CPF) was examined on rat hind paw Ten animals in each of three treatment groups received 2.5, 5.0, 10 mg/kg (i.p.) capsaicin respectively. Data obtained were pooled and analysed using repeated ANOVA, in a general linear model with the CPSS software. Results: Compared to the control group, the mean INR was statistically significant (P<0.05). Conclusion: Taken together, the use of capsaicin at therapeutic doses (2.5-10.0 mg/kg) may reduce thromboembolism without any clinically relevant alteration in platelets.
Effects of Capsaicin on Coagulation: Will this be the New Blood Thinner
doi:10.11648/j.cmr.20140305.17
Clinical Medicine Research
2014-09-27
© Science Publishing Group
Jolayemi Adebayo Taiwo Ezekiel
Ojewole John Akanni Oluwole
Effects of Capsaicin on Coagulation: Will this be the New Blood Thinner
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2014-09-27
2014-09-27
10.11648/j.cmr.20140305.17
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.17
© Science Publishing Group
Complementary and Alternative Medicine Use among HIV-Infected Patient’s on Anti-Retroviral Therapy in the Niger Delta Region, Nigeria
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.19
Background: Since the first case of HIV/AIDS was reported in Nigeria in 1986, HIV/AIDS has continued to penetrate the fabrics of all sectors of the Nigerian population. The plight of HIV/AIDS patients in Nigeria is made worse by inadequate supply of anti-retroviral (ARV) drugs. Methods: A prospective study was done between April and October 2013. Using a systematic sampling technique, 290 adult consenting male and female HIV/AIDS patients aged between 18 and 69 years who were on ARV drugs were recruited. They were assessed for use of complementary and alternative medicine (CAM) along with ARV drugs. Two research assistants assisted in data collection in a rural hospital using a semi-structured questionnaire. Results: Of the 290 subjects recruited, 259 (89.3%) had their data analyzed, while data for 31 (10.7%) subjects were discarded due to incomplete information. Subjects consisted of 101(39.0%) males and 158(61.0%) females. Of the 101 males 50(19.3%) used CAM; compared to 100(38.6%) females who also used CAM (p= 0.028). The mean age of CAM users was 34.39 (sd=10-62) years. Subjects between 29 and 49 years constituted the largest number of HIV- infected respondents who also used CAM. Subjects in the low income cadre patronized CAM more than those in the middle or higher income cadre (p=0.004). Herbal products were the most preferred CAM used by subjects in this study (31.7%); and was followed by faith and prayer healing (14.7%). Five (1.9%) subjects drank urine as a form of therapy. Most subjects in this study preferred CAM because of the naturalness of their source and also because of concern that ARV drugs alone may not effectively manage their HIV/AIDS infection. Conclusions: CAM use is high among HIV/AIDS patients on ARV drugs in the Niger Delta region of Nigeria. Because of the possible risks of interactions following the concurrent use of CAM and ARV drugs, care givers involved in the care of HIV/AIDS patients should be vigilant in this regard.
Background: Since the first case of HIV/AIDS was reported in Nigeria in 1986, HIV/AIDS has continued to penetrate the fabrics of all sectors of the Nigerian population. The plight of HIV/AIDS patients in Nigeria is made worse by inadequate supply of anti-retroviral (ARV) drugs. Methods: A prospective study was done between April and October 2013. Using a systematic sampling technique, 290 adult consenting male and female HIV/AIDS patients aged between 18 and 69 years who were on ARV drugs were recruited. They were assessed for use of complementary and alternative medicine (CAM) along with ARV drugs. Two research assistants assisted in data collection in a rural hospital using a semi-structured questionnaire. Results: Of the 290 subjects recruited, 259 (89.3%) had their data analyzed, while data for 31 (10.7%) subjects were discarded due to incomplete information. Subjects consisted of 101(39.0%) males and 158(61.0%) females. Of the 101 males 50(19.3%) used CAM; compared to 100(38.6%) females who also used CAM (p= 0.028). The mean age of CAM users was 34.39 (sd=10-62) years. Subjects between 29 and 49 years constituted the largest number of HIV- infected respondents who also used CAM. Subjects in the low income cadre patronized CAM more than those in the middle or higher income cadre (p=0.004). Herbal products were the most preferred CAM used by subjects in this study (31.7%); and was followed by faith and prayer healing (14.7%). Five (1.9%) subjects drank urine as a form of therapy. Most subjects in this study preferred CAM because of the naturalness of their source and also because of concern that ARV drugs alone may not effectively manage their HIV/AIDS infection. Conclusions: CAM use is high among HIV/AIDS patients on ARV drugs in the Niger Delta region of Nigeria. Because of the possible risks of interactions following the concurrent use of CAM and ARV drugs, care givers involved in the care of HIV/AIDS patients should be vigilant in this regard.
Complementary and Alternative Medicine Use among HIV-Infected Patient’s on Anti-Retroviral Therapy in the Niger Delta Region, Nigeria
doi:10.11648/j.cmr.20140305.19
Clinical Medicine Research
2014-09-29
© Science Publishing Group
Alphonsus Udo Idung
Festus Abasiubong
Complementary and Alternative Medicine Use among HIV-Infected Patient’s on Anti-Retroviral Therapy in the Niger Delta Region, Nigeria
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158
158
2014-09-29
2014-09-29
10.11648/j.cmr.20140305.19
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.19
© Science Publishing Group
Late Twiddler’s Syndrome in a Nigerian on a Demand Pacemaker
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.18
A 75 year old woman with unipolar ventricular pacemaker presented with cough, difficulty breathing and dizziness. An initial electrocardiogram (ECG) showed atrial fibrillation, incomplete right bundle branch block with no pacemaker spikes. The chest radiograph revealed twisting of the leads at various points. She was managed conservatively with anti-failure drugs and monthly ECG. The pacemaker could not be interrogated due to logistic reasons. However, the ECG during the 8th month of follow-up showed pacemaker spikes and complete left bundle branch block pattern suggestive of spontaneous return of pacemaker function.
A 75 year old woman with unipolar ventricular pacemaker presented with cough, difficulty breathing and dizziness. An initial electrocardiogram (ECG) showed atrial fibrillation, incomplete right bundle branch block with no pacemaker spikes. The chest radiograph revealed twisting of the leads at various points. She was managed conservatively with anti-failure drugs and monthly ECG. The pacemaker could not be interrogated due to logistic reasons. However, the ECG during the 8th month of follow-up showed pacemaker spikes and complete left bundle branch block pattern suggestive of spontaneous return of pacemaker function.
Late Twiddler’s Syndrome in a Nigerian on a Demand Pacemaker
doi:10.11648/j.cmr.20140305.18
Clinical Medicine Research
2014-09-29
© Science Publishing Group
Adamu Gati Umar
Ibok Idongesit Okon
Abdullahi Aishatu
George Alaba Okuku
Late Twiddler’s Syndrome in a Nigerian on a Demand Pacemaker
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2014-09-29
10.11648/j.cmr.20140305.18
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.18
© Science Publishing Group
Medical Problems in the Honeymoon in Newly Married Couples: An Overview
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.20
This is an overview on the medical problems, which might occur in the honeymoon period. The medical problems include several uncommon conditions .The most discussed ones in the medical literature are honeymoon cystitis and vaginismus .Future couples are also prone to skin diseases from overuse of cosmetics before wedding. A particular attention, in our paper, is given to the potential sexual injuries which may occur to the couples in this period together with a discussion on how to decrease their occurrence.
This is an overview on the medical problems, which might occur in the honeymoon period. The medical problems include several uncommon conditions .The most discussed ones in the medical literature are honeymoon cystitis and vaginismus .Future couples are also prone to skin diseases from overuse of cosmetics before wedding. A particular attention, in our paper, is given to the potential sexual injuries which may occur to the couples in this period together with a discussion on how to decrease their occurrence.
Medical Problems in the Honeymoon in Newly Married Couples: An Overview
doi:10.11648/j.cmr.20140305.20
Clinical Medicine Research
2014-10-09
© Science Publishing Group
Raeef Ahmad Qutob
Mutlak Abdullah Al Malky
Khalid Mohammad Al Aboud
Medical Problems in the Honeymoon in Newly Married Couples: An Overview
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2014-10-09
2014-10-09
10.11648/j.cmr.20140305.20
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140305.20
© Science Publishing Group
Tissue Scurvy – Not Shaken Baby
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.11
Parents and carers are often falsely accused of injuring a child asserting that unexplained bruises, fractures, retinal and subdural hemorrhages with ischemic encephalopathy, the so called “Triad”, are signs of physical abuse. However these features can be the result of Tissue Scurvy, a disorder of Vitamin C metabolism in which Vitamin C, although abundant in the plasma, is unable to enter the cell because of a lack of Insulin which is necessary to conduct the transfer of the Vitamin C into the cell. The cause is an autoimmune reaction to a viral, bacterial or parasitic infection or a vaccine which destroys the Insulin-producing Beta cells of the Pancreas, as evidenced by Hyperglycaemia and Glycosuria, in some genetically susceptible children. Here it is shown that the evidence of the Prosecution Experts alleging death from the Shaken Baby Syndrome was demonstrably flawed. The diagnosis Shaken Baby Syndrome is false and an innocent man was incarcerated. This irrational diagnosis should beabandoned.
Parents and carers are often falsely accused of injuring a child asserting that unexplained bruises, fractures, retinal and subdural hemorrhages with ischemic encephalopathy, the so called “Triad”, are signs of physical abuse. However these features can be the result of Tissue Scurvy, a disorder of Vitamin C metabolism in which Vitamin C, although abundant in the plasma, is unable to enter the cell because of a lack of Insulin which is necessary to conduct the transfer of the Vitamin C into the cell. The cause is an autoimmune reaction to a viral, bacterial or parasitic infection or a vaccine which destroys the Insulin-producing Beta cells of the Pancreas, as evidenced by Hyperglycaemia and Glycosuria, in some genetically susceptible children. Here it is shown that the evidence of the Prosecution Experts alleging death from the Shaken Baby Syndrome was demonstrably flawed. The diagnosis Shaken Baby Syndrome is false and an innocent man was incarcerated. This irrational diagnosis should beabandoned.
Tissue Scurvy – Not Shaken Baby
doi:10.11648/j.cmr.20140306.11
Clinical Medicine Research
2014-10-24
© Science Publishing Group
Michael D. Innis
Tissue Scurvy – Not Shaken Baby
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2014-10-24
10.11648/j.cmr.20140306.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.11
© Science Publishing Group
Management of Hematologic Toxicity in Patients with Advanced or Metastatic Gastric Cancer Treated with Docetaxel, Cisplatin and Fluorouracil (DCF): Results of Monocentric Experience
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.12
Background: Gastric adenocarcinoma is the second most common cause of cancer death worldwide. There is no standard regimen of chemotherapy for metastatic disease, although the regimen of ECF is the most used regimen, with a median survival of 7-9 months. With new regimens of chemotherapy, such as DCF, the median survival has increased, despite a major toxicities and 1-2% of toxic death.Patients And Methods: This is a monocentric experience. In three years (2009-2012) we have treated 36 chemo-naïve patients with histological diagnosis of locally advanced or metastatic gastric cancer with a DCF regimen. All patients were treated with a prophilactic Peg-filgrastim injection at 6th day of therapy. Results: A total of 168 cycles were administered (median 5 per patient, range 3–8). Major responses were observed in 10 patients, with 2 complete (5,5%) and 8 partial remissions (22,2%); 16 additional pts showed disease stabilization (44,4%) and 10 progressed (27,9%). Median OS times were 12 months. Median TTP were 9,5 months. Toxicity was acceptable, worst per patient toxicities were neutropenia (grade 3-4 in 15%), feverish neutropenia (11,1%) diarrhoea (grade 2 in 25% , grade 3 in 25%, grade 4 in 18,8%), asthenia (grade 2 in 8%), neurotoxicity (grade 3 in 4%), anhemia (grade 4 in 10%), four pts received blood transfusion. Conclusion: Time to response and ORR favor DCF over other schedule’s treatment according to literature. A trend towards increased myelosuppression and infectious complications was observed but the management of this and others side-effects is possible and not too difficult if pts is managed by an expert toxicities team. Infact we don’t have no-one toxic death.
Background: Gastric adenocarcinoma is the second most common cause of cancer death worldwide. There is no standard regimen of chemotherapy for metastatic disease, although the regimen of ECF is the most used regimen, with a median survival of 7-9 months. With new regimens of chemotherapy, such as DCF, the median survival has increased, despite a major toxicities and 1-2% of toxic death.Patients And Methods: This is a monocentric experience. In three years (2009-2012) we have treated 36 chemo-naïve patients with histological diagnosis of locally advanced or metastatic gastric cancer with a DCF regimen. All patients were treated with a prophilactic Peg-filgrastim injection at 6th day of therapy. Results: A total of 168 cycles were administered (median 5 per patient, range 3–8). Major responses were observed in 10 patients, with 2 complete (5,5%) and 8 partial remissions (22,2%); 16 additional pts showed disease stabilization (44,4%) and 10 progressed (27,9%). Median OS times were 12 months. Median TTP were 9,5 months. Toxicity was acceptable, worst per patient toxicities were neutropenia (grade 3-4 in 15%), feverish neutropenia (11,1%) diarrhoea (grade 2 in 25% , grade 3 in 25%, grade 4 in 18,8%), asthenia (grade 2 in 8%), neurotoxicity (grade 3 in 4%), anhemia (grade 4 in 10%), four pts received blood transfusion. Conclusion: Time to response and ORR favor DCF over other schedule’s treatment according to literature. A trend towards increased myelosuppression and infectious complications was observed but the management of this and others side-effects is possible and not too difficult if pts is managed by an expert toxicities team. Infact we don’t have no-one toxic death.
Management of Hematologic Toxicity in Patients with Advanced or Metastatic Gastric Cancer Treated with Docetaxel, Cisplatin and Fluorouracil (DCF): Results of Monocentric Experience
doi:10.11648/j.cmr.20140306.12
Clinical Medicine Research
2014-10-30
© Science Publishing Group
Turano Salvatore
Biamonte Rosalbino
Conforti Serafino
Mastroianni Candida Maria
Manfredi Caterina
Palazzo Salvatore
Management of Hematologic Toxicity in Patients with Advanced or Metastatic Gastric Cancer Treated with Docetaxel, Cisplatin and Fluorouracil (DCF): Results of Monocentric Experience
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2014-10-30
2014-10-30
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.12
© Science Publishing Group
Purple Urine Bag Syndrome as a Rare Manifestation of Urinary Tract Infection: A Case Report
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.13
Purple urine bag syndrome (PUBS) is purple discoloration of urinary catheter, tubing and bag and it is a rare and uncommon manifestation of urinary tract infection. Female gender, constipation, urinary tract infection, dementia, alkaline urine and high urinary bacterial counts are main risk factors. Here we report a 70 year old woman living in a nursing home presented with diarrhea, decreased oral intake and purple urine. The urine was evaluated and urine analysis showed PH=7 and pyuria. The result of urine culture was growth of more than 10¬0000 colony of Proteus Mirrabilis sensitive to Imipeneme. The patient condition improved after antibiotic therapy. The main reason of this phenomenon is not clearly recognized but some authors believe that Indigo (blue pigment) and Indirubin (red pigment) which are metabolite derivate of tryptophan can cause this uncommon discoloration. This condition is benign without any serious consequences and the treatment of underlying disease should be considered.
Purple urine bag syndrome (PUBS) is purple discoloration of urinary catheter, tubing and bag and it is a rare and uncommon manifestation of urinary tract infection. Female gender, constipation, urinary tract infection, dementia, alkaline urine and high urinary bacterial counts are main risk factors. Here we report a 70 year old woman living in a nursing home presented with diarrhea, decreased oral intake and purple urine. The urine was evaluated and urine analysis showed PH=7 and pyuria. The result of urine culture was growth of more than 10¬0000 colony of Proteus Mirrabilis sensitive to Imipeneme. The patient condition improved after antibiotic therapy. The main reason of this phenomenon is not clearly recognized but some authors believe that Indigo (blue pigment) and Indirubin (red pigment) which are metabolite derivate of tryptophan can cause this uncommon discoloration. This condition is benign without any serious consequences and the treatment of underlying disease should be considered.
Purple Urine Bag Syndrome as a Rare Manifestation of Urinary Tract Infection: A Case Report
doi:10.11648/j.cmr.20140306.13
Clinical Medicine Research
2014-11-21
© Science Publishing Group
Reza Elahi
Seyed Morteza Tabatabaee
Seyed Alireza Heydariezade
Mitra Ranjbar
Purple Urine Bag Syndrome as a Rare Manifestation of Urinary Tract Infection: A Case Report
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2014-11-21
2014-11-21
10.11648/j.cmr.20140306.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.13
© Science Publishing Group
Prevalence of Intestinal Schistosomiasis and Soil Transmitted Helminthiasis among Primary School Children in Umolante District, South Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.14
Introduction: Intestinal Schistosomiasis and Soil transmitted helminthic infections (STIs) are among the major public health problems in the world, especially in Subsaharan Africa. Objective: To determine the prevalence of intestinal schistosomiais and soil transmitted helminthic infections and associated factors among Umolante primary school children, South Ethiopia. Methods: A cross sectional study was conducted among Primary School Children in Umolante Destrict, South Ethiopia. A total of 405 school children were selected at random. For each selected subject interview and stool examination was done. Interviews were used to identify the risk factors. Stool specimens were examined using the Kato-Katz technique. Data was entered and analyzed using SPSS version 16.0 statistical packages software. Results: The overall prevalence of intestinal helminthic infection was 26.9%. The predominant parasites were hookworm 59(14.6%) and S.mansoni 51(12.6%). Prevalence of S.mansoni infection was significantly higher in males (p=0.006) whereas hookworm infection was significantly higher in females (P=0.015). Other helminthes found were E.vermicularis (1%), whipworm (1.5%), tapeworm (1.5%) and A.lumbricoides (0.5%). The highest prevalence of S.mansoni was reported in the age group of 10-14 years (17.8%) followed by the age group 15 and above (11.6%) and the difference was statistically significant (P=0.02). Geometric mean intensity was also highest in the same age group (245 eggs per gram). The overall prevalence of infection was 7.7% for girls and 17.1% for boys and the difference was statistically significant (p=0.006). Bathing practice in the nearby stream was significantly associated with S.mansoni infection (OR, 3.4, 95.0% C.I., 1.5-5.3, P=0.03). Conclusion and recommendation: On the basis of these results, it can be concluded that intestinal helminthic infections are important health problems among school children. Hence, integrated control programme including periodic deworming, shoes wearing, improving sanitation, provision of safe water supply are needed to have a lasting impact on transmission these diseases.
Introduction: Intestinal Schistosomiasis and Soil transmitted helminthic infections (STIs) are among the major public health problems in the world, especially in Subsaharan Africa. Objective: To determine the prevalence of intestinal schistosomiais and soil transmitted helminthic infections and associated factors among Umolante primary school children, South Ethiopia. Methods: A cross sectional study was conducted among Primary School Children in Umolante Destrict, South Ethiopia. A total of 405 school children were selected at random. For each selected subject interview and stool examination was done. Interviews were used to identify the risk factors. Stool specimens were examined using the Kato-Katz technique. Data was entered and analyzed using SPSS version 16.0 statistical packages software. Results: The overall prevalence of intestinal helminthic infection was 26.9%. The predominant parasites were hookworm 59(14.6%) and S.mansoni 51(12.6%). Prevalence of S.mansoni infection was significantly higher in males (p=0.006) whereas hookworm infection was significantly higher in females (P=0.015). Other helminthes found were E.vermicularis (1%), whipworm (1.5%), tapeworm (1.5%) and A.lumbricoides (0.5%). The highest prevalence of S.mansoni was reported in the age group of 10-14 years (17.8%) followed by the age group 15 and above (11.6%) and the difference was statistically significant (P=0.02). Geometric mean intensity was also highest in the same age group (245 eggs per gram). The overall prevalence of infection was 7.7% for girls and 17.1% for boys and the difference was statistically significant (p=0.006). Bathing practice in the nearby stream was significantly associated with S.mansoni infection (OR, 3.4, 95.0% C.I., 1.5-5.3, P=0.03). Conclusion and recommendation: On the basis of these results, it can be concluded that intestinal helminthic infections are important health problems among school children. Hence, integrated control programme including periodic deworming, shoes wearing, improving sanitation, provision of safe water supply are needed to have a lasting impact on transmission these diseases.
Prevalence of Intestinal Schistosomiasis and Soil Transmitted Helminthiasis among Primary School Children in Umolante District, South Ethiopia
doi:10.11648/j.cmr.20140306.14
Clinical Medicine Research
2014-11-25
© Science Publishing Group
Megbaru Alemu
Asrat Hailu
Gessessew Bugssa
Prevalence of Intestinal Schistosomiasis and Soil Transmitted Helminthiasis among Primary School Children in Umolante District, South Ethiopia
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180
180
2014-11-25
2014-11-25
10.11648/j.cmr.20140306.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.14
© Science Publishing Group
Incisor Inclination and Arch Width Changes Following Mandibular Setback Surgery for Correction of Mandibular Prognathism
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.15
Purpose: The aim of this study was to investigate and evaluate the changes of incisor inclination and arch width in the surgical-orthodontic treatment to correct a Class Ⅲ malocclusion resulting from skeletal mandibular prognathism. Materials and methods: The skeletal mandibular prognathism subjects consisted of 25 males and 20 females (mean age:22.8±4.2years). A lateral cephalogram was taken for each subject before preoperative orthodontic treatment (T1), presurgical (T2), and at completion of the postoperative orthodontic treatment (T3). Skeletal and dental values and arch width measurements at T1, T2 and T3 were obtained. Each cephalogram was traced and digitized twice. For statistical evaluation, all the data were expressed as Mean±Standard deviation and analyzed with SPSS software. Results: At pretreatment, dental compensation was normally found in both dental arches, including anterior and posterior teeth. During presurgical orthodontic treatment, most of the patient’s mandibular incisors were significantly decompensated (P<0.05), while no significant changes were noted in the maxillary incisors (P ≥ 0.05). The increase in maxillary inter-first molar width were statistically significant (P<0.05). With effective dental decompensation, the relationship between teeth and basal bone was improved obviously. It is beneficial for moving bone bulk in surgery. After the surgery, most of the patients (97.8%) finished with proper overjet and overbite, establish stable and harmony occlusion. Conclusion: By effective and proper dental decompensation, desired teeth positions could be achieved before surgery, which could lead to better surgical results.
Purpose: The aim of this study was to investigate and evaluate the changes of incisor inclination and arch width in the surgical-orthodontic treatment to correct a Class Ⅲ malocclusion resulting from skeletal mandibular prognathism. Materials and methods: The skeletal mandibular prognathism subjects consisted of 25 males and 20 females (mean age:22.8±4.2years). A lateral cephalogram was taken for each subject before preoperative orthodontic treatment (T1), presurgical (T2), and at completion of the postoperative orthodontic treatment (T3). Skeletal and dental values and arch width measurements at T1, T2 and T3 were obtained. Each cephalogram was traced and digitized twice. For statistical evaluation, all the data were expressed as Mean±Standard deviation and analyzed with SPSS software. Results: At pretreatment, dental compensation was normally found in both dental arches, including anterior and posterior teeth. During presurgical orthodontic treatment, most of the patient’s mandibular incisors were significantly decompensated (P<0.05), while no significant changes were noted in the maxillary incisors (P ≥ 0.05). The increase in maxillary inter-first molar width were statistically significant (P<0.05). With effective dental decompensation, the relationship between teeth and basal bone was improved obviously. It is beneficial for moving bone bulk in surgery. After the surgery, most of the patients (97.8%) finished with proper overjet and overbite, establish stable and harmony occlusion. Conclusion: By effective and proper dental decompensation, desired teeth positions could be achieved before surgery, which could lead to better surgical results.
Incisor Inclination and Arch Width Changes Following Mandibular Setback Surgery for Correction of Mandibular Prognathism
doi:10.11648/j.cmr.20140306.15
Clinical Medicine Research
2014-12-03
© Science Publishing Group
Fang Ning
Yinzhong Duan
Yi Xue
Donghui Yuan
Incisor Inclination and Arch Width Changes Following Mandibular Setback Surgery for Correction of Mandibular Prognathism
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188
2014-12-03
2014-12-03
10.11648/j.cmr.20140306.15
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.15
© Science Publishing Group
Magnitude and Associated Factors of Cutaneous Leishmaniasis; in Mekelle City, Ayder Referral Hospital, Tigray, Northern Ethiopia, 2014
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.16
Introduction; Cutaneous leishmaniasis is a neglected tropical disease strongly associated with poverty with an adverse health effects over the poorest populations of the world. The disease is endemic in 88 countries, 72 of them are developing countries including Ethiopia. It has been estimated that 12million people are infected and 350 million people are at risk with the annual incidence of new cases is estimated between 1.5-2million. Ethiopia has seen new outbreaks in areas previously not known to be endemic often with co-infection by the human immunodeficiency virus with rates reaching 5.6% of the cases and other associated risk factors. As best of my knowledge similar study was not conducted specifically in Mekelle even though other study conducted to the whole region, Tigray. Thus, this preliminary study concerns to determine the magnitude and associated factors of cutaneous leishmaniasis in Mekelle city.Objectives; To assess the prevalence and associated factors of cutaneous leishmaniasis on patients who visit dermatology out patient department in Ayder referral hospital, Mekelle, Tigray, Northern Ethiopia. Methods and subjects; Institutional based cross sectional study was conducted on 478 study population from Ayder referral hospital by using systematic random sampling technique. Data entry and analysis was conducted by using SPSS v-20. The association between different variables in relation to the outcome variable was measured by odds ratio with 95% confidence interval. All variables with P<0.05 in the bivariate analysis were included in the multivariate model, accepting P ≤0.05 as the inclusion level for the independent variables. Result; Prevalence of cutaneouse leishmaniasis in this study was nearly six percent (5.6%) with 99% response rate. Sex [AOR 2.1(95% CI); (0.15, 0.79)], income source being farmer [AOR 2.1(95% CI); (0.00.0.248)], location of the home near to both farm and gorge [AOR 10.1 (95% CI); (0.00, 0.574)] and presence of the hyrax [AOR 1.1(95% CI); (0.00, 0.60)] were statistically significant to the presence of cutaneouse leishmaniasis in Mekelle city. Conclusion The overall prevalence of cutaneouse leishmaniasis in the study area was relatively high (5.6%) having a statistical significant association with sex, income source (farmer), location of the residence near to farm land and gorge and the presence of hyrax. Thus, a continuous health education and awareness creation about the disease, factors and preventive methods of cutaneouse should be sought.
Introduction; Cutaneous leishmaniasis is a neglected tropical disease strongly associated with poverty with an adverse health effects over the poorest populations of the world. The disease is endemic in 88 countries, 72 of them are developing countries including Ethiopia. It has been estimated that 12million people are infected and 350 million people are at risk with the annual incidence of new cases is estimated between 1.5-2million. Ethiopia has seen new outbreaks in areas previously not known to be endemic often with co-infection by the human immunodeficiency virus with rates reaching 5.6% of the cases and other associated risk factors. As best of my knowledge similar study was not conducted specifically in Mekelle even though other study conducted to the whole region, Tigray. Thus, this preliminary study concerns to determine the magnitude and associated factors of cutaneous leishmaniasis in Mekelle city.Objectives; To assess the prevalence and associated factors of cutaneous leishmaniasis on patients who visit dermatology out patient department in Ayder referral hospital, Mekelle, Tigray, Northern Ethiopia. Methods and subjects; Institutional based cross sectional study was conducted on 478 study population from Ayder referral hospital by using systematic random sampling technique. Data entry and analysis was conducted by using SPSS v-20. The association between different variables in relation to the outcome variable was measured by odds ratio with 95% confidence interval. All variables with P<0.05 in the bivariate analysis were included in the multivariate model, accepting P ≤0.05 as the inclusion level for the independent variables. Result; Prevalence of cutaneouse leishmaniasis in this study was nearly six percent (5.6%) with 99% response rate. Sex [AOR 2.1(95% CI); (0.15, 0.79)], income source being farmer [AOR 2.1(95% CI); (0.00.0.248)], location of the home near to both farm and gorge [AOR 10.1 (95% CI); (0.00, 0.574)] and presence of the hyrax [AOR 1.1(95% CI); (0.00, 0.60)] were statistically significant to the presence of cutaneouse leishmaniasis in Mekelle city. Conclusion The overall prevalence of cutaneouse leishmaniasis in the study area was relatively high (5.6%) having a statistical significant association with sex, income source (farmer), location of the residence near to farm land and gorge and the presence of hyrax. Thus, a continuous health education and awareness creation about the disease, factors and preventive methods of cutaneouse should be sought.
Magnitude and Associated Factors of Cutaneous Leishmaniasis; in Mekelle City, Ayder Referral Hospital, Tigray, Northern Ethiopia, 2014
doi:10.11648/j.cmr.20140306.16
Clinical Medicine Research
2014-12-17
© Science Publishing Group
Feleke Tilahun
Workalemahu Alemu
Getasew Mulatu
Magnitude and Associated Factors of Cutaneous Leishmaniasis; in Mekelle City, Ayder Referral Hospital, Tigray, Northern Ethiopia, 2014
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2014-12-17
2014-12-17
10.11648/j.cmr.20140306.16
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.16
© Science Publishing Group
Anesthetic Considerations on Pulmonary Hypertension: A Case Report and Minireview
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.17
Pulmonary hypertension presents a great challenge to the anesthesiologist. The number of patients suffering from pulmonary hypertension presenting for surgery is increasing because of increased age and the modern medical and surgical therapy as well. We present a case of a patient suffering from pulmonary hypertension scheduled for left radical nephrectomy due to left kidney tumor. Preoperative optimization and prevention of deterioration of pulmonary hypertension and right side heart failure are the problems the anesthesiologist must deal with. A good collaboration among cardiologist, anesthesiologist, and the surgeon can guarantee the patient’s outcome.
Pulmonary hypertension presents a great challenge to the anesthesiologist. The number of patients suffering from pulmonary hypertension presenting for surgery is increasing because of increased age and the modern medical and surgical therapy as well. We present a case of a patient suffering from pulmonary hypertension scheduled for left radical nephrectomy due to left kidney tumor. Preoperative optimization and prevention of deterioration of pulmonary hypertension and right side heart failure are the problems the anesthesiologist must deal with. A good collaboration among cardiologist, anesthesiologist, and the surgeon can guarantee the patient’s outcome.
Anesthetic Considerations on Pulmonary Hypertension: A Case Report and Minireview
doi:10.11648/j.cmr.20140306.17
Clinical Medicine Research
2014-12-23
© Science Publishing Group
Andi Koraqi
Denada Lacej
Rezart Xhani
Myzafer Kaci
Gjergj Andrea
Rudin Domi
Anesthetic Considerations on Pulmonary Hypertension: A Case Report and Minireview
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2014-12-23
2014-12-23
10.11648/j.cmr.20140306.17
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.17
© Science Publishing Group
Atypical Onset of Refractive Accommodative Esotropia: A Case Report
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.18
A 27 year old female presented with symptoms of diplopia, headache, ptosis, ataxia, and macropsia. She was subjected to extensive and repetitive medical evaluations on 3 separate occasions over a 2 year period resulting in a delay in diagnosis, expense of the evaluations and unnecessary treatment. Ophthalmologic consultation uncovered a delayed onset of refractive accommodative esotropia. Signs and symptoms of refractive accommodative esotropia can simulate other neurologic diseases in adults.
A 27 year old female presented with symptoms of diplopia, headache, ptosis, ataxia, and macropsia. She was subjected to extensive and repetitive medical evaluations on 3 separate occasions over a 2 year period resulting in a delay in diagnosis, expense of the evaluations and unnecessary treatment. Ophthalmologic consultation uncovered a delayed onset of refractive accommodative esotropia. Signs and symptoms of refractive accommodative esotropia can simulate other neurologic diseases in adults.
Atypical Onset of Refractive Accommodative Esotropia: A Case Report
doi:10.11648/j.cmr.20140306.18
Clinical Medicine Research
2014-12-26
© Science Publishing Group
Feray Koc
Figen Tokucoglu
Atypical Onset of Refractive Accommodative Esotropia: A Case Report
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2014-12-26
2014-12-26
10.11648/j.cmr.20140306.18
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.18
© Science Publishing Group
Radical Cystectomy in Elderly Patients, Single Center, 25 Years Experience
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.19
Objectives: To investigate the relation between age and tumor characteristics and to evaluate oncologic results after radical cystectomy in elderly patients. Materials and Methods: We reviewed 501 patients retrospectively who underwent radical cystectomy because of bladder cancer. Patients were divided into two groups; greater than or equal to 70 (group 1) and less than 70-years-old (group 2). We compared tumor pathological characteristics and oncologic results in both groups. American Society of Anesthesiologists (ASA) score is less than three and there was no risk for major surgery for all patients. None of the patients did not receive neoadjuvant radiotherapy and/or chemotherapy. Results: There were 87 (17.4%) patients in group 1 and 414 (82.6%) patients in group 2. The mean age was 73.3±3.01 (70-85) in group 1, and 58.3±7.47 (34-69) in group 2. There were no significantly difference between gender (0.135), pathological T stage (p=0.483), lymph node involvement (p=0.462), grade (p=0.522), type of diversion (p=0.193), histological type (p=0.656) in both groups. Perioperative mortality were 3.9% in group 1 and 3.4% in group 2 (p=0.218). Perioperative complication rates were 16.6 % in group 1 and 17.4% in group 2 (p=0.469). Five years disease specific survival (DSS) rates were 61% in group 1 and 53% in group 2 (p=0.936). The mean DSS periods were 72.91 ± 5.35 months in group 1 and 76.25±7.45 months in group 2. Five years overall survival rates were 43.9% in group 1, 45.9% in group 2 (p=0.476). Mean overall survival periods were 54.02±8.47 in group 1 and 69.25±4.97 in group 2. In cox regression analyse; tumor stage (p=0.012) and lymph node involvement (p<0.001) were significant factors affected the survival in both groups. Conclusions: We found similar oncological results in patients who underwent radical cystectomy because of bladder cancer between young and elderly patients. We believe that age is not a contraindication factor for radical cystectomy operation. In addition preoperative performance statue of patients is important in terms of perioperative complications and mortality.
Objectives: To investigate the relation between age and tumor characteristics and to evaluate oncologic results after radical cystectomy in elderly patients. Materials and Methods: We reviewed 501 patients retrospectively who underwent radical cystectomy because of bladder cancer. Patients were divided into two groups; greater than or equal to 70 (group 1) and less than 70-years-old (group 2). We compared tumor pathological characteristics and oncologic results in both groups. American Society of Anesthesiologists (ASA) score is less than three and there was no risk for major surgery for all patients. None of the patients did not receive neoadjuvant radiotherapy and/or chemotherapy. Results: There were 87 (17.4%) patients in group 1 and 414 (82.6%) patients in group 2. The mean age was 73.3±3.01 (70-85) in group 1, and 58.3±7.47 (34-69) in group 2. There were no significantly difference between gender (0.135), pathological T stage (p=0.483), lymph node involvement (p=0.462), grade (p=0.522), type of diversion (p=0.193), histological type (p=0.656) in both groups. Perioperative mortality were 3.9% in group 1 and 3.4% in group 2 (p=0.218). Perioperative complication rates were 16.6 % in group 1 and 17.4% in group 2 (p=0.469). Five years disease specific survival (DSS) rates were 61% in group 1 and 53% in group 2 (p=0.936). The mean DSS periods were 72.91 ± 5.35 months in group 1 and 76.25±7.45 months in group 2. Five years overall survival rates were 43.9% in group 1, 45.9% in group 2 (p=0.476). Mean overall survival periods were 54.02±8.47 in group 1 and 69.25±4.97 in group 2. In cox regression analyse; tumor stage (p=0.012) and lymph node involvement (p<0.001) were significant factors affected the survival in both groups. Conclusions: We found similar oncological results in patients who underwent radical cystectomy because of bladder cancer between young and elderly patients. We believe that age is not a contraindication factor for radical cystectomy operation. In addition preoperative performance statue of patients is important in terms of perioperative complications and mortality.
Radical Cystectomy in Elderly Patients, Single Center, 25 Years Experience
doi:10.11648/j.cmr.20140306.19
Clinical Medicine Research
2014-12-31
© Science Publishing Group
Sacit Nuri Gorgel
Osman Kose
Ozan Horsanalı
Evren Sahin
Ugur Balci
Kutan Ozer
Cengiz Girgin
Radical Cystectomy in Elderly Patients, Single Center, 25 Years Experience
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2014-12-31
2014-12-31
10.11648/j.cmr.20140306.19
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20140306.19
© Science Publishing Group
A Comparative Analysis of the Efficacy of Short-Segment Pedicle Screw Fixation with that of Long-Segment Pedicle Screw Fixation for Unstable Thoracolumbar Spinal Burst Fractures
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150401.11
The indications for operative treatment and type of stabilization procedures for the treatment of thoracolumbar burst fracture remain controversial. As surgical reconstruction for the thoracolumbar burst fracture, both long-segment pedicle screw fixation and short-segment pedicle screw fixation including fractured vertebral body have been used widely. The present study evaluated the efficacy of short-segment fixation compared with that of long-segment fixation in terms of the radiological and clinical outcomes in unstable thoracolumbar burst fractures. From January 2007 to December 2012, 76 patients with thoracolumbar burst fracture underwent posterior pedicle screw fixation consecutively in our hospital. These patients were divided into two groups: the short-segment group, which included patients who underwent short-segment pedicle screw fixation including the fractured vertebral body, and the long-segment group, which included patients who underwent long-segment pedicle screw fixation (2 levels above and 1 level below the fractured vertebral body). There were 44 and 32 patients in the long-segment and short-segment group, respectively. Radiological assessment of the kyphotic angle was performed using the Cobb method immediately after the operation and at 3, 6, and 12 months postoperatively. The clinical outcomes were evaluated using the modified Mcnab criteria at the last follow-up. The sex ratio, mean age of patients, and composition of the fractured vertebral body were similar in both groups. In the long-segment and short-segment group, 37 (84.1%) and 26 (81.3%) cases showed excellent or good outcomes, respectively. The mean kyphotic angle at the immediate postoperative period was 7.3° ± 5.8° and 0.6° ± 11.9° in the long-segment and short-segment group, respectively. The average loss of kyphosis correction was 5.4° ± 4.4°, 8.6° ± 6.2°, and 10.5° ± 4.8° in the long-segment group and 4.1° ± 3.6°, 6.2° ± 5.2°, and 7.5° ± 4.4° in the short-segment group at 3, 6, and 12 months postoperatively, respectively. There was no statistically significant difference in the average loss of kyphosis correction between the two groups (p > 0.05). In conclusion, short-segment pedicle screw fixation including the fractured vertebral body might be as effective as long-segment pedicle screw fixation for the treatment of unstable thoracolumbar spinal burst fracture.
The indications for operative treatment and type of stabilization procedures for the treatment of thoracolumbar burst fracture remain controversial. As surgical reconstruction for the thoracolumbar burst fracture, both long-segment pedicle screw fixation and short-segment pedicle screw fixation including fractured vertebral body have been used widely. The present study evaluated the efficacy of short-segment fixation compared with that of long-segment fixation in terms of the radiological and clinical outcomes in unstable thoracolumbar burst fractures. From January 2007 to December 2012, 76 patients with thoracolumbar burst fracture underwent posterior pedicle screw fixation consecutively in our hospital. These patients were divided into two groups: the short-segment group, which included patients who underwent short-segment pedicle screw fixation including the fractured vertebral body, and the long-segment group, which included patients who underwent long-segment pedicle screw fixation (2 levels above and 1 level below the fractured vertebral body). There were 44 and 32 patients in the long-segment and short-segment group, respectively. Radiological assessment of the kyphotic angle was performed using the Cobb method immediately after the operation and at 3, 6, and 12 months postoperatively. The clinical outcomes were evaluated using the modified Mcnab criteria at the last follow-up. The sex ratio, mean age of patients, and composition of the fractured vertebral body were similar in both groups. In the long-segment and short-segment group, 37 (84.1%) and 26 (81.3%) cases showed excellent or good outcomes, respectively. The mean kyphotic angle at the immediate postoperative period was 7.3° ± 5.8° and 0.6° ± 11.9° in the long-segment and short-segment group, respectively. The average loss of kyphosis correction was 5.4° ± 4.4°, 8.6° ± 6.2°, and 10.5° ± 4.8° in the long-segment group and 4.1° ± 3.6°, 6.2° ± 5.2°, and 7.5° ± 4.4° in the short-segment group at 3, 6, and 12 months postoperatively, respectively. There was no statistically significant difference in the average loss of kyphosis correction between the two groups (p > 0.05). In conclusion, short-segment pedicle screw fixation including the fractured vertebral body might be as effective as long-segment pedicle screw fixation for the treatment of unstable thoracolumbar spinal burst fracture.
A Comparative Analysis of the Efficacy of Short-Segment Pedicle Screw Fixation with that of Long-Segment Pedicle Screw Fixation for Unstable Thoracolumbar Spinal Burst Fractures
doi:10.11648/j.cmr.20150401.11
Clinical Medicine Research
2015-01-14
© Science Publishing Group
Jin-Woo Hur
Jong-Joo Rhee
Jong-Won Lee
Hyun-Koo Lee
A Comparative Analysis of the Efficacy of Short-Segment Pedicle Screw Fixation with that of Long-Segment Pedicle Screw Fixation for Unstable Thoracolumbar Spinal Burst Fractures
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5
5
2015-01-14
2015-01-14
10.11648/j.cmr.20150401.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150401.11
© Science Publishing Group
Adverse Effects of Whole Blood Donation among Voluntary Blood Donors in Jos, Nigeria
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150401.12
Introduction: Despite collection of blood from apparently healthy individuals for allogeneic transfusion, blood givers are often faced with untoward reactions during or after blood donation. Aim: This study was to determine the rate of adverse reactions among voluntary blood donors at the National Blood Transfusion Service in Jos. Methods: All blood donors recruited by the centre between October 2012 and September 2014 were counseled and consent to participate in the research was obtained prior to donation. The age, sex, weight and blood pressure and the venue of donation were documented. The type of donation reaction during and or after donation were timed and documented. The haemoglobin level and haemoglobin phenotypes were determined. Results: Eleven thousand six hundred and fifty-five (63%) male and 37% females were studied. The overall rate of adverse effects was 2.05% with significantly higher rate of occurrence among donors aged 18-25 years (p˂0.0001), female donors (p=0.0001), weight 40-49 Kg (p=0.001), blood group B (p=0.002) haemoglobin phenotype AA (P=0.001). The rate of adverse reactions was also higher among first-time donors (p=0.002), indoor donations (p=0.001). All adverse effects documented in our donors occurred during donation (4%) and within 21 (96%) after donation. Dizziness affected 90% while severe reaction (faint) occurred in 3% of adverse reactors. Ingested meal was the vomits of all donors who vomited. Conclusion: Though adverse effects to blood donation is low in our centre, there is need for preparedness, donor education, prediction and mitigation of occurrences.
Introduction: Despite collection of blood from apparently healthy individuals for allogeneic transfusion, blood givers are often faced with untoward reactions during or after blood donation. Aim: This study was to determine the rate of adverse reactions among voluntary blood donors at the National Blood Transfusion Service in Jos. Methods: All blood donors recruited by the centre between October 2012 and September 2014 were counseled and consent to participate in the research was obtained prior to donation. The age, sex, weight and blood pressure and the venue of donation were documented. The type of donation reaction during and or after donation were timed and documented. The haemoglobin level and haemoglobin phenotypes were determined. Results: Eleven thousand six hundred and fifty-five (63%) male and 37% females were studied. The overall rate of adverse effects was 2.05% with significantly higher rate of occurrence among donors aged 18-25 years (p˂0.0001), female donors (p=0.0001), weight 40-49 Kg (p=0.001), blood group B (p=0.002) haemoglobin phenotype AA (P=0.001). The rate of adverse reactions was also higher among first-time donors (p=0.002), indoor donations (p=0.001). All adverse effects documented in our donors occurred during donation (4%) and within 21 (96%) after donation. Dizziness affected 90% while severe reaction (faint) occurred in 3% of adverse reactors. Ingested meal was the vomits of all donors who vomited. Conclusion: Though adverse effects to blood donation is low in our centre, there is need for preparedness, donor education, prediction and mitigation of occurrences.
Adverse Effects of Whole Blood Donation among Voluntary Blood Donors in Jos, Nigeria
doi:10.11648/j.cmr.20150401.12
Clinical Medicine Research
2015-01-28
© Science Publishing Group
Damulak Obadiah Dapus
Egesie Ochaka Julie
Chetle Ladi
Thomas Margaret
Adverse Effects of Whole Blood Donation among Voluntary Blood Donors in Jos, Nigeria
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10
10
2015-01-28
2015-01-28
10.11648/j.cmr.20150401.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150401.12
© Science Publishing Group
The Time Gap between Repeated Re-Happening Opportunistic Infections among People Living with HIV/AIDS Commencing Antiretroviral Treatment
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150401.13
Introduction: According to 2011 Ethiopian demographic health survey, the national and Amhara Regional state administration adult HIV prevalence was 1.5 % and 2.2% respectively. The major causes of morbidity and mortality of PLWHA (people living with HIV/AIDS) patients are OIs (opportunistic infections) that would occur in up to 40% of PLWHA. OIs are repeatedly happening in HIV (Human Immunodeficiency Virus) infected patients though there is no prior local evidence on time gap of repetition. Therefore the current study is aimed to determine time gap between repeated re-happening OIs and its associated factors among PLWHA who are initiated ART (Anti-Retroviral Treatment). Method: Institution based retrospective cohort study was conducted among 364 systematically selected PLWHA commencing ART. Time-gap was estimated using Kaplan-meier survival and actuarial life table. Hazard rate was calculated using Cox proportional-hazard model. Result: during follow up OIs were re-diagnosed in about three quarter (76.9%) of participants. In each week the probability of getting the re-happened OI was 1.1 per 100 persons. The median duration of staying free of OI re-happening was 66 weeks. In multivariate analysis using logistic regression, educational status, marital status, Prophylaxisis exposure, ART and Prophylaxisis drug adherence, hemoglobin and CD4 level were significantly associated with time gap of relapse. Thus organizations working on HIV/AIDS should further work to enhance time gap of relapse.
Introduction: According to 2011 Ethiopian demographic health survey, the national and Amhara Regional state administration adult HIV prevalence was 1.5 % and 2.2% respectively. The major causes of morbidity and mortality of PLWHA (people living with HIV/AIDS) patients are OIs (opportunistic infections) that would occur in up to 40% of PLWHA. OIs are repeatedly happening in HIV (Human Immunodeficiency Virus) infected patients though there is no prior local evidence on time gap of repetition. Therefore the current study is aimed to determine time gap between repeated re-happening OIs and its associated factors among PLWHA who are initiated ART (Anti-Retroviral Treatment). Method: Institution based retrospective cohort study was conducted among 364 systematically selected PLWHA commencing ART. Time-gap was estimated using Kaplan-meier survival and actuarial life table. Hazard rate was calculated using Cox proportional-hazard model. Result: during follow up OIs were re-diagnosed in about three quarter (76.9%) of participants. In each week the probability of getting the re-happened OI was 1.1 per 100 persons. The median duration of staying free of OI re-happening was 66 weeks. In multivariate analysis using logistic regression, educational status, marital status, Prophylaxisis exposure, ART and Prophylaxisis drug adherence, hemoglobin and CD4 level were significantly associated with time gap of relapse. Thus organizations working on HIV/AIDS should further work to enhance time gap of relapse.
The Time Gap between Repeated Re-Happening Opportunistic Infections among People Living with HIV/AIDS Commencing Antiretroviral Treatment
doi:10.11648/j.cmr.20150401.13
Clinical Medicine Research
2015-02-02
© Science Publishing Group
Habtamu Mellie Bizuayehu
The Time Gap between Repeated Re-Happening Opportunistic Infections among People Living with HIV/AIDS Commencing Antiretroviral Treatment
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16
16
2015-02-02
2015-02-02
10.11648/j.cmr.20150401.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150401.13
© Science Publishing Group
Our Experience on Oncoplastic Breast Surgery: Clinical Report and Mini Review
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150401.14
Breast cancer presents a common form of cancer in women, associated with increased mortality, costs, and psychosocial problems. Breast conserving surgery became a serious alternative of radical mastectomy in early stages of breast cancer. This technique tends to have the same oncological results as radical mastectomy but with better cosmetic results. Several factors may have an impact of what surgical technique is preferred by the patients. Breast cancer staging, education level, rural or urban residence, and the relationship between the surgical team and the patient, are the most important factors that cam modify the surgical technique. Albanian population has some specific regarding residence, education level, and a great difident sense regarding physicians. Our trail through this retrospective descriptive study tends to present and explain the results in our population.
Breast cancer presents a common form of cancer in women, associated with increased mortality, costs, and psychosocial problems. Breast conserving surgery became a serious alternative of radical mastectomy in early stages of breast cancer. This technique tends to have the same oncological results as radical mastectomy but with better cosmetic results. Several factors may have an impact of what surgical technique is preferred by the patients. Breast cancer staging, education level, rural or urban residence, and the relationship between the surgical team and the patient, are the most important factors that cam modify the surgical technique. Albanian population has some specific regarding residence, education level, and a great difident sense regarding physicians. Our trail through this retrospective descriptive study tends to present and explain the results in our population.
Our Experience on Oncoplastic Breast Surgery: Clinical Report and Mini Review
doi:10.11648/j.cmr.20150401.14
Clinical Medicine Research
2015-02-02
© Science Publishing Group
Artan Bodeci
Euglent Hoxha
Agim Karaj
Myzafer Kaci
Rudin Domi
Our Experience on Oncoplastic Breast Surgery: Clinical Report and Mini Review
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1
20
20
2015-02-02
2015-02-02
10.11648/j.cmr.20150401.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150401.14
© Science Publishing Group
Spontaneous Coronary Dissection as an Expression of Coronary Artery Disease: Correlation with Vasospasm
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150401.15
Background: Artificial coronary artery dissection is observed occasionally during percutaneous coronary intervention. However, “spontaneous” coronary artery dissection (SCAD) is not common and we tried to clarify its characteristics. Methods and Results: We reviewed the serial diagnostic coronary angiograms of 21,500 patients retrospectively. Sixty-two patients showed linear, longitudinal defects that were considered to be the angiographic expression of SCAD, in at least one major coronary artery. Vasospasm was shown in 38 patients. Among the remaining 24 subjects, 18 patients had chest pain even after all coronary narrowings of ≧50 %were treated with coronary intervention or bypass surgery. Chest pain was relieved promptly with sublingual administration of nitrate. Thus, 56 patients (90.3%) with SCAD were demonstrated or considered to have vasospasm. Fifty-two patients of these 56 individuals showed significant (≧50%) narrowing in at least one of the major coronary arteries. In the remaining 4 subjects, 3 patients subsequently developed significant coronary artery disease. Comparison of coronary risk factors was done in the 38 patients shown to have vasospasm and 144 patients with ordinary coronary artery disease. Smoking was more common in the group with vasospasm but there was no difference with regard to the other risk factors. Conclusion: SCAD seems to be an expression of coronary artery disease. However, vasospasm is a common factor in these patients.
Background: Artificial coronary artery dissection is observed occasionally during percutaneous coronary intervention. However, “spontaneous” coronary artery dissection (SCAD) is not common and we tried to clarify its characteristics. Methods and Results: We reviewed the serial diagnostic coronary angiograms of 21,500 patients retrospectively. Sixty-two patients showed linear, longitudinal defects that were considered to be the angiographic expression of SCAD, in at least one major coronary artery. Vasospasm was shown in 38 patients. Among the remaining 24 subjects, 18 patients had chest pain even after all coronary narrowings of ≧50 %were treated with coronary intervention or bypass surgery. Chest pain was relieved promptly with sublingual administration of nitrate. Thus, 56 patients (90.3%) with SCAD were demonstrated or considered to have vasospasm. Fifty-two patients of these 56 individuals showed significant (≧50%) narrowing in at least one of the major coronary arteries. In the remaining 4 subjects, 3 patients subsequently developed significant coronary artery disease. Comparison of coronary risk factors was done in the 38 patients shown to have vasospasm and 144 patients with ordinary coronary artery disease. Smoking was more common in the group with vasospasm but there was no difference with regard to the other risk factors. Conclusion: SCAD seems to be an expression of coronary artery disease. However, vasospasm is a common factor in these patients.
Spontaneous Coronary Dissection as an Expression of Coronary Artery Disease: Correlation with Vasospasm
doi:10.11648/j.cmr.20150401.15
Clinical Medicine Research
2015-02-10
© Science Publishing Group
Fumimaro Takatsu
Kenji Takemoto
Spontaneous Coronary Dissection as an Expression of Coronary Artery Disease: Correlation with Vasospasm
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26
26
2015-02-10
2015-02-10
10.11648/j.cmr.20150401.15
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150401.15
© Science Publishing Group
Review of Clinical Manifestations and Impact of Parasitic Protozoan Infections on Human Reproductive Health
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150402.11
Parasitic protozoan infections that affect reproductive health are being increasingly recognized as a serious global health problem with impact on individual women and men, their families and communities. The infections can have severe consequences, including infertility, ectopic pregnancy, chronic pelvic pain, miscarriage, and increased risk of HIV transmission. Some affect both men and women, and can also be transmitted from mothers to children during pregnancy and childbirth. These infections affect more than just reproductive health, the resultant morbidity also affects the economic productivity and quality of life of many individual women and men, and consequently, of whole communities, regions and countries. The review intents to re-focus the attention of health professionals on this subject by shedding light on these unjustly neglected parasitoses commonly considered of low public health importance. Many of these parasitic infections have been forgotten and have become the neglected diseases often overlooked and rarely a high priority globally.
Parasitic protozoan infections that affect reproductive health are being increasingly recognized as a serious global health problem with impact on individual women and men, their families and communities. The infections can have severe consequences, including infertility, ectopic pregnancy, chronic pelvic pain, miscarriage, and increased risk of HIV transmission. Some affect both men and women, and can also be transmitted from mothers to children during pregnancy and childbirth. These infections affect more than just reproductive health, the resultant morbidity also affects the economic productivity and quality of life of many individual women and men, and consequently, of whole communities, regions and countries. The review intents to re-focus the attention of health professionals on this subject by shedding light on these unjustly neglected parasitoses commonly considered of low public health importance. Many of these parasitic infections have been forgotten and have become the neglected diseases often overlooked and rarely a high priority globally.
Review of Clinical Manifestations and Impact of Parasitic Protozoan Infections on Human Reproductive Health
doi:10.11648/j.cmr.20150402.11
Clinical Medicine Research
2015-02-25
© Science Publishing Group
Mulambalah Chrispinus Siteti
Siteti Darwin Injete
Review of Clinical Manifestations and Impact of Parasitic Protozoan Infections on Human Reproductive Health
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2015-02-25
2015-02-25
10.11648/j.cmr.20150402.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150402.11
© Science Publishing Group
The Importance of Lymphovascular Invasion at Radical Cystectomy
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150402.12
Objectives: To investigate relationship between the lymphovascular invasion(LVI) and tumor characteristics and to evaluate effect on survival of LVI in patients who underwent radical cystectomy because of bladder cancer. Materials and Methods: Five hundred and six patients were enrolled the study between 1990 and 2013. Patients were divided into two groups in terms of lymphovascular invasion at final pathology after radical cystectomy. There were 108 patients with LVI(group1) and 244 patients without LVI(group2). Both groups were compared in terms of clinicopathologic features and survival. Results: There was no statically different for gender in both group(p=0,222).Lymh node involvement, grade, and p T stage were higher significantly in group 1(p<0,05). Positive lymph node number was 2.3±3.1 in group 1 and 0.6 ± 2.1 in group 2(p<0.001). Lymph node density was 24.3±30.1 in group 1 and 5.6±9.2 in group 2 (p<0.001).Estimated mean survival time was 27.2±3.4 months in group 1 and 80.2 ± 8.1 months in group 2 (p<0.001). Conclusions: Lymphovascular invasion is an independent prognostic factor for disease specific survival and effects survival negatively in patients who underwent radical cystectomy for bladder cancer. Patients with lymphovascular invasion should be considered for close monitoring after cystectomy.
Objectives: To investigate relationship between the lymphovascular invasion(LVI) and tumor characteristics and to evaluate effect on survival of LVI in patients who underwent radical cystectomy because of bladder cancer. Materials and Methods: Five hundred and six patients were enrolled the study between 1990 and 2013. Patients were divided into two groups in terms of lymphovascular invasion at final pathology after radical cystectomy. There were 108 patients with LVI(group1) and 244 patients without LVI(group2). Both groups were compared in terms of clinicopathologic features and survival. Results: There was no statically different for gender in both group(p=0,222).Lymh node involvement, grade, and p T stage were higher significantly in group 1(p<0,05). Positive lymph node number was 2.3±3.1 in group 1 and 0.6 ± 2.1 in group 2(p<0.001). Lymph node density was 24.3±30.1 in group 1 and 5.6±9.2 in group 2 (p<0.001).Estimated mean survival time was 27.2±3.4 months in group 1 and 80.2 ± 8.1 months in group 2 (p<0.001). Conclusions: Lymphovascular invasion is an independent prognostic factor for disease specific survival and effects survival negatively in patients who underwent radical cystectomy for bladder cancer. Patients with lymphovascular invasion should be considered for close monitoring after cystectomy.
The Importance of Lymphovascular Invasion at Radical Cystectomy
doi:10.11648/j.cmr.20150402.12
Clinical Medicine Research
2015-02-26
© Science Publishing Group
Sacit Nuri Gorgel
Osman Kose
Ozan Horsanalı
Evren Sahin
Ugur Balci
Kutan Ozer
Cengiz Girgin
The Importance of Lymphovascular Invasion at Radical Cystectomy
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37
37
2015-02-26
2015-02-26
10.11648/j.cmr.20150402.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150402.12
© Science Publishing Group
Assessment the Prevalence of Pulmonary Tuberculosis Patients at Yirga Cheffe Health Center from 2008-2013, Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150402.13
Mycobacterium tuberculosis, the causative agent of tuberculosis (TB), is one of the world’s most devastating human pathogens that cause more than 2 million deaths annually. In addition, an estimated 2 billion people are latently infected with M. tuberculosis. Ethiopia is ranked 7th among TB burden shouldering countries in the world. The data collection was carried out typically by secondary data source from already recorded document. The data was obtained from the data clack of pulmonary tuberculosis patients (PTB) individuals at Yirga Cheffe Health Center. From a total of 1190 subjects who are registered to assessed for tuberculosis diseases at the Yirga Cheffe Health Center study sites, 676 (56.81 %) male were diagnosed followed by female 514 (43.19 %) were diseased by Mycobacterium tuberculosis. The PTB disease were highly predominant among male with increase slightly across the year from 2008-2013 and the highest were 58.75 % at 2013. The TB disease were increased among children from 2008-2013 in both sex (male and female). The highest percentage of pulmonary tuberculosis patients were observed at 2012 on male at age >49 with 10.18 % while on female pulmonary tuberculosis patients were observed at 2011 with 7.32 %. To conclude that the prevalence of PTB disease among both sex at study area were high in early. The pulmonary tuberculosis patients were decreased across the 2008-2013.
Mycobacterium tuberculosis, the causative agent of tuberculosis (TB), is one of the world’s most devastating human pathogens that cause more than 2 million deaths annually. In addition, an estimated 2 billion people are latently infected with M. tuberculosis. Ethiopia is ranked 7th among TB burden shouldering countries in the world. The data collection was carried out typically by secondary data source from already recorded document. The data was obtained from the data clack of pulmonary tuberculosis patients (PTB) individuals at Yirga Cheffe Health Center. From a total of 1190 subjects who are registered to assessed for tuberculosis diseases at the Yirga Cheffe Health Center study sites, 676 (56.81 %) male were diagnosed followed by female 514 (43.19 %) were diseased by Mycobacterium tuberculosis. The PTB disease were highly predominant among male with increase slightly across the year from 2008-2013 and the highest were 58.75 % at 2013. The TB disease were increased among children from 2008-2013 in both sex (male and female). The highest percentage of pulmonary tuberculosis patients were observed at 2012 on male at age >49 with 10.18 % while on female pulmonary tuberculosis patients were observed at 2011 with 7.32 %. To conclude that the prevalence of PTB disease among both sex at study area were high in early. The pulmonary tuberculosis patients were decreased across the 2008-2013.
Assessment the Prevalence of Pulmonary Tuberculosis Patients at Yirga Cheffe Health Center from 2008-2013, Ethiopia
doi:10.11648/j.cmr.20150402.13
Clinical Medicine Research
2015-03-02
© Science Publishing Group
Fekadu Alemu Atire
Assessment the Prevalence of Pulmonary Tuberculosis Patients at Yirga Cheffe Health Center from 2008-2013, Ethiopia
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42
42
2015-03-02
2015-03-02
10.11648/j.cmr.20150402.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150402.13
© Science Publishing Group
The Efficiency of Hamilton Pretest Probability Value in Diagnosing Deep Vein Thrombosis
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150402.14
Deep vein thrombosis (DVT) is a condition, in which an obstruction of blood flow in veins is found due to the formation of blood clots in the deep veins. An objective diagnosis of DVT is based on ultrasonography examination. However, in poor countries, including Indonesia, many hospitals still do not have the facilities of ultrasonography, less vascular specialists, or D-dimer examination and therefore, to establish the diagnosis of DVT they only can rely on history taking and physical examination. To find out whether the high Hamilton PPS can be used to diagnosis of DVT and whether the high Hamilton score the greater the possibility for DVT, and to know it sensitivity and specificity. A cross-sectional study was done, which was conducted to identify the reliability (sensitivity and specificity) of Hamilton PPS in establishing DVT diagnosis. The study used the Color Duplex Sonography (CDS) for extremity veins as the gold standard. We enrolled 193 patients with probability of DVT. Hamilton PPS and extremity veins CDS were done and tabulation was performed and data was analyzed statistically. Data analysis for testing was performed by the logistic regression analysis and Receiver Operating Characteristic curve using a computer software program of SPSS version 17.0. Hamilton score has sensitivity 0.8, specificity 0.85, accuracy of value 0.84 and positive predictive value 0.63, negative predictive value 0.93.The correlation between Hamilton score and sonography to diagnosis of DVT is positive with the sensitivity and specificity of Hamilton score is ≥ 80 %.
Deep vein thrombosis (DVT) is a condition, in which an obstruction of blood flow in veins is found due to the formation of blood clots in the deep veins. An objective diagnosis of DVT is based on ultrasonography examination. However, in poor countries, including Indonesia, many hospitals still do not have the facilities of ultrasonography, less vascular specialists, or D-dimer examination and therefore, to establish the diagnosis of DVT they only can rely on history taking and physical examination. To find out whether the high Hamilton PPS can be used to diagnosis of DVT and whether the high Hamilton score the greater the possibility for DVT, and to know it sensitivity and specificity. A cross-sectional study was done, which was conducted to identify the reliability (sensitivity and specificity) of Hamilton PPS in establishing DVT diagnosis. The study used the Color Duplex Sonography (CDS) for extremity veins as the gold standard. We enrolled 193 patients with probability of DVT. Hamilton PPS and extremity veins CDS were done and tabulation was performed and data was analyzed statistically. Data analysis for testing was performed by the logistic regression analysis and Receiver Operating Characteristic curve using a computer software program of SPSS version 17.0. Hamilton score has sensitivity 0.8, specificity 0.85, accuracy of value 0.84 and positive predictive value 0.63, negative predictive value 0.93.The correlation between Hamilton score and sonography to diagnosis of DVT is positive with the sensitivity and specificity of Hamilton score is ≥ 80 %.
The Efficiency of Hamilton Pretest Probability Value in Diagnosing Deep Vein Thrombosis
doi:10.11648/j.cmr.20150402.14
Clinical Medicine Research
2015-03-03
© Science Publishing Group
Starry Homenta Rampengan
The Efficiency of Hamilton Pretest Probability Value in Diagnosing Deep Vein Thrombosis
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49
49
2015-03-03
2015-03-03
10.11648/j.cmr.20150402.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150402.14
© Science Publishing Group
Assessment of Level of Adherence to Anti Retroviral Therapy among Adult HIV Infected Patients in Mekelle Hospital, Northern Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150402.15
Introduction: HIV/AIDS is one of the most destructive epidemics the world has ever witnessed. Non-adherence to the proposed antiretroviral regimen is considered to be one of the greatest dangers to the response to treatment on an individual level and the dissemination of resistant viruses on the community level. An adherent patient is defined as one who takes > 95% of the prescribed doses. Objective: To assess the level of adherence and associated factors among adult HIV/AIDS patients receiving Highly Active Antiretroviral Therapy in Mekelle Hospital, Northern Ethiopia. Methods: A cross sectional study was carried out from January 1, 2013 to July 30, 2013 among 382 adult PLWHA (>=18 years) attending HAART clinic at Mekelle Hospital. Data was collected by a combination of structured questionnaire and document review. The data was entered and cleaned using Epi-Info; transported to SPSS 16.0 version for final analysis. Bivariate and multivariate analyses were performed to identify factors associated with adherence. Results: The rate of self reported adherence in the study based on the Schedule and indicator of the dose, time measurement in the last 7 days was (78.3%). Females were more adhered than males (185(87.7%)). Alcohol users have poor adherence than non alcohol users with 70.5% and 82.2% level of adherence respectively. Sex and educational status of the study participants were significantly associated with level of adherence with AOR (95% CI) of 3.81(2.18, 6.69) and 2.60(1.43, 4.71) respectively. Conclusion: The level adherence we found, 78.2%, is still very low considering the WHO recommendation of 95%. Sex and educational status of the study participants were significantly associated with level of adherence with AOR (95% CI) of 3.81(2.18,6.69) and 2.60(1.43,4.71) respectively. More focus should be given to males and individuals with low educational status to improve level of adherence and to assure the efficacy of HAART in prolonging the life of PLWHA. Adherence is a process, not a single event, and adherence support must, therefore, be integrated into regular clinical follow up. Investigation of factors related with long-term adherence would require longer follow-up than the present study.
Introduction: HIV/AIDS is one of the most destructive epidemics the world has ever witnessed. Non-adherence to the proposed antiretroviral regimen is considered to be one of the greatest dangers to the response to treatment on an individual level and the dissemination of resistant viruses on the community level. An adherent patient is defined as one who takes > 95% of the prescribed doses. Objective: To assess the level of adherence and associated factors among adult HIV/AIDS patients receiving Highly Active Antiretroviral Therapy in Mekelle Hospital, Northern Ethiopia. Methods: A cross sectional study was carried out from January 1, 2013 to July 30, 2013 among 382 adult PLWHA (>=18 years) attending HAART clinic at Mekelle Hospital. Data was collected by a combination of structured questionnaire and document review. The data was entered and cleaned using Epi-Info; transported to SPSS 16.0 version for final analysis. Bivariate and multivariate analyses were performed to identify factors associated with adherence. Results: The rate of self reported adherence in the study based on the Schedule and indicator of the dose, time measurement in the last 7 days was (78.3%). Females were more adhered than males (185(87.7%)). Alcohol users have poor adherence than non alcohol users with 70.5% and 82.2% level of adherence respectively. Sex and educational status of the study participants were significantly associated with level of adherence with AOR (95% CI) of 3.81(2.18, 6.69) and 2.60(1.43, 4.71) respectively. Conclusion: The level adherence we found, 78.2%, is still very low considering the WHO recommendation of 95%. Sex and educational status of the study participants were significantly associated with level of adherence with AOR (95% CI) of 3.81(2.18,6.69) and 2.60(1.43,4.71) respectively. More focus should be given to males and individuals with low educational status to improve level of adherence and to assure the efficacy of HAART in prolonging the life of PLWHA. Adherence is a process, not a single event, and adherence support must, therefore, be integrated into regular clinical follow up. Investigation of factors related with long-term adherence would require longer follow-up than the present study.
Assessment of Level of Adherence to Anti Retroviral Therapy among Adult HIV Infected Patients in Mekelle Hospital, Northern Ethiopia
doi:10.11648/j.cmr.20150402.15
Clinical Medicine Research
2015-03-06
© Science Publishing Group
Afewerki Kahsay Kidanemariam
Gebremedhin Gebreegziabiher Gebrehiwot
Assessment of Level of Adherence to Anti Retroviral Therapy among Adult HIV Infected Patients in Mekelle Hospital, Northern Ethiopia
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2015-03-06
2015-03-06
10.11648/j.cmr.20150402.15
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150402.15
© Science Publishing Group
The Basis and Potentials of Ogunlade Sex Determination Electrocardiographic Score (OSDES) in Young Adults
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150402.16
The potentials of electrocardiogram (ECG) in sex determination in young adults have not been extensively explored despite the fact that ECG is one of the most frequently performed medical procedures. This study aimed at developing a simple electrocardiographic score system that could assist in sex determination in young adults. Patterns of ECG in male and female young adults were carefully analyzed and features that could be used to delineate the ECG into male and female patterns were selected as criteria for formulation of a simple scoring system called Ogunlade sex determination electrocardiographic score (OSDES).Components of OSDES were point scores in four electrocardiographic parameters; T wave configuration in V1 (1-3), ST segment in V2 or V3 (1-3), QRS rotation (1-3) and heart rate (1-3). The total minimum and maximum scores were 4 and 12 respectively. An individual with a total score of < 7 was identified as a female while an individual with a score ≥ 7 was identified a male. Thus, with OSDES, ECG can be classified into two; male pattern and female pattern for male and female respectively. This unique scoring system was tested among 474 healthy young adults (294 males and 180 females). Two hundred and eighty eight (288) of the 294 males were correctly identified by OSDES as males while 174 of the 180 females were correctly identified as females (k = 0.946, p < 0.001). The study defined male and female ECG patterns and concluded that ECG can be used to determine sex among young adult population.
The potentials of electrocardiogram (ECG) in sex determination in young adults have not been extensively explored despite the fact that ECG is one of the most frequently performed medical procedures. This study aimed at developing a simple electrocardiographic score system that could assist in sex determination in young adults. Patterns of ECG in male and female young adults were carefully analyzed and features that could be used to delineate the ECG into male and female patterns were selected as criteria for formulation of a simple scoring system called Ogunlade sex determination electrocardiographic score (OSDES).Components of OSDES were point scores in four electrocardiographic parameters; T wave configuration in V1 (1-3), ST segment in V2 or V3 (1-3), QRS rotation (1-3) and heart rate (1-3). The total minimum and maximum scores were 4 and 12 respectively. An individual with a total score of < 7 was identified as a female while an individual with a score ≥ 7 was identified a male. Thus, with OSDES, ECG can be classified into two; male pattern and female pattern for male and female respectively. This unique scoring system was tested among 474 healthy young adults (294 males and 180 females). Two hundred and eighty eight (288) of the 294 males were correctly identified by OSDES as males while 174 of the 180 females were correctly identified as females (k = 0.946, p < 0.001). The study defined male and female ECG patterns and concluded that ECG can be used to determine sex among young adult population.
The Basis and Potentials of Ogunlade Sex Determination Electrocardiographic Score (OSDES) in Young Adults
doi:10.11648/j.cmr.20150402.16
Clinical Medicine Research
2015-03-17
© Science Publishing Group
Oluwadare Ogunlade
Muritala Abiola Asafa
The Basis and Potentials of Ogunlade Sex Determination Electrocardiographic Score (OSDES) in Young Adults
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62
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2015-03-17
2015-03-17
10.11648/j.cmr.20150402.16
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150402.16
© Science Publishing Group
Retinal Structural Changes in Patients with Mild Cognitive Impairment
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040201.11
Purpose: To assess retinal structural changes in persons with mild cognitive impairment (MCI) and to correlate these changes with the level of cognitive function. Material-methods: Using high-resolution spectral domain optical coherence tomography (SD-OCT) in MCI and control subjects we assess peripapillary Retinal Nerve Fiber Layer (RNFL) thickness loss, macular volume and macular thickness loss in all nine EDTRS (early treatment diabetic retinopathy study) areas, and macular Ganglion Cell Complex (GCC) (inner plexiform + ganglion cell layer + retinal nerve fiber) thickness loss. We assessed cognitive function using Mini Mental State Examination (MMSE) score. Results: In the study group there was found a statistically significant decrease in RNFL overall (Mann-Whitney test, p: 0.009) and temporal thickness (T-test, p: 0.013) and increased macular GCC Focal Volume Loss (FVL%) (Mann-Whitney test, p: 0.001) compared to the control group. In control group was also found a statistically significant positive correlation between retinal structural parameters and MMSE score. Conclusion: Our preliminary study results suggest that RNFL overall and temporal thickness in patients with MCI is significantly decreased compared to normal controls. GCC FVL% is significantly increased in patients with MCI compared to normal controls suggesting that there is macular focal loss of ganglion cells in MCI patients.
Purpose: To assess retinal structural changes in persons with mild cognitive impairment (MCI) and to correlate these changes with the level of cognitive function. Material-methods: Using high-resolution spectral domain optical coherence tomography (SD-OCT) in MCI and control subjects we assess peripapillary Retinal Nerve Fiber Layer (RNFL) thickness loss, macular volume and macular thickness loss in all nine EDTRS (early treatment diabetic retinopathy study) areas, and macular Ganglion Cell Complex (GCC) (inner plexiform + ganglion cell layer + retinal nerve fiber) thickness loss. We assessed cognitive function using Mini Mental State Examination (MMSE) score. Results: In the study group there was found a statistically significant decrease in RNFL overall (Mann-Whitney test, p: 0.009) and temporal thickness (T-test, p: 0.013) and increased macular GCC Focal Volume Loss (FVL%) (Mann-Whitney test, p: 0.001) compared to the control group. In control group was also found a statistically significant positive correlation between retinal structural parameters and MMSE score. Conclusion: Our preliminary study results suggest that RNFL overall and temporal thickness in patients with MCI is significantly decreased compared to normal controls. GCC FVL% is significantly increased in patients with MCI compared to normal controls suggesting that there is macular focal loss of ganglion cells in MCI patients.
Retinal Structural Changes in Patients with Mild Cognitive Impairment
doi:10.11648/j.cmr.s.2015040201.11
Clinical Medicine Research
2014-09-17
© Science Publishing Group
Demirtzoglou Iordanis
Tsolaki Magda
Gougoulias Kyriakos
Oikonomidis Panagiotis
Karampatakis Vasileios
Retinal Structural Changes in Patients with Mild Cognitive Impairment
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7
7
2014-09-17
2014-09-17
10.11648/j.cmr.s.2015040201.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040201.11
© Science Publishing Group
Alcohol Induced Neurocognitive Impairment (Wernicke - Korsakoff): A Hidden Syndrome
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040201.13
Wernicke’s encephalopathy (WE) is an acute neuro-psychiatric syndrome due to inadequate supply of thiamine (vitamin B1) to the brain which leads to significant morbidity and mortality. Although alcohol use is the most common predisposing factor but Wernicke’s encephalopathy can occur in any patient with nutritional deficiency conditions such as hyperemesis gravidarum, hemodialysis, malignancy, use of total parenteral nutrition without adequate thiamine, and abdominal surgery. In a developing country, there are more chances of thiamine deficiency, because of poor intake of nutrients in routine diet due to economic reasons and local customs and cultural practices concerning the processing and cooking of rice and other foodstuffs. The national household survey of drug use in India (2004) found prevalence of alcohol use in about 21.4% of male population between 18-40 age group. Most of the emergency physicians and general practitioners are not well sensitized about neuropsychiatric disorders in patients with alcohol use disorders. Such patients are still under diagnosed. Till date, no such studies are available about treatment of wernicke-korsakoff syndrome in Indian population. Educating clinicians, specially emergency physicians about evaluation and treatment of Wernicke-Korsakoff syndrome is as important as to educate people to eat well balanced, mixed diet containing thiamine rich food as most of these patients receive emergency treatment but are frequently unrecognized. If undiagnosed or inadequately treated, it is likely to proceed to Korsakoff syndrome. Therefore best treatment for Wernicke-Korsakoff syndrome is prompt diagnosis and adequate treatment.
Wernicke’s encephalopathy (WE) is an acute neuro-psychiatric syndrome due to inadequate supply of thiamine (vitamin B1) to the brain which leads to significant morbidity and mortality. Although alcohol use is the most common predisposing factor but Wernicke’s encephalopathy can occur in any patient with nutritional deficiency conditions such as hyperemesis gravidarum, hemodialysis, malignancy, use of total parenteral nutrition without adequate thiamine, and abdominal surgery. In a developing country, there are more chances of thiamine deficiency, because of poor intake of nutrients in routine diet due to economic reasons and local customs and cultural practices concerning the processing and cooking of rice and other foodstuffs. The national household survey of drug use in India (2004) found prevalence of alcohol use in about 21.4% of male population between 18-40 age group. Most of the emergency physicians and general practitioners are not well sensitized about neuropsychiatric disorders in patients with alcohol use disorders. Such patients are still under diagnosed. Till date, no such studies are available about treatment of wernicke-korsakoff syndrome in Indian population. Educating clinicians, specially emergency physicians about evaluation and treatment of Wernicke-Korsakoff syndrome is as important as to educate people to eat well balanced, mixed diet containing thiamine rich food as most of these patients receive emergency treatment but are frequently unrecognized. If undiagnosed or inadequately treated, it is likely to proceed to Korsakoff syndrome. Therefore best treatment for Wernicke-Korsakoff syndrome is prompt diagnosis and adequate treatment.
Alcohol Induced Neurocognitive Impairment (Wernicke - Korsakoff): A Hidden Syndrome
doi:10.11648/j.cmr.s.2015040201.13
Clinical Medicine Research
2015-02-08
© Science Publishing Group
Prabhoo Dayal
Ankur Sachdeva
Mina Chandra
Kishore Hindustani
Kuljeet Singh Anand
Alcohol Induced Neurocognitive Impairment (Wernicke - Korsakoff): A Hidden Syndrome
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2015-02-08
2015-02-08
10.11648/j.cmr.s.2015040201.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040201.13
© Science Publishing Group
Behavioral and Psychological Symptoms in Dementia and Caregiver Burden
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040201.12
Dementia is a mental health disorder of global public health concern. The syndrome of dementia may be caused by various underlying diseases, each characterized by a specific constellation of signs and symptoms in combination with a presumed underlying substrate of neuropathology. Behavioral and psychological symptoms are integral part of dementia. They increase morbidity, influence quality of life and are major source of care giver burden. To be effective, dementia care need to focus on the early detection of BPSD and its management. The spectrum of behavioral and psychological symptoms in different each types of dementia are different and they should be managed accordingly to relieve care giver burden.
Dementia is a mental health disorder of global public health concern. The syndrome of dementia may be caused by various underlying diseases, each characterized by a specific constellation of signs and symptoms in combination with a presumed underlying substrate of neuropathology. Behavioral and psychological symptoms are integral part of dementia. They increase morbidity, influence quality of life and are major source of care giver burden. To be effective, dementia care need to focus on the early detection of BPSD and its management. The spectrum of behavioral and psychological symptoms in different each types of dementia are different and they should be managed accordingly to relieve care giver burden.
Behavioral and Psychological Symptoms in Dementia and Caregiver Burden
doi:10.11648/j.cmr.s.2015040201.12
Clinical Medicine Research
2015-02-08
© Science Publishing Group
Arshad Yahya
Mina Chandra
Kuljeet Singh Anand
Jyoti Garg
Behavioral and Psychological Symptoms in Dementia and Caregiver Burden
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14
14
2015-02-08
2015-02-08
10.11648/j.cmr.s.2015040201.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040201.12
© Science Publishing Group
Prevalence of Refampcin Mono Resistant Mycobacterium Tuberculosis Among Suspected Cases Attending at Yirgalem Hospital
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150403.13
Introduction: Tuberculosis (TB) is a chronic communicable disease caused by Mycobacterium tuberculosis (MTB). M. tuberculosis is a slow- growing bacterium, resistant to most conventional antimicrobial agents partly due to its impermeable cell wall. It may persist in a dormant or latent form, unsusceptible to agents targeting growing bacteria. The Gen Xpert MTB/RIF is an automated molecular test which detects DNA sequences specific for MTB and RIF resistance by polymerase chain reaction with fully integrated sample processing in patients suspected of drug sensitive or multidrug resistant pulmonary tuberculosis. Objective: to determine Rifampicin Mono-Resistance Mycobacterium tuberculosis among patient attending atYirgalem Hospital from August-December, 2014.Method:A cross sectional study was conducted on Rifampicin Mono-Resistance in Mycobacterium tuberculosis among patient attending at Yirgalem Hospital from August-December, 2014,Yirgalem, Ethiopia. Result: A total of 236 participants were included under this study. Among these, males (57.6%) are slightly dominating female. Concerning to treatment history, 177 (75.0%) are new and the rest 59 (25.0%) retreated. Fifty eight (24.6%) of the total subjects were suspected for MDR tuberculosis. Twenty two (9.3%) of the subjects were smear positive. The highest positive finding of rifampcin susceptible Mycobacterium tuberculosis bacilli observed within age group of 16-30.The overall prevalence of pulmonary tuberculosis was 16.5%. From this prevalence, 3.4% was shared by Rifampcin mono-resistant Tuberculosis. Conclusion: Based on our study finding, The overall prevalence of pulmonary tuberculosis was 16.5%. From these, 3.4% was account for Rifampicin Mono-Resistance Mycobacterium tuberculosis among study subject. Most of the affected study subjects were productive age group. Therefore, we recommend that there should be enhanced efforts in detection of MDR tuberculosis in study area to control dissemination of the disease among the community.
Introduction: Tuberculosis (TB) is a chronic communicable disease caused by Mycobacterium tuberculosis (MTB). M. tuberculosis is a slow- growing bacterium, resistant to most conventional antimicrobial agents partly due to its impermeable cell wall. It may persist in a dormant or latent form, unsusceptible to agents targeting growing bacteria. The Gen Xpert MTB/RIF is an automated molecular test which detects DNA sequences specific for MTB and RIF resistance by polymerase chain reaction with fully integrated sample processing in patients suspected of drug sensitive or multidrug resistant pulmonary tuberculosis. Objective: to determine Rifampicin Mono-Resistance Mycobacterium tuberculosis among patient attending atYirgalem Hospital from August-December, 2014.Method:A cross sectional study was conducted on Rifampicin Mono-Resistance in Mycobacterium tuberculosis among patient attending at Yirgalem Hospital from August-December, 2014,Yirgalem, Ethiopia. Result: A total of 236 participants were included under this study. Among these, males (57.6%) are slightly dominating female. Concerning to treatment history, 177 (75.0%) are new and the rest 59 (25.0%) retreated. Fifty eight (24.6%) of the total subjects were suspected for MDR tuberculosis. Twenty two (9.3%) of the subjects were smear positive. The highest positive finding of rifampcin susceptible Mycobacterium tuberculosis bacilli observed within age group of 16-30.The overall prevalence of pulmonary tuberculosis was 16.5%. From this prevalence, 3.4% was shared by Rifampcin mono-resistant Tuberculosis. Conclusion: Based on our study finding, The overall prevalence of pulmonary tuberculosis was 16.5%. From these, 3.4% was account for Rifampicin Mono-Resistance Mycobacterium tuberculosis among study subject. Most of the affected study subjects were productive age group. Therefore, we recommend that there should be enhanced efforts in detection of MDR tuberculosis in study area to control dissemination of the disease among the community.
Prevalence of Refampcin Mono Resistant Mycobacterium Tuberculosis Among Suspected Cases Attending at Yirgalem Hospital
doi:10.11648/j.cmr.20150403.13
Clinical Medicine Research
2015-04-29
© Science Publishing Group
Mesfin Worku Hordofa
Teshome Befikadu Adela
Prevalence of Refampcin Mono Resistant Mycobacterium Tuberculosis Among Suspected Cases Attending at Yirgalem Hospital
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3
78
78
2015-04-29
2015-04-29
10.11648/j.cmr.20150403.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150403.13
© Science Publishing Group
Prevalence of Anemia Among Women Receiving Antenatal Care at Boditii Health Center, Southern Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150403.14
Background: Anemia is regarded as a major risk factor for unfavorable outcome of pregnancy both for the mother and the fetus. Methodology: A heath center based cross-sectional study was conducted in Boditii Health Centers from April 12 to June 23, 2012. Data was collected using pretested questionnaire, which contains socioeconomic, demographic and clinical characteristics of pregnant women shown to have association with anemia. A total of 125 pregnant women were enrolled in this study. HGB was measured using the Sahli-Hellinge method of HGB determination. Data was entered and statistical analysis was performed using SPSS version 16, software. Association between variables was done using chi square, and statistical significance was considered at P value < 0.05. Result: The prevalence of anemia obtained in this study was 77/125 (61.6%), based on the WHO criterion for the diagnosis of anemia in pregnancy, i.e. hemoglobin <11.0 g/dl (PCV <33%). In terms of severity, mild anemia was present in 41(53.2%) of women, moderate anemia was present in 36 (46.8%), and there were no cases of severe anemia. The prevalence of anemia in this study was 58.4% and 41.5% for primigravida and multigravida, respectively (P<0.05). Anemia was also found to increase as the gestational age increases, showing the highest prevalence in the third trimester (46.7%) than second (45.4%) and first trimester (7.8%), (P<0.001). Conclusion and Recommendation: From our results, we can conclude that anemia in pregnant women was highly prevalent in Boditti town. Our study revealed that the prevalence of anemia is higher in primigravidea than multigravidea. Anemia also increased as the gestational age increases. Intervention including health education about causes of anemia and its risk factors and antenatal care (ANC) follow up should be improved.
Background: Anemia is regarded as a major risk factor for unfavorable outcome of pregnancy both for the mother and the fetus. Methodology: A heath center based cross-sectional study was conducted in Boditii Health Centers from April 12 to June 23, 2012. Data was collected using pretested questionnaire, which contains socioeconomic, demographic and clinical characteristics of pregnant women shown to have association with anemia. A total of 125 pregnant women were enrolled in this study. HGB was measured using the Sahli-Hellinge method of HGB determination. Data was entered and statistical analysis was performed using SPSS version 16, software. Association between variables was done using chi square, and statistical significance was considered at P value < 0.05. Result: The prevalence of anemia obtained in this study was 77/125 (61.6%), based on the WHO criterion for the diagnosis of anemia in pregnancy, i.e. hemoglobin <11.0 g/dl (PCV <33%). In terms of severity, mild anemia was present in 41(53.2%) of women, moderate anemia was present in 36 (46.8%), and there were no cases of severe anemia. The prevalence of anemia in this study was 58.4% and 41.5% for primigravida and multigravida, respectively (P<0.05). Anemia was also found to increase as the gestational age increases, showing the highest prevalence in the third trimester (46.7%) than second (45.4%) and first trimester (7.8%), (P<0.001). Conclusion and Recommendation: From our results, we can conclude that anemia in pregnant women was highly prevalent in Boditti town. Our study revealed that the prevalence of anemia is higher in primigravidea than multigravidea. Anemia also increased as the gestational age increases. Intervention including health education about causes of anemia and its risk factors and antenatal care (ANC) follow up should be improved.
Prevalence of Anemia Among Women Receiving Antenatal Care at Boditii Health Center, Southern Ethiopia
doi:10.11648/j.cmr.20150403.14
Clinical Medicine Research
2015-05-09
© Science Publishing Group
Dereje Lelissa
Matiyas Yilma
Weldesenbet Shewalem
Amanuel Abraha
Mesfin Worku
Henock Ambachew
Misganaw Birhaneselassie
Prevalence of Anemia Among Women Receiving Antenatal Care at Boditii Health Center, Southern Ethiopia
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86
2015-05-09
2015-05-09
10.11648/j.cmr.20150403.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150403.14
© Science Publishing Group
Absolute Neutrophil Count as Predictor of Early Onset Sepsis
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150403.15
Background: Infant mortality rate (IMR) was found to increase in the newborn. The most frequent causes of death are infection, prematurity, low birth weight (LBW), neonatal asphyxia and birth trauma, respectively. Absolute neutrophil count (ANC) can be used as a marker of infection because of its faster, easier, simpler and cheaper nature. Objective: The study aims to identify the influence of an increase and decline in ANC on newborns from mothers with risk factors for early onset sepsis. Methods: This study was conducted as a a prospective cohort study from December 2013 to July 2014. The population included 120 newborns whose mother has risk factors of early onset sepsis and admitted to Dr. Wahidin Sudirohusodo Hospital, and joined hospital. The subjects were divided into three groups, ANC <1800/mm3, ANC 1800-5399/mm3 and ANC >5400/mm3. Results: Newborn from mother with risk factor of infection with ANC >5400/mm3 and ANC 1800-5399/mm3 shows a significant difference with p = 0.000 (p<0.001); OR 8.143; IK 95% 2.440-27.173. Cut off point of 10.710-10890/mm3 was found from ROC analyses in ANC >5400/mm3 group with sensitivity and specificity 89.47% and 80.95% respectively; PPV (Positive predictive value) 80.95%; NPV (Negative predictive value) 89.47%; p=0.000; OR 36.125; IC 95% 5.820 – 224.224. Conclusions: Absolute neutrophil count >10.710/mm3 in a term newborn from mother with infection risk factors can be used as predictor for early onset sepsis 36 fold higher than the ANC <10.710/mm3.
Background: Infant mortality rate (IMR) was found to increase in the newborn. The most frequent causes of death are infection, prematurity, low birth weight (LBW), neonatal asphyxia and birth trauma, respectively. Absolute neutrophil count (ANC) can be used as a marker of infection because of its faster, easier, simpler and cheaper nature. Objective: The study aims to identify the influence of an increase and decline in ANC on newborns from mothers with risk factors for early onset sepsis. Methods: This study was conducted as a a prospective cohort study from December 2013 to July 2014. The population included 120 newborns whose mother has risk factors of early onset sepsis and admitted to Dr. Wahidin Sudirohusodo Hospital, and joined hospital. The subjects were divided into three groups, ANC <1800/mm3, ANC 1800-5399/mm3 and ANC >5400/mm3. Results: Newborn from mother with risk factor of infection with ANC >5400/mm3 and ANC 1800-5399/mm3 shows a significant difference with p = 0.000 (p<0.001); OR 8.143; IK 95% 2.440-27.173. Cut off point of 10.710-10890/mm3 was found from ROC analyses in ANC >5400/mm3 group with sensitivity and specificity 89.47% and 80.95% respectively; PPV (Positive predictive value) 80.95%; NPV (Negative predictive value) 89.47%; p=0.000; OR 36.125; IC 95% 5.820 – 224.224. Conclusions: Absolute neutrophil count >10.710/mm3 in a term newborn from mother with infection risk factors can be used as predictor for early onset sepsis 36 fold higher than the ANC <10.710/mm3.
Absolute Neutrophil Count as Predictor of Early Onset Sepsis
doi:10.11648/j.cmr.20150403.15
Clinical Medicine Research
2015-05-19
© Science Publishing Group
Hijrah Harmansyah
Ema Alasiry
Dasril Daud
Absolute Neutrophil Count as Predictor of Early Onset Sepsis
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91
91
2015-05-19
2015-05-19
10.11648/j.cmr.20150403.15
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150403.15
© Science Publishing Group
Awareness of Post-Exposure Prophylaxis of HIV Among Health Care Personnel in Asella Teaching Hospital, Asella Town, South-East Ethiopia, 2014: Cross Sectional Study
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150403.12
Background: Post-exposure prophylaxis is short-term antiretroviral or immune globulin treatment to reduce the likelihood of viral infection after exposure to the blood or body fluids of an infected person. Timely post-exposure prophylaxis after needle stick exposure to high risk body fluids in work area can reduce the rate of transmission of human immunodeficiency virus significantly. Methods: This institution based cross sectional study was conducted in purposively selected 251 health personnel. Structured questionnaire which was adapted from similar study conducted in Addis Ababa city was used to collect data. Data was analyzed using chi-square test. Ethical clearance was obtained from Addis Ababa University, College of Health Sciences, Department of Nursing and Midwifery. Results: From the total study participants 88.8% respondents had information about post-exposure prophylaxis and 85.7% know presence of post-exposure prophylaxis in their hospital. In addition to that 48.2% respondents responded correctly to the use of post-exposure prophylaxis. From the study participants almost half of the non-health professionals didn’t know about post-exposure prophylaxis. Conclusion: Out of the total respondents, majority of them had good level of awareness about post exposure prophylaxis.
Background: Post-exposure prophylaxis is short-term antiretroviral or immune globulin treatment to reduce the likelihood of viral infection after exposure to the blood or body fluids of an infected person. Timely post-exposure prophylaxis after needle stick exposure to high risk body fluids in work area can reduce the rate of transmission of human immunodeficiency virus significantly. Methods: This institution based cross sectional study was conducted in purposively selected 251 health personnel. Structured questionnaire which was adapted from similar study conducted in Addis Ababa city was used to collect data. Data was analyzed using chi-square test. Ethical clearance was obtained from Addis Ababa University, College of Health Sciences, Department of Nursing and Midwifery. Results: From the total study participants 88.8% respondents had information about post-exposure prophylaxis and 85.7% know presence of post-exposure prophylaxis in their hospital. In addition to that 48.2% respondents responded correctly to the use of post-exposure prophylaxis. From the study participants almost half of the non-health professionals didn’t know about post-exposure prophylaxis. Conclusion: Out of the total respondents, majority of them had good level of awareness about post exposure prophylaxis.
Awareness of Post-Exposure Prophylaxis of HIV Among Health Care Personnel in Asella Teaching Hospital, Asella Town, South-East Ethiopia, 2014: Cross Sectional Study
doi:10.11648/j.cmr.20150403.12
Clinical Medicine Research
2015-03-23
© Science Publishing Group
Birhanu Alemu
Asrat Demessie
Atsede Fantahun
Kahsu Gebrekirstos
Awareness of Post-Exposure Prophylaxis of HIV Among Health Care Personnel in Asella Teaching Hospital, Asella Town, South-East Ethiopia, 2014: Cross Sectional Study
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2015-03-23
2015-03-23
10.11648/j.cmr.20150403.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150403.12
© Science Publishing Group
External Quality Assessment of Malaria Microscopy in Hawassa Health Facilities, Southern Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150403.11
Background: Misinterpretation of malaria microscopy results can lead to inappropriate case management of malaria. The objective of this study was to assess the quality of malaria microscopy among health facilities in Hawassa city. A cross - sectional study was conducted to assess the quality of malaria microscopy diagnosis in Hawassa city health facility laboratories from November 2012 to January 2013 in Sothern Ethiopia. Validated panel malaria slides were distributed to health facilities accompanied with a questionnaire that assessed factors related to malaria microscopy improvement. Operational definitions for correct result and major and minor errors were outlined. A total of 51 laboratory professionals in 10 health facilities were surveyed with a response rate of 85%. Results were collected and data was analyzed by SPSS, and Win Pepi software. Result: Of 306 malaria slides examined in Sample 1-Sample 6 [S1-S6] only 54% of the examinations reported correctly. Considering major errors in [S1-S4], the most common errors were reporting negative for positive slide 39/83(47%), species identification error 29/83(35%) and density 15/83 (18%). In mixed Plasmodium falciparum/Plasmodium vivax (Pf/Pv) sample, only 18% of participants made correct diagnosis in identifying both Pf/Pv species. In Plasmodium negative sample 45(88.2%) of participants scored (no parasites observed) correctly. Considering S1-S4, 29 of the 165 densities reported were different from the reference density established for each slide. 53% of participants had never participated in a formal training on malaria microscopy, and among those who did, more than half were trained earlier than 2008. All of the participants reported to use tap water in preparation of working Giemsa solution. Conclusion: The present assessment revealed a poor quality of malaria microscopy in Hawassa city administration health facilities. Therefore, responsible bodies are required to improve quality of malaria microscopy, and also provide regular refreshment training for laboratory professionals in malaria microscopy. Further similar study should be conducted in large scale.
Background: Misinterpretation of malaria microscopy results can lead to inappropriate case management of malaria. The objective of this study was to assess the quality of malaria microscopy among health facilities in Hawassa city. A cross - sectional study was conducted to assess the quality of malaria microscopy diagnosis in Hawassa city health facility laboratories from November 2012 to January 2013 in Sothern Ethiopia. Validated panel malaria slides were distributed to health facilities accompanied with a questionnaire that assessed factors related to malaria microscopy improvement. Operational definitions for correct result and major and minor errors were outlined. A total of 51 laboratory professionals in 10 health facilities were surveyed with a response rate of 85%. Results were collected and data was analyzed by SPSS, and Win Pepi software. Result: Of 306 malaria slides examined in Sample 1-Sample 6 [S1-S6] only 54% of the examinations reported correctly. Considering major errors in [S1-S4], the most common errors were reporting negative for positive slide 39/83(47%), species identification error 29/83(35%) and density 15/83 (18%). In mixed Plasmodium falciparum/Plasmodium vivax (Pf/Pv) sample, only 18% of participants made correct diagnosis in identifying both Pf/Pv species. In Plasmodium negative sample 45(88.2%) of participants scored (no parasites observed) correctly. Considering S1-S4, 29 of the 165 densities reported were different from the reference density established for each slide. 53% of participants had never participated in a formal training on malaria microscopy, and among those who did, more than half were trained earlier than 2008. All of the participants reported to use tap water in preparation of working Giemsa solution. Conclusion: The present assessment revealed a poor quality of malaria microscopy in Hawassa city administration health facilities. Therefore, responsible bodies are required to improve quality of malaria microscopy, and also provide regular refreshment training for laboratory professionals in malaria microscopy. Further similar study should be conducted in large scale.
External Quality Assessment of Malaria Microscopy in Hawassa Health Facilities, Southern Ethiopia
doi:10.11648/j.cmr.20150403.11
Clinical Medicine Research
2015-03-23
© Science Publishing Group
Bereket Zeleke
Girmay Admasu
Tigist Getachew
Endalish Kebede
Goshu Belay
Amanuel Abraha
Dawit Yihdego
Mengistu Hailemariam
Misganaw Birhaneselassie
External Quality Assessment of Malaria Microscopy in Hawassa Health Facilities, Southern Ethiopia
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2015-03-23
2015-03-23
10.11648/j.cmr.20150403.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150403.11
© Science Publishing Group
Variation of Radiographic Protocols: An Examination of Practice During Radiography of Axial and Appendicular Skeleton in the Accra Metropolis-Ghana
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.11
Background: Protocols provide a baseline for audit opportunity as well as evidence for clinical governance, since the use of protocols ensure compliance with documented scope of professional practice. Objectives: We determined the existence and variations of radiographic protocols for radiographic examinations of axial and appendicular skeleton in X-ray departments within the Accra Metropolis and also to establish whether there were variations in the projections taken among the departments for these examinations. Methods: A questionnaire containing mostly open ended question, was given to the radiographers who were in-charge of the departments and those in charge of the various clinical rooms of the selected hospitals and polyclinics to complete. Codes were assigned each of the departments, the examinations and the sets of projections indicated for the examinations. The data gathered was analyzed using SPSS version 16 software and presented in tabular and graphical forms. Results: In all eight X-ray departments were studied. Majority (80%) of the respondents indicated having protocols. All respondents agreed to the technical fact that examination protocols must be written and documented and copies made available in all clinical rooms. Conversely, only 20% of the respondents representing 25% of the departments surveyed had examination protocols document. Conclusion: Radiographic examination protocols were lacking in most departments. There was lack of understanding among Radiographers in the departments without protocols about the concept of examination protocols and so confused it with radiographic technique. The absence of protocols led to variations in the projections taken among the departments. It also negated the radiographers’ knowledge of radiographic techniques through the choice of wrong projections for some of the examinations, affecting the examination results and hence patient outcome.
Background: Protocols provide a baseline for audit opportunity as well as evidence for clinical governance, since the use of protocols ensure compliance with documented scope of professional practice. Objectives: We determined the existence and variations of radiographic protocols for radiographic examinations of axial and appendicular skeleton in X-ray departments within the Accra Metropolis and also to establish whether there were variations in the projections taken among the departments for these examinations. Methods: A questionnaire containing mostly open ended question, was given to the radiographers who were in-charge of the departments and those in charge of the various clinical rooms of the selected hospitals and polyclinics to complete. Codes were assigned each of the departments, the examinations and the sets of projections indicated for the examinations. The data gathered was analyzed using SPSS version 16 software and presented in tabular and graphical forms. Results: In all eight X-ray departments were studied. Majority (80%) of the respondents indicated having protocols. All respondents agreed to the technical fact that examination protocols must be written and documented and copies made available in all clinical rooms. Conversely, only 20% of the respondents representing 25% of the departments surveyed had examination protocols document. Conclusion: Radiographic examination protocols were lacking in most departments. There was lack of understanding among Radiographers in the departments without protocols about the concept of examination protocols and so confused it with radiographic technique. The absence of protocols led to variations in the projections taken among the departments. It also negated the radiographers’ knowledge of radiographic techniques through the choice of wrong projections for some of the examinations, affecting the examination results and hence patient outcome.
Variation of Radiographic Protocols: An Examination of Practice During Radiography of Axial and Appendicular Skeleton in the Accra Metropolis-Ghana
doi:10.11648/j.cmr.s.2015040301.11
Clinical Medicine Research
2015-03-02
© Science Publishing Group
Antwi W. K.
Gawugah J. N. K.
Kyei K. A.
Opoku S. Y.
Arthur L.
Anim Sampong S.
Ofori E. Batsa S.
Variation of Radiographic Protocols: An Examination of Practice During Radiography of Axial and Appendicular Skeleton in the Accra Metropolis-Ghana
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4
2015-03-02
2015-03-02
10.11648/j.cmr.s.2015040301.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.11
© Science Publishing Group
Potential Role of Randomised Control Trial in the Implementation of Evidenced-Based Practice from the Perspective of Diagnostic Imaging
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.12
Evidence-based practice (EBP) in imaging as in any health profession is to provide quality health care based on clinical governance. This is to ensure that quality care is provided daily based on a credible research evidence. Randomized Control Trial (RCT) has been accepted as the best research design to provide credible evidence of an intervention for patient care and if well conducted. Therefore other research methods need to be developed to provide credible systematic reviews for a wider application. It is clear that this research design has prospects in imaging, however for now imaging guidelines and general consensus of experts will still be preferred as RCTs are gradually being developed in imaging.
Evidence-based practice (EBP) in imaging as in any health profession is to provide quality health care based on clinical governance. This is to ensure that quality care is provided daily based on a credible research evidence. Randomized Control Trial (RCT) has been accepted as the best research design to provide credible evidence of an intervention for patient care and if well conducted. Therefore other research methods need to be developed to provide credible systematic reviews for a wider application. It is clear that this research design has prospects in imaging, however for now imaging guidelines and general consensus of experts will still be preferred as RCTs are gradually being developed in imaging.
Potential Role of Randomised Control Trial in the Implementation of Evidenced-Based Practice from the Perspective of Diagnostic Imaging
doi:10.11648/j.cmr.s.2015040301.12
Clinical Medicine Research
2015-03-02
© Science Publishing Group
Antwi W. K.
Kyei K. A.
Opoku S. Y.
Potential Role of Randomised Control Trial in the Implementation of Evidenced-Based Practice from the Perspective of Diagnostic Imaging
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9
9
2015-03-02
2015-03-02
10.11648/j.cmr.s.2015040301.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.12
© Science Publishing Group
The Role of Radiographer on the Use of Informed Consent
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.13
Background: Multidisciplinary health-care procedures do encounter some challenges that have some legal implications. One way of addressing these issues is by issuance and signing of medical consent. Obtaining medical consent is simply making sure that patients understand why a procedure is being recommended, which alternatives are available, what will happen if the procedure is not performed, how it will be done, and the risks involved. Aim: To assess information given to cancer patients before consent forms are signed and radiographers’ role on its usage. Methodology: Qualitative approach was used to assess patients’ information before signing consent and radiographers’ role of it. Open and close questions were used. Data was analyzed using SPSS (Statistical Package for the Social Sciences) version 18.0. Forty participants were used for the study. Results: The study indicated all the patients were adequately informed before signing consent forms. 86.7% of the radiographers were aware of the role extension and its legal implications but are not aware of any establishment practicing role extension in Ghana. Conclusion: It was revealed that all the patients who participated were informed of their diagnosis, treatment options, the duration of treatment and the risks involved before taken their treatment decision. Almost all radiotherapists were aware of role extension but were not aware of any establishment seeking to practice it in Ghana.
Background: Multidisciplinary health-care procedures do encounter some challenges that have some legal implications. One way of addressing these issues is by issuance and signing of medical consent. Obtaining medical consent is simply making sure that patients understand why a procedure is being recommended, which alternatives are available, what will happen if the procedure is not performed, how it will be done, and the risks involved. Aim: To assess information given to cancer patients before consent forms are signed and radiographers’ role on its usage. Methodology: Qualitative approach was used to assess patients’ information before signing consent and radiographers’ role of it. Open and close questions were used. Data was analyzed using SPSS (Statistical Package for the Social Sciences) version 18.0. Forty participants were used for the study. Results: The study indicated all the patients were adequately informed before signing consent forms. 86.7% of the radiographers were aware of the role extension and its legal implications but are not aware of any establishment practicing role extension in Ghana. Conclusion: It was revealed that all the patients who participated were informed of their diagnosis, treatment options, the duration of treatment and the risks involved before taken their treatment decision. Almost all radiotherapists were aware of role extension but were not aware of any establishment seeking to practice it in Ghana.
The Role of Radiographer on the Use of Informed Consent
doi:10.11648/j.cmr.s.2015040301.13
Clinical Medicine Research
2015-03-21
© Science Publishing Group
Kyei K. A.
Antwi W. K.
Opoku S. Y.
Yarney J.
Amoah E.
The Role of Radiographer on the Use of Informed Consent
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13
13
2015-03-21
2015-03-21
10.11648/j.cmr.s.2015040301.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.13
© Science Publishing Group
Challenges Faced by Radiography Students During Clinical Training
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.18
Background: Clinical training forms part of the requirements of every radiography student, for the award of Bachelor’s degree at the University of Ghana. The effectiveness of clinical training is responsible for the competency level that would be demonstrated by qualified radiography students. However, the capabilities of department to provide adaptive and well managed clinical training for undergraduate students have been reported as a limiting factor. Aim: The purpose of the study was to identify challenges facing the student radiographers during clinical training. Methods: The study was a quantitative one which employed a descriptive survey approach. The survey comprised of levels 300 and 400 students of the department of radiography which gathered forty-two (42) participants. A questionnaire was used to collect data for the study. Data obtained was summarized as frequencies, percentages, means and standard deviations using SPSS version 16.0. Results: The study revealed challenges faced by radiography students such as the gap between theory and practices, inadequate exposure to certain specialized procedures and time allotted to each treatment room. Conclusion: The study showed that clinical training can be enhanced by providing enough equipments and clinical areas for students, also films and cassettes must be made available before the date and time of clinical training. Finally, the theory aspects of clinical training must be in tune with the practice to enhance effective learning experience by students.
Background: Clinical training forms part of the requirements of every radiography student, for the award of Bachelor’s degree at the University of Ghana. The effectiveness of clinical training is responsible for the competency level that would be demonstrated by qualified radiography students. However, the capabilities of department to provide adaptive and well managed clinical training for undergraduate students have been reported as a limiting factor. Aim: The purpose of the study was to identify challenges facing the student radiographers during clinical training. Methods: The study was a quantitative one which employed a descriptive survey approach. The survey comprised of levels 300 and 400 students of the department of radiography which gathered forty-two (42) participants. A questionnaire was used to collect data for the study. Data obtained was summarized as frequencies, percentages, means and standard deviations using SPSS version 16.0. Results: The study revealed challenges faced by radiography students such as the gap between theory and practices, inadequate exposure to certain specialized procedures and time allotted to each treatment room. Conclusion: The study showed that clinical training can be enhanced by providing enough equipments and clinical areas for students, also films and cassettes must be made available before the date and time of clinical training. Finally, the theory aspects of clinical training must be in tune with the practice to enhance effective learning experience by students.
Challenges Faced by Radiography Students During Clinical Training
doi:10.11648/j.cmr.s.2015040301.18
Clinical Medicine Research
2015-03-21
© Science Publishing Group
Kyei K. A.
Antwi W. K.
Bamfo-Quaicoe K.
Offei R. O.
Challenges Faced by Radiography Students During Clinical Training
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3
41
41
2015-03-21
2015-03-21
10.11648/j.cmr.s.2015040301.18
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.18
© Science Publishing Group
Gonad Protection During Paediatric Abdomen and Pelvic X-Ray Examinations
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.16
Background: Evidence suggests that children are more susceptible to radiation risks or hazards. In particular, their gonads are more sensitive to the effects of radiation, especially at or below reproductive age. Protecting the gonads of children and adults is of particular importance to the imaging. Aim: To investigate level of the use of gonad protection during paediatric abdomen and pelvic X-ray examinations in the Accra metropolis. Method: A quantitative, descriptive and cross sectional survey were applied where systematic random sampling was used to select five hospitals from Accra Metropolis (Ghana) that provided radiological services and had permanent radiographers. Three different tools were used in the study for data collection: observation, questionnaire and evaluation of pediatric radiographs of abdomen and pelvis. Results: A total of 44 out of 46 Radiographers recruited in five hospitals completed the questionnaire and were also involved in the observational study. The study achieved a 95.65% response rate. It was identified that 46% (n=20) of the radiographers reported they had no gonad shields in their department. Few departments (13%) had no shields at all and 39% (n=17) of the respondents applied gonad shields only on male sexes. Although there were no laid down policies in the departments surveyed 55% of the respondents reported they were aware of policies regarding the use of gonad shields. Conclusion: It appears that there are no standardised national policies on radiation protection in general for hospitals to follow and so it is absent in the imaging departments. This has affected the availability of gonad shields and adherence to its application to protect patients. To improve quality diagnostic imaging service, there is the urgent need for management to pay serious attention to patient protection especially children against unnecessary exposure to ionising radiation during X-ray procedures. Hospital management must communicate the relevant policies and local rules concerning radiation protection in particular the use of gonad shield to protect children.
Background: Evidence suggests that children are more susceptible to radiation risks or hazards. In particular, their gonads are more sensitive to the effects of radiation, especially at or below reproductive age. Protecting the gonads of children and adults is of particular importance to the imaging. Aim: To investigate level of the use of gonad protection during paediatric abdomen and pelvic X-ray examinations in the Accra metropolis. Method: A quantitative, descriptive and cross sectional survey were applied where systematic random sampling was used to select five hospitals from Accra Metropolis (Ghana) that provided radiological services and had permanent radiographers. Three different tools were used in the study for data collection: observation, questionnaire and evaluation of pediatric radiographs of abdomen and pelvis. Results: A total of 44 out of 46 Radiographers recruited in five hospitals completed the questionnaire and were also involved in the observational study. The study achieved a 95.65% response rate. It was identified that 46% (n=20) of the radiographers reported they had no gonad shields in their department. Few departments (13%) had no shields at all and 39% (n=17) of the respondents applied gonad shields only on male sexes. Although there were no laid down policies in the departments surveyed 55% of the respondents reported they were aware of policies regarding the use of gonad shields. Conclusion: It appears that there are no standardised national policies on radiation protection in general for hospitals to follow and so it is absent in the imaging departments. This has affected the availability of gonad shields and adherence to its application to protect patients. To improve quality diagnostic imaging service, there is the urgent need for management to pay serious attention to patient protection especially children against unnecessary exposure to ionising radiation during X-ray procedures. Hospital management must communicate the relevant policies and local rules concerning radiation protection in particular the use of gonad shield to protect children.
Gonad Protection During Paediatric Abdomen and Pelvic X-Ray Examinations
doi:10.11648/j.cmr.s.2015040301.16
Clinical Medicine Research
2015-03-21
© Science Publishing Group
Kyei K. A.
Antwi W. K.
Gonad Protection During Paediatric Abdomen and Pelvic X-Ray Examinations
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2015-03-21
10.11648/j.cmr.s.2015040301.16
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.16
© Science Publishing Group
The Need for Good Radiation Protection in Diagnostic Imaging in Ghana
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.19
The need to re-examine radiation protection and safety measures to protect the people in Ghana is therefore essential. This is because medical X-ray diagnosis in the country continues to increase. It is the responsibility of the radiation worker to protect patients, self, staff and the members of the public against unnecessary exposure to ionizing radiation. Medical radiation protection is an important aspect of quality care that X-ray departments are expected to provide for their patients. Following increasing concern about radiation hazards from medical diagnostic x-ray, radiation dose assessment of patients undergoing medical diagnostic x-ray examinations has been suggested. However, to implement them requires an effective infrastructure which includes adequate laws and regulations, efficient regulatory system, experts on radiation protection and operational provisions.
The need to re-examine radiation protection and safety measures to protect the people in Ghana is therefore essential. This is because medical X-ray diagnosis in the country continues to increase. It is the responsibility of the radiation worker to protect patients, self, staff and the members of the public against unnecessary exposure to ionizing radiation. Medical radiation protection is an important aspect of quality care that X-ray departments are expected to provide for their patients. Following increasing concern about radiation hazards from medical diagnostic x-ray, radiation dose assessment of patients undergoing medical diagnostic x-ray examinations has been suggested. However, to implement them requires an effective infrastructure which includes adequate laws and regulations, efficient regulatory system, experts on radiation protection and operational provisions.
The Need for Good Radiation Protection in Diagnostic Imaging in Ghana
doi:10.11648/j.cmr.s.2015040301.19
Clinical Medicine Research
2015-03-21
© Science Publishing Group
Antwi W. K.
Kyei K. A.
The Need for Good Radiation Protection in Diagnostic Imaging in Ghana
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2015-03-21
10.11648/j.cmr.s.2015040301.19
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.19
© Science Publishing Group
A Learning Contract in Clinical Education and Fieldwork
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.17
Providing feedback to students is a vital skill needed by all clinical teachers. For students to develop and improve their skills in the activity they are involved in, they need to know how they are performing. Providing feedback does not follow that there will be optimal learning. Students should, in the initial stages, be made aware of the desired standard or goal, because it enables them to compare their own performance with the required standard. It is therefore suggested that it should be made known to the learner, some detail of what to do and what they can do in order to improve. Clinical activities of students without feedback could affect their skill training and the patients as well. Proper guidelines should be followed and attention should also be given to those students with learning difficulties.
Providing feedback to students is a vital skill needed by all clinical teachers. For students to develop and improve their skills in the activity they are involved in, they need to know how they are performing. Providing feedback does not follow that there will be optimal learning. Students should, in the initial stages, be made aware of the desired standard or goal, because it enables them to compare their own performance with the required standard. It is therefore suggested that it should be made known to the learner, some detail of what to do and what they can do in order to improve. Clinical activities of students without feedback could affect their skill training and the patients as well. Proper guidelines should be followed and attention should also be given to those students with learning difficulties.
A Learning Contract in Clinical Education and Fieldwork
doi:10.11648/j.cmr.s.2015040301.17
Clinical Medicine Research
2015-03-21
© Science Publishing Group
Antwi W. K.
Kyei K. A.
A Learning Contract in Clinical Education and Fieldwork
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35
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2015-03-21
10.11648/j.cmr.s.2015040301.17
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.17
© Science Publishing Group
Reflection on Facilitating Learning: A One-to-One Teaching and Learning Experience
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.15
Reflection on an experience has been found to improve practice and therefore it is included in the inter-professional training programmes of health the professions. It improves professional expertise because it allows learning from experience. Through reflective practice the conventional way of understanding and performing a particular duty could also be given a new sense. Reflection is a way of examining practice through series of critical and creative thinking which allows one to comprehend the reasons of some actions during practice and make a move to either improve on a positive situation or correct some negative actions. This paper is a descriptive narration of a reflection on action after a piece of teaching which formed part of a fieldwork education activity.
Reflection on an experience has been found to improve practice and therefore it is included in the inter-professional training programmes of health the professions. It improves professional expertise because it allows learning from experience. Through reflective practice the conventional way of understanding and performing a particular duty could also be given a new sense. Reflection is a way of examining practice through series of critical and creative thinking which allows one to comprehend the reasons of some actions during practice and make a move to either improve on a positive situation or correct some negative actions. This paper is a descriptive narration of a reflection on action after a piece of teaching which formed part of a fieldwork education activity.
Reflection on Facilitating Learning: A One-to-One Teaching and Learning Experience
doi:10.11648/j.cmr.s.2015040301.15
Clinical Medicine Research
2015-03-21
© Science Publishing Group
Antwi W. K.
Reflection on Facilitating Learning: A One-to-One Teaching and Learning Experience
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24
2015-03-21
2015-03-21
10.11648/j.cmr.s.2015040301.15
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.15
© Science Publishing Group
Effect of Clinical Placement; the Radiography Student in Ghana
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.14
Background: The clinical setting is one of the most valuable resources available to training institutions to prepare students to competently care for patients and also execute certain tasks with little or no supervision. Aim: To examine the impact of clinical placement on radiography students’ clinical experience. Methodology: A quantitative study design using a Likert-Scale questionnaire was used to assess clinical practice-learning environment. Data was analyzed using the Statistical Package for the Social Sciences Version 17.0 (SPSS). Forty seven (47) undergraduate student radiographers participated in the study. Results: Students indicated they had adequate knowledge and enjoyed their time on the clinical placement. They indicated that the staffs were supportive, friendly and approachable. The students were also able to achieve their learning outcome during placement, however feedbacks from supervisors according to the students were inadequate and students were not sure of the use of research findings by the clinical venues. Conclusion: Clinical placement had adequate student support. It is important however, to consider carefully where students have their clinical practice and at what point of their studies the different placements should be carried out. Collaboration between the key stakeholders is essential to ensure that students have a good experience at clinical placement.
Background: The clinical setting is one of the most valuable resources available to training institutions to prepare students to competently care for patients and also execute certain tasks with little or no supervision. Aim: To examine the impact of clinical placement on radiography students’ clinical experience. Methodology: A quantitative study design using a Likert-Scale questionnaire was used to assess clinical practice-learning environment. Data was analyzed using the Statistical Package for the Social Sciences Version 17.0 (SPSS). Forty seven (47) undergraduate student radiographers participated in the study. Results: Students indicated they had adequate knowledge and enjoyed their time on the clinical placement. They indicated that the staffs were supportive, friendly and approachable. The students were also able to achieve their learning outcome during placement, however feedbacks from supervisors according to the students were inadequate and students were not sure of the use of research findings by the clinical venues. Conclusion: Clinical placement had adequate student support. It is important however, to consider carefully where students have their clinical practice and at what point of their studies the different placements should be carried out. Collaboration between the key stakeholders is essential to ensure that students have a good experience at clinical placement.
Effect of Clinical Placement; the Radiography Student in Ghana
doi:10.11648/j.cmr.s.2015040301.14
Clinical Medicine Research
2015-03-21
© Science Publishing Group
Kyei K. A.
Antwi W. K.
Effect of Clinical Placement; the Radiography Student in Ghana
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2015-03-21
2015-03-21
10.11648/j.cmr.s.2015040301.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.s.2015040301.14
© Science Publishing Group
Prevalence, Clinical and Socio-Demographic Profiles of Dietary Supplements Users in a Tertiary Hospital in Uyo, South – South Nigeria
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150404.11
Introduction: Dietary Supplements are one of the most easy to access complementary therapies. Their popularity is related to increasing public awareness about health and health related issues. The objective of this study was to describe the prevalence, clinical and socio-demographic profiles of dietary supplements users among outpatient clinic attendees in the University of Uyo Teaching Hospital, a tertiary health institution in Uyo, South-South Nigeria. Method: This was a prospective descriptive cross-sectional study, involving 573 respondents carried out between September 2014 and February 2015. Using a systematic sampling technique, respondents aged between 18 and 69 years were recruited, data were collected with a structured self- administered questionnaire. Result: Of the 573 respondents recruited into the study, 62.2% (n=356) used dietary supplements; made up of 19.2% (n = 110) males and 43.0% (n =246) females. Dietary supplements use were more prevalent among respondents with post-secondary school education, 24.1% (n = 138), married 19.5%, (n=112), as well as those in the high level income group, 26.4% (n = 151).Herbs were the most preferred dietary supplements among respondents in this study accounting for 23.0% (n = 132).The reported major source of information about dietary supplements among respondents in this study was health care professionals 28.1% (n = 100). There was a statistically significant relationship between dietary supplements use and the presence of hypertension (p = 0.001); Diabetes mellitus (p = 0.002) and osteoarthritis (p = 0.004) among respondents in this study. Conclusion: Findings from this study show that dietary supplements are a ready source of complementary therapy. There is therefore a compelling need to regulate its standard and quality. Communication between patients and physicians is important so as to avoid any adverse effects associated with the concomitant use of dietary supplements and orthodox medicines.
Introduction: Dietary Supplements are one of the most easy to access complementary therapies. Their popularity is related to increasing public awareness about health and health related issues. The objective of this study was to describe the prevalence, clinical and socio-demographic profiles of dietary supplements users among outpatient clinic attendees in the University of Uyo Teaching Hospital, a tertiary health institution in Uyo, South-South Nigeria. Method: This was a prospective descriptive cross-sectional study, involving 573 respondents carried out between September 2014 and February 2015. Using a systematic sampling technique, respondents aged between 18 and 69 years were recruited, data were collected with a structured self- administered questionnaire. Result: Of the 573 respondents recruited into the study, 62.2% (n=356) used dietary supplements; made up of 19.2% (n = 110) males and 43.0% (n =246) females. Dietary supplements use were more prevalent among respondents with post-secondary school education, 24.1% (n = 138), married 19.5%, (n=112), as well as those in the high level income group, 26.4% (n = 151).Herbs were the most preferred dietary supplements among respondents in this study accounting for 23.0% (n = 132).The reported major source of information about dietary supplements among respondents in this study was health care professionals 28.1% (n = 100). There was a statistically significant relationship between dietary supplements use and the presence of hypertension (p = 0.001); Diabetes mellitus (p = 0.002) and osteoarthritis (p = 0.004) among respondents in this study. Conclusion: Findings from this study show that dietary supplements are a ready source of complementary therapy. There is therefore a compelling need to regulate its standard and quality. Communication between patients and physicians is important so as to avoid any adverse effects associated with the concomitant use of dietary supplements and orthodox medicines.
Prevalence, Clinical and Socio-Demographic Profiles of Dietary Supplements Users in a Tertiary Hospital in Uyo, South – South Nigeria
doi:10.11648/j.cmr.20150404.11
Clinical Medicine Research
2015-06-19
© Science Publishing Group
Idung Alphonsus Udo
Umoh Kufre Albert
Prevalence, Clinical and Socio-Demographic Profiles of Dietary Supplements Users in a Tertiary Hospital in Uyo, South – South Nigeria
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2015-06-19
2015-06-19
10.11648/j.cmr.20150404.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150404.11
© Science Publishing Group
Awareness and Practice of Cervical Cancer Screening among Women Accessing Care in a Rural Tertiary Hospital in Nigeria
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150404.16
Background. The burden of cervical cancer is on the increase, especially in developing countries, where programmed or regular screening for the disease with Papanicolaou smear is inadequate. The objective was to determine the awareness and practice of cervical cancer screening in a rural tertiary hospital in Nigeria. Methodology. 220 consecutive and consenting women of age 20–70years attending Federal Teaching Hospital, Ido-Ekiti and Comprehensive Health Centre, Oke-Isa, Ado-Ekiti, Ekiti State were recruited between April and August 2009. Relevant data were collected using interviewer-administered semi-structured questionnaires. Results. Mean age ± SD of participants was 41.2 ± 12.6 years and mean age at sexual debut was 20 years. Twenty three (10.7%) participants were single and all were sexually active. 147 (68.4%) had more than one life time sexual partner. 78 (36.3%) of participants were aware of cervical cancer but only 39(18.2%) were aware of its screening, and majority (71.8%) got to know about cervical cancer through health workers. Increasing age, multiple sexual partners, parity more than 4, having a partner who has multiple sexual partners and polygamy were significantly associated with development of pre-malignant lesions for cervical cancer in this study. Conclusion. Majority of the participants were not aware of CC and the steps to be taken to prevent it from occurring. This poses a tremendous health education challenge.
Background. The burden of cervical cancer is on the increase, especially in developing countries, where programmed or regular screening for the disease with Papanicolaou smear is inadequate. The objective was to determine the awareness and practice of cervical cancer screening in a rural tertiary hospital in Nigeria. Methodology. 220 consecutive and consenting women of age 20–70years attending Federal Teaching Hospital, Ido-Ekiti and Comprehensive Health Centre, Oke-Isa, Ado-Ekiti, Ekiti State were recruited between April and August 2009. Relevant data were collected using interviewer-administered semi-structured questionnaires. Results. Mean age ± SD of participants was 41.2 ± 12.6 years and mean age at sexual debut was 20 years. Twenty three (10.7%) participants were single and all were sexually active. 147 (68.4%) had more than one life time sexual partner. 78 (36.3%) of participants were aware of cervical cancer but only 39(18.2%) were aware of its screening, and majority (71.8%) got to know about cervical cancer through health workers. Increasing age, multiple sexual partners, parity more than 4, having a partner who has multiple sexual partners and polygamy were significantly associated with development of pre-malignant lesions for cervical cancer in this study. Conclusion. Majority of the participants were not aware of CC and the steps to be taken to prevent it from occurring. This poses a tremendous health education challenge.
Awareness and Practice of Cervical Cancer Screening among Women Accessing Care in a Rural Tertiary Hospital in Nigeria
doi:10.11648/j.cmr.20150404.16
Clinical Medicine Research
2015-07-31
© Science Publishing Group
Gabriel Olusegun Emanuel
Busari Olusegun Adesola
Komolafe Akinwumi Oluwole
Agboola Segun Mathew
Elegbede Olayide Toyin
Omoragbon Aishatu
Awareness and Practice of Cervical Cancer Screening among Women Accessing Care in a Rural Tertiary Hospital in Nigeria
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126
2015-07-31
2015-07-31
10.11648/j.cmr.20150404.16
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150404.16
© Science Publishing Group
Prevalence and Intensity of Soil-Transmitted Helminths Among School-Aged Children in Sigmo Primary School, Jimma Zone, South-Western Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150404.12
Background: School-aged children have been identified as high risk group of population to be infected with soil- transmitted helminths (STH) in developing countries. Although, there were previous reports concerning the prevalence; but limited data are available with regards to intensity of the STH. Therefore, the objective of current study was to assess the prevalence and intensity of STH and associated risk factors among school-aged children at Sigmo primary school. Method: Cross-sectional study design was conducted from March-April 2015, at Sigmo primary school children, Jimma Zone, Ethiopia. Study subjects were selected from grade 1-8 with in age groups between 5-18 yrs old with multistage sampling techniques. The demographic and risk factor analysis data were collected by using pre-tested and structured questionnaires from parents/guardian or teachers of the children. Prevalence and intensity of STH were determined by using Kato-Katz thick smear techniques. Student’s data were analyzed by SPSS version 20 software package, both logistic regression and chi-square statistical analysis approaches were applied. Results: Out of 330 calculated sample sizes, 302 were participated in the study. The overall prevalence of STH was 41.7%. A. lumbricoides was the predominant parasite (19.8%) followed by T. trichiura (15.6%). In logistic regression, latrine usage (AOR: 1.77, 95% CI, 1.09-2.87, P=0.020), habit of hand washing before meal (AOR=1.776, 95% CI, 1.098-2.871, P=0.019) and habit of hand washing after toilet (AOR=1.595, 95% CI, 1.005-2.531, P=0.048) were predictor of STH infections in the study area. Regarding sex as possible risk factor, male children were infected more than female children, but not statistical significant. Overall infection intensity of A. lumbricoides in the study area was (20.2%), T. trichiura (16.9%) and hookworm was (1.67%), respectively. Conclusion: Prevalence of STHs in the study area was quite high and calls for at least annual mass drug administration in addition to prompting preventive actions like health education, personal hygiene and provision of clean water in the study area.
Background: School-aged children have been identified as high risk group of population to be infected with soil- transmitted helminths (STH) in developing countries. Although, there were previous reports concerning the prevalence; but limited data are available with regards to intensity of the STH. Therefore, the objective of current study was to assess the prevalence and intensity of STH and associated risk factors among school-aged children at Sigmo primary school. Method: Cross-sectional study design was conducted from March-April 2015, at Sigmo primary school children, Jimma Zone, Ethiopia. Study subjects were selected from grade 1-8 with in age groups between 5-18 yrs old with multistage sampling techniques. The demographic and risk factor analysis data were collected by using pre-tested and structured questionnaires from parents/guardian or teachers of the children. Prevalence and intensity of STH were determined by using Kato-Katz thick smear techniques. Student’s data were analyzed by SPSS version 20 software package, both logistic regression and chi-square statistical analysis approaches were applied. Results: Out of 330 calculated sample sizes, 302 were participated in the study. The overall prevalence of STH was 41.7%. A. lumbricoides was the predominant parasite (19.8%) followed by T. trichiura (15.6%). In logistic regression, latrine usage (AOR: 1.77, 95% CI, 1.09-2.87, P=0.020), habit of hand washing before meal (AOR=1.776, 95% CI, 1.098-2.871, P=0.019) and habit of hand washing after toilet (AOR=1.595, 95% CI, 1.005-2.531, P=0.048) were predictor of STH infections in the study area. Regarding sex as possible risk factor, male children were infected more than female children, but not statistical significant. Overall infection intensity of A. lumbricoides in the study area was (20.2%), T. trichiura (16.9%) and hookworm was (1.67%), respectively. Conclusion: Prevalence of STHs in the study area was quite high and calls for at least annual mass drug administration in addition to prompting preventive actions like health education, personal hygiene and provision of clean water in the study area.
Prevalence and Intensity of Soil-Transmitted Helminths Among School-Aged Children in Sigmo Primary School, Jimma Zone, South-Western Ethiopia
doi:10.11648/j.cmr.20150404.12
Clinical Medicine Research
2015-06-25
© Science Publishing Group
Daniel Emana
Kalid Jemal
Mitiku Bajiro
Zeleke Mekonnen
Prevalence and Intensity of Soil-Transmitted Helminths Among School-Aged Children in Sigmo Primary School, Jimma Zone, South-Western Ethiopia
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2015-06-25
10.11648/j.cmr.20150404.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150404.12
© Science Publishing Group
Trends of Immuno-virological Response Among HIV-Infected Patients Receiving Highly Active Anti-retroviral Therapy at Hawassa, Southern Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150404.13
Background: Immunological and virological response evaluation is one of a critical tool for assessing treatment outcome, regimen change and patient’s management. However, data concerning any change in immunological and virological response in HIV infected patients using anti-retroviral treatment (ART) is scarce in Ethiopia. Method: This retrospective cohort study was conducted from April 2010–September 2013 at ART clinic of Hawassa University referral hospital. A total of 86 HIV-infected patients receiving Tenofovir, Stavudine and Zidovudine based regimen with either of Efavirenz or Nevirapine during ART initiation. Lamivudine is common for all. Adequate immuno-virological response for most patients under treatment is defined as an increase in CD4 cells of 50–150/µl per year and viral load (VL) drops to undetectable level (<150 copies/ml) after ≥ 6 months of ART. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) Version 20. Results: mean CD4+ cells count shows significant increment at 6, 12, 18 and 24 months after ART treatment among patients having VL <5 (log10) compared to those VL ≥5 (p=0.04; 0.002; < 0.0001; 0.001) respectively. Females have insignificantly better Mean CD4+ cells throughout 24 months. Also patients over 50 years of age do show an immune response after ART initiation. But, in relative to younger patients, their CD4 cells recovery is insignificantly sluggish. CD4+ cells and body weight of concordant positive responders show significant rising trend at 6, 12, 18, 24 months when compared to discordant responders + concordant non-responders, and p-value: (0.003 vs. 0.05; <0.0001 vs. 0.04; 0.001 vs.0.008; 0.001 vs.0.03) respectively. Moreover logistic regression models were applied and significant factors associated with discordant immuno-virological response were patient’s body weight (AOR=0.14; 95% CI: 0.03-0.7; p=0.02) and residence (AOR=20.3; 95% CI: 2.2-188; p=0.008). Conclusion: Immuno-virological response assessment is a critical tool for addressing treatment outcome, regimen change and patient’s management for those peoples living with HIV using ART. Therefore we recommend that treatment response decision should include both CD4+ cells count and viral load concurrently.
Background: Immunological and virological response evaluation is one of a critical tool for assessing treatment outcome, regimen change and patient’s management. However, data concerning any change in immunological and virological response in HIV infected patients using anti-retroviral treatment (ART) is scarce in Ethiopia. Method: This retrospective cohort study was conducted from April 2010–September 2013 at ART clinic of Hawassa University referral hospital. A total of 86 HIV-infected patients receiving Tenofovir, Stavudine and Zidovudine based regimen with either of Efavirenz or Nevirapine during ART initiation. Lamivudine is common for all. Adequate immuno-virological response for most patients under treatment is defined as an increase in CD4 cells of 50–150/µl per year and viral load (VL) drops to undetectable level (<150 copies/ml) after ≥ 6 months of ART. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) Version 20. Results: mean CD4+ cells count shows significant increment at 6, 12, 18 and 24 months after ART treatment among patients having VL <5 (log10) compared to those VL ≥5 (p=0.04; 0.002; < 0.0001; 0.001) respectively. Females have insignificantly better Mean CD4+ cells throughout 24 months. Also patients over 50 years of age do show an immune response after ART initiation. But, in relative to younger patients, their CD4 cells recovery is insignificantly sluggish. CD4+ cells and body weight of concordant positive responders show significant rising trend at 6, 12, 18, 24 months when compared to discordant responders + concordant non-responders, and p-value: (0.003 vs. 0.05; <0.0001 vs. 0.04; 0.001 vs.0.008; 0.001 vs.0.03) respectively. Moreover logistic regression models were applied and significant factors associated with discordant immuno-virological response were patient’s body weight (AOR=0.14; 95% CI: 0.03-0.7; p=0.02) and residence (AOR=20.3; 95% CI: 2.2-188; p=0.008). Conclusion: Immuno-virological response assessment is a critical tool for addressing treatment outcome, regimen change and patient’s management for those peoples living with HIV using ART. Therefore we recommend that treatment response decision should include both CD4+ cells count and viral load concurrently.
Trends of Immuno-virological Response Among HIV-Infected Patients Receiving Highly Active Anti-retroviral Therapy at Hawassa, Southern Ethiopia
doi:10.11648/j.cmr.20150404.13
Clinical Medicine Research
2015-06-29
© Science Publishing Group
Agete Tadewos Hirigo
Demissie Assegu Fenta
Tadewos Beyene Bala
Selamawit Gutema Bule
Meseret Regassa Gemechu
Trends of Immuno-virological Response Among HIV-Infected Patients Receiving Highly Active Anti-retroviral Therapy at Hawassa, Southern Ethiopia
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2015-06-29
2015-06-29
10.11648/j.cmr.20150404.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150404.13
© Science Publishing Group
Hematological Malignancies: Analysis of Myelogram Results over 21 Years in Lome Teaching Hospitals
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150404.14
Objectives: Determine the frequency of malignancies diagnosed in myelogram seen in hematology services of Campus and Sylvanus Olympio Teaching Hospitals in Lome from 1992 to 2013. Study the epidemiology profile of these diseases. Materials and methods: It was an analytical retrospective study of 469 cases of malignancies diagnosed in 1511 myelograms during 21 years in both teaching hospital of Lome. Results: Blood disorders represent 31.70% of the results of myelogram performed during 21 years in the Teaching Hospital of Lome. Each year, there is an average of 22.3 cases diagnosed hematological malignancies. The most hematological malignancies were Kahler's disease (28.57%), chronic myeloid leukemia (24.52%), chronic lymphocytic leukemia (22.17%), acute lymphoblastic leukemia (12.58%) and acute myeloid leukemia (8.10%). Other (4.05%) were represented by the essential hypereosinophilic syndrome (4 cases), hairy cell leukemia (4 cases), Sezary lymphoma (3 cases), essential thrombocythemia (3 cases), Waldenstrom's disease (2 cases), acute myelomonocytic leukemia (1 case), prolymphocytic leukemia (1 case) and plasma cell leukemia (1 case). By gender, the CLL is most predominant in women against CML in men. Hemopathies were observed at all ages of life. Conclusion: Hematological malignancies are diagnosed in the Teaching Hospital of Campus and Sylvanus Olympio in Lome with a high relatively frequency. This prevalence must be higher if all cases of malignancies diagnosed in Togo were recorded in a national cancer register. This study aims to knowledge of epidemiological aspects of hematological malignancies and improve the care of patients with hematological malignancies by the provision of adequate anti-mitotic drugs.
Objectives: Determine the frequency of malignancies diagnosed in myelogram seen in hematology services of Campus and Sylvanus Olympio Teaching Hospitals in Lome from 1992 to 2013. Study the epidemiology profile of these diseases. Materials and methods: It was an analytical retrospective study of 469 cases of malignancies diagnosed in 1511 myelograms during 21 years in both teaching hospital of Lome. Results: Blood disorders represent 31.70% of the results of myelogram performed during 21 years in the Teaching Hospital of Lome. Each year, there is an average of 22.3 cases diagnosed hematological malignancies. The most hematological malignancies were Kahler's disease (28.57%), chronic myeloid leukemia (24.52%), chronic lymphocytic leukemia (22.17%), acute lymphoblastic leukemia (12.58%) and acute myeloid leukemia (8.10%). Other (4.05%) were represented by the essential hypereosinophilic syndrome (4 cases), hairy cell leukemia (4 cases), Sezary lymphoma (3 cases), essential thrombocythemia (3 cases), Waldenstrom's disease (2 cases), acute myelomonocytic leukemia (1 case), prolymphocytic leukemia (1 case) and plasma cell leukemia (1 case). By gender, the CLL is most predominant in women against CML in men. Hemopathies were observed at all ages of life. Conclusion: Hematological malignancies are diagnosed in the Teaching Hospital of Campus and Sylvanus Olympio in Lome with a high relatively frequency. This prevalence must be higher if all cases of malignancies diagnosed in Togo were recorded in a national cancer register. This study aims to knowledge of epidemiological aspects of hematological malignancies and improve the care of patients with hematological malignancies by the provision of adequate anti-mitotic drugs.
Hematological Malignancies: Analysis of Myelogram Results over 21 Years in Lome Teaching Hospitals
doi:10.11648/j.cmr.20150404.14
Clinical Medicine Research
2015-07-05
© Science Publishing Group
Irenee Messanh Kueviakoe
Essohana Padaro
Kossi Agbetiafa
Yao Layibo
Malewe Kolou
Ahoefa Vovor
Akuete Yvon Segbena
Hematological Malignancies: Analysis of Myelogram Results over 21 Years in Lome Teaching Hospitals
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2015-07-05
10.11648/j.cmr.20150404.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150404.14
© Science Publishing Group
Orthostatic Hypotension (OH) in a Population of Hypertensive Patients in the University Hospital Gabriel Touré (UH GT)
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150404.15
Objective: This study was intended to determine the prevalence of HO and characteristics of patients who had an OH. Methodology: The study was cross-sectional, conducted in the cardiology department of the UH GT from January to June 2013 in a population of known hypertensive patients aged over 15 years seen as outpatients and who agreed to participate in the study. OH and NonOH were used to name patients with and without OH. OH was looked up to 5 min. The analysis was performed with SPSS software. Results: The overall prevalence of OH was 31.8% Age, SBP, DBP and HR were lower for NonHO patients resp. p = 0.004, <0.0001 <0.0001 and 0.016. The female sex had a low predictive value compared to male (OR 0.594 and p = 0.011). The OR for the occurrence of OH versus the age group > = 60 years were 1.974, 2.616 and 1.692 respectively for ages < 30, 30-44 and 45-59 years (p = 0.004). The OR for the occurrence of OH versus compared to higher education level were 0,411, 0,326 et 0,716 (p=0,049) resp. for unschooled, primary and secondary level. Conclusion: OH is frequent in the hypertensive population with nearly a third of patients. His research must be extended up to 5 minutes.
Objective: This study was intended to determine the prevalence of HO and characteristics of patients who had an OH. Methodology: The study was cross-sectional, conducted in the cardiology department of the UH GT from January to June 2013 in a population of known hypertensive patients aged over 15 years seen as outpatients and who agreed to participate in the study. OH and NonOH were used to name patients with and without OH. OH was looked up to 5 min. The analysis was performed with SPSS software. Results: The overall prevalence of OH was 31.8% Age, SBP, DBP and HR were lower for NonHO patients resp. p = 0.004, <0.0001 <0.0001 and 0.016. The female sex had a low predictive value compared to male (OR 0.594 and p = 0.011). The OR for the occurrence of OH versus the age group > = 60 years were 1.974, 2.616 and 1.692 respectively for ages < 30, 30-44 and 45-59 years (p = 0.004). The OR for the occurrence of OH versus compared to higher education level were 0,411, 0,326 et 0,716 (p=0,049) resp. for unschooled, primary and secondary level. Conclusion: OH is frequent in the hypertensive population with nearly a third of patients. His research must be extended up to 5 minutes.
Orthostatic Hypotension (OH) in a Population of Hypertensive Patients in the University Hospital Gabriel Touré (UH GT)
doi:10.11648/j.cmr.20150404.15
Clinical Medicine Research
2015-07-05
© Science Publishing Group
Bâ Hamidou Oumar
Menta Ichaka
Sangaré Ibrahima
Sidibé Noumou
Diall Ilo Bella
Coulibaly Souleymane
Daou Adama
Sogodogo Adama
Touré Mamadou
Traoré Aladji
Djiguiba Youssouf
Sanogo Kassoum Mamourou
Orthostatic Hypotension (OH) in a Population of Hypertensive Patients in the University Hospital Gabriel Touré (UH GT)
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2015-07-05
2015-07-05
10.11648/j.cmr.20150404.15
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150404.15
© Science Publishing Group
Background Factors Associated with the Complications of Coronary Artery Lesions Caused by Kawasaki Disease
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150405.11
Appropriate therapy during the acute phase of Kawasaki disease to prevent large coronary artery lesions (CAL) has not been established. The aim of this retrospective study was to investigate the usefulness of an initial single intravenous immunoglobulin (IVIG) therapy. In this study, I included a total of 200 pediatric patients who had received 2g/kg/day IVIG therapy for Kawasaki disease between 1999 and 2015 at the Department of Pediatrics, Aomori Prefectural Central Hospital. An initial IVIG therapy starting on day 5 was used as first-line therapy when possible. The second-line therapy was additional IVIG therapy, and the third-line therapy was an urinastatin infusion or plasma exchange. All patients received an initial single IVIG therapy with delayed or with concomitant administration of aspirin or flurbiprofen. Initial IVIG therapy resistance occurred in 48 of 200 patients (24%), and 17 patients (9%) received additional IVIG therapy. Four patients received urinastatin and one patient received plasma exchange as the third-line therapy. Before the 30th day, the prevalence of CAL was 5% (10/200); after 30 days, it was 2% (4/200). The maximal internal CAL diameter was 4.8 mm (Z score = 6.3) among all patients. Variable factors including IVIG resistance, responsiveness, and relapse of disease were associated with CAL complications. An initial single IVIG therapy may be useful for the prevention of large CAL caused by different factors of Kawasaki disease.
Appropriate therapy during the acute phase of Kawasaki disease to prevent large coronary artery lesions (CAL) has not been established. The aim of this retrospective study was to investigate the usefulness of an initial single intravenous immunoglobulin (IVIG) therapy. In this study, I included a total of 200 pediatric patients who had received 2g/kg/day IVIG therapy for Kawasaki disease between 1999 and 2015 at the Department of Pediatrics, Aomori Prefectural Central Hospital. An initial IVIG therapy starting on day 5 was used as first-line therapy when possible. The second-line therapy was additional IVIG therapy, and the third-line therapy was an urinastatin infusion or plasma exchange. All patients received an initial single IVIG therapy with delayed or with concomitant administration of aspirin or flurbiprofen. Initial IVIG therapy resistance occurred in 48 of 200 patients (24%), and 17 patients (9%) received additional IVIG therapy. Four patients received urinastatin and one patient received plasma exchange as the third-line therapy. Before the 30th day, the prevalence of CAL was 5% (10/200); after 30 days, it was 2% (4/200). The maximal internal CAL diameter was 4.8 mm (Z score = 6.3) among all patients. Variable factors including IVIG resistance, responsiveness, and relapse of disease were associated with CAL complications. An initial single IVIG therapy may be useful for the prevention of large CAL caused by different factors of Kawasaki disease.
Background Factors Associated with the Complications of Coronary Artery Lesions Caused by Kawasaki Disease
doi:10.11648/j.cmr.20150405.11
Clinical Medicine Research
2015-08-01
© Science Publishing Group
Toshimasa Nakada
Background Factors Associated with the Complications of Coronary Artery Lesions Caused by Kawasaki Disease
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2015-08-01
2015-08-01
10.11648/j.cmr.20150405.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150405.11
© Science Publishing Group
Molecular Epidemiology of Hepatitis C Virus and Predominant Genotype in India
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150405.13
Analysis of the HCV genome has demonstrated extremely high heterogeneity in both structural and nonstructural coding regions and there are at least six different genotypes that have generally been divided into several subtypes. Of the 6 different Hepatitis genotypes, genotypes 1-3 is common worldwide, type 1a and 1b are the most common, accounting for about 60% of global infections. They predominate in Northern Europe, Southern and Eastern Europe, North America, and Japan respectively. Type 2 is less frequently represented than type 1. Type 3 is endemic in south-east Asia and is variably distributed in different countries. The determination of the infecting genotype is important for the prediction of response to antiviral treatment; genotype 1 is generally associated with a poor response to interferon alone, unlike genotypes 2 and 3 which are associated with better responses. A total of 238 plasma samples were received from patients attending gastroenterology department across India for treatment from March 2008 – Aug 2010. The samples were analyzed for viral load by real time PCR by Taqman principle. HCV genotyping was carried out on the samples whose viral load was more than 300IU/ml (limit of detection as per the kit). Qiagen RNA columns were used for RNA extraction, followed by reverse transcription (Promega) and genotyping was performed by conventional PCR. Out of 238 samples, 117 were positive for 3a, 44 samples were load negative, 43 samples were non- typable due to less viral load i.e. less than 1000 IU/ml. 26 were type 1a, 107 were 3a, and 11 were 2a.
Analysis of the HCV genome has demonstrated extremely high heterogeneity in both structural and nonstructural coding regions and there are at least six different genotypes that have generally been divided into several subtypes. Of the 6 different Hepatitis genotypes, genotypes 1-3 is common worldwide, type 1a and 1b are the most common, accounting for about 60% of global infections. They predominate in Northern Europe, Southern and Eastern Europe, North America, and Japan respectively. Type 2 is less frequently represented than type 1. Type 3 is endemic in south-east Asia and is variably distributed in different countries. The determination of the infecting genotype is important for the prediction of response to antiviral treatment; genotype 1 is generally associated with a poor response to interferon alone, unlike genotypes 2 and 3 which are associated with better responses. A total of 238 plasma samples were received from patients attending gastroenterology department across India for treatment from March 2008 – Aug 2010. The samples were analyzed for viral load by real time PCR by Taqman principle. HCV genotyping was carried out on the samples whose viral load was more than 300IU/ml (limit of detection as per the kit). Qiagen RNA columns were used for RNA extraction, followed by reverse transcription (Promega) and genotyping was performed by conventional PCR. Out of 238 samples, 117 were positive for 3a, 44 samples were load negative, 43 samples were non- typable due to less viral load i.e. less than 1000 IU/ml. 26 were type 1a, 107 were 3a, and 11 were 2a.
Molecular Epidemiology of Hepatitis C Virus and Predominant Genotype in India
doi:10.11648/j.cmr.20150405.13
Clinical Medicine Research
2015-08-03
© Science Publishing Group
Pushpalatha Manjunatha
Satish Kumar Amarnath
P. K. Menon
Arun Kumar H. R.
Bala Satish M.
S. J. Sabarish Babu
Molecular Epidemiology of Hepatitis C Virus and Predominant Genotype in India
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142
2015-08-03
2015-08-03
10.11648/j.cmr.20150405.13
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150405.13
© Science Publishing Group
Conventional, Acupuncture-Like or Brief-Intense: Is There Any Difference Between TENS Modalities According to Outcomes of Chronic Low Back Pain with Lumbar Disc Herniation
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150405.14
Objectives: To evaluate the differences between Conventional, Acupuncture-like and Brief-intense TENS in chronic low back pain with lumbar disc herniation. Methods: 160 patients who were diagnosed as lumbar disc herniation were randomized into 4 groups: Group1= Conventional TENS, Group2= Acupuncture-like TENS, Group3= Brief-intense TENS, Group4= Sham TENS. Hotpack, ultrasound and exercise were applied all groups (5 days/week for 3 weeks). Patients were evaluated before treatment, a week after baseline, at the end of treatment and a month after the end of treatment. Ostwestry Low Back Pain Disability Questionnaire (OLBP) and Short-Form 36 physical component (SF-36PCS), mental component (SF-36MCS) scores, Modified Lumbar Schober test (MLS), Straight Leg Raising test (SLR) and Femoral Stretching test (FS) results and Visual Analog Scale for pain (VAS) at activity and at rest were recorded. After the exclusion, statistical analysis was administered to 135 participants (44 males and 91 females). Results: There were no differences according to demographic data (p>0,05). For each evaluation step, we compared the means of MLS, SLR, VASactivity, VASrest, OLBP, SF-36PCS and SF-36MCS and found no significant difference (p>0,05). At the end of first week, all groups showed significant improvement according to SLR (p=0,046, p=0,035, p=0,035, p=0,045, respectively) and VASrest (p=0,038, p=0,048, p=0,045, p=0,048, respectively); only group 1 (p=0,034) and group 3 (p=0,045) showed significant improvement for VASactivity. At the end of treatment, all groups showed significant improvement for MLS, SLR, VASactivity, VASrest, OLBP and SF-36PCS (p<0,05). Conclusions: Pain relief is seem to be starting earlier in treatment regimens including conventional and brief-intense TENS. Probably, final outcomes of the treatment regimens for pain and functional capacity, with or without TENS don’t differ.
Objectives: To evaluate the differences between Conventional, Acupuncture-like and Brief-intense TENS in chronic low back pain with lumbar disc herniation. Methods: 160 patients who were diagnosed as lumbar disc herniation were randomized into 4 groups: Group1= Conventional TENS, Group2= Acupuncture-like TENS, Group3= Brief-intense TENS, Group4= Sham TENS. Hotpack, ultrasound and exercise were applied all groups (5 days/week for 3 weeks). Patients were evaluated before treatment, a week after baseline, at the end of treatment and a month after the end of treatment. Ostwestry Low Back Pain Disability Questionnaire (OLBP) and Short-Form 36 physical component (SF-36PCS), mental component (SF-36MCS) scores, Modified Lumbar Schober test (MLS), Straight Leg Raising test (SLR) and Femoral Stretching test (FS) results and Visual Analog Scale for pain (VAS) at activity and at rest were recorded. After the exclusion, statistical analysis was administered to 135 participants (44 males and 91 females). Results: There were no differences according to demographic data (p>0,05). For each evaluation step, we compared the means of MLS, SLR, VASactivity, VASrest, OLBP, SF-36PCS and SF-36MCS and found no significant difference (p>0,05). At the end of first week, all groups showed significant improvement according to SLR (p=0,046, p=0,035, p=0,035, p=0,045, respectively) and VASrest (p=0,038, p=0,048, p=0,045, p=0,048, respectively); only group 1 (p=0,034) and group 3 (p=0,045) showed significant improvement for VASactivity. At the end of treatment, all groups showed significant improvement for MLS, SLR, VASactivity, VASrest, OLBP and SF-36PCS (p<0,05). Conclusions: Pain relief is seem to be starting earlier in treatment regimens including conventional and brief-intense TENS. Probably, final outcomes of the treatment regimens for pain and functional capacity, with or without TENS don’t differ.
Conventional, Acupuncture-Like or Brief-Intense: Is There Any Difference Between TENS Modalities According to Outcomes of Chronic Low Back Pain with Lumbar Disc Herniation
doi:10.11648/j.cmr.20150405.14
Clinical Medicine Research
2015-08-05
© Science Publishing Group
Ilker Ilhanli
Conventional, Acupuncture-Like or Brief-Intense: Is There Any Difference Between TENS Modalities According to Outcomes of Chronic Low Back Pain with Lumbar Disc Herniation
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150
150
2015-08-05
2015-08-05
10.11648/j.cmr.20150405.14
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150405.14
© Science Publishing Group
Prevalence and Associated Factors of Sexually Transmitted Infections Based on the Syndromic Approach among HIV Patients in ART Clinic; Ayder Referral Hospital, Northern Ethiopia
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150405.12
Background: Sexually transmitted Infections represent a large burden of disease worldwide with an annual incidence of about 333 million cases. In Ethiopia, studies on Sexually Transmitted Infections (STIs) among HIV patients are very few; therefore, conducting research on STIs in general and among HIV patients in particular is an important input to design policy and strategy aimed at preventing and controlling the infections. Objective: To determine the prevalence and associated factors of sexually transmitted infections among HIV patients in ART clinic; Ayder referral hospital, Tigray, Ethiopia. Methods: Institution based cross sectional study design was conducted among 353 HIV patients in Ayder hospital, ART clinic from July to September 2014. A systematic random sampling technique was used to identify study subjects. Data were collected using structured questionnaire and entered into and analyzed using SPSS 20 for windows. Descriptive analyses were used to estimate the prevalence of STIs and selected characteristics of patients. The effects of predictors on having STIs were analyzed using logistic regression and their effects were depicted using OR adjusted for confounding. P-value less than 0.05 were considered as statistical significant for all tests. Result;: Among total respondents; 150 (42.5%) were male and 203 (57.5%) female HIV patients .The prevalence of sexually transmitted infections based on the syndromic approach was 8.5% with specific prevalence of (4.6%) urethral discharge syndrome,(2.8%) genital ulcer syndrome, none of them scrotal swelling syndrome, (2.5%) lower abdominal pain syndrome,(0.3%)inguinal bubo and (5.5%) had vaginal discharge syndrome. 8 patients (26.7%) had recurrent disease and 28 patients (93.3%) treated without their partners. After multivariable logistic regression analysis, age (AOR=11.3 (95%CI: 1.1-116.5), marital status (AOR=0.031 (95%CI: 0.001-0.93) and having new sexual partner within the last three months (AOR=152.7 (95%CI: 3.7-6274) were significantly associated with STI syndromes p-value<0.05. Conclusion and recommendations: The prevalence of sexually transmitted infections based on the syndromic approach among HIV patients was 8.5% and the factors associated with STIs among HIV patients were: age, marital status and having new sexual partner within the last three months. Moreover, further studies to explore the predictor variables are highly recommended.
Background: Sexually transmitted Infections represent a large burden of disease worldwide with an annual incidence of about 333 million cases. In Ethiopia, studies on Sexually Transmitted Infections (STIs) among HIV patients are very few; therefore, conducting research on STIs in general and among HIV patients in particular is an important input to design policy and strategy aimed at preventing and controlling the infections. Objective: To determine the prevalence and associated factors of sexually transmitted infections among HIV patients in ART clinic; Ayder referral hospital, Tigray, Ethiopia. Methods: Institution based cross sectional study design was conducted among 353 HIV patients in Ayder hospital, ART clinic from July to September 2014. A systematic random sampling technique was used to identify study subjects. Data were collected using structured questionnaire and entered into and analyzed using SPSS 20 for windows. Descriptive analyses were used to estimate the prevalence of STIs and selected characteristics of patients. The effects of predictors on having STIs were analyzed using logistic regression and their effects were depicted using OR adjusted for confounding. P-value less than 0.05 were considered as statistical significant for all tests. Result;: Among total respondents; 150 (42.5%) were male and 203 (57.5%) female HIV patients .The prevalence of sexually transmitted infections based on the syndromic approach was 8.5% with specific prevalence of (4.6%) urethral discharge syndrome,(2.8%) genital ulcer syndrome, none of them scrotal swelling syndrome, (2.5%) lower abdominal pain syndrome,(0.3%)inguinal bubo and (5.5%) had vaginal discharge syndrome. 8 patients (26.7%) had recurrent disease and 28 patients (93.3%) treated without their partners. After multivariable logistic regression analysis, age (AOR=11.3 (95%CI: 1.1-116.5), marital status (AOR=0.031 (95%CI: 0.001-0.93) and having new sexual partner within the last three months (AOR=152.7 (95%CI: 3.7-6274) were significantly associated with STI syndromes p-value<0.05. Conclusion and recommendations: The prevalence of sexually transmitted infections based on the syndromic approach among HIV patients was 8.5% and the factors associated with STIs among HIV patients were: age, marital status and having new sexual partner within the last three months. Moreover, further studies to explore the predictor variables are highly recommended.
Prevalence and Associated Factors of Sexually Transmitted Infections Based on the Syndromic Approach among HIV Patients in ART Clinic; Ayder Referral Hospital, Northern Ethiopia
doi:10.11648/j.cmr.20150405.12
Clinical Medicine Research
2015-08-03
© Science Publishing Group
Abraha Gebrelibanos Kahsay
Frehiwot Daba
Abraham Getachew Kelbore
Sefonias Getachew
Prevalence and Associated Factors of Sexually Transmitted Infections Based on the Syndromic Approach among HIV Patients in ART Clinic; Ayder Referral Hospital, Northern Ethiopia
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138
138
2015-08-03
2015-08-03
10.11648/j.cmr.20150405.12
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150405.12
© Science Publishing Group
Twin Reversed Arterial Perfusion (TRAP) Sequence: A Case Report in Fallujah Maternity and Children Hospital, Fallujah, Iraq
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150405.15
Introduction. Twin reversed arterial perfusion (TRAP) sequence is a rare complication of multiple pregnancy caused by defects in early embryogenesis. The pump twin supplies the acardiac recipient twin with blood, and although the pump twin is usually structurally normal, congenital anomalies have sometimes been reported. We report a case of twin reversed arterial perfusion sequence with feet polydactly in the surviving pump twin. This was the 1st case reported in Fallujah city, Iraq. Case report. A 22 years old. gravida 2, para 0. abortion 1, full term lady presented to the delivery room with labour pain with no history of any prenatal care. She gave no history of any familial congenital anomaly and there was no history of consanguinity with her hasbund. She has been referred for cesearian section delivery as an emergency as there was no progress in labour. Ultrasound examination at the delivery room revealed the diagnosis of monozygotic twin, one was normal & the 2nd was diagnosed as (abnormal) with difficulty in visualization of the fetal parts and gender. Conclusion. Twin-Reversed Arterial Perfusion (TRAP) sequence is a rare complication of monozygotic multiple gestation. Accurate antenatal diagnosis is essential to improve the prognosis of this rare entity.
Introduction. Twin reversed arterial perfusion (TRAP) sequence is a rare complication of multiple pregnancy caused by defects in early embryogenesis. The pump twin supplies the acardiac recipient twin with blood, and although the pump twin is usually structurally normal, congenital anomalies have sometimes been reported. We report a case of twin reversed arterial perfusion sequence with feet polydactly in the surviving pump twin. This was the 1st case reported in Fallujah city, Iraq. Case report. A 22 years old. gravida 2, para 0. abortion 1, full term lady presented to the delivery room with labour pain with no history of any prenatal care. She gave no history of any familial congenital anomaly and there was no history of consanguinity with her hasbund. She has been referred for cesearian section delivery as an emergency as there was no progress in labour. Ultrasound examination at the delivery room revealed the diagnosis of monozygotic twin, one was normal & the 2nd was diagnosed as (abnormal) with difficulty in visualization of the fetal parts and gender. Conclusion. Twin-Reversed Arterial Perfusion (TRAP) sequence is a rare complication of monozygotic multiple gestation. Accurate antenatal diagnosis is essential to improve the prognosis of this rare entity.
Twin Reversed Arterial Perfusion (TRAP) Sequence: A Case Report in Fallujah Maternity and Children Hospital, Fallujah, Iraq
doi:10.11648/j.cmr.20150405.15
Clinical Medicine Research
2015-08-11
© Science Publishing Group
Samira T. Abdulghani Alaani
Twin Reversed Arterial Perfusion (TRAP) Sequence: A Case Report in Fallujah Maternity and Children Hospital, Fallujah, Iraq
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153
153
2015-08-11
2015-08-11
10.11648/j.cmr.20150405.15
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150405.15
© Science Publishing Group
Causes of Admission and out Comes Among Preeclampsia and Eclampsia Mothers Admitted to Jimma University Specialized Hospital Intensive Care Unit
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150405.16
Background: Preeclampsia is a multisystem hypertensive disorder of pregnancy with new onset after 20 weeks gestation which is a leading cause of worldwide maternal and fetal morbidity-mortality. Objective: To assess causes of ICU admission and outcomes among pre-eclampsia and eclampsia mothers admitted to Jimma University Specialized Hospital. Methods: A retrospective cross sectional study was conducted at JUSH from May 3 to 8, 2015, all ICU admitted preeclampsia and eclampsia mother’s records from January 1, 2010 to December 31, 2014 were included by consecutive sampling with inclusion and exclusion criteria. Causes of admission, complications and outcomes were obtained from patient records and analyzed by SPSS version 16.0, finally the results presented using simple frequency tables and figures. Chi square (x2) test calculated to analyze the statistical association between patients outcome and other variables, p-value less than 0.05 was considered statistically significant. Result: A total of 1981 patients admitted to Jimma University specialized hospital ICU over the last five years (January 1, 2010 to December 31, 2014) from this 326 of them were preeclampsia and eclampsia mothers and this gives admission rate of 16.5%. For this study only total of 314 preeclampsia and eclampsia mothers records were used and 12mothers cards were excluded by exclusion criteria. The main causes of admission to ICU were eclampsia 106 (33.8%), General condition need close observation 77(24.5%), pulmonary edema 63 (20.1%), postoperative bleeding 31(9.9%) While the main complications were pulmonary edema 82(26.1%), acute renal injury 76(24.2), HELLP syndrome 57(18.2%) and mortality rate of 7.3%.There is association level of blood pressure with maternal outcomes. Conclusion: Rate of maternal admission, complications and mortality is found to be high at JUSH ICU, Jimma University with other stakeholders has to work in improving high quality of cares provided to reduce maternal complications and mortality
Background: Preeclampsia is a multisystem hypertensive disorder of pregnancy with new onset after 20 weeks gestation which is a leading cause of worldwide maternal and fetal morbidity-mortality. Objective: To assess causes of ICU admission and outcomes among pre-eclampsia and eclampsia mothers admitted to Jimma University Specialized Hospital. Methods: A retrospective cross sectional study was conducted at JUSH from May 3 to 8, 2015, all ICU admitted preeclampsia and eclampsia mother’s records from January 1, 2010 to December 31, 2014 were included by consecutive sampling with inclusion and exclusion criteria. Causes of admission, complications and outcomes were obtained from patient records and analyzed by SPSS version 16.0, finally the results presented using simple frequency tables and figures. Chi square (x2) test calculated to analyze the statistical association between patients outcome and other variables, p-value less than 0.05 was considered statistically significant. Result: A total of 1981 patients admitted to Jimma University specialized hospital ICU over the last five years (January 1, 2010 to December 31, 2014) from this 326 of them were preeclampsia and eclampsia mothers and this gives admission rate of 16.5%. For this study only total of 314 preeclampsia and eclampsia mothers records were used and 12mothers cards were excluded by exclusion criteria. The main causes of admission to ICU were eclampsia 106 (33.8%), General condition need close observation 77(24.5%), pulmonary edema 63 (20.1%), postoperative bleeding 31(9.9%) While the main complications were pulmonary edema 82(26.1%), acute renal injury 76(24.2), HELLP syndrome 57(18.2%) and mortality rate of 7.3%.There is association level of blood pressure with maternal outcomes. Conclusion: Rate of maternal admission, complications and mortality is found to be high at JUSH ICU, Jimma University with other stakeholders has to work in improving high quality of cares provided to reduce maternal complications and mortality
Causes of Admission and out Comes Among Preeclampsia and Eclampsia Mothers Admitted to Jimma University Specialized Hospital Intensive Care Unit
doi:10.11648/j.cmr.20150405.16
Clinical Medicine Research
2015-08-20
© Science Publishing Group
Nega Desalegn
Merga Haile
Causes of Admission and out Comes Among Preeclampsia and Eclampsia Mothers Admitted to Jimma University Specialized Hospital Intensive Care Unit
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5
159
159
2015-08-20
2015-08-20
10.11648/j.cmr.20150405.16
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150405.16
© Science Publishing Group
Enuresis and Encopresis: Remarks about a Possible Sharing
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150405.17
The clinical experience tends towards a possible sharing between enuresis and encopresis in pediatric age. This pattern goes back again to a maturative delay in the neurofunctional competence. The differentiation of therapies for nocturnal enuresis and for encopresis responds to the peculiarities of children and their families
The clinical experience tends towards a possible sharing between enuresis and encopresis in pediatric age. This pattern goes back again to a maturative delay in the neurofunctional competence. The differentiation of therapies for nocturnal enuresis and for encopresis responds to the peculiarities of children and their families
Enuresis and Encopresis: Remarks about a Possible Sharing
doi:10.11648/j.cmr.20150405.17
Clinical Medicine Research
2015-08-22
© Science Publishing Group
Bolla G.
Sercia F.
Longo R.
Enuresis and Encopresis: Remarks about a Possible Sharing
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162
162
2015-08-22
2015-08-22
10.11648/j.cmr.20150405.17
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150405.17
© Science Publishing Group
Photoplethysmographic Waveforms Recorded from Patients with Untreated Hypertension
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150405.18
The goal of this study was to establish whether changes in microvascular perfusion play an important role in the development of hypertension. To achieve this goal, we measured the photoplethysmographic waveforms recorded from the fingertips of patients with untreated hypertension. The photoplethysmographic waveforms were obtained from 60 healthy, normotensive male controls (NTs) and 30 untreated hypertensive male patients (HTs). The NTs were divided into two groups: a younger NT group (age 20 to 40 years, 30 individuals) and an older NT group (age 40 to 60 years, 30 individuals). The PPG waveform displayed a steep rise and a notch on the falling slope in the younger NT group. And for younger subjects, there were two positive waves (P1 and P2) and one negative wave (V).In the older NT group, a more gradual rise and fall was observed. For the HT group, no pronounced dicrotic notch was observed. A program was used to calculate the P2/P1 and P2/V ratios. The P2/P1 and P2/V ratios can indicate the perfusion to the fingertips during cardiac diastole. There were no significant differences in P2/P1 between the older NT group and HTs (0.37±0.07 versus 0.33±0.05, p>0.05).The P2/V ratios were significantly different between the older NT group and HTs (0.93±0.11 versus 0.59±0.08, p<0.05). These results indicate that there is a decrease in perfusion to the fingertips in hypertensive subjects during cardiac diastole.
The goal of this study was to establish whether changes in microvascular perfusion play an important role in the development of hypertension. To achieve this goal, we measured the photoplethysmographic waveforms recorded from the fingertips of patients with untreated hypertension. The photoplethysmographic waveforms were obtained from 60 healthy, normotensive male controls (NTs) and 30 untreated hypertensive male patients (HTs). The NTs were divided into two groups: a younger NT group (age 20 to 40 years, 30 individuals) and an older NT group (age 40 to 60 years, 30 individuals). The PPG waveform displayed a steep rise and a notch on the falling slope in the younger NT group. And for younger subjects, there were two positive waves (P1 and P2) and one negative wave (V).In the older NT group, a more gradual rise and fall was observed. For the HT group, no pronounced dicrotic notch was observed. A program was used to calculate the P2/P1 and P2/V ratios. The P2/P1 and P2/V ratios can indicate the perfusion to the fingertips during cardiac diastole. There were no significant differences in P2/P1 between the older NT group and HTs (0.37±0.07 versus 0.33±0.05, p>0.05).The P2/V ratios were significantly different between the older NT group and HTs (0.93±0.11 versus 0.59±0.08, p<0.05). These results indicate that there is a decrease in perfusion to the fingertips in hypertensive subjects during cardiac diastole.
Photoplethysmographic Waveforms Recorded from Patients with Untreated Hypertension
doi:10.11648/j.cmr.20150405.18
Clinical Medicine Research
2015-09-02
© Science Publishing Group
Yanchun Hu
Yanxia Hu
Shenju Song
Photoplethysmographic Waveforms Recorded from Patients with Untreated Hypertension
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167
167
2015-09-02
2015-09-02
10.11648/j.cmr.20150405.18
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=151&doi=10.11648/j.cmr.20150405.18
© Science Publishing Group